High Blood Pressure (hypertension)
What is it?
Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels. Changes in the body that could cause BP to increase are being overweight, poor diet, high cholesterol, mental stress and age. The heart must use more energy to pump against the greater resistance of the cardiovascular system.
How exercise can help
Exercise training is an integral component for the treatment and prevention of high blood pressure. Exercise programmes that primarily include endurance training, resistance training or both, not only lower blood pressure, but have a role in the primary prevention, as well as the ongoing treatment and control of hypertension.
High Cholesterol (hypercholesterolaemia)
What is it?
This is the presence of high levels of cholesterol in the blood. It can lead to the narrowing of arteries because they become clogged with fatty substances called plaques, which can subsequently lead to symptoms related to cardiovascular disease (CV).
How exercise can help
In the context of cardiovascular disease, high cholesterol can be tackled by increased physical activity together with simple dietary changes (and if necessary, treated with lipid lowering drugs).
Coronary Obstructive Pulmonary Disease (COPD)
What is it?
This is the term widely used in the medical community for a condition characterised by irreversible airflow limitation and progressive airflow obstruction. COPD generally follows a two- fold pathway- bronchitis and emphysema. The airways become narrowed, leading to limitation in airflow to and from the lungs.
How exercise can help
There is little evidence to support the use of exercise to improve lung function in COPD clients, but the cardiopulmonary benefits that exercise can offer help improve tolerance to activities and daily living, and enhance quality of life. Almost any level of physical activity can result in favourable improvements in oxygen utilisation, work capacity and anxiety levels. Two benefits are desensitisation to breathlessness (dyspnoea) and increased muscle strength.
Asthma
What is it?
Asthma often starts in childhood and may disappear in adolescence; this is likely due to the increase in the size of the airways. 50% of children stay asthmatic through adulthood. It is an allergic response which causes the airway to narrow and/or become obstructed.
Asthma is caused by both host factors (primarily genetic) and environmental factors (those that trigger asthma). These factors influence how severe asthma is and how well it responds to medication.
How exercise can help
In terms of exercise, aerobic exercise improves the efficiency of the heart and lungs. Resistance training can benefit an individual because the maintenance/ enhancement of muscular strength and endurance will facilitate improvement in ADLs (Activities of Daily Living).
Physical training should be regarded as a general approach to lifestyle intervention for asthma management, coupled with appropriate education about exercise induced asthma.
Obesity
What is it?
Obesity is a condition in which weight gain has reached the point where it poses significant risks to health. Some people are more susceptible to weight gain for genetic reasons, but the fundamental cause of obesity is consuming more calories than are expended in daily life.
A short-term issue of being overweight may be joint pain, while a longer-term issue (and potentially more harmful to health) may be high blood pressure (hypertension).
How exercise can help
More recently, one exercise aim is to encourage the accumulation of physical activity during the day to help distribute energy expenditure throughout the day, especially when it is challenging for an individual to participate in formal exercise.
Diabetes (type 1 and 2)
What is it?
Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. One result is hyperglycaemia, or raised blood sugar, which over time leads to serious damage to the many of the body’s systems, especially the nerves and blood vessels.
Type 1, is characterised by a functional loss of insulin producing cells, which in turn leads to a deficiency in the hormone insulin.
Type 2, usually begins when a person builds up a cellular resistance to the effects of insulin. Two factors which are thought to contribute towards the risk of Type 2 diabetes are i) obesity and ii) diet/inactivity.
How exercise can help
One benefit is that aerobic exercise increases insulin sensitivity and non-insulin dependent muscle glucose uptake, which persists long after aerobic exercise, even after pre-exercise glycogen levels have been restored. A benefit of resistance training is a reduction in arterial blood pressure.
Osteoarthritis
What is it?
Osteoarthritis (also known as degenerative joint disease) is defined as a disorder of synovial joints. Most often there is pain and stiffness along with some joint function limitation. Early physical signs include: bony enlargement at affected joints, misalignment and/or joint deformity. The signs may be present as: joint instability and buckling, and loss of function. The causes of osteoarthritis are not clearly understood, although when cartilage destruction exceeds cartilage synthesis, osteoarthritis develops.
How exercise can help
Both aerobic and resistance training demonstrate significant improvements in both pain and function. Historically, exercise programmes for arthritis clients were restricted to range of movement exercises with periods of rest. It is now recognised that inactivity over time will lead to loss of: muscle strength, joint stability and functional capacity. One of the aims of exercise is to improve mobility and flexibility, and a benefit would be to reduce pain.
Rheumatoid arthritis
What is it?
Rheumatoid arthritis is often referred to as an autoimmune disease. There is evidence to suggest that abnormalities in the components of the immune system lead the body to develop abnormal immune and inflammatory responses, particularly in the joints, characterised by inflammation and swelling of the synovial membrane. This means that joints are tender to touch, and hands may be red and puffy.
How exercise can help
As with osteoarthritis, both aerobic and resistance training demonstrate significant improvements in both pain and function. Historically, exercise programmes for arthritis clients were restricted to range of movement exercises with periods of rest. It is now recognised that inactivity over time will lead to loss of the following: muscle strength, joint stability and functional capacity. One of the aims of exercise is to increase muscle strength and reduce deconditioning of muscles, and a benefit of this would be to maintain independence of the individual by reducing disability.
Osteoporosis
What is it?
The World Health Organisation has defined osteoporosis as: ‘a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility, and consequently an increased risk of fracture.’ Put simply, there is an imbalance between bone resorption and bone deposition, which usually develops slowly over years without any visible signs or symptoms.
How exercise can help
One aim would be to increase bone density, which happens because exercise stimulates bone formation. An additional benefit would be that regular exercise increases muscle strength, coordination and balance and therefore decreases the likelihood of falls, especially in older individuals.
Total Joint Replacement
What is it?
This involves the surgical replacement of diseased joint surfaces with implants, which restores proper pain free function of the joint. As degeneration occurs the ends of the bone surface become worn down and often, the cartilage covering the ends of the bone wears away.
How exercise can help
Exercise can be used to restore and/or maintain range of movement, build muscular strength, and enhance function in activities of daily living. It is possible to improve outcomes related to physical activity by implementing exercise programmes. Research has shown that that resumption of activity after joint surgery can relieve pain, improve function, increase mobility and enhance psychological wellbeing.
To ensure long term success, a prehabilitation exercise programme should be developed (generally for a minimum of 6 weeks). This should improve pre-operative functional status and muscle strength levels, and dramatically reduce the necessity for in-client rehabilitation.
Simple mechanical back pain
What is it?
Mechanical, or non-specific back pain, (the most common form of back pain) is defined as ‘back pain not attributed to a recognisable, known specific pathology’. It is considered to be a mechanical problem caused by a disturbance of function, not by serious structural damage or any specific/underlying disease. Therefore, simple mechanical back pain has a physical cause.
Where pain arises suddenly during physical loading of the back, the issue may stem from benign musculoskeletal problems, such as sprains or muscle strains (possibly due to overactivity).
How exercise can help
Exercise training that consists of individually designed programmes, including stretching or strengthening can i) reduce pain (improving health and wellbeing) and ii) improve function (preventing debilitation by inactivity). There is strong evidence that advice to stay active is associated with faster symptomatic recovery, and leads to less chronic disability and less time off work than bed rest or usual care.