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SIR MUIR GRAY: Putting your feet up when you're ill can make you worse!

The first person to visit me at the hospital when I woke up in the morning after a stent was placed in a coronary artery was not a doctor or nurse, but a fitness trainer.

Just 12 hours earlier, I’d had a heart attack, signaled by severe chest pain.

The trainer said I had booked a weekly exercise program in a fortnight, when the acute phase of my recovery would be over.

It started on time and lasted three months. I didn’t sweat for the first few weeks as I got harder and harder on the treadmill, but I did sweat before the three months were up.

The exercise—and the encouragement from other survivors—was great because it gave me back both the confidence and fitness that I lost in the two weeks I was housebound.

The first person to visit me at the hospital when I woke up in the morning after a stent was placed in a coronary artery was not a doctor or nurse, but a fitness trainer.  Just 12 hours earlier I had had a heart attack, signaled by severe chest pain

The first person to visit me at the hospital when I woke up in the morning after a stent was placed in a coronary artery was not a doctor or nurse, but a fitness trainer. Just 12 hours earlier I had had a heart attack, signaled by severe chest pain

The consultant who placed the stent also prescribed the exercise and helped me understand that fitness was even more important than before the heart attack – as it is for people with a chronic problem.

Exercise is literally a miracle treatment, with no side effects, only benefits.

Further evidence of the miraculous nature of exercise therapy was provided by my youngest daughter, who developed type 1 diabetes as a teenager and broke her spine in a skiing accident five years later.

She required surgery but suffered from severe post-operative pain and immobility, which exacerbated her diabetes problems.

Yet she treated her health problems in a gym, not a clinic, where the punch bag was more important than any drug.

Indeed, in 2015, the Academy of Medical Royal Colleges, the body that advises on standards of care and education in the UK, published a report with the unusually dramatic title Exercise: The Miracle Cure.

This summarized the evidence on the benefits of exercise for common physical and mental health problems, highlighting that the benefits outweigh the risks.

The consultant who placed the stent also prescribed the exercise and helped me understand that fitness was even more important than before the heart attack - as it is for people with a chronic problem [File photo]

The consultant who placed the stent also prescribed the exercise and helped me understand that fitness was even more important than before the heart attack - as it is for people with a chronic problem [File photo]

The consultant who placed the stent also prescribed the exercise and helped me understand that fitness was even more important than before the heart attack – as it is for people with a chronic problem [File photo]

For example, it said that for type 2 diabetes, “exercise has a statistically and clinically significant beneficial effect on” [blood sugar] check’. For arthritis, physical activity improves symptoms of osteoarthritis by 22 to 83 percent and does not worsen this condition. It has benefits in reducing pain, improving function, improving quality of life and mental health.”

For cancer, ‘exercise helps with side effects of treatment, improves mood, fatigue and stamina and probably extends life’.

Yet, despite very strong evidence of safety and effectiveness, this advice has not yet been passed on by the NHS.

Take, for example, a friend who happened to have a heart attack in the same week as me.

Because she had been admitted to a general medical ward and not a cardiology ward, she was told after having her stent placed that she ‘d better take it easy’. This left her depressed and in tears for days as she felt her life was over, although only in her fifties, as I got ready for my classes. Practice has healed her: we set her on the right path.

Exercise is still not generally promoted or prescribed by the NHS. Since the end of my three-month post-stent gym sessions, I have not received any encouragement or information about the need to exercise.

In contrast, I’ve had at least 1,000 inserts from all those boxes of pills I pick up at the pharmacy, detailing the benefits and side effects of my medication.

Of course people need more than just information about exercise. Many also need encouragement, coaching and support, and there are simply not enough doctors and physiotherapists to even meet the acute needs of the population. The vacancy rate for physiotherapists rises to 20 percent.

So how can exercise or activity therapy not only be recommended but also performed?

The answer is to hire personal trainers, many of whom are currently working in gyms with healthy young people. This group of professionals has knowledge of the human body and psychology and should be involved in health care.

To support them, there’s the wonderful We Are Undefeatable campaign run by 16 of the largest health and social care charities, supported by Sport England and the National Lottery.

Activity therapy could significantly reduce healthcare demand by preventing disease recurrence or by reversing or even curing people with long-term conditions such as depression, type 2 diabetes and high blood pressure. It would also reduce the need for social care by preventing or delaying the onset of frailty, disability and dementia.

Each place would have its own NHS Activity Therapy Service.

This revolution is already underway, and funding it will require shifting resources away from interventions that are ineffective — about 10 percent of all prescription drugs, according to a health ministry report on overprescribing. This wasted money amounts to about £1 billion a year.

It’s not just about reducing mortality to help people live longer, it’s about enabling people to live longer and better.

Sir Muir Gray is an NHS public health adviser and a professor of primary health care at the University of Oxford.

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