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Prescribing exercise interventions for patients with chronic conditions - from Canada

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Apologies in advance for poor presentation - am suffering a setback or something, but hope this is appropriate. It includes reference to 'chronic fatigue syndrome' and cites 'White PD', so maybe they don't know!

Prescribing exercise interventions for patients with chronic conditions

Tammy C. Hoffmann BOccThy (Hons 1) PhD, Chris G. Maher BAppSc(Phty) PhD, Tom Briffa BPhysEd PhD,
Catherine Sherrington BAppSc(Physio) PhD, Kim Bennell BAppSci(Physio) PhD, Jennifer Alison MSc PhD,
Maria Fiatarone Singh MD, Paul P. Glasziou MBBS PhD

http://www.cmaj.ca/content/early/2016/03/14/cmaj.150684
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Forgot to include the Physician's First Watch reference:

How to Prescribe Exercise to Patients with Chronic Health Conditions
By Kelly Young
Edited by
- Jaye Elizabeth Hefner, MD

A review in CMAJ offers advice on how to prescribe exercise to patients with chronic medical conditions, including chronic obstructive pulmonary disease, low back pain, knee or hip osteoarthritis, type 2 diabetes, chronic fatigue syndrome, coronary heart disease, and heart failure.

Among the condition-specific recommendations:

-- For chronic nonspecific low back pain, a physiotherapist can guide patients in motor control exercises and graded activity.
-- For type 2 diabetes, the review recommends a structured program of aerobic exercise and/or resistance training to improve glucose control.
-- For COPD, patients should undergo pulmonary rehabilitation in hospital outpatient departments or community facilities.

The document provides evidence of exercise's benefits, contraindications, and potential adverse effects for each condition.

The authors conclude: "Even when a family physician may not be involved in delivering the exercise intervention, they should know the main elements of an evidence-based exercise intervention so they can discuss with patients and refer appropriately."

Link(s):
CMAJ article (Free PDF) http://response.jwatch.org/t?ctl=7689:5FF9B588B7CB016C0C5D25A7640665F4&
Background: NEJM Journal Watch General Medicine coverage of exercise referrals (Your NEJM Journal Watch registration required) http://response.jwatch.org/t?ctl=768A:5FF9B588B7CB016C0C5D25A7640665F4&
 

Denise

Senior Member
Messages
1,095
Appendix 5 of the CMAJ article is delightful (NOT).
http://www.cmaj.ca/content/suppl/2016/03/14/cmaj.150684.DC1/150684-view-5-at.pdf

upload_2016-3-21_18-17-24.png
 

lansbergen

Senior Member
Messages
2,512

To reverse the physical deconditioning, exercise intolerance and avoidance that has been caused by
inactivity and to gradually re-engage the person in physical activity. Based on the assumption that chronic fatigue syndromeis maintained by physiological changes of deconditioning andactivity avoidance - which can be reversed.

Pace is all about decondition. Nothing to do with ME.
 

Kati

Patient in training
Messages
5,497
Apologies in advance for poor presentation - am suffering a setback or something, but hope this is appropriate. It includes reference to 'chronic fatigue syndrome' and cites 'White PD', so maybe they don't know!

Prescribing exercise interventions for patients with chronic conditions

Tammy C. Hoffmann BOccThy (Hons 1) PhD, Chris G. Maher BAppSc(Phty) PhD, Tom Briffa BPhysEd PhD,
Catherine Sherrington BAppSc(Physio) PhD, Kim Bennell BAppSci(Physio) PhD, Jennifer Alison MSc PhD,
Maria Fiatarone Singh MD, Paul P. Glasziou MBBS PhD

http://www.cmaj.ca/content/early/2016/03/14/cmaj.150684

Thank you for sharing @MeSci. i wonder if you could add to the title it's coming from Canada to alert Canadian advocates. This begs for a response (but I am currently not able to muster) and at the very least for Canadians to look at.
 

Old Bones

Senior Member
Messages
808
ME-exercise-text.JPG
ME-exercise-table.JPG
Thank you for sharing @MeSci. i wonder if you could add to the title it's coming from Canada to alert Canadian advocates. This begs for a response (but I am currently not able to muster) and at the very least for Canadians to look at.

I can't say I "like" the original post, but I'm glad that @MeSci brought this document to my attention. Thanks.

Considering the Canadian Consensus Criteria is one of the best-known and most-respected ME criteria around the world, it boggles the mind that CMAJ appears not to be aware of it. If they were, they wouldn't publish such fiction. Above is an excerpt they need to read.
 
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Kati

Patient in training
Messages
5,497
View attachment 15118 View attachment 15117

I can't say I "like" the original post, but I'm glad that @MeSci brought this document to my attention. Thanks.

Considering the Canadian Consensus Criteria is one of the best-known and most-respected ME criteria around the world, it boggles the mind that CMAJ appears not to be aware of it. If they were, they wouldn't publish such fiction. Above is an excerpt they need to read.
Patients had to beg the Canada public Health Agency to publish the Canadian Consensus Criteria, and when they did a couple years ago, they supplied an australian link.

Do not assume that the CCC is widely distributed- or read in Canada and across medical associations. Cohrane reviews are more respected.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Thank you for sharing @MeSci. i wonder if you could add to the title it's coming from Canada to alert Canadian advocates. This begs for a response (but I am currently not able to muster) and at the very least for Canadians to look at.
Is the changed title OK? Sorry but I am really not with it at present.
 

Old Bones

Senior Member
Messages
808
Patients had to beg the Canada public Health Agency to publish the Canadian Consensus Criteria, and when they did a couple years ago, they supplied an australian link.

Do not assume that the CCC is widely distributed- or read in Canada and across medical associations.

@Kati I had no idea -- thanks for enlightening me. I've often wondered about the Australian link. Another reason to be ashamed, and alarmed, about the treatment (including lack of treatment) of ME patients in Canada.
 

u&iraok

Senior Member
Messages
427
Location
U.S.
View attachment 15118 View attachment 15117

I can't say I "like" the original post, but I'm glad that @MeSci brought this document to my attention. Thanks.

Considering the Canadian Consensus Criteria is one of the best-known and most-respected ME criteria around the world, it boggles the mind that CMAJ appears not to be aware of it. If they were, they wouldn't publish such fiction. Above is an excerpt they need to read.

Thanks for the Response to Exercise chart, it's great.