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Exercise as a Standard Treatment Method Essay

Updated August 8, 2022

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Exercise as a Standard Treatment Method Essay essay

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Exercise is Medicine (EiM) is recognised as a global initiative concerned with the idea of promoting the uptake of physical activity as a form of preventative therapy and prescriptive medicine for chronic diseases (Sallis, 2015). The EiM initiate is a relatively new approach that was established based on the partnership formed between the American Medical Association and the American College of Sports Medicine in 2007 (Jonas & Phillips, 2012). The concept was developed based on the assumption that mainstream medicine failed to acknowledge the importance associated with physical activity and that prescribing exercise had the potential of becoming a standard treatment-based method (Sallis, 2009).

As a result, the effect of exercise is often referred as a ‘magic pill’ which can be supplied by medical professionals, due to the apparent impact physical activity has upon various clinical health issues (Sallis, 2015). Based on these interpretations, both clinicians and health practitioners have been encouraged to prescribe exercise as a pharmacological alternative when tailoring interventions and treatment plans to combat noncommunicable diseases such as cardiovascular disease, cancer, hypertension and obesity (Pedersen & Saltin, 2015). Alongside prescribing exercise, medical professionals request patients to accept responsibility for their own well-being and acknowledge that they need to engage in more physical activity in order to achieve and maintain health (Berryman, 2010).

As a result, the EiM initiative may be the next advancement in modern medicine for health practitioners to implement as it would lessen the economic burden placed on health care budgets associated with prescriptive medication (Allender et al., 2007). Nonetheless, despite the movement of EiM, the initiative does possess certain drawbacks (Neville, 2013). A central issue concerned with the EiM initiative is that the notion of prescribing exercise reduces a patient’s autonomy. Prescribing exercise puts an increasing emphasis on an individual to exercise as a health obligation and promotes the sense that exercise is more of a social responsibility (Neville, 2013).

According to Entwistle et al. (2010), the aspect of autonomy is concerned with a patient’s freedom to make informed decisions concerning health care interventions they may receive. The concept that clinicians should provide options that would allow patients to make voluntary judgments concerning their well-being is undoubtedly important, as individuals are likely to be discouraged if unsolicited treatments are prescribed. A theoretical approach that may provide some clarity concerning the underlying theory related to physical activity adherence is Self-determination theory (SDT) proposed by Ryan and Deci (2000). SDT is concerned with the reasons as to why certain behaviours are performed, specifically concentrating on the degree to which an individual’s motivation to perform specific activities originates from either internal or external processes.

SDT places great emphasis on the idea that an individual’s well-being and autonomous motivation is manipulated as a result of three initiate psychological needs which consist of autonomy, competence, and relatedness. It is perceived that settings that are seeming supportive of autonomy ultimately lead to the greater satisfaction of these three innate needs, which fundamentally increase an individual’s autonomous motivation concerning physical activity. For example, research conducted by Edmunds et al. (2007) concluded that an individual’s autonomous motivation towards exercise leads to improvements related to adherence, as well as an individual’s overall well-being (Duda et al., 2014). In contrast, an individual’s ability to initiate exercise suffers significantly as a result of prescribing physical activity under the standard provisions (Kernis et al., 2000).

According to Ryan and Connell (1989), an individual’s sense of ownership to make informed decisions commences from an internally perceived locus of causality, which internalises an individual’s behaviour leading to greater adherence. However, if exercise is prescribed a patient’s autonomy is removed, which is likely to hinder an individual’s ability to internalise their behaviour as this decision is not from their own accord. As a result, prescribing exercise impacts both an individual’s intrinsic motivation and autonomy towards their treatment, ultimately obstructing their adherence towards physical activity. It is widely recognised that prescribing exercise is not as simple as taking a ‘pill’ and can be burdensome in comparison to mainstream medicine, as patients need to moderate their time effectively in order to accommodate for lifestyle changes.

