CSP Congress


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The Chief Medical Officer of the FIA, Dr John Searle, spoke at the Annual Congress of the Chartered Society of Physiotherapy, in Liverpool on October 15. His subject was 'Fitness as a routine part of health care - pie in the sky or exciting possibility?' He summarised the present epidemic of diseases which result from a sedentary life style together with the ways in which exercise can promote health and reduce these risks. He stressed the importance of partnerships with health professionals including physiotherapists and looked forward to the day when a fitness professional would be part of every GP team in the country. The talk was well received and many questions came from the audience.

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CSP Congress

  1. 1. Making exercise a normal part of health care Pie in the sky? John Searle Chief Medical Officer, Fitness Industry Association
  2. 2. Where am I coming from? <ul><li>NHS consultant </li></ul><ul><li>RA diagnosed in my mid-fifties </li></ul><ul><li>Key role of exercise </li></ul><ul><li>Personal trainer </li></ul><ul><li>CMO - FIA working with </li></ul><ul><ul><ul><li>Health professionals and DH </li></ul></ul></ul><ul><ul><ul><li>Fitness sector </li></ul></ul></ul>
  3. 3. Fitness sector’s objective <ul><li>To establish exercise as a normal part of healthcare </li></ul><ul><li>in the prevention of disease </li></ul><ul><li>as part of the treatment of disease </li></ul><ul><li>in the promotion of healthy and independent old age </li></ul>
  4. 4. WHY? <ul><li>What is the biggest threat to the nation’s wellbeing? </li></ul>
  5. 10. Threats to the nation’s wellbeing <ul><li>Terrorism </li></ul><ul><li>Climate change </li></ul><ul><li>Economic instability </li></ul><ul><li>Diseases of Western affluence </li></ul><ul><li>Ageing population </li></ul>
  6. 11. Obesity <ul><li>2010 </li></ul><ul><li>Men 24% </li></ul><ul><li>Women 25% </li></ul><ul><li>Children 16% </li></ul><ul><li>2050 </li></ul><ul><li>Men 60% </li></ul><ul><li>Women 50% </li></ul><ul><li>Children 25% </li></ul>
  7. 12. Heart disease <ul><li>Annual: 275,00 heart attack annually </li></ul><ul><li>Deaths: 120,00 </li></ul><ul><li>UK death rates highest in the world </li></ul>
  8. 13. Heart disease <ul><li>Annual: 275,00 heart attack annually </li></ul><ul><li>Deaths: 120,00 </li></ul><ul><li>UK death rates highest in the world </li></ul>
  9. 14. Strokes <ul><li>110,000 annually </li></ul><ul><li>Third biggest killer </li></ul>
  10. 15. Type 2 diabetes <ul><li>2,000,000 cases in the UK </li></ul><ul><ul><li>heart attack </li></ul></ul><ul><ul><li>stroke </li></ul></ul><ul><ul><li>hypertension </li></ul></ul><ul><ul><li>kidney failure </li></ul></ul><ul><ul><li>peripheral vascular disease </li></ul></ul>
  11. 16. Falls <ul><li>30% of 65+ have a fall </li></ul><ul><li>50% are recurrent </li></ul>
  12. 17. Dementia <ul><li>820,000in UK </li></ul><ul><li>1:3 >65 will suffer from some form of dementia </li></ul><ul><li>£23 billion: annual cost of care </li></ul>
  13. 18. Depression 40,000,000 prescriptions for depression each year in the UK
  14. 19. Older people <ul><li>2010: 9.7m 65+(16% population) </li></ul><ul><li>2015: 14m 65+ </li></ul><ul><li>60% of hospital bed days. </li></ul>
  15. 20. The state of the nation A sedentary, overweight population, costing billions of pounds every year, heading for dementia and nursing homes. Do we want to go there?
  16. 21. Slow, mass suicide
  17. 22. But we have the answer ‘ the benefits of regular physical activity on health, longevity and wellbeing easily surpass the effectiveness of any drugs or other medical treatment.’
  18. 23. John Dryden:1631-1700 By chance our learned fathers earned their food,Toil strained the nerve and purified the blood.But we, their sons, a pampered race of men Are limited to three score years and ten.Better to hunt in fields for health unsought Than fee the doctor for a nauseous draft.The wise for cure on exercise depend;God never made his work for man to mend.
