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Strength Training as Medicine in the International Guidelines of Disease Treatment

The significance of good physical fitness and regular physical exercise to health is undisputed. There is strong scientific evidence to support the benefits and effects of physical exercise in preventing both diseases and their risk factors, as well as in treatment and rehabilitation of diseases. 

The international disease treatment guidelines confirm that regular exercise plays a significant role in prevention, treatment and rehabilitation of long-term illnesses such as hypertension, diabetes, and heart diseases—combined with other life-style changes and medication if needed.

Research has long shown that good physical fitness and regular exercise promote health and reduce risk of premature death. Furthermore, muscular strength has been shown to associate inversely and independently with death from all causes (Ruiz et al. 2008). Strength training—alongside endurance training and daily habitual physical activity—is included in the disease treatment guidelines for prevention, treatment and rehabilitation of all abovementioned diseases. For example, a weekly strength training session over 30 minutes in duration reduced incidence of coronary heart disease by 23 % compared to participants who did not do strength training at all (Tanasescu et al. 2002). Good muscle strength has also been shown to have a protective effect against heart diseases (Silventoinen et al. 2009). A recent study also indicated that regular (≥ 2 times per week) strength training by over 65-year-olds reduced risk of death by 46% compared to those who did not do any strength training (Kraschnewski et al. 2016). There is also convincing evidence of benefits of strength training in the treatment and rehabilitation of coronary heart disease, and one cannot overlook the fact that, in addition to health benefits, exercise-based cardiac rehabilitation is cost-efficient as well (Hautala et al. 2016). 

Research carried out in Ireland and in Belgium shows interesting findings on the relationship of senior-aged population to smart devices and intelligent technology. The objective of the study was to ex-amine the willingness of heart disease patients aged 62 years on average to use wellness technology as an aid in physical exercise as rehabilitation. 97 % of the patients had a mobile phone and 91 % used the internet. Additionally, 75 % reported being interested in using technology as an aid in rehabilitation. (Buys et al. 2016). A couple of months ago, I carried out a similar study in connection with a lecture I presented at an event organized by Oulu Heart Association in Finland and found the results to be similar. We can, therefore, conclude that using technology is part of everyday life of senior-aged population, too, and using technology in order to increase physical activity and to monitor it on an ongoing basis should be encouraged.

Although benefits of physical exercise surely appeal to us in theory, actually implementing an exercise routine in everyday life of people of all ages requires concrete actions. For example, an individually customized training prescription drafted together with a physiotherapist is a good start for an active life involving regular physical exercise. Clear and safe goal-setting, gradual increase of training load, taking one’s own preferences into consideration, and the exercise experience itself as well as follow up—for example in a HUR smart gym environment—provide support when working towards physical activity goals. There will probably be days on which it is challenging to get moving and go to the gym or jogging, but it is worth bearing in mind that, most of the time, at the latest after the training session, a reward awaits in the form of uplifted spirits and new energy which can be felt for a long time.

Arto Hautala, PhD, Adjunct Professor of Physiotherapy
HUR, Director of Research and Education
Physical Activity Guidelines Expert appointed by the Finnish Medical Society Duodecim and the Executive Board of Current Care
Chair and editor in the working group planning Finnish Current Care Guideline for exercise-based cardiac rehabilitation appointed by the Finnish Association of Physiotherapists


1. Ruiz JR et al. Association between muscular strength and mortality in men: prospective cohort study. BMJ 2008.
2. Tanasescu M et al. Exercise type and intensity in relation to coronary heart disease in men. JAMA 2002.
3. Silventoinen K et al. Association of body size and muscle strength with incidence of coronary heart disease and cerebrovascular diseases: a population-based cohort study of one million Swedish men. Int J Epidemiol 2009.
4. Kraschnewski JL et al. Is strength training associated with mortality benefits? A 15year cohort study of US older adults. Prev Med 2016.
5. Hautala AJ et al.  Economic evaluation of exercise-based cardiac rehabilitation in patients with a recent acute coronary syndrome. Scand J Med Sci Sports 2016.
6. Buys R et al. Cardiac patients show high interest in technology enabled cardiovascular rehabilitation. BMC Med Inform Decis Mak 2016.

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