Dr. Mairym Villalobos Solís, Ed. D. in Kinesiology
MCS Collaborator
Strong evidence supports physical activity and exercise as fundamental strategies for preventing and
treating chronic diseases.
Despite this, the CDC notes that only 24.2% of adults in the U.S. in 2020, and 7.3% of Puerto Ricans in
2019 met the recommendations for aerobic physical activity and muscle strengthening as recommended by
the Physical Activity Guidelines for Americans (2018). This represents a global problem that contributes
to rising healthcare costs and chronic diseases such as cancer, heart disease, cerebrovascular disease,
depression, Alzheimer’s and type 2 diabetes.
Regular exercise is equally effective or even superior to drugs in the secondary prevention of chronic
diseases and the rehabilitation of patients after a stroke. In addition, it reduces the risk of
premature death by 20-30%.
Given this scenario, healthcare professionals have a crucial role to play in promoting physical activity
among their patients. The Exercise is Medicine (EIM) initiative, founded by the American College of
Sports Medicine (ACSM) in 2007, seeks to integrate physical activity and exercise as a standard part of
the disease prevention and treatment paradigm. This involves recording physical activity as a vital sign
during each medical visit, prescribing exercise, and using communication strategies to promote
behavioral changes regarding physical activity.
Below are the physical activity guidelines for diseases that represent the leading causes of death and
risk factors in Puerto Rico. These recommendations provide clear, disease-specific guidelines, tailored
to individual patient needs, as recommended by EIM and the ACSM.
Table: Diseases and Their Physical Activity Guidelines
| Disease |
Component |
Frequency |
Intensity |
Time |
Type |
| Alzheimer’s |
Aerobic Activity |
5 times per week. |
Light or somewhat difficult. |
Start with a few minutes and build up to 30-60 minutes per day. |
Any rhythmic activity (walking, dancing, swimming). |
| Muscle Training |
> 2 times per week (1 day rest between sessions). |
Start with a light effort and gradually increase. |
1-3 sets of 8-12 repetitions. |
Hand weights, cans, bottles, resistance bands, weight machines, or body exercises. |
| Cancer |
Aerobic Activity |
3-5 times per week |
Very light to somewhat difficult |
Start with a few minutes and build up to 30-60 minutes per day. |
Walking, light cycling, yoga, tai chi, or aquatic exercises |
| Muscle Training |
2-3 times per week (1 day rest between sessions) |
Start with a light effort and gradually increase. |
Start with 10-15 repetitions for each major muscle group. |
Hand weights, cans, bottles, resistance bands, weight machines, or body exercises |
| Type 2 Diabetes |
Aerobic activity |
3-7 days/week |
Very light to somewhat difficult |
Start with a few minutes and build up to 30-60 minutes per day. |
Any rhythmic activity (walking, dancing, swimming, cycling) |
| Muscle Training |
2-3 times per week (1 day rest between sessions) |
Start with a light effort and gradually increase to moderate to high intensity. |
Start with 10-15 repetitions for each major muscle group. |
Hand weights, cans, bottles, resistance bands, weight machines or chair push-ups |
| Hypertension |
Aerobic activity |
At least 2-3 days per week |
Somewhat difficult to difficult |
Start with a few minutes and increase to > 30 minutes a day. |
Any rhythmic activity (walking, dancing, swimming, cycling) |
| Muscle Training |
2-3 times per week (1 day rest between sessions) |
Start with a light effort and gradually increase. |
Up to 8-12 high-intensity repetitions for each major muscle group |
Hand weights, cans, bottles, resistance bands, weight machines, or body exercises |
How can we promote physical activity during patient interventions?
Motivational communication is an effective tool in this process. It helps patients set goals, identify
resources, and evaluate the effectiveness of the plan once the change is implemented. Healthcare
providers can use the following questions to start the conversation with their patients to promote the
adoption of physical activity as part of a healthy lifestyle:
- How would you describe your physical health from a year ago to today? Do you feel the same, better,
or worse?
- Does your physical health status limit your performance of certain daily activities, such as
bathing, cooking, washing, or moving a table or chair?
- Do you currently engage in any physical activity?
Because the amount, type and intensity of recommended physical activity varies from person to person,
it’s important to remind patients that “exercise has so many health benefits, that any amount is better
than none.” Prescribing physical activity should be part of the recommendations made to patients to
treat or prevent their health conditions. The collaboration of the healthcare professional to make
physical activity an integral part of the patient’s care is essential.
At MCS, and as part of our commitment to support our providers in caring for their patients, we
developed the MCS Club Te Paga program, which is aimed at members and the community in general to
promote physical activity through yoga, Zumba, tai chi, aqua aerobics and other modalities in different
parts of the island. Those interested can join the MCS Club Te Paga Facebook group or call
1-833-590-2599, Monday to Friday from 8:00 a.m. to 5:00 p.m.
References:
- https://www.cdc.gov/nccdphp/dnpao/data-trends-maps/index.html
- https://nccd.cdc.gov/dnpao_dtm/rdPage.aspx?rdReport=DNPAO_DTM.ExploreByLocation&rdRequestForwarding=Form
- https://www.cdc.gov/nchs/products/databriefs/db443.htm
- https://www.exerciseismedicine.org/exercise-is-medicine-revisiting-its-vital-role-in-healthcare-amidst-disappointing-trends-in-physical-activity-advice/
-
https://pubmed.ncbi.nlm.nih.gov/26213523/
- https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
- Rouleau, C. R., Lavoie, K. L., Bacon, S. L., Vallis, M., Corace, K., Campbell, T. S., & Canadian
Network for Health Behavior Change and Promotion (CAN-Change) http://www.ciberesp es(2015) Training
healthcare providers in motivational communication for promoting physical activity and exercise in
cardiometabolic health settings: do we know what we are doing?. Current Cardiovascular Risk Reports,
9, 1-8.
- https://health.gov/paguidelines/second-edition/pdf/Physical_
Activity_Guidelines_2nd_edition.pdf
- https://es.familydoctor.org/ejercicio-como-empezar/?adfree=true
- https://www.mayoclinic.org/es/healthy-lifestyle/fitness/in-depth/exercise/art-20048389?p=1
