Movement as Medicine

Question 1

What are modifyable risk factors?

Answer 1

Smoking

Alcohol

Diet

Physical Activity

Question 2

Movement causes risk reduction in what diseases?

Answer 2

Hypertension, Ischaemic heart disease, type 2 diabetes, stroke, colon cancer.

Question 3

Define physical inactivity

Problems with inactivity?

Answer 3

• Less than 30 minutes of moderal physical activity per week
• Longer stay in hospital
• Speeds up ageing

Question 4

How to encourage under 5s

5-18s

19-64

65+

Answer 4

Under 5s -  reduce time spent in infant carriers, car seats or highchairs  reduce time spent in walking aids or baby bouncers  reduce time spent in front of the TV or other screens  develop good habits  make moving fun

5-18  consider ways for children to “earn” screen time  agree a family limit to screen time per day  make bedrooms a TV- and computer-free zone  set “no screen time” rules to encourage kids to be active  encourage participation in house chores such as setting the table or taking the bins out  choose gifts such as a scooter, skateboard, ball or kite to encourage active play  Parents could lead by example by also reducing their TV time and other sitting-based tasks.  value participation in activity not achievement

19-64 - stand on the train or bus  take the stairs and walk up escalators  set a reminder to get up every 30 minutes  place a laptop on a box or similar to work standing  stand or walk around while on the phone  take a walk break every time you take a coffee or tea break  walk to a co-worker’s desk instead of emailing or calling  swap some TV time for more active tasks or hobbies

65+ Some older adults (aged 65 and over) are known to spend 10 hours or more each day sitting or lying down, making them the most sedentary population group. There are social norms expecting those in later years to ‘slow down’ and rest  avoid long periods sat in front of a TV or computer  stand up and move during TV advert breaks  stand or walk while on the phone  use the stairs as much as possible  take up active hobbies such as gardening and DIY  join in community-based activities, such as dance classes and walking groups  take up active play with the grandchildren  do most types of housework Loss of balance and strength causes falls

Question 5

Helping people change their behaviours (motivational interviewing) RULE

Answer 5

Resist the “righting reflex” – people are often ambivalent – they want to – they might be able to – they see good reason to – they know they need to – BUT… Telling people the right thing to do makes them defend themselves and argue against you – reinforcing the status quo

Understand your patient’s motivations What are their reasons to change? – Show an interest in their concerns, values and motivations – Explore their perceptions about their current situation “why would you want to change?” “how might you do it?” “have you managed to take up/stop anything before?” “what helped you then?”

Listen to your patient​ - – you don’t have all the answers – they are the experts in themselves – empathic interest – guessing about meaning – demonstrating they are important and you care for them

Empower your patient – if people take an active interest and role in their health care outcomes are better – explore how they can make a difference to their health (don’t base it on your life!) – support their hope that change is possible – get them to think out loud why and how to change (reinforces change)