Exercise and chronic diseases

Most patients with type 2 diabetes will benefit from exercise as it improves insulin sensitivity and glucose and glycated haemoglobin (HbA1c) levels, especially when combined with dietary measures.

Performing a minimum of 150 minutes a week of aerobic exercise alone or in combination with strength exercises improves triglyceride levels, systolic blood pressure and decreases the waist circumference.

Any exercise routine must be planned in advance to avoid an excessive drop in blood glucose (hypoglycaemia), especially in those cases when the person is treated with insulin or certain types of drug that can cause hypoglycaemia.

Exercise reduces probability of cardiovascular disease by 30%. In people who have had a heart attack, it reduces mortality by 20-25%.

An aerobic exercise programme increases the efficiency of the cardiovascular system and controls related risk factors.

Exercising at least three hours per week (spread over several days) is recommended. It doesn't have to be strenuous exercise, but the heart rate should be racing a little and there should be a shortness of breath. It is best to start gradually, without getting tired, and push for a little more each day until the individual notices these sensations, approximately three weeks after the start of the activity.

This general rule might not be appropriate for some people, so consult a healthcare professional about the type of exercise and the appropriate intensity for each case before starting.

If something isn’t right, such as a choking sensation or chest pain, stop the exercise routine and consult a healthcare professional before resuming.

Moderate exercise reduces blood pressure levels and achieves better control of medication, leading to less consumption of them. In addition, it prevents high blood pressure by 30%.

Regular practice of non-competitive aerobic physical exercise (walking, cycling, swimming, etc.) is recommended. Ideally, it is done every day rather than on alternate days, and the session should preferably last one hour rather than 30 minutes. In any case, full exercise should only be done after a training period.

Modification of lifestyle, particularly an increase in exercise and weight reduction, is an essential part of the management of osteoarthritis. Although people who have osteoarthritis tend to avoid exercise, it has been shown to be effective and to improve joint pain and function, as well as functional impairment, even in older people.

Gentle physical exercise such as walking on flat ground, swimming or cycling is recommended to prevent and improve joint osteoarthritis. High-impact exercise is not appropriate because it would worsen the joint condition and increase symptoms.

In moments of great pain, it is best to partially rest for a period.

Personalised physical activity brings multiple health benefits. It helps control weight, lowers total cholesterol and triglycerides and increases the ratio of ‘good’ cholesterol (HDL).

Patients who exercise and eat healthily are more successful in modifying their lifestyles in the long term and reducing the risk of coronary heart disease.

Lack of physical activity is the only extrinsic risk factor that can have a negative influence on the development of osteoporosis. Not being active, for whatever reason, is a factor that predisposes individuals to developing the disease, so prolonged rest should be avoided.

In periods of convalescence, after a fracture or for any other reason, such as accidents or consequences from accidents related to functional deficits or chronic diseases that cause pain or functional disability, small improvements must be used to start moving, without forcing it and while remaining aware of pain levels.

As much as possible, physical activity must be restored to prevent osteoporosis due to not being active.

In postmenopausal women, exercise helps prevent a decrease in bone mineral density in the lumbar spine and femoral neck. It also has a beneficial impact on balance, strength and muscular endurance. All this helps prevent the appearance of fractures in postmenopausal women.

For patients with Parkinson's disease physical exercise is important for individuals who have this disease, but strenuous exercise should be avoided and adapted to the possibilities of each person. In case of motor fluctuations (periods that alternate good mobility due to the effect of medication with the appearance of symptoms), the most of periods of improvement is essential. Recommended exercises include Tai chi, tango, treadmills or elliptical machines and cycling. Patients who fall frequently must be careful and cautious. The exercise must be engaging for the patient as that will ensure they maintain continuity.

Exercise improves functionality, leg strength, balance, fatigue tolerance and quality of life.

Increased physical activity and exercise are associated with significant weight reduction and long-term weight loss. Exercise also increases metabolic activity, reduces body fat, and improves overall cardiorespiratory fitness.

Physical activity adapted to the possibilities of each person and done regularly contributes to weight control, improves associated risk factors and positively influences the feeling of well-being. The following is recommended to increase physical activity levels:

People who do moderate physical activity have, on average, 30% less risk of developing colon cancer and 20-40% less risk of developing breast cancer compared to people who live a sedentary lifestyle.

It is important for those people diagnosed with a neoplasm to maintain their usual routines and to practice any type of exercise, within their possibility and whenever it is not contraindicated. Staying active helps minimise the side effects of treatment and facilitates earlier recovery. Physical activity provides a greater feeling of well-being, muscles are kept toned, fatigue decreases, appetite increases, tension is controlled, constipation is decreased and it helps relax the mind. Physical therapy exercises are very important after surgery and when there is loss of muscle mass in the legs. Ask the healthcare team what level of activity is the most appropriate after an operation.

Exercise improves the quality of sleep and reduces the risk of anxiety and depression. People who exercise are less at risk of cognitive decline and dementia.

For example, people with Alzheimer's disease should stay active not only mentally, but also physically. Staying active through light exercise such as walking 45 minutes per day (or another equivalent exercise) three times per week is important to keeping fit, and will decrease the risk of cardiovascular problems, increase feelings of well-being and improve mood and behavioural disorders.

Exercise improves symptoms and helps the patient to walk for longer periods or on sloping terrain. This allows for increased daily activities and energy consumption.

Playing sports is recommended for asthma patients, as long as the asthma is well controlled. Patients whose asthma comes on when they do exercise can take the short-acting bronchodilator 10 to 15 minutes beforehand.

Physical activity helps maintain adequate weight, improves cardiovascular function, exercise tolerance and decreases rescue treatment.