Knowing that chronic disease is a major problem causing a financial drain on our economic healthcare system is the first step. Recognizing the underlying root causes of chronic disease is the second step. Implementing a program, addressing chronic disease within your physical therapy practice, with your patients is obligatory, if we are going to have any impact on preventing these diseases and helping our patients improve their function and quality of life.
A 48 year old patient who comes to us with osteoarthritis of the knee, who is also 80 pounds overweight, can do stationary cycling, straight leg raises, quad sets, and closed kinetic chain activities, however until they significantly decrease their body weight the adverse effects related to cumulative forces on the knee will continue.
Introducing your patients to the idea that their lack of appropriate exercise, their food choices and body weight are significant contributors to their problem will open the door for addressing the causes of their condition. Educate your patients on the benefits of a healthy lifestyle change, which includes increased exercise/activity and weight loss by providing your patients with the following information.
Inform your patients that just a 5-10% reduction in their current weight will significantly improve parameters of health including:
- Reduction in blood pressure 5 mmHg
- Increase in HDL 5 mg/dL
- 40 mg/dL reduction in triglyceride
- .5% reduction in HbA1C
Let your patient know that there is evidence that physical activity may be associated with a lower risk of several common forms of cancer, most notably colon and breast cancer.
Tell your patient that regular exercise decreases blood pressure in approximately 75% of hypertensive persons with an average decrease of 11 and 8 Hg mm for systolic and diastolic blood pressure respectively.
Inform your patient of the strong evidence from randomized controlled studies that moderate physical activity combined with weight loss and an improved diet can confer a 50-60% reduction in risk of developing diabetes among those already at high risk.
Also let your patients know that studies demonstrate an inverse association with fruit and vegetable intake and the risk of cardiovascular disease and all-cause mortality.
Finally, offer to help your patient set realistic weight loss goals, 5-10% of their initial weight has demonstrated improvements in parameters of health. Provide your patient with a wellness packet that helps them track their exercise and provides information on good food choices. Offer to help your patient track their weight loss and lifestyle changes involving exercise and food choices as they progress with their physical therapy program.
This type of intervention addresses the ‘whole’ person and has the potential to have both an immediate and future positive impact on your patient. As physical therapists, we truly become an instrument for healing our patients when we are addressing chronic disease.
Latest posts by Jeff Gilliam, PT, PhD, OCS (see all)
- The White Elephant in the Clinic - July 26, 2018
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- Encouraging Your Patient to make a Healthy Lifestyle Change - December 16, 2016
- How to Address Obesity in the Patient with Osteoarthritis of the Weight Bearing Joints - October 15, 2016
- Increasing and Activating Whole Body Muscle Mass Reduces Insulin Resistance - August 8, 2016