Principles of Exercise for Patients with Chronic Diseases

Principles of Exercise for Patients with Chronic Diseases

Principle of Focusing on Aerobic Exercise

Although the causes of various chronic diseases differ significantly, the lack of physical activity has been proven to be an independent contributing factor to many chronic diseases. The Western countries first advocated the concept of "exercise is medicine" or "exercise is a remedy," based on the fact that fitness exercises can prevent and treat various chronic diseases.

During physical activity, multiple organ systems such as the nervous and muscular systems work in coordination, which requires energy consumption, much like a car needs various components to burn gasoline or use batteries to operate. The energy required for human movement comes from three sources: the rapid breakdown of phosphocreatine stored in muscle tissue, anaerobic glycolysis of glucose (a special form of biochemical reaction that produces lactate and heat), and aerobic oxidation of carbohydrates, fats, and proteins. Protein oxidation for energy supply only occurs under extreme conditions, such as extreme overload exercise, adverse environments, or certain disease states. In general fitness exercises, the energy needed by the body is supplied by aerobic oxidation of carbohydrates and fats, while the anaerobic glycolysis system is only used during high-intensity exercises. For example, in situations like 100-meter and 400-meter races, fast-paced cycling competitions, Boxing, etc., the body relies on anaerobic oxidation for energy production under stress. In other words, the body uses anaerobic energy supply only when subjected to stress. The normal energy supply form is aerobic oxidation, which is the most crucial biochemical reaction in the body's metabolic process. Many chronic diseases are currently associated with abnormal aerobic oxidation processes in the human body. Therefore, aerobic exercise can effectively consume carbohydrates and fats as energy sources, promote an active metabolic process, and ensure the normal functioning of the body's aerobic oxidation reactions.

As many chronic diseases are related to the imbalance of "diet and exercise," increasing energy expenditure in chronic disease patients and stimulating the normal functioning of the body's aerobic oxidation system undoubtedly play a crucial role in their rehabilitation. A considerable amount of evidence proves that long-term, low-intensity aerobic exercise is most effective for the normal functioning of the cardiovascular system and energy metabolism. It is an effective "remedy" for preventing various chronic diseases. Similarly, for those already suffering from certain chronic diseases, low-intensity, long-duration aerobic exercise not only ensures the safety of the patients' fitness exercises but also serves as an effective means to enhance their overall physical functions, delay disease progression, and achieve recovery. Therefore, various forms of aerobic exercise are the first-choice activities for fitness exercise in chronic disease patients.

Principle of Gradual Progression

People often ask what type of exercise is most effective for weight loss, basketball, or swimming? The answer is that any exercise can effectively reduce body weight if certain factors are considered: First, the exercise load must be reasonable, and second, it must be consistent. This principle also applies to the treatment and rehabilitation of any chronic disease. Physical exercises have a slow and gradual impact on the body's internal environment and functions. The process involves the self-organizing enhancement of bodily functions through exercise stimulation, and it cannot happen overnight. Although this principle may seem simple, not many people truly practice the perseverance required in exercise rehabilitation and treatment.

Another reason for the importance of perseverance is that the positive effects of exercise on the body will diminish shortly after the exercise is discontinued. If one cannot maintain consistency, the initial effects of exercise will quickly fade away. On the contrary, consistent exercise will make the body's metabolism and energy supply during physical activities a habitual process. This means that under certain exercise loads, the body will preferentially use a specific energy system, depending on the "metabolic habits" formed by the body during long-term exercise. Only through long-term exercise can this effect be achieved.

The principle of gradual progression means that during the process of exercise treatment and rehabilitation, both the intensity and quantity of exercise should be continuously adjusted and gradually increased. As mentioned earlier, long-duration, low-intensity aerobic exercise targets exercise load. The terms "long-duration" and "low-intensity" are relative concepts, and their specific values depend on the individual's physical condition. After exercising at a certain intensity for a period, the intensity may become relatively low for the individual because their exercise capacity has improved. In such cases, the exercise intensity needs to be increased to meet the body's new demands. After a certain period of exercise, the exercise load can be fixed within a certain range to maintain the body's functional level. At this functional level, the exercise load should be adjusted accordingly with changes in the seasons, climate, and the individual's physical condition, allowing for flexibility in planning.

