Exercises Focus in Europe, Asia Week Passes Over Patients

Exercises emphasize clinical, institutional and community care settings, according to a research review published in BMC Public Health and SportsHealth. Exercise choices are important to patients, clinicians, policymakers and healthcare professionals and are needed to help achieve discharge as efficiently as possible, the authors say.

Sleep, exercise and rest were associated with better care of patients in hospitals across Europe, suggests the research presented at the European Congress on Sports Medicine and Exercise (ECSPM) in Munich, Germany.

•“We are no strangers to analyzing the quality of medical care. Our findings are particularly relevant following recent health care reform in North America,” said lead author Dr. Eric Chappell, MD, chief of the Sports Medicine and Exercise Disorders Unit at BIDMC.Chappell, a cardiologist and sleep medicine specialist at BIDMC, told Medscape Medical News that the present analysis “took into account the full range of clinically relevant exercise interventions people might encounter during their regular care and lifestyle”.Thus, he says, the results are generalizable to all countries of Europe, Australia and the U.S. After accounting for appropriate schedules and appropriate intensity of exercise, the analysis concludes that in the short term, “exercise for most Europeans and particularly in the European countries, is either not or rarely recommended for management of pain based on need, duration and mobility status.”

The potential impact that requires prompt evaluation of patients with end stage chronic pain and their caregivers, he says, is “not clear.” But, he adds, psychological, social and cognitive benefits of exercise are critical to patients dependent on pain medication and their caregivers. Exercise may also help with mental and physical functioning, so further heightened monitoring may be needed.

About 1 in 4 adults in the U.S. will have chronic pain, and about 15 percent of chronic pain patients will need emergency department treatment annually. In Europe and the U.S., the prevalence of chronic pain is 33 percent.

Chappell and researchers analyzed data from ended-point studies which used data collected from 2002 to 2017, for an average of 55 000 patients. Across all regions in the world, the proportion of chronic pain patients who were performing ≥3 hours of exercise has increased from 2.8 percent in 2002 to 10.7 percent in 2017 (P less than .001). The mean age of these patients was 55 years for Europeans, 57 years for Americans and 65 years for Asians, rounded to the nearest several months.

Patient demographics included gender, race (white, African-American, and Hispanic), body mass index and chronic pain status. Exemplar evidence of exercise-related changes in outcomes reported by patients ranged from a 12 percent increase in Oswestry scores after only moderate light intensity exercise (swimming) to significant changes in perceived pain over time.

Sixteen percent of the patients in the analyzed study population were misclassified as sedentary for the specified duration of their follow-up period, and if misclassification, prevalence of chronic pain was 16.3 percent in end point studies, which indicates that about 17 percent of chronic pain patients had fulfilled the criteria for clinical end point studies, and 49 percent of those patients (P less than .001) had lost ≥1 percent of ≥5 percent of ≥10 percent of ≥10 percent of ≥15 percent of ≥15 percent of ≥10 percent of >10 percent of >30 percent of >10 percent of lame.

One limitation of the analysis was the relatively short term efficacy of exercise interventions seen in end point 2, whereas outcome assessments in end point 3, 4, and 7 were collected after one and 15 years (Table 1).

Asymptomatic users, plateau and strong exercise, and pale, stop short physical performance or isometric exercise, were assessed in 44