Take activity to heart

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This article was published 1/11/2021 (206 days ago), so information in it may no longer be current.

Nandita Selvanathan manages two heart conditions — both of which have caused her chest pains and repeated hospital visits.

"What was bothering me in my daily life was my frequent hospitalization. I went to the hospital quite a few times. That’s never a pleasant experience," she says. "With my chest pains, I had drained energy, both mentally and physically."

Selvanathan, 63, has two structural heart concerns — shrinkage of a heart valve and a dilated aorta. She has also experienced an arrhythmia and heart palpitations (rapid heart rhythms or skips) and notes that having high blood pressure "doesn’t help."

At the suggestion of a friend, Selvanathan went to the Wellness Institute in 2015 to participate in the cardiac rehabilitation program. The education and supervised exercise regimen is designed for people with cardiovascular disease who are recovering from a heart attack, stents, peripheral artery disease, heart failure or irregular heart rhythms.

"My friend’s husband had gone to the cardiac rehab program and because I had heart issues for many years, my friend suggested I try it," she says. "So, I went to my doctor and he said it would be a good idea."

A new study conducted in Winnipeg found that having a membership at a medical fitness facility, such as the Wellness Institute or the Reh-Fit Centre, could lower your risk of dying by 60 per cent. The 10-year retrospective study also found members have a 13 per cent lower risk of being hospitalized.

"If you have a heart attack, there’s a six-week program that’s specific for people post-heart attack at either (the Wellness Institute or Reh-Fit Centre)," says Dr. Alan Katz, professor of family medicine and community health sciences, director of the Manitoba Centre for Health Policy (MCHP) and one of the study’s researchers. "But we need to be more proactive in supporting prevention and keeping people healthy."

The study was conducted by researchers from the Chronic Disease Innovation Centre at Seven Oaks General Hospital and the Department of Family Medicine at the University of Manitoba in collaboration with the Manitoba Centre for Health Policy.

When it comes to health intervention, Katz says physical activity is an ideal way to improve outcomes and avoid hospitalization.

"One of the most important things we can do with primary prevention is promote exercise. We know that when physicians and primary care providers actually prescribe exercise to a patient, that person is more likely to do that," he says. "Unfortunately, we spend so much money on treating disease, that our health-care system doesn’t have enough resources to keep people healthy rather than wait until they’re sick and then spend more money."

The study, published in the American Journal of Preventive Medicine, is the first to examine the long-term health outcomes of those who attend a medical fitness facility versus those who don’t. It monitored 19,000 new adult members at both the Wellness Institute and the Reh-Fit Centre over a 10-year period. Their average age was 47.

"We know that the benefits of exercise often take time to show, that’s why we needed to do it (over 10 years)," Katz says. "We knew the longer we could include, the more the benefits would accrue."

By collecting anonymized electronic sign-in information, researchers found regular attendance — more than three times per week — at these types of medical fitness facilities lowered hospitalization by 39 per cent. Compared to non-members, those who went one to three times per week had a 20 per cent lower risk while low frequency attendees had a nine per cent lower risk. Members had access to an annual health assessment, group fitness classes, fitness equipment and certified fitness staff.

The researchers used databases at MCHP to compare members’ health status with those of a control group of more than 500,000 people from the general Winnipeg population. They were matched based on age, sex, income and health conditions.

"This is a unique opportunity to do something like this here in Winnipeg," says Dr. Katz. "We know that these programs are consistent over time and really do benefit."

A decade ago, Selvanathan would see a cardiologist annually to measure and monitor her heart valve shrinkage and dilation.

"They told me if it were to become out of control, that they would perform open heart surgery," she says. "That’s where I was headed."

Selvanathan’s chest pains and heart palpitations severely affected both her physical and mental condition. Things got so bad she became unconscious twice, once fainting in her kitchen.

"Luckily my son was there; he was very young at the time. He called 911 and I went to the hospital," she says. "We came to Canada in 2000 and I don’t have family here that I can rely on. That caused a lot of anxiety," she says. "I knew that I had to do something if I wanted to maintain my job and quality of life."

Now, after six years of going to the Wellness Institute, her health has vastly improved.

"I’m still on medication but my blood pressure has been normal, my symptoms are significantly reduced and I haven’t had any recent hospital visits," she says. "My (valve) dilation has stabilized and my condition is no longer deteriorating."

During her time in the cardiac rehabilitation program, Selvanathan had the guidance of physicians, nurses and dietitians who taught her the benefits of exercise, nutrition and stress management. The team also conducted a thorough health assessment and created a personalized program for her.

"The first thing (the Wellness Centre did) was a proper assessment of me and my condition. They slowly increased my exercise schedule — they didn’t ask me to do 10 laps on the same day. They made sure I didn’t overdo it," she says. "There were many trained staff there and they kept an eye on me, which was very beneficial."

Katz says medical fitness facilities allow on-site health professionals to ask members specific questions about their health and risk factors. Healthcare systems, he says, aren’t set up that way.

"Most family doctors don’t have the time to (ask those questions) with everybody because they’re so busy looking after people who already have chronic conditions as opposed to the preventive aspect of health," Katz says.

The study researchers conclude that health-care systems should consider the medical fitness model as a preventive public health strategy to encourage physical activity participation.

"You can safely (exercise) under supervision and, ultimately, from a health policy perspective, it would be really nice if the health-care system provided some support for these kinds of facilities," Katz says. "(People) will benefit by living longer and staying out of the hospital."

Selvanathan remains an active Wellness member. She hasn’t been able to visit the facility due to the pandemic but plans to return this month. Typically, she goes three or four times a week, spending an hour in a range of activities. She is comforted knowing that experienced staff are on-hand to help.

"Every time I ask somebody about the equipment, they come and help. I’m always grateful for that. When you’re healthier, you’re able to perform better at work and at home," she says. "Everybody needs a starting point and when you do it under guidance from an expert, you feel more confident. That’s what happened to me."

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