Preventive and therapeutic physical training
conducted on a large number of epidemiological, experimental and clinical data
have provided unequivocal and definitive evidence on the capacity of physical
activity to reduce morbidity and mortality linked to cardiovascular,
respiratory, metabolic and oncological diseases and to improve physical
performance and the quality of life of those who practice it. Furthermore,
physical activity appears to significantly reduce the risk of developing
Among these studies,
many have demonstrated the positive effects of a physical exercise program on
the natural history of cardiovascular, respiratory, metabolic and oncological
diseases, as well as on their prevention.
For the reasons just
exposed and accepted by the most prestigious international Scientific Societies
(American Heart Association, American College of Sports Medicine, Royal College
of Physicians of London, OMS), physical activity is proposed in many prevention
programs both primary and secondary.
It is important to
stress that, so that if we have health benefits, the physical activity
practiced must be adequate, appropriate and correct. It is therefore worth
emphasizing that the prescription of physical exercise in healthy subjects and
even more so in those suffering from pathologies is a delicate act and not
without risks and has the same responsibilities as the prescription of a
surgical procedure , of a diet or a drug treatment.
In fact, without
prejudice to the existence of numerous advantages for those who practice
physical activity, we must not overlook the many contraindications to exercise
and forget that a poorly conducted training can have negative effects on health.
Physical exercise is proposed as a physiological
preventive and therapeutic means, effective and low cost, but not without
possible risks, which must be appropriately evaluated as much as the benefits.
In analogy to what happens for a drug, in fact, our
body responds to the "administration" of physical exercise, with
respiratory, cardiovascular, humoral, autonomic nervous system, hormonal,
muscular and osteoarticular adjustments, depending on the type of exercise
applied and the physical and health condition of the person who performs it.
Therefore, in analogy to what happens for a drug, it
seems appropriate for the doctor to take care of prescribing the physical
activity correctly to a sedentary subject, healthy or suffering from any
pathology, bearing in mind that the different types of exercise and sports have
on the body physiological effects respiratory, cardiovascular and metabolic
acute (adjustments) and chronic (adaptations) and that these adjustments and
adaptations can determine unfavorable (physiopathological) effects on the
cardiovascular apparatus, but also on other apparatuses, first among all the
There are two academically trained medical figures to deal with the movement: the sports doctor and the physiatrist.
The Physician Specialist in Physical and Rehabilitative
Medicine deals, instead, with congenital and acquired disabilities,
coordinating and conducting the work of a rehabilitation team of an Individual
Rehabilitation Project conducted, as a rule, for a short period after an
accident or surgery.
There are numerous legal norms that expressly recognize the role of practice "directed to the promotion of individual and collective health" to physical-sporting activity and among these, also the Law of 23 December 1978, n. 833, instituting the National Health Service (SSN), with which "the health protection of sports activities" is explicitly indicated as an objective of the NHS (art. 2 / II, letter e).
Nevertheless, I am sorry to say, the academic training that qualifies for the profession of General Practitioner, and which allows working in agreement with the National Health Service since 2007, does not provide for the acquisition of competences and prescribing skills of physical therapy preventive and therapeutic.
It happens, however, that it is precisely during the
exercise of my professional activity as a General Practitioner in agreement
with the National Health Service, that every day, for years, assisted patients
suffering from pathologies for which the international scientific literature
emphasizes the benefits that could derive from a regular, adequate and correct
practice of physical activity and to help whom I decided that I had to do more.
It is for all the above reasons that, day after day, I
have chosen to train and qualify myself to be able to professionally deal with
nutrition and physical training for preventive and therapeutic purposes.
From my point of view, the General Practitioner and
Personal Trainer can, in fact, fill the gap in university and medical
specialization programs that do not include professional courses about the
clinical application and the prescription of physical exercise in those who
need it most. , ie those suffering from obesity, diabetes, cardiovascular and
respiratory diseases and orthopedic type following injuries treated with
physiokinesitherapy and stabilized.
Paola Micale 2019 - Contacts