Preventive and therapeutic physical training

Numerous studies 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 depression.

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.


Warning !

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 locomotor one.

There are two academically trained medical figures to deal with the movement: the sports doctor and the physiatrist. 

The Physician Specialist in Sports Medicine and Exercise deals prevalently with protecting the health of those who practice sports.

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