Take 10 laps and call me in the morning

By KRISTYN ECOCHARD, UPI Correspondent  |  Oct. 17, 2006 at 10:53 AM
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WASHINGTON, Oct. 17 (UPI) -- Prescribing exercise may be more effective than simply recommending it, new research suggests.

The study -- "Exercise and Older Patients: Prescribing Guidelines" -- is by Ann McDermott and Heather Mernitz, researchers at the Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University in Boston.

Aerobic, resistance, balance and flexibility training all have been proven in past studies to help older adults build strength, maintain bone density and improve balance, coordination and mobility. Such training also reduces risk of falling and improves independence in performing everyday activities.

"There's tons of research that doctors don't know how to use," McDermott said. "It doesn't benefit the public."

McDermott and Mernitz aim to give medical practitioners a one-stop overview of exercise research for specific health conditions and provide guidelines for tailored exercise prescriptions. Oftentimes families and doctors are afraid to recommend exercise in older patients because of the risk of injury.

Experts said the new approach seems promising.

"Anything that helps older people exercise is beneficial," said Dorree Lynn, clinical psychologist and founder of FiftyandFurthermore.com.

Physical activity has always had some degree of inherent risk and safety concerns, said Brian Focht, assistant professor in the school of public health at Ohio State University. However, with appropriate activities and supervision, there is minimal risk. Numerous studies with frail elderly have shown positive outcomes with little risk of injury when exercise is done in moderation with proper progression and supervision.

"People might be much more at risk of long-term harm by not exercising," McDermott said.

The authors give doctors the "how-to" of prescribing exercise, in steps similar to those used in prescribing drugs: Be as specific as possible; make the exercise prescriptions condition-specific; tell patients exactly how often and how long to do them; intensify the progression about every three months.

The prescription should also be personalized. Patients who have dogs could exercise by going for walks, whereas those who dislike the outdoors could take classes at a gym.

"Aerobic exercise is very important," said William Greenough, professor of psychology and psychiatry at the University of Illinois. "Other ways that make it easier to introduce exercise into a daily routine are excellent."

Vagueness about what exercises should be done limits doctors and patients. With prescription medicines, there's no confusion, Greenough said. Knowing what's expected makes following directions easier.

"Justice is not being done by just suggesting exercise and not saying how to do it," he said.

McDermott and Mernitz provide the do's and don'ts for arthritis, diabetes, osteoporosis and several other age-related diseases. For example, McDermott said, a patient with osteoporosis should strength-train but avoid any twisting motions that could damage their fragile bones.

If they adhere to their prescriptions, patients may see results in a couple of weeks, though it could take as long as several months.

"People often overestimate the amount of activity needed to see change," Ohio State's Focht said. "This could be an important strategy to get the message to those older Americans who have misconceptions about exercise."

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