According to Alberta Health Services, “approximately 30% of Albertans report having at least one chronic disease and that number increases to over 75% if you are 65 years of age or older.”1 In 2012, chronic diseases cost Canadian society more that $90 billion a year in lost productivity and health-care costs.2
Many people have a risk of developing a chronic disease due to modifiable lifestyle behaviours such as physical inactivity, poor eating and smoking. Even something as simple as a pulled muscle can cause people to stop exercising and increase their risk of developing a chronic disease.
If you or a family member have recently been diagnosed with a chronic condition such as diabetes, arthritis, heart disease or cancer that is affecting your quality of life, it’s important to remember that a chronic condition does not define who you are. It is quite possible to live well with a chronic disease.
What is a chronic disease?
The World Health Organization defines a chronic or non-communicable disease as: “a disease that is of long duration, is slow to progress and is not passed from person to person.”3 In Alberta, the most common chronic diseases are high blood pressure, diabetes, chronic obstructive pulmonary disease (COPD), asthma, heart failure, coronary artery disease, obesity, and depression.4 The term “chronic condition” is often used interchangeably with “chronic disease” but is a somewhat broader term that encompasses both non-communicable diseases and other health conditions that can impact a person’s quality of life and independence (e.g., blindness, deafness, or developmental delay).
As Alberta’s population ages and the prevalence of chronic diseases continues to increase, government and health-care organizations are focusing on helping people manage their chronic disease. To achieve this, there is a shift away from the traditional, medically driven, approach to treatment, while moving towards helping people self-manage their disease.
What is self-management?
Self-management is defined as “the day-to-day tasks an individual must undertake to control or reduce the impact of disease on physical health status.”5 These tasks include having the support, ability, and confidence to deal with the medical and the emotional management of the chronic disease and its effect on your quality of life.6
The Government of Canada released a document in 2012 entitled “Self-management Support for Canadians with Chronic Health Conditions.”6 This report talks about activities such as seeking help from a nutritionist to manage your diet, talking to your pharmacist or physician about the right medications to take, joining an exercise class, or making an appointment with your physiotherapist to look at strategies to improve or maintain your overall fitness level. The actual changes you make (considered the positive outcomes of effective self-management) include eating better, exercising more, effectively monitoring and responding to your symptoms, taking your medications correctly and knowing when to seek professional help.6
Where do I start?
Ask for help from a health-care professional. They can provide the support you need to face challenges and achieve success.
Common treatment for the management of chronic disease often focuses on:
Providing education about the disease and the lifestyle changes recommended
Maintaining or increasing activity levels and incorporating daily exercise
Evidence tells us that exercise and activity changes can positively impact the management of many chronic diseases, including: high blood pressure, diabetes, chronic obstructive pulmonary disease (COPD), asthma, heart failure, coronary artery disease, obesity, and depression.6 The more you know about your disease the more you can understand the need for these changes and how to get started.
The role of physical activity
Lack of confidence, not knowing what’s safe, and fear of aggravating the condition are often the biggest obstacles when it comes to physical activity for people with chronic conditions. However, experts agree that physical activity improves health, quality of life, and may actually reverse the progression of some chronic conditions.
If you have a chronic condition that limits your ability to exercise regularly, here are a few tips to help you get active.
1. Get support
To build your confidence and understanding of how to exercise safety with a chronic condition, work with a health professional that understands how to exercise safely and understands your condition. Physiotherapists are uniquely qualified to design exercise programs specifically geared to your condition.
2. Find the right environment
Find an environment where you feel safe, can build confidence and experience early success. This could be a community centre, a health-care facility, a pool or fitness facility or even a group exercise and education program for people with a specific condition. The point is to find an environment where you feel comfortable and not intimidated.
3. Create structure
Having pre-set structures will help support you in staying active. Set goals that are important to you and that you are confident you can achieve in the short term. Identify possible barriers that may block you from achieving your goals. Identify time, place and activities that will work for you and your life.
4. Get social
Share your goals with others who will be supportive. Enlist family members, friends, co-workers, pets, etc. to exercise with. Consider joining a support group of other people with chronic diseases.
How a physiotherapist can help
A physiotherapist will be able to help you understand the diagnosis and how it may affect your life, what immediate steps you can take to manage the disease and give you recommendations to assist you to develop lifelong strategies to live the life you want.
You may also be referred to a specific program such as cardiac or respiratory rehabilitation where a physiotherapist will work with you as you learn ways to increase your endurance and strength in a safe and supervised environment.
A physiotherapist can be a source of motivation, guidance and problem solving during the ups and downs of managing your journey through life with a chronic disease.
Alberta Health Services. Chronic Disease Management resource center. Available at: https://www.albertahealthservices.ca/info/page11934.aspx . Accessed Jan 18, 2018.
5 Mirolla, M. (2004). The cost of chronic disease in Canada. Ottawa, ON: Chronic Disease Prevention Alliance of Canada. Available at: http://www.gpiatlantic.org/pdf/health/chroniccanada.pdf Accessed Feb 16, 2018.
World Health Organization. Health topics: Noncommunicable diseases. Available at: http://www.who.int/topics/noncommunicable_diseases/en/ . Accessed Jan 18, 2018
Auditor General of Alberta. Report of the Auditor General of Alberta: Health-Chronic Disease Management. September 2014. Available at: https://www.oag.ab.ca/webfiles/reports/OAGSept2014Report.pdf Accessed Jan 18, 2018.
Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J. Self-management approaches for people with chronic conditions: a review. Patient Education and Counseling 48 (2002) 177-187.
Self-management support for Canadians with chronic health conditions: A focus for primary health care. 2012. Available at: http://www.selfmanagementbc.ca/uploads/HCC_SelfManagementReport_FA.pdf Accessed Feb 16, 2018
Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports 2006: 16 (Suppl.1) 3-63.