SPEAKER SPECIAL

Speaker

Willem van Mechelen

Willem van Mechelen (MD, PhD, Dr. h.c., FACSM, FECSS) initially started his career as a PE-teacher. He now is professor of occupational and sports medicine at Amsterdam University Medical Centers (location VUmc) in Amsterdam, the Netherlands. He is also director -shareholder of the VUmc spin-off company Evalua Nederland B.V. ('Ltd') and non-executive board member of Arbo Unie B.V.. He was honored with the ACSM citation award and the honorary memberships of the Royal Dutch PE-teachers Association and of the Dutch Society for Occupational Medicine and has been inaugurated in the Wall of Fame of the Amsterdam University for Applied Sciences. In 2017 the University of Brussels awarded him with an honorary doctorate degree.

Introduction

Jürgen Steinacker

Jürgen Michael STEINACKER, is Professor of Medicine at the University of Ulm and head of the Division of Sports and Rehabilitation Medicine. The division provides outpatient care in cardiology and general sports medicine and rehabilitation services for cardiac and cancer patients, a Physiology and Performance Centre for top athletes and a Molecular Muscle Biology Laboratory. Among others, he is Chair of the European Initiative for Exercise in Medicine, Chief Editor of the German Journal of Sports Medicine; Member of the Health, Medical and Research Committee, World Anti-Doping-Agency (WADA) and vice chair of the Scientific Committee of the German Society of Sports Medicine. Focus is also on large epidemiological projects: “Join the healthy boat”, funded by the Baden-Württemberg Trust deals with physical activity and healthy life style in primary school children in the state of Baden-Württemberg. He has been Team doctor of German rowing since 1989  and Member of FISA´s Sports Medicine Commission since 2000.

EIEIM - A growing Initiative

Physical activity has a major positive impact on health and several health related outcomes, as well in prevention and treatment of chronic diseases and should be included in medical care. Physical activity should be considered by all health care providers as a vital sign in every patient visit and that patients should be effectively counselled for and referred to physical activity according to their health needs. The European Initiative for Exercise in Medicine (EIEIM) was founded as non-profit non-governmental organization for Europe with collaborations with EIM in the United States and currently  17 European countries being involved in EIEIM.

Philip Treleaven

Philip Treleaven is Director of the UK Centre for Financial Computing & Analytics (www.financialcomputing.org) and Professor of Computing at UCL. Twenty years ago his research group development much of the early fraud detection technology. In 2000 Prof Treleaven was the Director of the UK National Sizing Survey (SizeUK) which pioneered the use of 3D Whole Body Scanners for anthropometrics surveys. For the past 16 years Prof. Treleaven’s research group has developed algorithmic trading systems with many of the leading banks.
UCL is the leading university for AI/Machine Learning research in the UK, and spun out DeepMind bought by Google for €500m.

Exercise in Medicine – game changing technologies
We are undergoing a ‘data’ revolution – a data tsunami – this is having a profound effect across science and medicine. The data science technologies of artificial intelligence (AI), Internet of Things (IoT), Big data and behavioural/predictive analytics, and blockchain are poised to revolutionize sport, exercise and health. For example, these techniques contribute to accurately and reliably assessing physical activity habits, the determinants of physical activity and the impact of changes in physical activity.
This presentation introduces these data science technologies and discusses opportunities for ‘exercise in medicine’.

Mats Börjesson

Börjesson, Mats ; MD is a Specialist in Internal Medicine and Cardiology;FESC, FACC, FACSM.
Professor, Head of Center for Health and performance (CHP) and Inst of neuroscience and Physiology, Göteborg University and Sahlgrenska University Hospital/Östra, Goteborg, Sweden.

Chairman, section of Sports Cardiology, European Society Cardiology, 2008-10; Chairman, Swedish Society of Exercise and Sports Medicine, 2013-15,
Chairman, Swedish Society of Cardiology, 2016-18;
Chairman of the "Task Force of Physical Activity", WHO-network Health Promoting Hospitals 2013-16; Member of the IOC Task Force on “prevention of non-communicable diseases”, 2013-14; Member of EFSMA scientific committees, 2014-, and FIMS scientific committee; Member of Exercise is Medicine (EIM) Europe, steering board, 2014-.
Invited speaker at >130 international conferences and author of >200 peer-review scientific papers and book chapters.

EIM in primary care- Sweden leads by example

Increased physical activity (PA) is associated with improved health and methods to increase PA in clinical practice are needed. The Swedish physical activity on prescription (PAP)-method focuses on incorporating physical activity into the lifestyle of the patient in the long term. The model consists of individual counselling on PA, a person-centered approach and structured follow-up. For reference the FYSS book, collecting the most evidence-based prescription of exercise (type, intensity, duration, frequency) for a multitude of diseases (www.fyss.se) is used.

