Free Nursing Dissertations - Specific Consideration Of The Evidence Base Can Point To Evidence Of The
Specific consideration of the evidence base can point to evidence of the specific physiological benefits to be gained by regular exercise. If we look at the AHA paper (1996), it shows us that there is hard evidence of physiological improvement in many of the physiological parameters following an adaptive period of regular exercise. A critical reviewer would have to comment that the exercise undertaken by the subjects studies was rather greater than the 30 mins. brisk walking suggested by the Government, but as an evidence base, the findings are valid and probably capable of extrapolation to lesser degrees of exercise. The adaptive changes that were identified in the paper included:-
Increase in maximum oxygen uptake (VO2 max)
Higher cardiac stroke volume
Lower resting heart rate
Beneficial changes in skeletal muscle allowing for more efficient supply of oxygen
increased capillary density
increased myoglobin content
increased oxidative enzyme capacity
Age-related changes in cardiovascular function
Left ventricular function
The risk of death in older people
It is also important to appreciate that apart from these comparatively obvious cause and effect changes from exercise, there are other health related benefits to be had from exercise. Exercise will help to reduce obesity. (AHA 1999).
Successful control of obesity, together with regular exercise, will reduce the lifetime risk of developing Type II diabetes mellitus to almost zero (Kujala UM et al 1998). It can also have the effect of improving lung function and also to reduce the overall incidence of a number of pulmonary diseases (Allied Dunbar 2000)
There are some (limited) studies that suggest that there may also be a reduction in the rates of some types of cancer that are related to regular exercise (Hakim A et al 1998)
Analysis and conclusions
From this limited review we can show that the concepts that underpin the Government White Paper Choosing Health: Making Healthier choices easier" are firmly evidence based.
With regard to the author’s work in the primary healthcare team as a community nurse, this evidence base may be entirely exemplary but it does not take account of the practical difficulties of apathy and general lack of persistent enthusiasm that are encountered when some health promotion activities are undertaken on a community level. (Berwick D. 1996)
The author has been active in trying to set up and run a Healthy Walks Scheme in order to encourage the public to try to make a positive change and to improve their health generally. Despite a great deal of publicity and promotional activities, one has to be despondent at the general lack of enthusiasm to actually get up and to walk on a regular basis. (To the client: obviously I am guessing here and you may choose to modify this).
Dissertations - Free Nursing Dissertations
