Exercise not only benefits physical health, but also one’s mental and emotional well-being. As such, a holistic approach to health centred around regular exercise is the key to building a healthier society. Find out how general practitioners can get involved in the growing ‘Exercise Is Medicine’ movement, and be a champion for healthy living through effective exercise prescription.
Exercise is the cornerstone of a healthy lifestyle. It is a universal prescription that transcends age, gender, all abilities and environmental circumstances.
It is a low-cost, low-tech and generally safe non-drug intervention that offers a plethora of benefits that will prevent, slow, stop and reverse the progression of chronic diseases.
The importance of exercise cannot be overstated as it offers an array of physical, mental and emotional benefits that positively impact individuals’ lives. Whether young or old, male or female, able-bodied or differently abled, and regardless of the challenges posed by one’s existing health conditions – integrating regular exercise into daily routines can significantly contribute to enhanced well-being and the effective prevention and management of many chronic health conditions.
Years of scientific research have shown that individuals who maintain an active and fit way of life live longer, healthier and happier lives than those who do not.
1. Physical benefits
Regular exercise plays a pivotal role in reducing the risk of chronic medical conditions such as cardiovascular diseases, type 2 diabetes and obesity. Physical activity helps maintain healthy body weight, regulate blood pressure and improve blood sugar control, all of which contribute to a decreased likelihood of developing these cardiovascular and metabolic conditions.
Recent studies have also highlighted the role of regular exercise in improving the immune system, as well as the prevention and management of cancers.
For individuals already living with chronic medical conditions, exercise is a boon. It can alleviate symptoms, enhance quality of life, and potentially slow disease progression.
Conditions like arthritis benefit from improved joint flexibility and strength.
Respiratory conditions can see improvements in lung capacity through aerobic exercises.
With regular exercise, diabetics see improvement in their blood sugar control, thus reducing the burden of polypharmacy and preventing the onset of diabetes-related macrovascular and microvascular complications.
Exercise promotes strong bones and muscles, reducing the risk of fractures and osteoporosis, which is especially crucial as individuals age.
Weight-bearing exercises and strength training stimulate bone density and muscle mass, promoting overall mobility and independence.
2. Mental and emotional benefits
The positive impact of exercise is not limited to physical health; it extends to mental and emotional well-being as well.
Regular physical activity stimulates the release of endorphins, often referred to as the ‘feel-good’ hormones. These neurotransmitters alleviate stress, anxiety and depression, fostering better mental health. This aspect is particularly important in today’s fast-paced and stressful world, where mental health concerns are on the rise.
Additionally, studies have shown that physical activity is linked to better cognitive function and a reduced risk of neurodegenerative diseases like Alzheimer’s and dementia.
3. Meeting diverse needs
Furthermore, exercise is an equaliser, accessible to all, regardless of demographics and physical abilities.
Tailored exercise routines can be designed for individuals with diverse needs, ensuring that everyone can partake in the benefits.
For seniors, exercise improves balance and flexibility, reducing the risk of falls and fractures.
Pregnant women can benefit from appropriate prenatal exercises that enhance strength and overall comfort during pregnancy.
Even individuals with disabilities can find exercises that suit their capabilities, contributing to enhanced quality of life.
In a world where healthcare strategies continue to evolve, the convergence of medicine and physical activity has emerged as a powerful paradigm shift.
What is the EIM initiative?
At the forefront of this movement stands the Exercise is Medicine (EIM) initiative, a global movement pioneered by the American College of Sports Medicine (ACSM).
This visionary initiative transcends traditional healthcare approaches, recognising exercise as a potent prescription for a healthier society and transforming the way we perceive and integrate physical activity within the realm of healthcare.
EIM strives to establish the assessment and promotion of physical activity as a fundamental aspect of clinical care, bridging the gap between healthcare and evidence-supported physical activity resources for individuals of diverse abilities and from all walks of life.
It advocates for healthcare professionals, including physicians, to incorporate physical activity into their treatment plans and to refer patients to evidencebased exercise programmes and certified exercise specialists in the community.
What is the EIM solution?
The EIM solution outlines the method to kickstart this effort by fostering collaborations between local healthcare systems and medical facilities, and community fitness resources – thus constructing a solid foundation of trust to facilitate coordinated healthcare.
When healthcare systems and community fitness organisations collaborate, establishing seamless referral and communication channels, patients are more likely to receive exercise advice and recommendations, and will also actively participate and adhere to the prescribed physical activity programmes.
What does the EIM solution involve?
The EIM solution requires the dedication of healthcare and community leaders and advocates. This can be accomplished through the following actions:
Evaluating the physical activity levels of each patient during every clinic consultation
Briefly counselling patients regarding physical activity, or providing them with a personalised exercise plan tailored to their specific medical conditions and health goals
Referring patients to suitable physical activity resources, such as evidence-supported exercise programmes facilitated by qualified fitness professionals in the community
Exercise Is Medicine Singapore (EIMS) is the local chapter of the EIM global initiative.
Rooted in the belief that physical activity is not only essential for individual well-being but also holds the key to building a healthier society, EIMS has positioned itself at the forefront of Singapore’s healthcare landscape.
Established in 2012 and hosted by Changi General Hospital, this pioneering movement, aligned with the broader Healthier SG initiative, showcases the profound impact that a holistic approach to health, centred around regular exercise, can have on the lives of individuals and the entire nation.
