Debate: How should doctors prescribe exercise to ensure compliance and engagement?
How to Effectively Prescribe Exercise (Psychiatric Times):
Exercise can be a useful tool in managing symptoms of anxiety and depression. Learn how you can integrate exercise prescriptions into your treatment plans.
While most of us appreciate its importance, we also recognize that avoidance is exceedingly common. Too often patients hear the word exercise and develop an aversive reaction, as they anticipate that it involves intensive training reserved only for the athletically elite. So how can one simply and effectively counsel a patient on exercise to increase their chances of engagement?
After condensing the information in the literature and combing it with strategies for compliance, we feel it is possible to come up with sample exercise prescriptions. For example, a patient with low exercise tolerance and motivation could be prescribed 30 minutes of moderate walking … Since the mood benefits of exercise have often been shown to be intensity independent, it is more than possible to work within the patient’s exercise tolerance and physical limits.
In addition, it can be beneficial to discuss with patients the neurobiological changes seen during exercise that may contribute to elevation of mood and improved cognition…An exercise prescription is an important treatment option and a great adjunct to medications. The key is prescribing physical activity in a way that the patient will comply and remain engaged with.
Recent Study on Physical Activity, Neuroplasticity and Mood:
Therapeutic benefits of physical activity for mood: A systematic review on the effects of exercise intensity, duration, and modality (Journal of Psychology):
- Abstract: In contemporary society, people experience considerable stress in their daily lives. Therefore, developing effective approaches and convenient means to cope with their mood problems is important nowadays. Physical activity has been consistently reported as a cost-effective way to improve physical fitness, prevent mental illnesses, and alleviate mood problems. In this systematic review, the effects of exercise intensity, duration, and modality on mood change are discussed. Results show that moderate-intensity anaerobic exercise is associated with greater mood improvements. The relationship between exercise duration and mood change is non-linear; A regime of 10- to 30-minute exercise is sufficient for mood improvements. For exercise modality, anaerobic exercise improves mood, but the efficacy of aerobic and mindfulness-related exercises remains to be further examined. In addition to the systematic review of potential moderators, a narrative review of psychological and neurophysiological theories of exercise effects on mood is provided; we have highlighted the central role of neuroplasticity in integrating the two classes of theories. An adoption of neuroimaging techniques in future research is critical to reveal the mechanisms underpinning the therapeutic influence of physical activity on affective responses. Some future research directions are also raised.