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”

jull.kurniarobbi@ui.ac.id

jull.kurniarobbi@ui.ac.id

nilamoersadik@yahoo.com

nilamoersadik@yahoo.com