How exercise prescriptions could change the NHS

This article was taken from: https://www.theguardian.com/education/2018/mar/19/how-exercise-prescriptions-could-change-the-nhs

By Helena Pozniak

Sports medicine graduates will be in high demand to combat inactivity epidemic

We know exercise is good for us, yet human beings may now be on the verge of dangerous levels of inactivity. Historically we’ve always been active, from our hunter gatherer past to manual labour in the industrial age – until cars, computers and labour-saving devices took much of the physicality out of work. Now, according to analysis of national health statistics by the British Heart Foundation, 39% of adults in the UK fail to achieve recommended levels of physical activity or exercise. But recent research shows how crucial activity is to our health. To spread the word about the health benefits of exercise, a new master’s course is due to start this year at Loughborough University – to complement an existing range of sports and exercise medicine master’s degrees around the country.

“We’re targeting the full allied health professional range,” says Dr Dale Esliger, programme leader of the MSc in exercise as medicine, which launches this October. Based in the National Centre for Sport and Exercise Medicine – an Olympic legacy facility – this course differs slightly from current sports medicine master’s. Students won’t be attending elite athletes beside the pitch, but rather looking at “prescribing” exercise to the wider population, investigating the value of techniques such as mindfulness, and researching how to deploy digital tools to motivate people to exercise more. As a nation, we’re behind the likes of Australia in formalising exercise advice within the health service, says Esliger. “In the future we hope to see more exercise professionals within the NHS,” he says. “If we want clinicians to write exercise rather than drug prescriptions, we need to give them the knowledge to do that.”

Elsewhere, the University of Nottingham’s sports and exercise medicine MSc does involve working with elite athletes – rugby players from Leicester Tigers or dancers from the Birmingham Royal Ballet among others. A large chunk of the course is given over to understanding the relationship between physical activity and health, says course director Dr Kim Edwards. An ultra marathon runner herself, she’s well aware of the dangers of a sedentary lifestyle.

“I try to use the stairs, I make myself walk around the building. I come from a public health background and that element of the course – how exercise can prevent disease – is very important, though it can feel the poor relation to the glamour of treating soccer players by the pitch.”

Nottingham’s course is divided into two streams: one targets clinicians – GPs, physiotherapists and medics – while the other applied master’s is suitable for students with a broader background, such as sports scientists and non-clinicians who might want to gain experience with patients. “We’ve had sports experts, human biology graduates, even people from business backgrounds who want to make the career move.” Some will go on to train as physiotherapists, says Edwards, while students on the non-applied course may go on to further research or specialist roles in the health service.

With 50 students across both courses, Nottingham has seen applications rise for the past six years. “There’s room in the NHS for new roles, such as exercise instructors, that don’t currently exist,” says Edwards.

Other acclaimed sports medicine master’s courses are offered by the University of Bath and at University College London, where postgraduate Kosta Ikonomou is relishing the opportunity to work with rugby players – he’s a concussion expert and a physiotherapist, and he’s volunteered to assist at this year’s London marathon. His fellow students include GPs, medics, fellow physios and even an osteopath.

“The programme is very research-based and very strong on the benefits of exercise – it’s the best medicine. All athletes train to prevent injury and improve performance. But we’re not just looking at the elite. We’re also looking how to prevent injuries in the general public and help ageing and adolescent populations.”

Doctor’s orders: why we should exercise

Easing chronic pain
Virtually everyone benefits from becoming more physically active, research shows. But 39% of adults in the UK fail to get enough exercise. In the past, people with chronic pain were advised to rest. Now, a number of recent studies have indicated that exercise can ease chronic pain and improve physical function in individuals, leading to a corresponding improvement in quality of life in some cases. While more research needs to be conducted, the signs that exercise and physical activity could help in the management of chronic pain appear to be positive.

Fighting cardiovascular disease
A sedentary lifestyle more than doubles the risk of cardiovascular disease. Regular physical activity can cut the risk of many long-term illnesses and conditions, including coronary heart disease, strokes, type two diabetes, cancer, obesity and mental health problems. Regular participation in sport can save between £1,750 and £6,900 in healthcare costs per person, according to Sport England.

Mental health benefits
Being active enables personal wellbeing and encourages positive thoughts and feelings about the future, according to a survey of more than 5,000 students by Scottish Student Sport (sponsored by Precor). Almost three quarters (73%) of active students said thoughts about their future had changed for the better since taking part in sport and physical activity. Overall, 47% of students thought taking part in sport would increase their employability “quite a lot”.

Engagement in intensive sport at school can increase pupils’ attendance and attainment, according to one study. In one school participating in a coaching and mentoring programme offered by charity Greenhouse Sports, students outperformed their peers by up to a third of a grade in English and 40% of a grade in maths.

The 150 minutes-a-week rule
To stay healthy, the NHS says adults (16-94) should try to be active daily and have at least 150 minutes every week of moderate aerobic activity such as cycling, brisk walking or even household chores – or 75 minutes of vigorous activity – and strength exercises two or more days a week. Double that, says the World Health Organisation, if you want further benefits.