Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions, 2021, Reid et al

In my view an active live is a symptom of good health.

And a reduced life, a symptom of reduced health.

Is there any evidence that pushing people to artificially display symptoms of good health, improves the underlying poor health?

Certainly not when I try do normal stuff without regard to my condition.
Nor when an alcoholic tries to drink socially without regard for his alcoholism.
Nor when a diabetic tries to eat as normal people do without taking insulin.

The list could go on.

So why push exercise (a symptom of good health) on those with reduced stamina (or any poor health)? Is that not just like asking a diabetic to ignore his dietary needs, or asking an alcoholic to ignore his alcoholism?
 
We challenge recommendations that individuals with stable LTCs require medical clearance before autonomously increasing their physical activity levels. We suggest that routine preparticipation screening in this group poses an unnecessary barrier to self-directed physical activity and engagement with the physical activity, sport and leisure sectors.
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So it's back to work for one-legged tightrope walkers.
 
Jonathan Edwards said:
I am not sure what services being overwhelmed would contribute. It doesn't seem a reason to encourage even more people attending physio sessions.
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I don’t think that that is a concern for anyone promoting this.

I doubt that the idea is for most
patients to see fully qualified professionals for Physiotherapy. Not in practice. Or if they do, this is likely to be a brief encounter. In a group perhaps. Offer of a couple of photocopy sheets with patchy illustrations of the exercises expected. Only where CCG feeling flush. More likely not. Instead an instruction to “Google”.

I expect the authors do indeed expect that there will be increased waiting lists for one on one time with a Physiotherapist. They may harbour some hope that this will serve to encourage further access for this particular department, to a larger share of overall increasingly scarce funding. That this direction of travel won’t result in a practice of side stepping of their services.

Still for most patients there will be ‘triage’ brief phone call or online questionnaire and directions for most straight on over to a commercial gym privatised community sports facility or to regularise having a walk in the park etc.

Something (propaganda?) to add grease to this process, is the above Study’s
recommendation to remove the requirement for medical clearance to exercise, where such a requirement currently exists.

Such medical clearance would if still in play slow this process right down. Especially with so many more GPs leaving practice than joining, can prove quite difficult to access their medical opinions.

Opportune moment to present discovery that so many patients do not need medical supervision after all. Phew pretty lucky.
 
Ash said:
I don’t think that that is a concern for anyone promoting this.

I doubt that the idea is for most
patients to see fully qualified professionals for Physiotherapy. Not in practice. Or if they do, this is likely to be a brief encounter. In a group perhaps. Offer of a couple of photocopy sheets with patchy illustrations of the exercises expected. Only where CCG feeling flush. More likely not. Instead an instruction to “Google”.
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In the blurb about the recent petition on creating a mechanism for reporting harms from psycho behavioural interventions the petition author said:

Given that many Long Covid patients now also have the key defining characteristic of M.E - Post Exertion Malaise and are being referred by GPs for exercise 'rehab' programmes in leisure centres and gyms, there is a very clear need for a mechanism to report harms from exercise. Most Physiotherapists do not know how to screen for PEM, it is highly doubtful that gym instructors know how to screen for it when it is not included in any Physiology handbooks.

see https://www.change.org/p/department...-9ba2-06a633f298f3?source_location=topic_page
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Sending people off to general exercise classes and to personal trainers would seem to be a logical conclusion from this article as it is in effect saying ‘now we unambiguously known that exercising whilst experiencing significant long term health problems is always good and never harmful, and if you experience any adverse responses just push on and ignore them’.

The chances are the casual reader, perhaps already a true believer, will ignore the half hearted small print warning about ME and Long Covid, and certainly risks taking on board that a mistaken belief that exercise for many other conditions, even where the wrong form or level exercise may be harmful, is a universal panacea.
 
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