Exercise is Medicine: 1.ความเป็นมา 1. ที่มา Exercise is Medicine: 1.ความเป็นมา พต.รศ.ดร.รุ่งชัย ชวนไชยะกูล Ph.D.(Exercise Physiology) Manager, Exercise is medicine Thailand, ACSM วิทยาลัยวิทยาศาสตร์และเทคโนโลยีการกีฬา มหาวิทยาลัยมหิดล

คนไทยชอบออกกำลังกายหรือไม่ 0427 9534

Original study 1953 article in The Lancet 31,000 male employees of London Transport Ages 35-64 Conductors (active) vs. drivers (sedentary) Conductors with 1/2 the CHD mortality rate as drivers 1978 epidemiologic study Heart attack rates and energy expenditure 16,936 male college alumni, Ages 35-74 Inverse 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):161-175 Morris JN, Heady JA, Raffle PA, Roberts CG, Parks JW. Coronary heart-disease and physical activity of work. Lancet. 1953; 265: 1053–1057.

Benefits of Active Lifestyle

What is Exercise is Medicine? Putting science into clinical practice Univ.South Calorina Exercise is the best “medicine” around Assess physical activity in ALL patients Only RARE patients needs GXT before exercise GXT pts with symptomatic CV/pulm dz WHY EIM? Medical care costs in the U.S are ~17% of GNP, by far the highest in the world Thailand…………. Most health problems are the result of unhealthy lifestyles By traditional public health markers such as longevity, chronic disease rates, infant mortality, etc; the U.S. ranks far behind many other countries We must be more aggressive in integrating appropriate physical activity into lifestyle, medical practice and public health programs ……with prevention, promotion and curative purposes Exercise is medicine is an answer!

ถอดบทเรียน Lessons Learned from South Calorina U การออกกำลังที่ได้ผลต้องใช้เวลานาน 18-24 เดือน เหลือประมาณ 25-30% ที่อยู่ร่วมจนจบ 35% ไม่บรรลุผลตามเป้าหมายที่ตั้งไว้ Counseling by PhD level behavioral exercise physiologist, psychologist B.A. level in health educators mail and telephone electronic communications

Changes Lifestyle Interventions Integrated with Electronic Health Records: Kaiser Permanente (Exercise as Vital Sign)

Exercise as a Vital Sign Within the Visit Navigator, you will now see the “Exercise Vitals” section immediately following the “Vitals” section.

Exercise as a Vital Sign When you click on the “Exercise Vitals” the section opens up to display the 2 exercise intake questions that can be completed in a quick manner. The date and time this data was captured will also be noted/stored.

Telehealth and Weight Change 87 participants (73 women & 14 men) Mean age 50 years Treatment groups (Quasi-experimental design) Traditional class Telehealth—interaction with RD via web and email Control No difference in satisfaction between traditional and telehealth Telehealth more convenient than traditional (p<0.0001) p <0.05 Control Kg change at 6 mo Traditional Telehealth Haugen HA et al. Obes 2007; 15:3067-77

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 exercise Physically active physicians are more likely to discuss exercise with their patients Kevin deWeber, MD, FAAFP Director, Primary Care Sports Medicine Fellowship, USUHS

Part 1