The EIMS mission
Through the EIM solution, EIMS hopes to catalyse positive change, empower individuals, and contribute to the overarching goal of creating a healthier and more vibrant Singapore as part of the Healthier SG strategy.
1. Healthcare systems and providers
EIMS conducts regular certification courses to upskill healthcare providers including physicians, nurses and allied health professionals in:
Physical activity levels assessment
Exercise pre-participation screening
These skills are essential for their role in Healthier SG to discuss and prescribe lifestyle intervention plans (health plans) to their patients.
Additionally, EIMS plays an integral role in the development of various care protocols that will support and guide healthcare providers in the Healthier SG ecosystem.
2. Physical activity resources (places, programmes and professionals)
Community partners can potentially function as an extension of the healthcare team by leveraging the expertise of certified exercise and fitness professionals, along with evidence-based programmes.
EIMS conducts parallel courses to upskill professionals in the fitness industry, so that they can interpret the exercise prescriptions from the healthcare team and provide exercise guidance as well as supervision to clients with clinical conditions.
In addition, EIMS works closely with various national organisations, healthcare institutions and community partners to develop evidence-based physical activity intervention programmes and design physical activity spaces in the community.
3. Digital health technology
Singapore’s healthcare system boasts a diverse range of technologies capable of incorporating healthy lifestyle interventions seamlessly. EIMS harnesses these technologies to achieve the following objectives:
Embedding physical activity as a fundamental health indicator and establishing clear referral pathways
Identifying patients who would gain from lifestyle interventions
Monitoring and facilitating the exchange of patient information
On the community/fitness side, EIMS works closely with community partners to provide input for the development of digital platforms, devices and applications such as Healthy 365 that will facilitate activity tracking, promote participant engagement and monitor outcomes.
"To be diagnosed with high blood pressure and related issues at the age of 28 is not fun at all; it is a spoiler to life. Luckily for me, I had the presence of mind to evaluate my situation and make important changes.
From someone who used to be active in all sports up to the age of 23, life cannot, logically, take a turn in five years. I knew my faults, my weaknesses – the cigarettes and lack of exercise.
Giving up the cigarette was difficult. I tried all known tricks, from switching to cigars, to Nicorette, to acupuncture and to other ideas – none worked, until I made a promise to give up smoking. I could not break a promise.
Doctors recommended jogging as part of the exercise prescription given, and I started to go back to slow jogging and keeping a log of all my runs. In the log book, I used to record my daily runs, recording the timings and how I felt during and after the runs (recovery). This became a basis for me to compare today’s run with yesterday’s, and last week’s, and even last month’s.
I used to go to the East Coast Parkway for my daily 10 km runs and 21 km runs on weekends. Seeing improved results was in itself an instrument of motivation. I started looking for variations to my exercise programme. Instead of taking the lift to my office on the 12th floor, I would walk up the stairs, sometimes with dead weights attached to my ankle. I also ventured into the world of Kango-aerobics – doing cardioaerobics in shoes that are made for jumping.
Each day got better, and seeing improved results was in itself such a positive motivation. If I had been on the conventional course of treatment, I would quite possibly have become a ‘drug-dependent junkie’. Luckily for me, daily exercises have made me overcome my medical conditions, and have taken me to a different playing field – a world of marathons and ultramarathons – a phase of my life which otherwise may not have been possible."
The ‘Exercise Prescription Course for Primary Care Physicians’ aims to equip physicians with the competence to prescribe exercise safely, effectively and confidently for their patients, taking into consideration the time constraints that every busy healthcare provider encounters.
The curriculum is structured on the fundamental premise that regular physical activity is essential for the prevention and management of many chronic medical conditions, and as such, should be routinely evaluated as an integral component of all medical care.
The course covers the basics of exercise prescription for healthy individuals as well as those with chronic medical conditions.
The two-day workshop includes lectures, practicum and case discussions, culminating in a written assessment.
The course content is largely based on clinical evidence established by contemporary research work and the EIM chapter of the ACSM.
Doctors who successfully complete the course will be given a certificate that is valid for three years.
Click here for more information and upcoming course dates.
Click here to register today.
Dr Fadzil Hamzah practices in the Department of Sport & Exercise Medicine at Changi General Hospital and is the Operational Lead at the SingHealth Duke-NUS Sport & Exercise Medicine Centre’s clinical site at Singapore General Hospital. He also looks after the health of our national athletes in Team Singapore and is a visiting clinician at the Singapore Sport Institute. Additionally, he is the Director of Community Programmes for Exercise is Medicine Singapore, as well the Community Director at the SingHealth Duke-NUS Sport & Exercise Medicine Centre.
Recently, he was appointed as the Deputy Director for Health Promotion and Disease Prevention at the SingHealth Office of Regional Health. Dr Fadzil is very passionate in promoting fitness, health and physical activity, as well as supporting citizen-centric and last-mile service delivery for the underserved and underprivileged in the community.
GPs can call the SingHealth Duke-NUS Sport & Exercise Medicine Centre for appointments at the following hotlines or click here to visit the website:
Singapore General Hospital: 6326 6060Changi General Hospital: 6788 3003Sengkang General Hospital: 6930 6000KK Women's and Children's Hospital: 6692 2984
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