PAP has been in use in Swedish primary care, since the beginning of the 2000´s, although the uptake has been varied. The method has been studied in a number of studies. The effect of PAP on level of physical activity was recently summarized in a systematic review and included data reported from five RCTs and one cohort study (eight papers), using the GRADE-system. The results show that the Swedish PAP increase the level of physical activity compared to no PAP, in adult individuals who have been deemed to be in need of increased physical activity by healthcare (Onerup 2018). Important differences between the Swedish PAP and other models for promoting physical activity is that PAP is more person-centered and individualised. Thus, the Swedish PAP can be used in clinical practice to increase the level of PA in insufficiently active patients. The method is now being spread around Europe in a EU-project, involving 10 countries.

Rienk Dekker

Rienk Dekker is a consultant in rehabilitation medicine and an associate professor in the Department of Rehabilitation Medicine of the University Medical Center Groningen, the Netherlands.  
In the field of scientific research, education and patient care he focuses on physical activity, sports and rehabilitation. In the context of research he delivered his PhD in 2004, has published over 75 peer-reviewed international (co-)authored articles on this subject and is involved in a number of related PhD-projects. He  succeeded in acquiring relevant grants to facilitate research in this field. As a principal investigator and rehabilitation physician he aims to implement the principles of  an active life style in preferably all rehabilitation treatments as a means to enhance the outcome of the rehabilitation process.

On a blue print for EIM in Dutch Hospital Care.

Physical inactivity, referred to as a pandemic by the Lancet in 2012, has led to an increase in the prevalence of lifestyle-related
chronic diseases on a global scale. Though life expectancy has increased, physical inactivity remains an impediment to healthy
ageing: additional life years are often spent in illness. As such, there is a need for more awareness surrounding the preventive
and curative role of physical activity and lifestyle in healthcare. The prescription of physical activity and exercise in clinical care has been advocated worldwide through the ‘exercise is medicine (E=M)’ paradigm. Prescribing an active lifestyle and exercise as treatment options in clinical care can be used to prevent, treat, and oftentimes reverse lifestyle-related chronic diseases. However, E=M currently has no position in general routine hospital care, which is hypothesized to be due to attitudinal, and practical barriers to implementation.

During the presentation the present status of the project will be elucidated and the first outcomes of the activities of the research
group and consortium will be shared.

Ulf Ekelund

I am professor in Physical Activity and Health at the Norwegian School of Sport Sciences and research scientist at the Norwegian Public Health Institute (20%). Before moving to Norway in 2012, I led a research programme in physical activity epidemiology at the MRC Epidemiology Unit, University of Cambridge, UK. My main research areas include assessment of physical activity and sedentary time, patterns and trends in population levels of physical activity and the role of sedentary time and physical activity for preventing chronic diseases across the life course.
Outside work, I am a keen exerciser and enjoy outdoor activities such as cross-country skiing, hiking, running and cycling. I love travelling, exploring new places and wildlife.  

To sit or not to sit – epidemiological and experimental evidence and implications for clinical settings
Physical activity is one of the most potent behaviours for preventing non-communicable diseases and for promoting healthy longevity. Recently, observational, experimental and intervention-trial evidence has emerged, identifying sedentary behaviour as a new risk factor to be addressed in relation to many chronic diseases. In response to this, many health authorities have included recommendations aimed at reducing sitting time for disease prevention and for improving public health. In this presentation, the epidemiological evidence on the associations and interactions between physical activity and sedentary time for preventing disease and promoting longevity will be discussed. Novel data examining the combined and dose-response associations between device-based measured sedentary time and physical activity with clinical endpoints will be presented. Finally, reducing and frequently interrupting prolonged sitting of time with brief periods of movement may be a practical approach for offsetting the hazards of too much sitting. 

Kathryn Schmitz

Dr. Schmitz has published over 230 peer reviewed scientific papers and has had $25 million dollars in funding for her research since 2001.  She was the lead author of the first ACSM Roundtable on Exercise for Cancer Survivors, which published guidance for exercise testing and prescription for cancer survivors in July 2010.  In June 2017, she became president-elect of the American College of Sports Medicine.  She assumed the presidency in June 2018. In March 2018 Dr. Schmitz chaired an International Multidisciplinary ACSM Roundtable on Exercise and Cancer Prevention and Control.  The physicians, outpatient rehabilitation specialists, researchers, and exercise professionals in the room broadly agreed it is time for exercise oncology to go prime time.  The question is how.  Dr. Schmitz’ professional mission is to answer that question.

