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Exercise for Chronic Disease Relief
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Exercise for Chronic Disease Relief

For people who suffer from a chronic disease, exercise can decrease discomfort, improve daily functioning, and enhance overall quality of life. There are many choices in what type of activity you might choose. Overall, find something that you enjoy doing and a place that is comfortable for you to do it in.

Although being physically active in general is good for anyone, some exercises provide specific benefits. Here's how different types of exercise can help people with specific chronic diseases.

Types of Exercise

There are three basic categories of exercise:

Aerobic exercise—exercises that raise your heart rate through repetitive movement of large muscles groups. The two types of aerobic exercise are:

  • Weightbearing—your muscles work against the force of gravity. Examples: jogging, walking, dancing.
  • Nonweightbearing—the force of gravity does not play a major role. Examples: biking, swimming, rowing.

Strength training exercise—exercises that increase the power, tone, and efficiency of individual muscles by contracting isolated muscles against resistance. For example: lifting weights. The increase in heart rate is short-lived compared to aerobic exercise.

Stretching—Exercises that improve or maintain the flexibility of your muscles. Good flexibility is important to keeping a full range of motion and decreasing your chances of injury. Ideally, you should stretch after each exercise session.

Disease Impact

Overall, all three types of exercises are important in an effective program. However, the list below demonstrates how a certain types of exercise can directly impact your specific health condition.

Heart Disease

Many researchers and health professionals have found that regular exercise reduces the risk of having a heart attack, particularly for people with coronary artery disease (CAD).

Specific benefits of exercise for people with heart disease include:

  • Stronger heart muscle
  • Fewer incidences of angina
  • Reduced cholesterol
  • Reduced plaque build-up inside the arteries
  • Better weight and blood pressure control

Type of exercise that can reduce risk of heart disease and heart attack—Aerobic exercise

High Cholesterol

Cholesterol is found in cells throughout your body. Although it tends to get a bad rap, cholesterol is actually essential for life. It only contributes to heart disease when you have too much of certain types of cholesterol or too little of other types.

According to Richard Stein, MD, spokesperson for the American Heart Association, regular aerobic exercise will raise the "good" cholesterol (HDL) and moderately decrease the "bad" cholesterol (LDL). He emphasizes that when exercise is combined with a healthy, low-fat diet, these changes can be significant.

Type of exercise that have been shown to improve cholesterol levels: Aerobic

Diabetes

Diabetes is a disorder of the body's insulin production and usage, and it is a major risk factor for coronary artery disease. If there is not enough insulin, glucose (fuel for all cells) cannot get from the blood to the cells. As a result, the body is essentially starved and the glucose builds up in the blood. Exercise can make the cells more sensitive to insulin, and more glucose can move from the blood into cells.

"Exercise improves the sensitivity of the body's cells to insulin and therefore, improves blood glucose control, as well as many other cardiovascular risk factors," says Charlotte Hayes, MMSc, RD, a certified diabetes educator.

Types of exercise that influence insulin sensitivity and cardiovascular risk factors: Aerobic and Strength Training

High Blood Pressure

"Moderate exercise has been shown to control blood pressure by increasing the efficiency of the circulatory system," says Marlene Janco, MS, RD, a consultant who promotes the Dr. Dean Ornish Program for Reversing Heart Disease. "The blood pressure lowers because the heart muscle pumps better, the blood vessels are more relaxed, the heart requires less oxygen to work, and the kidneys function better."

Types of exercise that have been shown to lower blood pressure: Aerobic

Stroke

A stroke occurs when not enough blood is reaching part of the brain. This causes the cells in that area to die. "A high intensity workout developed to meet the specific needs of the individual is a key element in helping a patient recover from a stroke," says Susan Barker, PT, PhD, professor of physical therapy at Misericordia University.

Exercise may help brain cells near the stroke area get more oxygen, and it may improve strength and coordination of the affected muscles. A stroke can create some physical impairments. Exercise recommendations may vary depending on the severity of the stroke and the person's limitations.

Type of exercise for stroke recovery and prevention: Aerobic, Strength Training, and Stretching.

Cancer

"Physical activity is a missing link for many people in treatment for cancer," says Diane Doster, MS, founder of CancerFit in Sedona, Arizona. "Moderate exercise combats fatigue and reduces nausea and depression." Studies suggest that cancer patients who do not have depression have a better chance of survival than those who do.

Types of exercise found to boost energy and mood: Aerobic and Strength Training

Lung Disease

Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis, is the most common form of lung disease. Exercise improves quality of life for patients with COPD by increasing:

  • Exercise capacity
  • Breathing efficiency
  • Muscles' oxygen uptake
  • Flow of air when exhaling

Types of exercise shown to improve respiratory ability: Aerobic

Arthritis

Continuous motion is essential for the health of your joints, especially arthritic ones. Regular exercise promotes strength and flexibility, and helps preserve the resiliency of joint surfaces. This is especially important in the legs and feet where breakdown of joint cartilage contributes to osteoarthritis.

Types of exercise shown to improve joint health: Nonweightbearing Aerobic and Strength Training. Water exercises are ideal.

Osteoporosis

"Bones are alive and constantly under construction, as well as demolition," says Michael LeRoux, MS, DC, founder of Ocean State Chiropractic and Sports Rehabilitation in Providence, Rhode Island. Weightbearing exercises maintain bone density and strength by tipping the balance in favor of bone formation.

Felicia Cosman, MD, clinical director for the National Osteoporosis Foundation adds that muscle strength is just as important as bone strength, because it helps prevent falls—a major cause of fractures.

Type of exercise shown to improve bone density: Weightbearing Aerobic and Strength Training

In any condition, a well-rounded exercise program will have all three types of exercise involved. Aerobic exercise will increase your endurance and ability to get through longer workouts. Strength training will build muscle strength and allow you to tolerate higher intensities as well improve balance and agility. Stretching can decrease stiffness and risk of injury.

Talk to your physician before beginning any exercise program. You can also consult with an exercise specialist to help you develop a routine.

RESOURCES:

American Heart Association
http://www.americanheart.org

The American Orthopaedic Society for Sports Medicine
http://www.aossm.org

Arthritis Foundation
http://www.arthritis.org

National Institutes of Health
http://www.nih.gov

National Osteoporosis Foundation
http://www.nof.org

RESOURCES:

Canadian Society of Exercise Physiology
www.csep.ca

Healthy Canadians
http://www.healthycanadians.gc.ca

References

Exercise Management for Persons with Chronic Diseases and Disabilities. The American College of Sports Medicine. Human Kinetics; 1997.

Fagard R.H.: Exercise characteristics and the blood pressure response to dynamic physical training. Med Sci Sports Exerc 33. S484-S492.2001

The "I Hate to Exercise" Book for People with Diabetes. American Diabetes Association; 2001.

Junnila JL, Runkle GP. Coronary Artery Disease Screening, Treatment, and Follow-up. Primary Care: Clinics in Office Practice—Volume 33, Issue 4 (December 2006).

Onitilo AA, Nietert PJ, Egede LE. Effect of depression on all-cause mortality in adults with cancer and differential effects by cancer site. Gen Hosp Psychiatry—01-SEP-2006; 28(5): 396-402.

Your guide to exercising with asthma. Phys Sportsmed. 1998 Jun;26(6).



Last reviewed February 2008 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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