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| Michelle N McDonnell* | |
| NHMRC Research Training Fellow, School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide SA 5001, Australia | |
| Corresponding Author : | Michelle N McDonnell NHMRC Research Training Fellow School of Health Sciences University of South Australia GPO Box 2471, Adelaide SA 5001, Australia Tel: +61 88302 1684 E-mail: michelle.mcdonnell@unisa.edu.au |
| Received March 04, 2012; Accepted March 04, 2012; Published March 07, 2012 | |
| Citation: McDonnell MN (2012) Let’s Get Physical. J Nov Physiother 2:e114. doi:10.4172/2165-7025.1000e114 | |
| Copyright: © 2012 McDonnell MN. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | |
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| Editorial |
| For the second time in the history of the United Nations, the General Assembly met in September last year to discuss noncommunicable (NCDs) diseases. The World Health Organization has identified that noncommunicable diseases like heart attacks and strokes, cancers, diabetes and respiratory illnesses account for over 60% of the deaths in the world today [1]. While positive moves have been made to reduce mortality from cardiovascular diseases (CVD), they the number one cause of death globally: more people die annually from CVDs than from any other cause [2]. |
| Many aspects of leading diseases now approaching epidemic proportions, for example diabetes, obesity and hypertension, can be ameliorated by addressing lifestyle factors such as diet, physical activity levels and harmful use of alcohol and tobacco use. Addressing these shared risk factors can impact upon many NCDs, and have a significant impact upon health and wellbeing globally. Physical inactivity has a substantial impact on healthcare budgets also, with direct health costs, lost productivity and social costs associated with inactivity [3]. |
| The good news is that this NCD (physical inactivity) can be treated, even cured, and physical therapists (PTs) have a valuable role to play. Every dollar invested in proven community-based prevention programs (increasing physical activity, improving nutrition and reducing smoking levels) returns an investment in terms of health care savings of $5.60 within 5 years [4]. We already know what to do, they challenge is to make it happen. |
| Physical therapists are ideally placed to impact upon lifestyle choices made by the people we have committed to help. We understand movement, we are experts at prescribing exercises aimed at improving function at the level of impairment (to reduce pain, to increase strength) but also directed at changing behaviours. Often this is specific to the area of the body that we are treating, but we could broaden our approach to address other factors also. For many of our clients with back pain or lower limb problems being overweight contribute to their impairment and hinders their recovery. It can be difficult to motivate someone to lose weight, but the individuals we see have a lot to gain if we can work as a team to address issues like physical activity and obesity. |
| Working within a community allows physical therapists to advise clients on ways that they may become more physically active. We know the local area, perhaps the pleasant walks that are at just the appropriate duration and intensity, the fitness centers and sports facilities in the area. We can advise on which physical activities might best suit their condition, for example helping get people back into the pool as part of their overall fitness as well as recovering from their condition. Many physical therapists are doing this already; focusing on the other major lifestyle choices associated with NCDs (tobacco, excess alcohol consumption, diet) but the challenge perhaps it to make it universal, and fun. |
| Some areas of physical therapy involve more challenge that others in terms of getting our clients physical. According to recent literature, people following stroke are inactive [5], unfit [6], and a significant proportion are depressed and fatigued [7]. Current clinical practice guidelines [8,9] recommend that cardiovascular fitness should be addressed during rehabilitation and people living in the community with stroke should have access to interventions to improve their fitness. The available data would suggest that either this service is not available in many communities, or that it is not taken up by stroke survivors, perhaps due to barriers such as communication, impaired cognition, caregiver stress, depression, fatigue and social isolation [10]. It is worth noting, however, that physician recommendations to exercise may double the likelihood that stroke survivors would exercise [11]. PTs could play a greater role in this area in the future, should we wish to do so, to increase activity levels in people with a variety of chronic diseases. |
| While many younger PTs may not be as familiar with Olivia Newton-John, we need to encourage all PTs to “get physical” with our clients, increase physical activity levels and make a significant impact on the next generation. The challenge for us is to communicate with our clients and reverse the trend towards sedentary behaviour and obesity for all of the individuals we are fortunate enough to meet and treat. |
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