The EiM initiative advertises that exercise is both a feasible and inexpensive method by which an individual can prevent and manage clinical health issues (Berryman, 2010). However, this is unfortunately not the case as opportunities to initiate physical activity are somewhat costly and can be relatively time consuming, which can have long-lasting effects on other social determinants such as the individuals personal and occupational commitments along with not having adequate access of equipment. As a result, prescribing exercise to patients will need to consider these social determinants as they are critical aspects which are likely to affect the individual’s time management skills. Therefore, exercise prescriptions need to take into account the individual’s autonomy in order to accommodate for these barriers, as this will enhance the patient’s ability to internalise their behaviour, which will enhance their adherence.

A further criticism concerned with EiM is that exercise fails to possess a definitive dose, as there are inconsistencies regarding the rate at which exercise should be prescribed. Research published by Pedersen and Salting (2015) evaluated the effects of exercise in 26 different chronic diseases in order to analyse the optimal dose-response. However, the doses applied throughout this review were received through a generic set of guidelines. As a result, this implies that prescribing exercise lacks individual specificity, suggesting that personalised prescriptions are required, and that advice must be tailored to each medical condition (van Dillen et al., 2013). Therefore, this notion follows the assumption that exercise is not suitable for all, implying that specific guidelines concerning physical activity levels need to be put in place. The idea of generally prescribing exercise is likely to have damaging effects and could deteriorate social determinants such as gender inequality.

According to Schutzer and Graves (2004) it is apparent that women are more susceptible to report barriers in relation to physical activity in comparison to males, with participation rates decreasing with age. It is evident that these barriers are associated with female gender roles that include responsibilities such as housework as well as child care, which contribute to reductions concerning physical activity. As a result, these responsibilities make it increasingly difficult for females to prioritise their health due to the requests and needs of their significant others. In addition, there are relatively few exercise interventions that are specifically tailored to women and address the specific barriers preventing them from initiating physical activity (Segar et al., 2002), which is likely to affect their self-efficacy. This notion can be clarified through Self-efficacy theory (SET) proposed by Bandura (1977), which concerns an individual’s degree of confidence to complete a task effectively. It is essential that if exercise is be considered as a pharmacological alternative, steps must be put in place in order to accommodate gender differences as well as address the potential barriers.

Through failing to prescribe exercise effectively this is likely to discourage patients from following their treatment, ultimately affecting an individual’s ability to initiate physical activity and implement a healthier lifestyle. As a result, through prescribing generalised prescriptions, females may be incapable of maintaining this treatment as a result of the barriers associated with their responsibilities, reducing their participation. Therefore, if exercise is to be categorised as a form of medicine, prescription must compensate for the potential barriers an individual may face as a result of this treatment. In comparison to medical aid, exercise requires an individual to maintain constant determination whereas medical prescription may only involve taking a single pill, which puts an increasing pressure on the individual to commit to their exercise program.

However, if exercise prescription is not specifically tailored to the individual, patients may experience low levels of self-efficacy as they may not be able to complete their treatment. Another criticism concerned with the EiM initiative is the absence of knowledge a patient may possess surrounding the valued outcomes of performing exercise. It is evident that the EiM initiative was originally established on the bases that being physically fit, will invariably lead to an individual becoming healthy. This implies that causality exists between the relation of fitness and health, and that fitness ultimately results in positive health outcomes.

However, according to an editorial published by Eijsvogels and Thompson (2015), it is suggested that despite the undeniable health benefits that arise from physical activity, a curvilinear relationship seems to exist between the dosage of exercise and its influence on health. It is suggested that higher doses of physical activity can be detrimental to an individual’s health and has been associated with increased risks of cardiovascular mortality (Williams & Thompson, 2014, Mons et al., 2014). In this regard, lacking knowledge concerning the therapeutic range in which medication should be prescribed can lead to damaging side effects, which can contribute to premature mortality (Compton et al., 2013, Jones, Lurie, & Woodcock, 2014).

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