Have you ever wondered how exercise can improve a chronic condition? Maybe you have. Maybe not. There is reason now more than ever before to be concerned about the rising cases of chronic diseases.

According to the World health organization report 2018, It is estimated that 30% of Kenyans who are currently over the age of 65 have at least two chronic diseases. Chronic diseases are among the most common and costly health problems in Kenya. Their complications may be prevented and controlled through appropriate healthcare strategies.

Kenya’s health systems are yet to adapt to the challenge posed by chronic illnesses. Where Kenya has scored well in controlling diseases like AIDS and other infectious diseases, it has been almost blind to the rising cases of diseases such as diabetes, heart disease, cancer among others.

The death toll from chronic diseases could equal that of infectious diseases, maternal and newborn death, and malnutrition combined by 2030 according to WHO. Facilities that offer healthcare services are yet to be equipped to be able to diagnose and treat chronic illnesses effectively.

Can exercise improve chronic conditions?

Exercise is medicine – and not just preventive medicine. For many conditions – including cardiovascular disease, diabetes and mild-to-moderate depression – exercise can be as effective a treatment as some types of medications.  

“Exercise is very beneficial for people with chronic conditions,” says Esther Ngesa, a registered physiotherapist at Cardiovascular Health department at Moi Teaching and Referral Hospital.

“At present, most disease guidelines presently have exercise as a component of their treatment.”

Research has shown the benefits of exercise for managing chronic conditions:

• Exercise is a pillar of cardiovascular rehabilitation, which reduces the risk of death or future heart attack. It’s now recommended for all patients after a heart attack or other cardiovascular event.
• Exercise helps people with diabetes and pre-diabetes manage their blood sugar levels, among other benefits.
• Regular exercise is effective in managing anxiety and mild-to-moderate depression, and in preventing recurrences.
• Exercise is recommended for people with musculoskeletal conditions such as osteoporosis and osteoarthritis.

“It’s really important that people get exercise in their lifestyle no matter what their chronic condition is,” Ngesa says.

Some people with chronic conditions may need individual instructions or supervised programs to begin an exercise routine safely. That’s one of the advantages of cardiac rehab: it’s a specialized, supervised program for people with heart disease. People with other conditions – such as osteoarthritis – may feel they can’t exercise because of pain. However, the right exercise program can actually help manage pain, which in turn improves things like mobility and independence.

“At Cardiovascular Health department, we have a lot of people who come because of a heart condition, but also have underlying musculoskeletal issues such as arthritis or osteoporosis,” Ngesa says. “After they’ve been doing regular exercise over time, they start to see the benefits in those areas as well as their heart health.”

It’s understandable for people with a chronic condition to have concerns about physical activity, but Ngesa stresses the importance of seeing exercise as part of a treatment plan, rather than a potential risk.

“I get a lot of questions from people who are worried about exercise: worried about the right amount of exercise, worried about getting injured, worried something might be too strenuous on their heart,” she says. “I tell them they’re actually doing more harm to themselves by not exercising. That’s how important it is to get some type of healthy exercise into your lifestyle.”

The beneficial role of exercise in chronic disease management is well recognized, but the challenge of effective exercise prescription within primary care persists. Initiatives requesting clinicians to prescribe specific exercises to their patients has left two underlying questions; Who is the most appropriate clinician to prescribe exercise to meet the unique needs of individuals living with more than one disease; How does this clinician ensure appropriate and safe exercise prescriptions are provided?

According to  Dr Lelei, a physiotherapist from Moi teaching and referral hospital, three studies were completed to begin addressing the aforementioned questions. A nationally distributed survey compared exercise curricula between physiotherapy, nursing, and medical programs, while a systematic literature review showed overlapping physiological and subjective markers that clinicians may use to define safe exercises for individuals living with multiple chronic diseases.

The bottom line is, exercise is the pill that your doctor prescribed. Take it without fail.