Medical rehabilitation and fitness: what are the differences in approaches and aims?

Many patients before or during a course of medical rehabilitation after injuries, fractures, surgeries, strokes, manifestations of chronic pain wonder: "What is the difference between rehabilitation and exercises in a fitness centre?” In fact, these are two different approaches to restoring health and functionality. Let's look into it together with Anatoly Fesyun, Acting Director of NMRC for Rehabilitation and Balneology of the Ministry of Health of Russia, Dr. Sci. (Medicine).

NMRC Rehabilitation and Balneology of the Ministry of Health of Russia is the leading institution of the Ministry of Health of the Russian Federation in the field of medical rehabilitation, with a century of experience in this area. This is where scientific research is conducted, and innovative medical technologies are developed and introduced into both complex and personalized medical rehabilitation and spa treatment programmes.

Anatoly Fesyun, Acting Director of NMRC for Rehabilitation and Balneology of the Ministry of Health of Russia, Dr. Sci. (Medicine), Associate Professor, spoke about the differences in approaches and aims between the programme of medical rehabilitation in medical institutions and exercising in fitness centres:

Aims:
Medical rehabilitation is aimed at restoring or maximally compensating functional disorders, as well as improving the quality of life and social adaptation of the patient after diseases and other pathological conditions, taking into account the individual specifics of patients of any age group.
Fitness training is more focused on conditionally healthy individuals and is mainly aimed at achieving a certain physical shape (weight loss, gaining muscle mass).
The main commandment is abstaining from doing harm! Medical supervision: the importance of diagnostics, control and follow-up.

Medical rehabilitation at our Centre begins with an initial consultation with the doctors of a multidisciplinary rehabilitation team, examination of the medical history (including laboratory and other methods of medical examination), making an accurate rehabilitation diagnosis, rehabilitation forecast and development of an individual medical rehabilitation plan that takes into account the specific features of the patient's body and condition. The attending physicians carry out constant monitoring of the patient to prevent possible complications and minimize the risk of adverse events as much as possible. Medical surveillance allows the programme to be adjusted in accordance with physiological changes and progress to be evaluated regularly. All exercises are based on safe and correct movement in the decompression mode, where, for example, even in the presence of osteoarthritis, the joint surfaces are gently stretched and not the other way round.

In fitness centres, although there may be personal trainers, there is no systematic professional medical surveillance - there is no record of the necessary and safe load, no monitoring of the heart, respiration and muscle tissue. Most clients of gyms come up with their own exercise programme or follow the instructor's recommendations and exercise on their own. The stresses that the body undergoes during uncontrolled fitness are often harmful and lead to deterioration of physical health. It is not uncommon for neurologists, orthopaedic traumatologists and cardiologists of our Centre to see patients with injuries (dislocated vertebrae, muscle strains, etc.) and functional disorders resulting from mistakes made during fitness club sessions.

Methods:
NMRC for Rehabilitation and Balneology of the Ministry of Health of Russia is a National Research Medical Centre. Here, doctors and instructors always rely on the proven effectiveness of treatment programmes and their techniques based on the results of thousands of patients. Medical rehabilitation is a set of measures that help to fully or partially recover impaired body functions after diseases or injuries. Medical rehabilitation includes various methods and procedures such as robotic biofeedback mechanotherapy, exercise therapy, physiotherapy, hydrokinesotherapy, massage, psychotherapy, occupational therapy, balneotherapy and many others.

A fitness centre usually offers only general workouts such as cardio, strength training and group exercise classes, but these tend not to address the specific anatomical and physiological characteristics, needs and limitations of an individual.

Exercise equipment:
Rehabilitation simulators differ from fitness centre equipment in that they are of a more complex structure. They are therapeutic devices for performing special exercises passively or actively to help restore lost (fully or partially) functions after injuries, fractures, strokes and other diseases and conditions. Rehabilitation simulators provide precisely calibrated duration and intensity of load, regulation of movement amplitude depending on the existing pathology and functional state of a patient. In addition, they are a kind of unique simulators with biofeedback, virtual reality. They affect the deep stabilization system of the spinal muscular corset.

Exercise equipment is simpler in fitness centres. Training sessions usually take place on traditional treadmills, exercise bikes, weight machines, etc.

Psychological support:
Another advantage of the medical rehabilitation programme is a psychological support for patients, a change of attitude towards treatment and lack of faith in recovery, a professional attitude towards success and return to a productive life. The aim of psychotherapeutic impact is to eliminate painful disorders by restructuring the patient's attitude to certain difficulties that are the cause of psychogenic reactions. You will not receive psychological support from a medical psychologist at your gym. Length of training sessions:

Also, one of the FAQs from patients is why do fitness centre sessions last 40-45 minutes, but medical rehabilitation procedures last 10-15 minutes? Vigorous physical training and excessive efforts to return to the condition "before the disease" can lead to dangerous complications. You need to be within reasonable limits! The body needs to recover. You should increase the intensity of workouts gradually. And strictly under the control of medical staff! The length of procedures in the medical rehabilitation programme ranges from 10-15 minutes. At the same time, the total duration of all rehabilitation activities during the day averages 3 hours. The load should be distributed in such a way that active exercises that require considerable physical effort are replaced by less tiring or passive ones.

Summing up, it is important to note that training in fitness centres with adequately selected load can act as a means of maintaining the achieved results after undergoing medical rehabilitation and as an additional measure to stay fit. In any case, before starting exercises it is necessary to consult a physician who will help to design an effective and safe programme on the way to restoring health. Self-care is an important component of health and well-being.