Sport and Exercise Medicine: The UK trainee perspective (A BJSM blog series)

By Dr Catherine Lester

This was the first education day of its kind and masterminded by SEM consultant Dr Kate Hutchings. The course covered a wide variety of topics in a subject often poorly taught, both in undergraduate and postgraduate training.

Tutors included several SEM practitioners, exercise physiologists, a PhD health economics research fellow and the director of British Nordic walking.

The day consisted of thirteen sessions. It is difficult to summarise the day’s events in a single blog. However, personal highlights included:

• Mr Gould’s research, within the Leicester Kidney Exercise Team, which has shown promising clinical results and had excellent demonstrations of Dialysis patients on custom made cycles during their dialysis sessions.
• Ms Ann Gates, Founder and Director of Exercise Works, who discussed ‘The Paradigm Shift in Physical Activity Interventions’ and;
• Dr John Buckley who encouraged the attendees to “practice what we preach” and made us stand for the second half of his presentation on physical activity (PA) in CVD rehabilitation. The day concluded with high quality research presented by Dr Pascale Kippelen on Exercise in Asthma.

Keeping to the theme of exercise and strength training, I have organised the key elements of the day’s education into 3 sets of 4 reps:

Set 1: 4 Numbers

1. 0% – The number of 65+ year old women meeting modest PA recommendations (The Health survey for England 2008)
2. 12 weeks– The number of weeks that funding is provided for exercise prescription. Imagine prescribing a proven life changing medication for a chronic condition and then removing it after 3 months.
3. 58% of men and 78% of women, by age 74, can’t walk 30min or more (BHF 2012 statistics)
4. 672,973 the number of daily clinical opportunities to encourage PA in the NHS

Set 2: 4 Great Resources and References

1. Let’s get moving: commissioning guidance
2. Exercise works
3. Generation games 
4. The Cochrane meta-analyses: Physical training for Asthma [1]

Set 3: 4 Take Home Points for myself

1. Apply the brief intervention to every consult
2. Exercise as the 5th ‘vital sign’ [2]
3. Inactivity and obesity trigger persistent, low-grade systemic inflammation [3]
4. I am NOT naturally proficient at Nordic Walking, despite excellent tutoring.

I would highly recommend the course to those interested in exercise medicine and PA.

References 

[1] Carson KV, Chandratilleke MG, Picot J, Brinn MP, Esterman AJ, Smith BJ. Physical training for asthma. Cochrane Database Syst Rev. 2013;9:CD001116.

[2] Sallis R. Developing healthcare systems to support exercise: exercise as the fifth vital sign. Br J Sports Med. 2011;45(6):473-4.

[3] Handschin C, Spiegelman BM. The role of exercise and PGC1alpha in inflammation and chronic disease. Nature. 2008;454(7203):463-9.

****************************

Dr Catherine Lester graduated from the University of the Witwatersrand in 2004, She completed her MSc at QMUL in 2011 and is currently in a SEM research post at Charing Cross.   She worked at the Olympics and Paralympics during London 2012, and has worked with England Women’s Hockey, Australian rowing and is the team doctor for the junior GB Ultimate Disc teams.

Dr James Thing co-ordinates “Sport and Exercise Medicine: The UK trainee perspective” monthly blog series.