Responsibility of sport and exercise medicine in preventing and managing chronic disease: applying our knowledge and skill is overdue
Identifieur interne : 005158 ( Main/Exploration ); précédent : 005157; suivant : 005159Responsibility of sport and exercise medicine in preventing and managing chronic disease: applying our knowledge and skill is overdue
Auteurs : Gordon O. Matheson [États-Unis] ; Martin Klügl [États-Unis] ; Jiri Dvorak [Suisse] ; Lars Engebretsen [Norvège] ; Willem H. Meeuwisse [Canada] ; Martin Schwellnus [Afrique du Sud] ; Steven N. Blair [États-Unis] ; Willem Van Mechelen [Pays-Bas] ; Wayne Derman [Afrique du Sud] ; Mats Börjesson [Suède] ; Fredrik Bendiksen [Norvège] ; Richard Weiler [Royaume-Uni]Source :
- British Journal of Sports Medicine [ 0306-3674 ] ; 2011-12.
Abstract
Background The rapidly increasing burden of chronic disease is difficult to reconcile with the large, compelling body of literature that demonstrates the substantial preventive and therapeutic benefits of comprehensive lifestyle intervention, including physical activity, smoking cessation and healthy diet. Physical inactivity is now the fourth leading independent risk factor for death caused by non-communicable chronic disease. Although there have been efforts directed towards research, education and legislation, preventive efforts have been meager relative to the magnitude of the problem. The disparity between our scientific knowledge about chronic disease and practical implementation of preventive approaches now is one of the most urgent concerns in healthcare worldwide and threatens the collapse of our health systems unless extraordinary change takes place. Findings The authors believe that there are several key factors contributing to the disparity. Reductionism has become the default approach for healthcare delivery, resulting in fragmentation rather than integration of services. This, in turn, has fostered a disease-based rather than a health-based model of care and has produced medical school curricula that no longer accurately reflect the actual burden of disease. Trying to ‘fit’ prevention into a disease-based approach has been largely unsuccessful because the fundamental tenets of preventive medicine are diametrically opposed to those of disease-based healthcare. Recommendation A clinical discipline within medicine is needed to adopt disease prevention as its own reason for existence. Sport and exercise medicine is well positioned to champion the cause of prevention by promoting physical activity. Conclusion This article puts forward a strong case for the immediate, increased involvement of clinical sport and exercise medicine in the prevention and treatment of chronic disease and offers specific recommendations for how this may begin.
Url:
DOI: 10.1136/bjsports-2011-090328
Affiliations:
- Afrique du Sud, Canada, Norvège, Pays-Bas, Royaume-Uni, Suisse, Suède, États-Unis
- Alberta, Angleterre, Californie, Caroline du Sud, Grand Londres, Hollande-Septentrionale, Svealand, Østlandet
- Amsterdam, Calgary, Londres, Oslo, Stockholm
- Université de Calgary
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Matheson</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, Division of Sports Medicine & Human Performance Laboratory, Stanford University School of Medicine, Stanford, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Klugl, Martin" sort="Klugl, Martin" uniqKey="Klugl M" first="Martin" last="Klügl">Martin Klügl</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Orthopaedic Surgery, Division of Sports Medicine & Human Performance Laboratory, Stanford University School of Medicine, Stanford, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Dvorak, Jiri" sort="Dvorak, Jiri" uniqKey="Dvorak J" first="Jiri" last="Dvorak">Jiri Dvorak</name><affiliation wicri:level="1"><country xml:lang="fr">Suisse</country><wicri:regionArea>Schulthess Clinic, Zurich</wicri:regionArea><wicri:noRegion>Zurich</wicri:noRegion></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Suisse</country><wicri:regionArea>FIFA Medical Assessment & Research Center (F-MARC), Zurich</wicri:regionArea><wicri:noRegion>Zurich</wicri:noRegion></affiliation></author><author><name sortKey="Engebretsen, Lars" sort="Engebretsen, Lars" uniqKey="Engebretsen L" first="Lars" last="Engebretsen">Lars Engebretsen</name><affiliation wicri:level="1"><country