Benefits of Exercise: Update

A few weeks ago, a brief review of the health benefits of exercise was posted on the STAR Physical Therapy blog (see Exercise is Medicine from Nov 4, 2013). In the way of an update, a recent article was published in the British Medical Journal (Naci H, Ioannidis J, 2013) that sheds a different light on the relationship between exercise and health.  A team of researchers from the United Kingdom and the US set out to compare the effectiveness of exercise and drug interventions for common health conditions. They looked at hundreds of clinical trials involving hundreds of thousands of people. What they found was that exercise and drug therapy have very similar effects on preventing death among people with coronary heart disease, heart failure, diabetes, and following stroke. These were the populations being studied.

So the results of this study pose an interesting question about standard and usual medical management of common, chronic health conditions. Why is there a lack of emphasis on exercise as a potential substitute for drugs in chronic disease management? When it is safe, why not exercise instead of take pills? The authors make a point to highlight the bias in the research toward drug trials. They suggest that if exercise was studied with the same intensity as drug therapies, we may find that exercise is actually more beneficial than medications for some conditions or under some circumstances.

Of course, the incentives for research on the effectiveness of drugs for disease differ considerably than those for research on the effectiveness of exercise interventions. And exercise is not always an attractive option because the individual has to do something physical in order to reap the benefits. It is much easier to take a pill. But this does not account for the side effects of many medications, nor all of the additional physiological benefits of exercise, including the impact of physical activity on mental health.

Many insurers are getting the message and starting to create incentives for their members to engage in physical activity. They understand that exercise is the best medicine for primary prevention, and can also be at least equal to the best medicine for some chronic health conditions. But not everyone knows how to exercise safely and effectively. Physical therapists can help in creating individualized exercise programs for those that want to take a proactive approach to their health.

Marcia Miller Spoto, PT, DC, OCS