Exercise is a cornerstone for the prevention and treatment of disease and should be prescribed by physicians to their patients and added to the curriculum of medical schools and residency programs, said Dr. Irfan Asif, endowed professor of sports and exercise medicine at the University of Alabama at Birmingham Heersink School of Medicine.
“There’s an importance to prescribing physical activity to patients besides just saying that exercise is good for you,” Asif said as part of The Ernest Cole Brock III Continuing Medical Education Lecture Series hosted by the College of Community Health Sciences in February.
Asif is also professor and chair of the Department of Family and Community Medicine and associate dean for Primary Care and Rural Health at the UAB Heersink School of Medicine. His presentation was titled “Exercise as Medicine: A Prescription for Athletic Performance and Health.”
“In the United States, we spend a lot of money on health care but compared to other developed countries we have among the poorest health outcomes,” he said.
Alabama ranks 48th among all states for overall health and 49th for blood pressure, 48th for diabetes, 46th for obesity and 45th for high cholesterol. When it comes to physical activity, the state ranks 45th.
Research and studies have shown that physical activity can prevent or treat chronic diseases. Physically active people have lower health risks for Type 2 diabetes, high blood pressure, coronary heart disease and stroke, as well as breast and colorectal cancer and bone fractures.
“The benefits of exercise are clear, but what’s not clear is how to communicate this to patients,” Asif said. “Writing a prescription for exercise can be a powerful tool.”
He said to start, physicians should determine the “functional capacity” of a patient by asking two simple questions: Can you walk approximately 10 minutes at a moderate pace without experiencing limiting symptoms, like shortness of breath; and can you climb two standard flights of stairs without stopping because of limiting symptoms.
Asif encouraged audience members to use the FITT-VP model when designing an exercise prescription, which includes the following: Frequency (how often is exercise done each week); intensity (how hard is the exercise); time (how long is the exercise duration); type (what is the mode of exercise); volume (what is the total amount of exercise); and progression (how is the program advanced).
He said an exercise prescription should be individualized with consideration for health status, physical ability, age, training responses and individual goals.
“As a primary care provider, you have a role that patients really take to heart,” Asif said. He said 9 out of 10 patients would listen if their doctor prescribed an exercise plan, and he presented a study showing that older patients who received a physical activity prescription increased their activity by 131 minutes per week.
What’s also important is to meet your patients where they are in their “lived experience. In an environment where it’s not safe to go out every day, you might have to come up with other solutions,” he said.
Asif said medical education has an important role to play in advancing exercise as medicine. Medical students, residents and fellows receive just a few hours, if any, of instruction on the importance of physical activity in the prevention and treatment of diseases. “Medical education must do a better job of preparing our future workforce to help patients make lifestyle changes, such as engaging in physical activity.”
The Ernest Cole Brock III Endowment for Continuing Medical Education was established in 2013 by Dr. Ernest Cole Brock, Jr., and his wife, Hannah Brock, for the purpose of funding The Ernest Cole Brock III Continuing Medical Education Lecture Series. Brock practiced orthopedics in Tuscaloosa and was later recruited by University of Alabama head football coach, Paul “Bear” Bryant, to work with the football team. Brock volunteered his services as an orthopedic surgeon for the team for more than 25 years. With the lecture series, the Brocks wish to honor the memory of their son, Ernest Cole Brock III, and to promote the education of treating concussions and other athletic injuries in varsity athletes and active individuals.