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Exercise is Medicine (EIM) is a nonprofit initiative co-launched on November 5, 2007, by the American College of Sports Medicine and the American Medical Association, with support from the Office of the Surgeon General and the 18th Surgeon General Regina Benjamin.
The Exercise is Medicine (EIM) initiative calls for physical activity to be included as a standard part of medical treatment and the patient care process. [1] EIM urges healthcare providers to assess the physical activity levels of their patients at every visit, provide physically inactive patients with brief counseling, and 'write' a basic exercise prescription. Before leaving the clinic setting, inactive patients should also receive a referral to available physical activity resources in the community to assist with becoming more physically active. EIM should be differentiated from Exercise Medicine, which is a medical specialty that exists in some countries, as part of Sport & Exercise Medicine.[ citation needed ]
EIM was started by American College of Sports Medicine President Robert E. Sallis, MD, FACSM in 2007, who has continued to serve as the chair of the EIM initiative since its inception. Under the guidance of Dr. Sallis and the EIM advisory board, Adrian Hutber, PhD, served as the first vice president and has overseen the global development of the initiative over its first decade of existence. From 2007-2017, EIM grew into a "global health" initiative with a presence in more than 40 countries worldwide. The initial five years of the initiative focused on increasing global awareness that "exercise is good medicine". [2] More recently, efforts have shifted toward the strategic implementation of the EIM Solution in healthcare systems.[ citation needed ]
The Exercise is Medicine Solution is the practical implementation of EIM in a health system. [3] The EIM Solution is designed as a simple, brief four-step process that can be carried out in the clinical setting in under five minutes by the entire healthcare team.
1. The first step, and initiator, of the EIM Solution, is the systematic assessment of every patient's physical activity levels. [4] The Physical Activity Vital Sign is an evidence- and practice-based tool consisting of two questions to determine whether the patient is meeting the established physical activity guidelines. This tool for assessing patient physical activity levels has been successfully integrated into several healthcare systems including the Kaiser Permanente health systems of Northern [5] and Southern [6] California, as well as in Intermountain Health. [7]
2. The second step is to provide brief advice or counseling regarding the importance of regular physical activity, specifically relevant to that patient's medical history and situation. Several physical activity counseling models have been shown to be effective in increasing patient physical activity levels including the "5As" (Ask, Advise, Agree, Assist, Arrange), [8] [9] motivational interviewing, [10] and the use of the transtheoretical model. [11]
3. The third step of the EIM Solution is to provide eligible patients (i.e., patients who are not completing 150 minutes of moderate to vigorous aerobic activity in a week) with a basic physical activity prescription, depending on the health, fitness level, and preferences of the patient. Prescriptions can be given out in a number of different formats including exercise prescriptions entered into the electronic health record and provided to the patient in the after-visit summary paperwork or a pad (a format patients are familiar with in receiving prescriptions for medications). [12] The first major exercise prescription program was the Green Prescription started by the Sport and Recreation New Zealand in 1998. [13]
4. The final, and perhaps most crucial, component of the EIM Solution is ensuring that all eligible patients receive a physical activity referral to supportive resources to assist them in engaging in greater physical activity levels. [14] Patients may be referred to existing physical activity resources within a health system (i.e., wellness programs, cardiac rehabilitation programs, physical therapy), self-directed programs (i.e., walking programs, smartphone apps), or community-based resources. Within the community setting, all physical activity places (i.e., YMCA centers, Jewish Community Centers, and other community fitness centers), and exercise professionals should be considered for inclusion in a physical activity network.[ citation needed ]
Over its first decade of existence, EIM has expanded to include partners in more than 40 countries. The EIM Global Health Network consists of EIM Regional Centers in Chile (EIM Latin America), Germany (EIM Europe), and Singapore (EIM Southeast Asia) that help oversee the expansion and development of the initiative in their respective regions.[ citation needed ]
To establish an EIM National Center, national leaders in a country are required to enlist the support of a national primary care organization, a national sports medicine and/or exercise science organization, as well as a leading academic institution. It is also strongly encouraged that the National Ministry of Health is invited to participate as a part of the National Center. The National Center is hosted by a national institution (an academic institution, health organization, or other non-profit organization) under the direction of a National Center Director, acting on behalf of the National Center Advisory Board.[ citation needed ]
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient education, physical intervention, rehabilitation, disease prevention, and health promotion. Physical therapists are known as physiotherapists in many countries.