xml:lang="fr">Norvège</country><wicri:regionArea>Orthopaedic Center, Ullevål University Hospital, University of Oslo</wicri:regionArea><wicri:noRegion>University of Oslo</wicri:noRegion></affiliation></author><author><name sortKey="Meeuwisse, Willem H" sort="Meeuwisse, Willem H" uniqKey="Meeuwisse W" first="Willem H" last="Meeuwisse">Willem H. Meeuwisse</name><affiliation wicri:level="4"><country xml:lang="fr">Canada</country><wicri:regionArea>Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Schwellnus, Martin" sort="Schwellnus, Martin" uniqKey="Schwellnus M" first="Martin" last="Schwellnus">Martin Schwellnus</name><affiliation wicri:level="1"><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>UCT Research Unit for Exercise Science & Sports Medicine, Department of Human Biology, University of Cape Town, Newlands</wicri:regionArea><wicri:noRegion>Newlands</wicri:noRegion></affiliation></author><author><name sortKey="Blair, Steven N" sort="Blair, Steven N" uniqKey="Blair S" first="Steven N" last="Blair">Steven N. Blair</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Departments of Exercise Science and Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina</wicri:regionArea><placeName><region type="state">Caroline du Sud</region></placeName></affiliation></author><author><name sortKey="Van Mechelen, Willem" sort="Van Mechelen, Willem" uniqKey="Van Mechelen W" first="Willem" last="Van Mechelen">Willem Van Mechelen</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Public and Occupational Health and EMGO Institute for Health & Care Research, VU University Medical Center, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Derman, Wayne" sort="Derman, Wayne" uniqKey="Derman W" first="Wayne" last="Derman">Wayne Derman</name><affiliation wicri:level="1"><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>UCT Research Unit for Exercise Science & Sports Medicine, Department of Human Biology, University of Cape Town, Newlands</wicri:regionArea><wicri:noRegion>Newlands</wicri:noRegion></affiliation></author><author><name sortKey="Borjesson, Mats" sort="Borjesson, Mats" uniqKey="Borjesson M" first="Mats" last="Börjesson">Mats Börjesson</name><affiliation wicri:level="3"><country xml:lang="fr">Suède</country><wicri:regionArea>Astrands Laboratory, The Swedish School of Sports and Health Sciences and Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Acute and Cardiovascular Medicine, Sahlgrenska University Hospital/Ostra, Goteborg</wicri:regionArea><wicri:noRegion>Goteborg</wicri:noRegion></affiliation></author><author><name sortKey="Bendiksen, Fredrik" sort="Bendiksen, Fredrik" uniqKey="Bendiksen F" first="Fredrik" last="Bendiksen">Fredrik Bendiksen</name><affiliation wicri:level="3"><country xml:lang="fr">Norvège</country><wicri:regionArea>Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Weiler, Richard" sort="Weiler, Richard" uniqKey="Weiler R" first="Richard" last="Weiler">Richard Weiler</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Sport & Exercise Medicine, Homerton University Hospital NHS Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">British Journal of Sports Medicine</title><title level="j" type="abbrev">Br J Sports Med</title><idno type="ISSN">0306-3674</idno><idno type="eISSN">1473-0480</idno><imprint><publisher>BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine</publisher><date type="published" when="2011-12">2011-12</date><biblScope unit="volume">45</biblScope><biblScope unit="issue">16</biblScope><biblScope unit="page" from="1272">1272</biblScope></imprint><idno type="ISSN">0306-3674</idno></series><idno type="istex">8BDF363381F54899B93770210B4AE12D4148B73C</idno><idno type="DOI">10.1136/bjsports-2011-090328</idno><idno type="href">bjsports-45-1272.pdf</idno><idno type="ArticleID">bjsports-2011-090328</idno><idno type="PMID">21948123</idno><idno type="local">bjsports;45/16/1272</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0306-3674</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background The rapidly increasing burden of chronic disease is difficult to reconcile with the large, compelling body of literature that demonstrates the substantial preventive and therapeutic benefits of comprehensive lifestyle intervention, including physical activity, smoking cessation and healthy diet. Physical inactivity is now the fourth leading independent risk factor for death caused by non-communicable chronic disease. Although