Exercise for patients with chronic disease

Most patients with chronic disease can benefit from rehabilitation efforts to optimize their functioning within the limitations placed on them by the disease and/or treatment and to increase their responsibility in their health care. Rehabilitation should include education and counseling in nutrition, behavioral change, exercise conditioning, and clinical concerns. The exercise portion can be accomplished in a supervised or unsupervised setting, depending on the patient's clinical status and needs. The exercise prescription must be modified to meet the clinical needs of the patient. Supervised settings may increase compliance and provide the primary care physician with valuable follow-up information that will assist in long-term medical care. The primary care physician has the responsibility of carefully screening patients, referring them into the appropriate exercise setting, and incorporating the rehabilitation results into the patient's long-term care. Physician support can dramatically enhance the success of the rehabilitation efforts.