In common usage and medicine, health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity". A variety of definitions have been used for different purposes over time. Health can be promoted by encouraging healthful activities, such as regular physical exercise and adequate sleep, and by reducing or avoiding unhealthful activities or situations, such as smoking or excessive stress. Some factors affecting health are due to individual choices, such as whether to engage in a high-risk behavior, while others are due to structural causes, such as whether the society is arranged in a way that makes it easier or harder for people to get necessary healthcare services. Still, other factors are beyond both individual and group choices, such as genetic disorders.
Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of the elderly. The term geriatrics originates from the Greek γέρων geron meaning "old man", and ιατρός iatros meaning "healer". It aims to promote health by preventing, diagnosing and treating disease in older adults. There is no defined age at which patients may be under the care of a geriatrician, or geriatric physician, a physician who specializes in the care of older people. Rather, this decision is guided by individual patient need and the caregiving structures available to them. This care may benefit those who are managing multiple chronic conditions or experiencing significant age-related complications that threaten quality of daily life. Geriatric care may be indicated if caregiving responsibilities become increasingly stressful or medically complex for family and caregivers to manage independently.
Preventive healthcare, or prophylaxis, is the application of healthcare measures to prevent diseases. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes that begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.
In the healthcare industry, pay for performance (P4P), also known as "value-based purchasing", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for performance systems usually evaluate process quality and efficiency, such as measuring blood pressure, lowering blood pressure, or counseling patients to stop smoking. This model also penalizes health care providers for poor outcomes, medical errors, or increased costs. Integrated delivery systems where insurers and providers share in the cost are intended to help align incentives for value-based care.
A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include diabetes, functional gastrointestinal disorder, eczema, arthritis, asthma, chronic obstructive pulmonary disease, autoimmune diseases, genetic disorders and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome. An illness which is lifelong because it ends in death is a terminal illness. It is possible and not unexpected for an illness to change in definition from terminal to chronic. Diabetes and HIV for example were once terminal yet are now considered chronic due to the availability of insulin for diabetics and daily drug treatment for individuals with HIV which allow these individuals to live while managing symptoms.
Self-care has been defined as the process of establishing behaviors to ensure holistic well-being of oneself, to promote health, and actively manage illness when it occurs. Individuals engage in some form of self-care daily with food choices, exercise, sleep, reading and dental care. Self-care is not only a solo activity as the community—a group that supports the person performing self-care—overall plays a large role in access to, implementation of, and success of self-care activities.
Adolescent medicine also known as adolescent and young adult medicine is a medical subspecialty that focuses on care of patients who are in the adolescent period of development. This period begins at puberty and lasts until growth has stopped, at which time adulthood begins. Typically, patients in this age range will be in the last years of middle school up until college graduation. In developed nations, the psychosocial period of adolescence is extended both by an earlier start, as the onset of puberty begins earlier, and a later end, as patients require more years of education or training before they reach economic independence from their parents.
Health literacy is the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment. There are multiple definitions of health literacy, in part, because health literacy involves both the context in which health literacy demands are made and the skills that people bring to that situation.
Frailty is a common geriatric syndrome that embodies an elevated risk of catastrophic declines in health and function among older adults. Frailty is a condition associated with ageing, and it has been recognized for centuries. It is a marker of a more widespread syndrome of frailty, with associated weakness, slowing, decreased energy, lower activity, and, when severe, unintended weight loss. As a frequent clinical syndrome in the elderly, various health risks are linked to health deterioration and frailty in older age, such as falls, disability, hospitalization, and mortality. Generally, frailty refers to older adults who lose independence. It also links to the experiences of losing dignity due to social and emotional isolation risk. Frailty has been identified as a risk factor for the development of dementia.
Patient education is a planned interactive learning process designed to support and enable expert patients to manage their life with a disease and/or optimise their health and well-being.
Lifestyle medicine (LM) is a branch of medicine focused on preventive healthcare and self-care dealing with prevention, research, education, and treatment of disorders caused by lifestyle factors and preventable causes of death such as nutrition, physical inactivity, chronic stress, and self-destructive behaviors including the consumption of tobacco products and drug or alcohol abuse. The goal of LM is to improve individuals' health and wellbeing by applying the 6 pillars of lifestyle medicine (nutrition, regular physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connection) to prevent chronic conditions such as cardiovascular diseases, diabetes, metabolic syndrome and obesity. By focusing on these 6 areas to improve health, LM can prevent 80% of chronic illnesses and non-communicable diseases (NCD).
