Pendekatan
kedokteran
olahraga
dalam
kedokteran
komunitas
Sri NilawatiSri Nilawati
J Kurniarobbi
J Kurniarobbi
Nani Cahyani
Nani Cahyani
IKK – July, 20th 2012
Sports medicine
approach
in community
medicine
Sri NilawatiSri Nilawati
J Kurniarobbi
J Kurniarobbi
Nani Cahyani
Nani Cahyani
IKK – July, 20th 2012
Changing lifestyleChanging lifestyle
High calorie/fat intakeHigh calorie/fat intake
Lack of physical activityLack of physical activity
Uncontrolled stressUncontrolled stress
Pollution/dangerous substances Pollution/dangerous substances exposureexposure
WHO. 2002. Common Risk Factor, Move for Health
Role of physical activity and exercise in disease prevention and rehabilitation
ACSM, Exercise for Chronic Diseases, 2001
General Health Profile General Health Profile of Indonesiaof Indonesia
0
50
100
50 60 70 80 90
SickDead
0
50
100
50 60 70 80 90
SickDead
INFECTION
NON INFECTION (ncd)
"If we could give every individual the "If we could give every individual the right amount of nourishment and right amount of nourishment and exercise, not too little and not too much, exercise, not too little and not too much, we would have found the safest way to we would have found the safest way to health.“health.“
Hippocrates (460-377 BC)Hippocrates (460-377 BC)
FACTORS THAT AFFECT HEALTHFACTORS THAT AFFECT HEALTH
Principles and labs for fitness and wellness
““Move for Health”Move for Health”(WHO 2002)(WHO 2002)
Global initiative for controlling NCDGlobal initiative for controlling NCD
Urges physically active lifestyle for all Urges physically active lifestyle for all WHO membersWHO members
10 perilaku hidup bersih dan sehat di rumah tanggaPusat Promosi Kesehatan Kementerian Kesehatan RI
10 perilaku hidup bersih dan sehat di rumah tanggaPusat Promosi Kesehatan Kementerian Kesehatan RI
Standar Kompetensi Standar Kompetensi Dokter (KKI 2006)Dokter (KKI 2006)
to advice a patient about life-styleto advice a patient about life-style
kemampuan lulusan dokterkemampuan lulusan dokter mengkomunikasikan cara hidup mengkomunikasikan cara hidup aktifaktif (kemampuan tingkat 4) (kemampuan tingkat 4)
konsep, teori, prinsip maupun indikasi, konsep, teori, prinsip maupun indikasi, cara melakukan, komplikasi, dan cara melakukan, komplikasi, dan sebagainyasebagainya
Key TermKey Term
Physical Activities:Physical Activities:Human activities in life which involve muscles and certain Human activities in life which involve muscles and certain amount of energy expenditureamount of energy expenditure
Exercise: Exercise: Structured physical activity characterized by specific Structured physical activity characterized by specific movement performed for health and/or amusement movement performed for health and/or amusement purposespurposes
Sports: Sports: Physical activity characterized by the element of Physical activity characterized by the element of play/game and involve competition with oneself, others or play/game and involve competition with oneself, others or natural elementnatural element Beyer E. 1992. Dictionary of Sports.
TYPES OF PHYSICAL ACTIVITYTYPES OF PHYSICAL ACTIVITY
Health Health
Kesehatan adalah keadaan sehat, Kesehatan adalah keadaan sehat, baik secara fisik, mental, spritual baik secara fisik, mental, spritual maupun sosial yang maupun sosial yang memungkinkan setiap orang memungkinkan setiap orang untuk hidup produktif secara untuk hidup produktif secara sosial dan ekonomis. (Health sosial dan ekonomis. (Health Act/UU No. 36 tahun 2009)Act/UU No. 36 tahun 2009)
Physical FitnessPhysical Fitness
The ability to perform daily activities The ability to perform daily activities without undue fatigue and the without undue fatigue and the capability of maintaining such ability capability of maintaining such ability throughout lifethroughout life
Exercise testing and prescriptionA health-related approach
Physical Fitness trendPhysical Fitness trend& changes in intellectual profile& changes in intellectual profile
Physically Active Physically Active Lifestyle:Lifestyle:
how to start? how to start?No need to change overnight, start with one No need to change overnight, start with one
and add another one every day or so.and add another one every day or so.
Begin physical activity slowly, gradually Begin physical activity slowly, gradually build to higher levelsbuild to higher levels
It will reduces the risk of injury and feeling It will reduces the risk of injury and feeling of defeat from unrealistic goalsof defeat from unrealistic goals
http://hgic.clemson.edu/factsheets/hgic4032.htm
Physically Active Physically Active LifestyleLifestyle
No specific definitionNo specific definition
Represents new lifestyleRepresents new lifestyle
Increase or change daily activity by Increase or change daily activity by choosing activities with more muscles choosing activities with more muscles involvedinvolved
For everyone: For everyone: Children, Adult and Children, Adult and ElderlyElderly
Actife Lifestyle Actife Lifestyle ChildrenChildren
Goals:Goals:
To develop motor skillsTo develop motor skills
Maintain health statusMaintain health status
Recommendation:Recommendation:
Active physical play 1hour/dayActive physical play 1hour/day
Actife Lifestyle Actife Lifestyle AdolescentsAdolescents
Goals:Goals:
To develop: To develop:
movement skillsmovement skills
physical capacityphysical capacity
social skillssocial skills
Recommendation:Recommendation:
Combination of play, individual and team sportsCombination of play, individual and team sports
Intra and/or extra curricular activityIntra and/or extra curricular activity
Most days of the weekMost days of the week
Actife Lifestyle Actife Lifestyle AdultsAdults
Goals:Goals: Maintain health, productivity and Maintain health, productivity and
independenceindependence
Provide examplesProvide examples
SocializationSocialization
Recommendation:Recommendation: Combination of moderate exercise and Combination of moderate exercise and
sportssports
3-5x/week frequency3-5x/week frequency
20-60 minutes/session20-60 minutes/session
http://livelonger.health.gov.au
THE MANDALA OF HEALTHTHE MANDALA OF HEALTH
Levels of PreventionLevels of PreventionReduction of risk factors before occurrence of disease, condition, or injury
Early detection of the potential for the development of disease or condition, or the existence of a disease while asymptomatic
Treatment of an existing symptomatic disease process to ameliorate its effects, or delay or prevent its progress
Community DiagnosisCommunity Diagnosis
Awareness of NCDs prevalence in Awareness of NCDs prevalence in community.community.
Systematic effort to engage individual Systematic effort to engage individual and/or family in active lifestyle.and/or family in active lifestyle.
Public facilities, schools and Public facilities, schools and workplaces as center of activities.workplaces as center of activities.
Utilizing community resources and Utilizing community resources and potentials.potentials.
Further competence Further competence needed needed
Physical Physical aactivity and ctivity and healthhealth
HHuman physical activity uman physical activity
Physical activity level and Physical activity level and measurement measurement
Risk management of pRisk management of physical hysical activity activity programprogram
Physical activity group managementPhysical activity group management
Physical activity Physical activity program in the program in the
communitycommunity
ConclusionsConclusions
Physical inactivity and other common Physical inactivity and other common risk factors contribute to significant risk factors contribute to significant increase of NCDincrease of NCD
Be physically active! (You and your Be physically active! (You and your patients)patients)
Increase or change daily physical activity Increase or change daily physical activity or engage yourself in exercise or sportsor engage yourself in exercise or sports
Foundation of healthy and fit community Foundation of healthy and fit community
““Exercise is Exercise is
medicine”medicine”