Tailored Physical Activity Proves Crucial for Managing Chronic Illnesses
Experts highlight that tailored physical activity can significantly improve muscle strength, bone density, and quality of life for patients living with chronic illnesses.
Living with a chronic illness often involves fatigue, pain, and shortness of breath, leading many patients to reduce or completely stop physical activity. However, experts emphasize that tailored exercise can play a crucial role in preserving muscle mass, bone density, and overall quality of life.
Exercise as Medicine
"Physical activity is medicine," explains Dr. Michal Atzmon, a physical therapist from the Department of Physical Therapy at Ariel University and the Endocrinology, Diabetes, and Metabolism Institute at Sheba Medical Center. "Like any medication, its type and dosage must be individually tailored based on the patient's specific illness, functional status, medical treatments, limitations, and personal preferences." Dr. Atzmon notes that very few medical conditions require an absolute ban on movement, and such restrictions are usually temporary. Prolonged avoidance of physical activity, on the other hand, accelerates muscle and bone loss.
Prof. Naama Constantini, a family medicine and sports medicine specialist, lecturer at the Hebrew University Faculty of Medicine, and director of the Heidi Rothberg Sports Medicine Center at Shaare Zedek Medical Center, highlights the broad systemic benefits of exercise. "The rewards of physical activity are immense: beyond preserving bones, it helps patients cope with chronic illnesses and comorbidities," she says. "In diabetes, tailored exercise assists with blood sugar regulation; for dialysis patients, it can improve function and quality of life." However, experts stress that exercise complements medical treatment rather than replacing it.
Tailored Approaches for Specific Conditions
Chronic conditions affect bones and muscles in different ways. In chronic lung diseases, breathlessness often hinders movement. Dr. Atzmon recommends interval training—short bursts of exertion followed by recovery—alongside strength exercises. For diabetes patients, customized routines help maintain metabolic balance, though precautions are necessary when peripheral neuropathy is present. In cases of Crohn's disease or colitis, exercise plans must account for whether the patient is in remission or experiencing a flare-up, as well as nutritional absorption issues. During cancer treatments, carefully calibrated exercise can alleviate fatigue and enhance daily functioning.
The Importance of Weight-Bearing Activity
Not all forms of exercise impact bones equally. Weight-bearing activities against gravity, such as brisk walking, running, dancing, and jumping, are essential for building and maintaining bone density. Resistance training using weights or body weight is equally vital for both bones and muscles. While swimming is an excellent low-impact activity for cardiovascular health, it does not provide the same gravitational load required for bone strengthening. Experts recommend combining swimming with weight-bearing exercises and ensuring adequate balance and coordination training to prevent dangerous falls.
General Guidelines and Future Outlook
For healthy adults, international and local guidelines recommend 150 to 300 minutes of moderate-intensity aerobic activity per week, supplemented by major muscle group strengthening at least twice weekly. Individuals with chronic conditions should start slowly and gradually increase intensity under professional guidance. These vital topics and systemic integration will be discussed at the upcoming annual conference of ILA, the Israel Osteoporosis and Bone Diseases Society, scheduled for November 11 at the Yitzhak Rabin Center in Tel Aviv.