there have been efforts directed towards research, education and legislation, preventive efforts have been meager relative to the magnitude of the problem. The disparity between our scientific knowledge about chronic disease and practical implementation of preventive approaches now is one of the most urgent concerns in healthcare worldwide and threatens the collapse of our health systems unless extraordinary change takes place. Findings The authors believe that there are several key factors contributing to the disparity. Reductionism has become the default approach for healthcare delivery, resulting in fragmentation rather than integration of services. This, in turn, has fostered a disease-based rather than a health-based model of care and has produced medical school curricula that no longer accurately reflect the actual burden of disease. Trying to ‘fit’ prevention into a disease-based approach has been largely unsuccessful because the fundamental tenets of preventive medicine are diametrically opposed to those of disease-based healthcare. Recommendation A clinical discipline within medicine is needed to adopt disease prevention as its own reason for existence. Sport and exercise medicine is well positioned to champion the cause of prevention by promoting physical activity. Conclusion This article puts forward a strong case for the immediate, increased involvement of clinical sport and exercise medicine in the prevention and treatment of chronic disease and offers specific recommendations for how this may begin.</div></front></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Canada</li><li>Norvège</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Suisse</li><li>Suède</li><li>États-Unis</li></country><region><li>Alberta</li><li>Angleterre</li><li>Californie</li><li>Caroline du Sud</li><li>Grand Londres</li><li>Hollande-Septentrionale</li><li>Svealand</li><li>Østlandet</li></region><settlement><li>Amsterdam</li><li>Calgary</li><li>Londres</li><li>Oslo</li><li>Stockholm</li></settlement><orgName><li>Université de Calgary</li></orgName></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Matheson, Gordon O" sort="Matheson, Gordon O" uniqKey="Matheson G" first="Gordon O" last="Matheson">Gordon O. Matheson</name></region><name sortKey="Blair, Steven N" sort="Blair, Steven N" uniqKey="Blair S" first="Steven N" last="Blair">Steven N. Blair</name><name sortKey="Klugl, Martin" sort="Klugl, Martin" uniqKey="Klugl M" first="Martin" last="Klügl">Martin Klügl</name></country><country name="Suisse"><noRegion><name sortKey="Dvorak, Jiri" sort="Dvorak, Jiri" uniqKey="Dvorak J" first="Jiri" last="Dvorak">Jiri Dvorak</name></noRegion><name sortKey="Dvorak, Jiri" sort="Dvorak, Jiri" uniqKey="Dvorak J" first="Jiri" last="Dvorak">Jiri Dvorak</name></country><country name="Norvège"><noRegion><name sortKey="Engebretsen, Lars" sort="Engebretsen, Lars" uniqKey="Engebretsen L" first="Lars" last="Engebretsen">Lars Engebretsen</name></noRegion><name sortKey="Bendiksen, Fredrik" sort="Bendiksen, Fredrik" uniqKey="Bendiksen F" first="Fredrik" last="Bendiksen">Fredrik Bendiksen</name></country><country name="Canada"><region name="Alberta"><name sortKey="Meeuwisse, Willem H" sort="Meeuwisse, Willem H" uniqKey="Meeuwisse W" first="Willem H" last="Meeuwisse">Willem H. Meeuwisse</name></region></country><country name="Afrique du Sud"><noRegion><name sortKey="Schwellnus, Martin" sort="Schwellnus, Martin" uniqKey="Schwellnus M" first="Martin" last="Schwellnus">Martin Schwellnus</name></noRegion><name sortKey="Derman, Wayne" sort="Derman, Wayne" uniqKey="Derman W" first="Wayne" last="Derman">Wayne Derman</name></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Van Mechelen, Willem" sort="Van Mechelen, Willem" uniqKey="Van Mechelen W" first="Willem" last="Van Mechelen">Willem Van Mechelen</name></region></country><country name="Suède"><region name="Svealand"><name sortKey="Borjesson, Mats" sort="Borjesson, Mats" uniqKey="Borjesson M" first="Mats" last="Börjesson">Mats Börjesson</name></region><name sortKey="Borjesson, Mats" sort="Borjesson, Mats" uniqKey="Borjesson M" first="Mats" last="Börjesson">Mats Börjesson</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Weiler, Richard" sort="Weiler, Richard" uniqKey="Weiler R" first="Richard" last="Weiler">Richard Weiler</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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