EIM for cancer patients

The evidence base supporting exercise in the context of cancer care has grown 281% since 2010.  In March 2018, the American College of Sports Medicine convened its second roundtable on exercise for cancer prevention and control.  The gathering included organizations from around the globe and across the continuum of cancer care.  One product of this meeting was the development of a new Exercise is Medicine in Oncology Call to Action, which calls for application of the Exercise is Medicine Solution to be applied across oncology care.  This talk will present this action plan.

Joost Klaase

Joost Klaase works as a hepatobiliary surgeon at the Department of Hepatobiliary Surgery and Liver Transplantation of the University Medical Center Groningen. He is engaged in minimally invasive pancreatic and liver surgery. He is Professor of Surgery at the Rijksuniversiteit Groningen. He was until recently Chairman of the Dutch Liver Surgery Working  Group and Chairman of the Scientific Board of the Dutch Hepatobiliary Audit. He is Chairman of the Managed Clinical Network HPB Surgery North East Netherlands. His research topic is optimization of perioperative care in hepatobiliary surgery. His main interest is in prehabilitation. This means improving functional capacity and physiological reserve of patients before surgery or start of treatment.

EIM as pre-hab in pre-operative care
The chance of development of minor or major complications after abdominal surgery for cancer is 10-20% and 20-30%, respectively.   A complicated postoperative course leads to decrease in quality of life. Complications, especially in the elderly patient with multimorbidity,  lead to dependency and eventually death. Complications after abdominal surgery are responsible for a 2-3 times increase in hospital admission costs and account for an unpanned readmission rate as high as 25%.
Preoperative training of non-fit patients (anaerobic threshold < 11 ml/min/kg) scheduled for  abdominal cancer surgery, reduces the percentage of patients with one or more postoperative complications with almost 50%. Besides improvement of preoperative physical fitness, optimization of the other 5 modifiable patient risk factors (frailty, nutritional status, iron deficiency anaemia, psychological resilience, intoxications) can even further  improve outcome after major abdominal surgery.

Chin A Paw

Prof.dr. Mai Chin A Paw is professor of Public and Occupational Health emphasizing Epidemiology of Child Health at Amsterdam UMC (location VU University Medical Center). In her research she takes a true translational approach from science to society by combining her scientific expertise in human movement science and epidemiology resulting in innovative studies in real-world situations. Her research focuses on determinants and health consequences of physical activity (PA) and sedentary behaviour (SB) in youth, with a strong interest in underlying mechanisms and innovations in risk factor research. Recently, she and her colleagues concluded the research project SMART MOVES!, in which she investigated the effects of physical activity on cognitive and academic performance in children.

Physical activity and cognition; what do we know in kids?

The physical and mental health benefits of physical activity (PA) are widely acknowledged but less is known about the potential effects of PA on cognitive and academic performance. A number of reviews and reports on this topic have been published during the last decade, but not all of these reviews took into account the methodological quality of the included studies. Using the latest insights from her systematic review including a methodological quality assessment as well as a Delphi study with a multidisciplinary, international group of experts on the topic, prof. Chin A Paw will summarize the current evidence on the effects of PA interventions on cognitive and academic performance in children. She will touch upon research challenges and provide recommendations for future research.

Esther van Sluijs

Dr Esther van Sluijs works at the Centre for Diet and Activity Research (MRC Epidemiology Unit), University of Cambridge, UK. Here she leads a research programme aiming to develop and evaluate interventions to promote physical activity in young people, and use observational research to further understand where, when and how physical activity interventions in young people may be targeted. Esther’s work involves observational studies, intervention research, and evidence synthesis and particularly focuses on physical activity behaviour in family and educational contexts.

Physical activity interventions for children; do they really work?

Regular physical activity is important for young people’s current and future health, well-being, and academic performance. Evidence consistently shows that young people’s levels of physical activity are insufficient for optimal health. Globally, the vast majority of children do not meet the World Health Organisation (WHO) recommended 60 minutes of moderate-to-vigorous physical activity (MVPA) each day, and physical activity declines during childhood and adolescence and into adulthood. Identifying ways to promote and maintain active living in young people is therefore a critical public health issue, but intervention efforts to date generally show limited impact. In this talk, I will review the most recent intervention evidence of school-based physical activity interventions, explore our understanding of the reasons for the limited impact (including implementation issues), and discuss future directions for young people’s physical activity promotion.

