The exercise prescription

Abstract

Do you remember the story about cardiac non-disease in children?1,2 You should, as it is a great example of good medical and parental intentions to care going wrong. In that paper2 researchers studied and followed-up a group of school children who had been diagnosed as having an ‘innocent’ heart murmur. The parents had been fully reassured about the innocence of the murmur. Yet the children with the diagnosis were treated as ‘fragile’ and ‘vulnerable’ and in need of extra care. They were ‘protected’ from taking a fully active part in games, and ended up as disabled as children who had significant structural heart lesions. At the opposite extreme, one of the authors (Peter Davies) remembers going out climbing with a friend at university. At lunchtime his friend calmly pulled out his insulin syringe and injected himself. Up till then he had had no idea that his friend was diabetic. To his friend, diabetes was simply something he dealt with. The friend was considerably stronger and fitter than Dr Davies. Two papers in this issue raise the question of what we should tell people with chronic illnesses about exercise. The first is about asthmatic school children in Dundee, and their own, their parents', and their teachers' perceptions of their ability to take part in physical activity.3 From this paper it is clear that there are many false limiting beliefs among these children about their asthma, some of which arise from what we as doctors have told them. Is this another example of a way in …