Contemporary health challenges. How can physiotherapy have an impact

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Presentation transcript:

Contemporary health challenges. How can physiotherapy have an impact Contemporary health challenges. How can physiotherapy have an impact? Obesity and physical inactivity Dominique Hansen, PhD, FESC Hasselt University, Faculty of Medicine and Life Sciences, Hasselt, Belgium Heart Centre Hasselt, Hasselt, Belgium

Obesity epidemic

Obesity epidemic

Obesity epidemic

Obesity epidemic

We are currently failing to suppress the obesity epidemic

Physical inactivity epidemic European Opinion Research Group: Eurobarometer Report 2014

Relation obesity – physical (in)activity

What is the role of the European physiotherapist? The European physiotherapist plays a crucial role! They are experts in exercise training in obesity: Knowledge of exercise physiology Knowledge of pathology/pathophysiology Knowledge of pharmacotherapy Knowledge of how to approach patients

Importance of exercise should not be underestimated Ross R, et al J Appl Physiol 1996; 81: 2445-55 Larson-Meyer DE, et al. Med Sci Sports Exerc 2010; 42: 152 Myers J. et al. N Engl J Med 2002; 346:793-801. Artero EG, et al. J Am Coll Cardiol. 2011; 57:1831-1837

Importance of exercise should not be underestimated Physiotherapy for obese individuals is not only about body weight or adipose tissue mass It goes much further: explain so to patients and allied healthcare professionals Physiotherapy is highly effective in ‘internal diseases’ Does the term ‘cardiorespiratory physiotherapy’ cover all our competences?

Assess for co-morbidities in our patients

Exercise must be prescribed correct Exercise training at low intensity To accelerate fat mass loss Exercise training in fasted state Local strength training To induce local fat mass loss Exercise should last >45 min Threshold for better fat mobilisation Maximize caloric expenditure Monitor what happens AFTER exercise Stimulation of daily physical activity Prevention of compensations in diet Generate permanent lifestyle change

Exercise must be prescribed correct Different exercise physiology Chronotropic incompetence HR – workload relation is altered Endocrine abnormalities Leading to lowered fat mobilisation Changes in muscle phenotype Lowered type 1 fibre % Ventilatory abnormalities Lowered tidal volumes Be aware of sarcopenic obesity in some patients! Elevated risk for orthopaedic injuries

Lifelong learning Hansen D, Exercise therapy in adult individuals with obesity, New York, 2014, Nova Science Publishers

Change in current practice PROLONGED PROGRAMME From one-on-one in-practice exercise LIMITED PROGRAMME DURATION …to mentoring, coaching and re-assessing

Change in current practice START AT YOUNGER AGE

How to apply clinical guidelines in first-line practices?

Contact: Dominique.hansen@uhasselt.be