The Doctor's role in Promoting Physical Activity Flashcards

1
Q

What should we be doing in primary care to promote physical activity

A

Ask about physical activity status at every consultation
-identify inactive adults, advise 30mins of moderate activity 5/7 days

Brief physical activity is almost just as effective as intensive intervention
NNT for physical exercise is lower than smoking cessation

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2
Q

Why is exercise under utilised by doctors

A

Own habits

Ignoring evidence and seeing reasons not to prescribe

  • lack of time
  • exercise addiction
  • fear of being sued if injuries happen

Lack of financial incentive

Limited knowledge and confidence

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3
Q

How would you conduct a consultation on physical activity

A
5A's
Ask = current status, PEH, PMH
-what's the most active thing you've done in the last week, is this typical for you?
-how much?
-what are the barriers

Assess = where are they in the change cycle

Advise = come up with SMART goals together

Assist = provide resources and referrals to help to meet goals

Arrange = follow up to assess progress and barriers

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4
Q

What are the contraindications for physical activity

A

Absolute
-major acute injury/immediately post surgery
-heart failure with symptoms at rest
-uncontrolled disease
*diabetes
*asthma
*severe HTN 200/115+
*new arrythmias
Acute infection with systemic symptoms (viral myocarditis risk)
-red flag symptoms (chest pain, PND, SOB, pitting edema)

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5
Q

Name the 5 stages of change

How would you support the person at each stage

A

Precontemplation => raise awareness

Contemplation => assess barriers and worries, increase necessity and confidence

Preparation => set SMART goals

Action => come up with strategies to implement change and barriers

Maintenance => follow up and reassess barriers. If they have relapsed, explore why

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6
Q

How might you support your patients in engaging in physical activity

A

List of benefits, written summary
Knowledge of public health, community programmes

Apps

  • Couch to 5k
  • Nike Training
  • Fitness Buddy Pro
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7
Q

What are the risks of exercise?

A

Low for most people but the risk to health of not exercising is likely to be greater
-MSK, CV events

Reduce risk
-warm up, cool down

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8
Q

How would you write an exercise prescription?

What considerations should you make?

A

FITT
Frequency
-3-5x/7 aerobic
-2/7 strengthening

Intensity

  • low = singing
  • moderate = conversation
  • high = can’t talk

Time
-30mins or 15mins at high intensity

Type of activity

  • cardio (accessible, sociable)
  • strength (5-6 types, 8-10 reps)
  • balance, coordination

Ensure that it is

  • appropriate
  • if sedentary, start low intensity and work up
  • any chest pain/symptoms => seek medical help
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9
Q

Can you do an exercise referral?

A

NHS funded 12wks specialist exercise
-community walking, gym specialist

Green social prescriptions
-nature based interventions

Can phone exercise professional for motivational interview and advice

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10
Q

When would you consider a specialist exercise referral?

A

Cardiac/COPD rehab
Exercise, weight management for obese
Falls prevention classes for elderly
High risk patients may see a Sport and Exercise Medicine consultant

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