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Sunday, 21 April 2019

Physical And Sport Activities: A Guide To Facilitate Medical Prescription

Every Wednesday, Dr. Jean Marc Sene, sports doctor and doctor of the national judo team, presents his sports column in Priority Health.

This week, he explains
Moving more and fighting against the sedentary lifestyle is a public health message that is still struggling to get into practice.

Dr Jean-Marc Sene:  Physical activity has beneficial effects on health both preventive and curative. And these benefits far outweigh the risks, even for people with chronic conditions. It is therapeutic in its own right.

With an increasingly sedentary population, more frequently affected by chronic diseases, the development of physical activity is a major focus of the latest public health plans: national plan nutrition health, plan obesity, cancer plan, etc.

The benefits of physical activity are well established. Regular physical activity (such as cycling, walking, or even gardening) has health benefits that far outweigh the risks. However, in France, the study of the Public Health Agency France conducted among adults aged 18 to 74 years in 2014 found that only 53% of women and 70% of men reached the recommendations of the WHO in terms of activity physical health.

What is a sedentary lifestyle and what are the risks to health?

The sedentary lifestyle causes two million deaths a year in the world, according to WHO.

Sedentary activities include all activities performed at rest, sitting or lying down or standing up without moving, outside of the hours of sleep. For example: Traveling by car, watching television, working on a computer, reading upright ...

It is now considered that this time spent in sedentary activities should be less than 7 hours a day, which is less and less the case today.

A sedentary lifestyle has deleterious effects on health, regardless of the level of physical activity of a person: it increases cardiovascular morbidity and mortality, the risk of type 2 diabetes, the risk of endometrial cancer

Paradoxically, one can be physically active and sedentary. For each person, the challenge is to increase the physical activity time while decreasing the time spent in sedentary activities.

Since 2016, the law provides that treating physicians can prescribe a physical activity adapted to their patients with chronic disease in long-term condition. For this purpose, they can prescribe a free physical activity and easy to practice even alone, adapted to the state of health of the patient (such as walking, for example).

However, the impact of physical activity on health, documented specifically for many diseases, is still insufficiently known to doctors. In addition, they have few practical tools to help them conduct a targeted medical consultation and estimate the real risk of a serious cardiovascular event (myocardial infarction, sudden death ...) related to the practice of physical activity.

To prescribe a physical activity or sport, the doctor must focus on physical activities of daily life especially active travel such as cycling, walking or climbing stairs. Advantage: These are safe and easily accessible activities, especially for people with chronic illnesses, the elderly or the less motivated, for whom the term sport can be discouraging right away.

What does the guide published by the Haute Autorite de Sante propose today?

The Haute Autorite de Sante wishes, with the publication of its guide entitled "promotion, consultation and prescription of physical activity and sport for the health", Lift a number of these brakes and promote the development of this non-drug therapy that is physical activity. The guide proposes a base of general knowledge about physical activity and sedentary and their impact on health; the unfolding of a consultation dedicated to physical activity; and practical tools (exercise fitness questionnaire, exercise risk assessment chart, fitness assessment tools, and motivation office, etc.). In addition to this document, the HAS proposes the first series of 6 guidelines for the prescription of physical activity by pathology for overweight and obesity, type 2 diabetes, hypertension (hypertension),

The work published by the HAS thus pursues two objectives:

- develop advice and prescription of physical activity by doctors, both in the prevention and treatment of chronic diseases or conditions for which physical activity has shown beneficial effects.

-commit to the implementation of a policy of promotion of the prescription activity in primary care with the development at the local or regional level of coordinated multidisciplinary health care pathways, associating treating doctor, health professionals and professionals of the activity physical and sports.

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