Principle of Combining Leisure and Entertainment

Many people tend to approach exercise in a utilitarian way, but this approach is strongly discouraged in this book. The utilitarian approach to exercise means placing excessive emphasis on the health and therapeutic benefits of exercise, even viewing exercise as a cure-all, similar to medication, and considering it the most important activity in life. This attitude often makes exercisers view physical activity as a task or even a source of stress. For instance, some elderly individuals, after retiring, set their alarms to wake up at the crack of dawn and attend exercise sessions promptly, creating unnecessary tension for themselves. Such an approach is detrimental to health and can increase mental stress. Moreover, it is essential to choose a time for exercise that feels relaxed and leisurely, rather than forcing oneself to wake up and exercise punctually. Exercising early in the morning is not necessarily a good thing. Many studies in exercise physiology have confirmed that early exercise is not beneficial to health because when the body transitions from a state of sleep to exercise, there needs to be an adaptation process for the functions of various organs and systems. Otherwise, it may be harmful to the health of certain organs and systems, especially the cardiovascular system. There have been many instances of accidents during morning exercises. People can't help but wonder, is exercise good or bad? In fact, scientific exercise can promote health, while unscientific exercise can cause harm and even dangerous consequences.

Therefore, exercise, especially therapeutic and rehabilitation exercises, should be considered as a means of leisure and entertainment. It should increase physical activity in a relaxed and enjoyable state, benefiting the body, mind, and spirit. For this, several external conditions should be considered when engaging in exercise: First, choose the most relaxed and leisurely time, taking into account the weather, sunlight, air quality, etc., during that time. For example, many exercise physiology experts emphasize that the best exercise time is between 3 p.m. and 5 p.m. because, during this period, there is usually sufficient sunlight and relatively weak ultraviolet rays. In most seasons, this time also has the most suitable temperature of the day. Additionally, the air quality during 3 p.m. to 5 p.m. is relatively good. With various means of transportation stirring up dust throughout the day, the dust begins to settle in the evening. In the early morning, this settling process has not yet finished, and although the air feels fresher in the morning due to the lower temperature, it is not actually so. Secondly, for exercise, one can choose group activities and good exercise companions, combining exercise with social interactions. During exercise, individuals can communicate mentally, emotionally, and exchange information with others, turning exercise into both physical activity and entertainment. Thirdly, during exercise, it is essential to control the exercise load to ensure that the exerciser always feels relaxed and pleasant. For exercise, it is not a case of "overload" leading to "excess recovery."

Principle of Not Completely Replacing Medication

For some patients with chronic diseases, exercise cannot completely replace medication, but it can assist in promoting recovery. Some chronic disease patients have been taking medication for many years, which not only entails a considerable financial burden but also constantly reminds them of their patient status every time they take medication, resulting in additional psychological pressure. Nowadays, certain fitness and qigong organizations promote their exercise activities as a way to relieve patients from the burden of daily medication, claiming that practitioners can completely recover to their pre-illness state. However, this kind of promotion is irresponsible. In many cases, chronic disease patients need to take medication for life, such as some diabetes and hypertension patients. Stopping medication can be dangerous for them. Exercise can achieve complete recovery for certain degrees of illness, while for some diseases, it can only promote recovery or maintain the patient's good condition and slow down the progression of the disease.

Scientific exercise has a broad and profound impact on the health of patients with chronic diseases. Patients can actively engage in exercise on the basis of medication treatment, allowing exercise and medication to complement each other, improve bodily functions, gradually reduce the patient's dependence on medication, and enter a virtuous cycle of bodily activities. From this perspective, many chronic diseases can achieve complete recovery through appropriate exercise, but this requires individualized approaches based on specific diseases and patients.