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Introduction

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Better to hunt in fields for health unbought Than fee the doctor for a nauseous draught. The wise for cure on exercise depend; God never made his work for man to mend.

John Dryden (1631–1700)

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Physical inactivity is the biggest public health problem of the 21st century (Chapter 1).1 This chapter supplements Chapter 16, which outlines the principles of exercise prescription and potential health benefits of exercise. It also complements Chapter 54, which provides exercise prescription for neurological conditions and mental health. Our aim is to provide clinicians with a quick reference exercise prescription guide for common medical conditions.

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Primary care clinicians play an important role in influencing their patient’s physical activity behaviors.2 We argue that ministries of health and health authorities should place a book of exercise prescriptions on every physician’s desk. We acknowledge the various superb resources that already provide base standards on physical activity and health. These include:

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  • World Health Organization. Global recommendations on physical activity for health3

  • Swedish National Institute of Public Health. Physical activity in the prevention and treatment of disease4 (Fig. 60.1 on p. 1160) (available in English, Swedish, and Vietnamese)

  • the US National Physical Activity Plan section on clinical medicine, www.physicalactivityplan.org/healthcare.php5

  • the White Paper on physical activity in clinical practice, developed for the US national plan6

  • US Department of Health and Human Services. The Physical activity guidelines for Americans7(www.health.gov/paguidelines)

  • the Canadian consensus reports on physical activity and childhood obesity: Canadian physical activity guidelines 2011.8

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Figure 60.1

Also highlighted in Chapters 16 and 54, this Swedish book, featured here on the cover of the British Journal of Sports Medicine, is a tremendous resource for exercise prescription for over 60 conditions. We recommend a copy be placed in every consulting room. A free PDF copy of the book can be downloaded for personal use from www.fyss.se.

REPRODUCED WITH PERMISSION FROM BJSM

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Thus, a breadth of information is available on exercise prescription. However, recommended doses of activity (frequency, intensity, duration, and type of exercise) vary considerably, in part due to the range in scientific rigor applied across publications. Evidence ranges from level 1 to level 5 (Chapter 3). The tables below are collated from a number of published sources to amalgamate the best of the currently available evidence. The essential components of exercise prescription are aerobic and resistance training exercises;9 flexibility exercises are also recommended.10 For the primary prevention of chronic illness, Tables 60.1 and 60.2 serve as an excellent guideline.9

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Table 60.1  

Physical activity recommendations for healthy adults ≤65 years

 

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