  19. 24. Exercise <ul><li>Reduces the risk of developing these diseases </li></ul><ul><li>Is a key component in their management </li></ul><ul><li>Promotes a healthy and independent old age </li></ul>
  20. 25. Coronary artery disease <ul><li>Aerobic exercise: </li></ul><ul><li>150’ moderate intensity / 75’ high intensity exercise per week </li></ul><ul><li>20-30% reduction in risk of CV disease </li></ul><ul><li>(Hamer and Chida 2008) </li></ul>
  21. 26. Exercise and disease risk reduction <ul><li>CV disease +++ </li></ul><ul><li>Type 2 diabetes +++ </li></ul><ul><li>Obesity +++ </li></ul><ul><li>PM breast cancer ++ </li></ul><ul><li>Colon cancer + </li></ul><ul><li>Depression ++ </li></ul><ul><li>Cognitive impairment + </li></ul><ul><li>O’Donovan G et al (2010) </li></ul>
  22. 27. Exercise as part of treatment <ul><li>BJSEM August 2009 </li></ul><ul><li>CV disease: CAD, HF, BP+, cholesterol + </li></ul><ul><li>COPD </li></ul><ul><li>Asthma </li></ul><ul><li>OA and RA </li></ul><ul><li>Type 2 DM </li></ul><ul><li>Parkinsons’s </li></ul><ul><li>MS </li></ul>
  23. 28. Exercise in older age <ul><li>‘ Among those >65 years, physical activity is strongly associated with reduced health resources and costs’ </li></ul><ul><li>(Woolcott JC et al 2010) </li></ul>
  24. 29. What can we do? <ul><li>Culture change among health professionals </li></ul><ul><li>Engagement between health and fitness professionals </li></ul><ul><li>Move the fitness industry from cosmetics to health </li></ul>
  25. 30. Culture change among health professionals <ul><li>Our own health and fitness </li></ul>
  26. 31. Health professionals <ul><li>Why are we an unhealthy bunch? </li></ul><ul><li>Increasing work loads </li></ul><ul><li>Constrained resources </li></ul><ul><li>Loss of control </li></ul><ul><li>Stress </li></ul><ul><ul><ul><li>weariness </li></ul></ul></ul><ul><ul><ul><li>no time </li></ul></ul></ul><ul><ul><ul><li>poor nutrition </li></ul></ul></ul>
  27. 32. Culture change among health professionals <ul><li>our own health and fitness </li></ul><ul><li>education - evidence base </li></ul><ul><li>rewards </li></ul><ul><li>make it easier to recommend/prescribe exercise </li></ul>
  28. 33. Engagement between health and fitness professionals <ul><li>CSP/FIA Joint Working Group </li></ul><ul><ul><li>referral guidelines between each other </li></ul></ul><ul><ul><li>referral advice for GPs </li></ul></ul><ul><ul><li>joint educational opportunities </li></ul></ul>
  29. 34. Engagement between health and fitness professionals <ul><li>Joint Consultative Forum between the </li></ul><ul><li>fitness sector and the Medical Royal </li></ul><ul><li>Colleges </li></ul><ul><li>best practice guidance for using exercise in the treatment of chronic disease </li></ul><ul><li>advice to doctors, fitness professionals and the DH </li></ul>
  30. 35. Engagement between health and fitness professionals <ul><li>Local contacts - the changing context </li></ul><ul><li>of GP commissioning and public health </li></ul><ul><li>boards </li></ul>
  31. 36. Move the fitness industry from cosmetics to health <ul><li>How has the fitness industry developed? </li></ul>
  32. 37. Industry development 1960’s and 70’s
  33. 38. Industry development Industry development 1980’s
  34. 39. Industry development 1990’ & 2000’s - equipment
  35. 40. Industry development 1990’ & 2000’s ‘ looking good feeling great’
  36. 41. Fitness Industry 2010+ <ul><li>Health agenda </li></ul><ul><ul><li>disease prevention </li></ul></ul><ul><ul><li>disease treatment </li></ul></ul><ul><ul><li>healthy and independent old age </li></ul></ul><ul><ul><li>through clubs and community hubs </li></ul></ul>
  37. 42. Making a start
  38. 43. Who is missing?