Need for Rehabilitation is at its highest level ever

Exercise as a key in therapy

In rehabilitation

• Conclusion
  • Although limited in quantity, existing randomised trial evidence on exercise interventions suggests that exercise and many drug interventions are often potentially similar in terms of their mortality benefits in the secondary prevention of coronary heart disease, rehabilitation after stroke, treatment of heart failure, and prevention of diabetes

In primary prevention

• Network meta-analysis
  • 319 randomized controlled trials
    • 197 exercise interventions (10 461 pts)
    • 194 antihypertensive medication(29 281 pts)
• Overall: individuals who receive AH medications tend to achieve greater reductions in SBP
• In hypertensive patients: different types of exercise interventions appear to be equally effective as most antihypertensive medications

Exercise Therapy - Class 1 recommendation

Primary prevention

Secondary prevention and rehabilitation

However,

• Do we have one 'drug prescription' that fits all diseases/patients?
  
• Do we have one 'exercise intervention' that fits all diseases/patients?

Personalised Exercise Prescriptions

Parameters

• Frequency
  • How often
  • per...?
• Intensity
  • % of HRmax, HRrest, VT-zones
  • % 1RM, 1MVC
  • Borg test, Talk test
• Types (modus)
  • endurance
    • interval vs continuous
  • resistance
    • dynamic - isometric
    • inspiratory vs peripheral
    • strength/endurance
  • Other modaliites
• Time (duration)
  • how many minutes/sessions per week

Fundamentals

Exercise prescription in summary

• Flexibility
• Creativity
  • To personalize your exercise prescription
  • To increase the probability your client will make long-term commitments to a physically active life