งานนำเสนอเรื่อง: "Exercise is Medicine: 1.ความเป็นมา"— ใบสำเนางานนำเสนอ:
1 Exercise is Medicine: 1.ความเป็นมา 1. ที่มาExercise is Medicine:1.ความเป็นมาพต.รศ.ดร.รุ่งชัย ชวนไชยะกูลPh.D.(Exercise Physiology)Manager, Exercise is medicine Thailand, ACSMวิทยาลัยวิทยาศาสตร์และเทคโนโลยีการกีฬา มหาวิทยาลัยมหิดล
3 Original study 1953 article in The Lancet 31,000 male employees of London TransportAges 35-64Conductors (active) vs. drivers (sedentary)Conductors with 1/2 the CHD mortality rate as drivers1978 epidemiologic studyHeart attack rates and energy expenditure16,936 male college alumni, Ages 35-74Inverse relationship between heart attack rates and activity level!Paffenbarger RS Jr. Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol, 1978: 108(3):Morris JN, Heady JA, Raffle PA, Roberts CG, Parks JW. Coronary heart-disease and physical activity of work. Lancet. 1953; 265: 1053–1057.
5 What is Exercise is Medicine? Putting science into clinical practice Univ.South CalorinaExercise is the best “medicine” aroundAssess physical activity in ALL patientsOnly RARE patients needs GXT before exerciseGXT pts with symptomatic CV/pulm dzWHY EIM?Medical care costs in the U.S are ~17% of GNP, by far the highest in the worldThailand………….Most health problems are the result of unhealthy lifestylesBy traditional public health markers such as longevity, chronic disease rates, infant mortality, etc; the U.S. ranks far behind many other countriesWe must be more aggressive in integrating appropriate physical activity into lifestyle, medical practice and public health programs ……with prevention, promotion and curative purposesExercise is medicine is an answer!
6 ถอดบทเรียน Lessons Learned from South Calorina U การออกกำลังที่ได้ผลต้องใช้เวลานาน เดือนเหลือประมาณ 25-30% ที่อยู่ร่วมจนจบ35% ไม่บรรลุผลตามเป้าหมายที่ตั้งไว้Counseling byPhD level behavioral exercise physiologist, psychologistB.A. level in health educatorsmail and telephoneelectronic communications
7 ChangesLifestyle Interventions Integrated with Electronic Health Records: Kaiser Permanente (Exercise as Vital Sign)
8 Exercise as a Vital Sign Within the Visit Navigator, you will now see the “Exercise Vitals”section immediately following the “Vitals” section.
9 Exercise as a Vital Sign When you click on the “Exercise Vitals” the section opens up to display the2 exercise intake questions that can be completed in a quick manner.The date and time this data was captured will also be noted/stored.
10 Telehealth and Weight Change 87 participants (73 women & 14 men)Mean age 50 yearsTreatment groups (Quasi-experimental design)Traditional classTelehealth—interaction with RD via web andControlNo difference in satisfaction between traditional and telehealthTelehealth more convenient than traditional (p<0.0001)p <0.05ControlKg change at 6 moTraditionalTelehealthHaugen HA et al. Obes 2007; 15:
11 Physicians and their Patients 47% of primary care physicians include an exercise history as part of their initial examination (self report)Only 13% of patients report physicians giving advice about exercisePhysically active physicians are more likely to discuss exercise with their patientsKevin deWeber, MD, FAAFPDirector, Primary Care Sports Medicine Fellowship, USUHS