Ugo Giordano

Ugo Giordano MD works at the Bambino Gesu’ Children’s Hospital in Rome, Italy, from more than 25 years. He has graduated at “La Sapienza“ University in Rome, Italy, in 1993 and specialized at the same University in Sports Medicine in 1997. He had a Master in Pediatric Cardiology with the Professor F.M.Galioto at the Georgetown University on the subject of Rehabilitation of Children after Cardiac Surgery and with the Prof BS Alpert at the University of Tennessee in Memphis on the subject of Pediatric Arterial Hypertension. He is an expert in functional evaluation in Pediatric Cardiology and had numerous speeches during the Annual Meeting of the American Academy of Pediatrics – Section of Cardiology and Cardiac Surgery about Rehabilitation of sick children and Pediatric Hypertension. He has wrote many paper about exercise medicine and hypertension in patients operated on for aortic coarctation.
He experienced more than twenty years in the field of arterial hypertension in pediatrics in terms of diagnostic, clinical and therapeutic management

EIM for the clinical paediatric population

My paper concerns the prescription of physical exercise in pediatric age, both in healthy subjects and those suffering from chronic pathology. In particular it will be shown how much activity it is good to practice, both in terms of weekly hours that in terms of advising the boys on which is the most suitable physical activity for the physical conditions of the subject that, after the acute phase of the illness, returns to the normal life, both healed or cured.

Kathleen Martin Ginis

Dr. Kathleen Martin Ginis is a Distinguished University Scholar and a Professor in the Faculty of Medicine and in the School of Health and Exercise Sciences at the University of British Columbia. Dr. Martin Ginis’s research program focuses on physical activity behaviour change, and the psychosocial and health-related consequences of physical activity participation, particularly among people with physical disabilities. She has received over $12 million in research funding and has published over 250 peer-reviewed research articles. A passionate advocate for community-engaged research, in 2014, the Government of Ontario awarded Dr. Martin Ginis the Ontario Medal of Good Citizenship in recognition of her long-standing contributions to science designed to improve the lives of people living with spinal cord injury. Dr. Martin Ginis resides in Kelowna, British Columbia where she loves to run, snowshoe, and kayak with her husband and daughter.

Implementing Exercise is Medicine in Community-Dwelling Persons with Physical Disabilities

Among people with physical disabilities, one of the most frequently-cited barriers to exercise participation is a lack of basic information on how to be physically active with a disability. Similarly, physicians and other health care professionals often cite a lack of knowledge about what to recommend or prescribe, as their primary reason for not promoting exercise to patients and clients with disabilities. The development and implementation of disability-specific exercise guidelines are important steps toward addressing these barriers. Exercise guidelines are systematically developed, evidence-based statements that provide age- and ability-specific information on the course of action required to maintain or improve fitness or health. Using the Canadian Multiple Sclerosis Physical Activity Guidelines and the International Scientific Spinal Cord Injury Exercise Guidelines as examples, a systematic, evidence-based and community-engaged process will be shared for formulating exercise guidelines. In addition, evidence-based strategies will be presented for translating and implementing exercise guidelines among community-dwelling people with physical disabilities.

James Rimmer

James H. Rimmer, PhD is a Professor in the School of Health Professions at the University of Alabama at Birmingham (UAB). He has an adjunct faculty appointment in the Department of Physical Medicine and Rehabilitation in the School of Medicine. Rimmer directs two U.S. technology-driven federally funded centers, the National Center on Health, Physical Activity and Disability (funded by CDC since 1999), and the Rehabilitation Engineering Research Center on Interactive Exercise Technologies and Exercise Physiology for People with Disabilities (funded by the National Institute on Disability, Independent Living and Rehabilitation Research since 2002). His research interests explore the use of new and emergent technologies in developing biobehavioral and environmental strategies to promote beneficial physical activity and healthful weight management in adults with physical disabilities.

Exercise promotion programs for people with disabilities:  Use of Teleexercise to Reach the Most Difficult to Reach

The Research and Development (R&D) efforts needed to break the cycle of deconditioning and promote greater health and function among people with disabilities must be performed in a logical, interdependent framework that uses new and emerging technologies to reach underserved populations who have difficulty accessing exercise/wellness facilities.  In the U.S., there is a gross misrepresentation of the effects of exercise on people with disabilities.  Small samples sizes involving subgroups who have access to transportation and have the capacity to get to an exercise facility on a regular basis likely do not represent certain subgroups of people with disabilities who cannot access these studies or programs.  Telerehabilitation is gaining momentum as a method of service delivery that is convenient and cost effective.  When community and clinically-based exercise/recreation programs are extremely difficult to get to and/or participate in on a regular basis, telerehabilitation, or what we refer to as teleexercise, holds enormous potential for reaching the most underserved groups of people with disabilities.  It eliminates the barrier of transportation, offers participants the flexibility of exercising at their preferred time of day, and does not involve as much energy or time getting to an exercise facility.  This presentation will describe a set of teleexercise projects that are targeting people with neurological disability who are typically unable or unwilling to participate in clinic- and community-based exercise trials. 

