Docs adding a dose of exercise to prescriptions

Mr William Gan, a retiree, with Dr Benedict Tan from Changi General Hospital who has an treatment programme for those with chronic diseases that involves exercise. Photo: ST

Doctors are prescribing exercise more often to their patients, after attending an exercise prescription course by Exercise is Medicine Singapore (EIMS), going by a survey of last year's 26 attendees.

Ten out of 16 doctors who responded say they are prescribing exercise more often, while the remaining six say that they are continuing to prescribe exercise at the same frequency.

EIMS trains doctors on how to prescribe exercise. It also trains allied health and fitness professionals on how to safely supervise exercise prescribed by the doctor.

The courses are rolled out worldwide and the content came mostly from the Singapore team, which also educates trainers under the same programme in Malaysia, Indonesia, Thailand and the Philippines.

Dr Kelvin Koh, 31, says the course that he attended in February this year equipped him to discuss and prescribe exercise for patients with chronic ailments, such as hypertension, diabetes, high cholesterol and heart disease.

"I used to prescribe exercise to approximately one to five patients a month," he said. "After the course, I find that I am prescribing exercise to patients routinely, up to five to 10 patients a week."

Dr Benedict Tan, who heads Changi General Hospital's Changi Sports Medicine Centre, said: "After the doctors go through the course, they will prescribe exercise to more patients. For example, they will realise that those with depression can also benefit from regular exercise."

Dr Tan chairs EIMS, the local chapter of a global initiative to encourage primary care physicians and other healthcare providers to include exercise in their treatment plans for patients.

"Exercise leads to a lower risk of breast cancer and colon cancer, which is something many people don't realise," said Dr Tan.

He points out that physical inactivity is the fourth leading cause of death globally.

It wasn't so in the past.

"Physical activity was part of life and that's why there were so few health problems. Industrialisation brought about a sedentary lifestyle," he added.

The 2010 National Health Survey revealed that 39.1 per cent of Singaporeans were physically inactive and 11 per cent were obese.

More than half of Singaporeans over the age of 40 have a chronic medical condition, such as high blood pressure, high cholesterol or diabetes.

Yet, patients do not always listen to their doctor.

Nearly 44 per cent of those who were referred to a fitness professional declined to go for treatment, the EIMS survey showed.

This may be less of a problem if they know how much exercise can help them. The solution could also simply lie with starting slow.

"Don't tell a sedentary person to go to the gym, see a personal trainer, or do cross-fit and pilates," said Dr Tan. "It can start with walking the dog and playing with your grandchildren."

Get moving

Research shows that being physically inactive exposes a person to a greater risk of dying than smoking, obesity, hypertension or high cholesterol levels.

Active people in their 80s have a lower risk of dying than inactive people in their 60s.

It is better to be fit and overweight than unfit with a lower percentage of body fat.

Regular physical activity can lower a person's risk of:

- Alzheimer's disease by about 40 per cent;

- stroke by 27 per cent; and

- type 2 diabetes by 58 per cent, and be twice as effective in treating type 2 diabetes as the standard insulin prescription.

It also lowers the incidence of heart disease and high blood pressure by about 40 per cent.


This article was first published on July 7, 2015.
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