Deconditioning

• Deconditioning can be intervened by PA and exercise
  • Type 2 diabetes is proven to have the same treatment process with exercise and physical activity as pharmaceutical intervention.
• Deconditioning can lead to
  • Cardiac & vascular morbidity
  • Insulin resistance
  • Cancer (Colon/Breast/Lung)
  • Arterial Hypertension
  • Bone and joint disease
    • (Osteoporosis, Arthritis)
  • Mental health: Depression
  • Sarcopenia

Phases of initiation of intervention

• Healthy at risk
  • Primary prevention and obtaining healthy life style
  • Healthy nutrition
  • Engaging in exercise program
• Pre-clinical
  • Pharamacotherapy
  • Prescribe Physical activity
  • Self management for initial symptoms
  • E-Health: population who are on the trajectory to develop a problem
• Event
  • Emergency care
  • These patients present with a profile of physical inactivity that has been like a habit for a long time
• Clinical Disease
  • Rehabilitation
  • Tailored exercise training
• Palliation
  • Rehab could be part of it but not a primary objective
• Always know that there will be a trajectory before they present with their profiles that was described before.

Inactivity leads to Comorbidity

• The longer the patient has a chronic case, the more disability and comorbidities will there be.
• It usually also cause more inactivity —> lead to systemic disease
• Find what is linked to the initial chronic condition (Genetic, exposure, risk factor etc.)
• We could only tackle the disability such as MSK, CV or mental health issues.

Components of Rehabilitation

• Improving exercise tolerance
  • Physiological improvement of muscle, CV system, metabolic, cognitive mental health
• Interventions aiming at daily PA (Taking the stairs rather than the elevator)
  • Performed at low-intensity
  • We can combine it with exercises as literature have recommended.
  • These population might find that performing 30mins of moderate intensity as hard, rather they could perform a 5min brisk exercise
• Enhancing self-management
  • Management of the disease in its specific aspects of recognition of problems, adequate self-care and pathology