Get Going...Keep Moving

There's a scene in the TV mini-series "Band of Brothers" when a company of soldiers, under intense enemy fire from a machinegun post, freezes up and stops moving forward. The commanding officer, sensing that staying put is suicidal, rallies the men by moving out himself and pushing everyone else along, breaking the spell of fear and anxiety. They capture the gun and continue moving forward to the next challenge.

Health and physical activity complement each other: If you want to be healthy, then be active. Even minimal levels of physical activity have health-protective benefits, one of the key aspects of current 'Exercise Lite' guidelines that call for only 20-30 minutes of moderate intensity physical activity most days of the week. (And you can do it in 10-minute segments!)

The advantages of being physically active are well established and listing them here is unnecessary preaching to the choir. But another aspect of physical activity is easily overlooked, and that is its role in recovery from illness or injury. Although all of us hope to be healthy and active as long as possible, everyone has to face the fact that we don't live forever, and sometimes things happen that, despite our best intentions and efforts, derail our workout schedules. It could be a heart attack, joint replacement surgery, a freak accident, Lyme disease, cancer .. Something unanticipated and unwanted shows up, and we have to deal with it.

Years ago, the standard prescription for many types of illness was rest. Heart attack patients were sent home from the hospital to rest and avoid overexertion. Cancer patients were told to rest, especially because of the fatigue accompanying chemotherapy and radiation. The prevailing wisdom was that physical inactivity and rest promoted recovery by avoiding unnecessary strain on cardiovascular and other systems.

Times have changed, and graded activity is becoming a standard part of rehabilitation for almost any type of illness, accident or injury. Coronary bypass patients are up and walking within a day or so of surgery in cardiac rehabilitation units. Physical activity is being routinely prescribed post-treatment for many forms of cancer. Active strengthening and conditioning, a technique known as PREhabilitation now often precedes joint surgery. The bottom line? Being physically active, at a level appropriate for one's state of health or illness, not only has health protective benefits, but also promotes healing and recovery as well.

A recent study published by the American Cancer Society nicely illustrates this pattern. Fatigue is a common side effect of radiation therapy, and patients are often advised to rest and take it easy. In this study, 66 men with localized prostate cancer were randomly assigned to either an exercise or non-exercise control group prior to four weeks of radiation therapy. Those in the exercise group participated in a home-based, moderate-intensity walking program in which they walked for 30 minutes at least three days per week during treatment at 60-70 percent of their maximum heart rate. Control group patients were advised to rest if they experienced fatigue during their treatment

By the end of radiotherapy, men in the control group showed increased fatigue, while those who exercised did not. Participants in the exercise program were able to walk significantly farther than at baseline, whereas those in the control condition showed a decrease in distance covered.

The authors of the study concluded that moderate-intensity walking during treatment improved physical functioning and reduced treatment-related fatigue. This study was published in the journal Cancer in 2004 (vol.101 #3, p550-557).

The bottom line? Physical activity seems to be beneficial, regardless of one's state of health or illness. When we're healthy, being active enhances resistance to illness, but it also helps speed recovery and healing when something goes wrong.

Paul Salmon, Ph.D., M.S., is a faculty member at the University of Louisville, an ACSM-certified health fitness instructor, and a member of KHF's Editorial Advisory Board. You can contact him with comments or questions at psalmon@louisville.edu.