Pulmonary rehabilitation, also known as respiratory rehabilitation, is an important part of the management and health maintenance of people with chronic respiratory disease who remain symptomatic or continue to have decreased function despite standard medical treatment. It is a broad therapeutic concept. It is defined by the American Thoracic Society and the European Respiratory Society as an evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities. In general, pulmonary rehabilitation refers to a series of services that are administered to patients of respiratory disease and their families, typically to attempt to improve the quality of life for the patient. Pulmonary rehabilitation may be carried out in a variety of settings, depending on the patient's needs, and may or may not include pharmacologic intervention.
Exercise prescription commonly refers to the specific plan of fitness-related activities that are designed for a specified purpose, which is often developed by a fitness or rehabilitation, or Exercise medicine specialist for the client or patient. Due to the specific and unique needs and interests of the client/patient, the goal of exercise prescription should focus on motivation and customization, thus making achieving goals more likely to become successful. Exercise prescription should take into account the patient's medical history, and a pre-examination of a patient's physical fitness to make sure a person has the capacity to perform the exercises.
Chronic fatigue syndrome (CFS), also called myalgic encephalomyelitis (ME) or ME/CFS, is a complex, debilitating, long-term medical condition. Core symptoms are lengthy flare-ups of the illness following ordinary minor physical or mental activity, known as post-exertional malaise (PEM); greatly diminished capacity to do tasks that were routine before the illness; and sleep disturbances. The Center for Disease Control and Prevention's (CDC) diagnostic criteria also require at least one of the following: (1) orthostatic intolerance or (2) impaired memory or attention. Frequently and variably, other symptoms occur involving numerous body systems, and chronic pain is very common. The often incapacitating fatigue in ME/CFS is different from that caused by normal strenuous exertion, is not significantly relieved by rest, and is not due to a previous medical condition. Diagnosis is based on the person's symptoms because no confirmed diagnostic test is available.
Digital health is a discipline that includes digital care programs, technologies with health, healthcare, living, and society to enhance the efficiency of healthcare delivery and to make medicine more personalized and precise. It uses information and communication technologies to facilitate understanding of health problems and challenges faced by people receiving medical treatment and social prescribing in more personalised and precise ways. The definitions of digital health and its remits overlap in many ways with those of health and medical informatics.
Cultural competence in healthcare refers to the ability for healthcare professionals to demonstrate cultural competence toward patients with diverse values, beliefs, and feelings. This process includes consideration of the individual social, cultural, and psychological needs of patients for effective cross-cultural communication with their health care providers. The goal of cultural competence in health care is to reduce health disparities and to provide optimal care to patients regardless of their race, gender, ethnic background, native languages spoken, and religious or cultural beliefs. Cultural competency training is important in health care fields where human interaction is common, including medicine, nursing, allied health, mental health, social work, pharmacy, oral health, and public health fields.
The taxonomy of the burden of treatment is a visualization created for health care professionals to better comprehend the obstacles that interfere with a patient's health care plan. It was created as a result of a worldwide, qualitative-based study that asked adults with chronic conditions to list the personal, environmental, and financial barriers that burden a patient. The purpose of this visualization is to help health care providers develop personalized management strategies that the patient can follow through a narrative paradigm. The goal is to target interventions, achieve an interpersonal doctor-patient relationship, and improve health outcomes.
Idiopathic chronic fatigue (ICF) or chronic idiopathic fatigue or insufficient/idiopathic fatigue is characterized by unexplained fatigue that lasts at least six consecutive months. which does not meet the criteria for chronic fatigue syndrome. It is widely understood to have a profound effect on the lives of patients who experience it.
Exercise medicine is a branch of medicine that deals with physical fitness and the prevention and treatment of injuries and illness with exercise. In some countries, Sport and Exercise Medicine (SEM) is a recognized medical specialty. Exercise medicine is therefore an emerging physician (non-surgical) specialty, but there is also a belief that exercise is treatment of such fundamental benefit that it should be incorporated into all medical specialties. Allied health practitioners also can specialize in exercise such as exercise physiologists, physiotherapists, athletic trainers and podiatrists.