Sonja DeGroot

Dr. Sonja de Groot is senior researcher at the Amsterdam Rehabilitation Research Center | Reade and Center for Human Movement Sciences at the UMC Groningen. Dr. De Groot was the coordinator of the Dutch multi-center research programs entitled 'Restoration of mobility in SCI rehabilitation' and 'ALLRISC' and was one of the initiators of the HandbikeBattle research project. She is the secretary of the research committee of the Dutch Flemish Spinal Cord Society (DuFScoS) and is the section editor for Spinal Cord, a specialized, international journal on spinal cord related topics. Dr. De Groot's current research interests include the study of (spinal cord injury) rehabilitation, exercise physiology, wheelchair propulsion and configuration, and adapted sports. For more information, please visit https://www.rug.nl/staff/sonja.de.groot/research

Exercise for manual wheelchair users
Wheelchair users have a relatively inactive lifestyle. Their activity level is distinctly lower than measured in matched able-bodied persons or in persons with other chronic diseases. Several studies have shown that an inactive lifestyle is associated with a lower fitness level, poorer health, reduced social participation and a lower quality of life for wheelchair users. There are, however, a number of ways in which wheelchair users can remain active in daily life, for instance, by using a handcycle for mobility, and by participating in (wheelchair) sports. Some (Dutch) initiatives to improve fitness, health and quality of life of wheelchair users through exercise, such as ReSpAct, the HandbikeBattle and WHEELS, will be presented. General practitioners and rehabilitation professionals, among others, play an important role in assisting wheelchair users to engage in an active lifestyle as soon as possible and over the lifespan. Exercise is a key factor in helping wheelchair users to become and stay fit. Fitness in turn improves associated and secondary conditions, as well as activities in daily life, participation in life roles, and overall quality of life. 

Tom de Bruijne

Tom De Bruyne (1975) is co-founder of  the Amsterdam based consultancy SUE Behavioural Design. SUE helps companies to create smarter marketing and communication through of behavioural psychology. SUE facilitates Behavioural Design Sprints and trains these skills and habits at the Behavioural Design Academy. He works for a broad range of international clients, applying Behaviuoral Design Method to get people to donate, to get them to vote, to save more, to recycle, to get people out of debts, etc. SUE works in front and behind the screens for organizations as UNHCR, Heineken, Amnesty, Oxfam, Clinclowns, several departments at the Dutch Government, Sony Music, Rabobank, ABN AMRO bank, Randstad, Talpa Radio and the Dutch Liberal Party VVD and the Belgian Socialist Party, amongst many others. Tom is Tedx speaker, leading columnist in the leading Dutch Marketing Magazine Adformatie. He’s an elected Fellow at the Economics Department of the University of Leuven in Belgium.   

Marketing Exercise as Medicine: How to design interventions for behavioral change.

How to get people to act ups their desire to change their behavior? As we all know, there’s a very wide gap between our current self and our future self. Whereas our future self is disciplined, our current self has difficulties to say not to temptation and laziness. I want to explore a number of behavioural design principles and technique to get people to resist temptation, trigger action, and build and maintain a habit.

Menno de Bree

Menno de Bree (1974) lectures on philosophy and ethics. Before joining the University Medical Center Groningen, he used to work for Heineken and Nyenrode Business University, specializing in doing philosophy with professionals. De Bree writes a weekly column for Het Financieele Dagblad, the leading Dutch financial newspaper and is widely known for his rather pessimistic world view. He hates sports.

On the ethics of EIM

The bodily life, the kind of life that we share with other animals, has traditionally been regarded as the lowest form of life. We have a body, but our identity primarily lies within our soul and our capacity to think.Things started to change, however, in the 19th century. Friedrich Nietzsche famously stated that humans are failed animals, and that health would become the most important value in the late 20th century. I guess he was right about both claims. Our body is of a disastrous design, and health has become on of the leading motives in modern life.  In this talk, I will shortly address the philosophical backgrounds of this development, and I will argue that we should get back to the spiritual life - the sooner the better. Health and health promoting activities only have secondary value within my picture of the good life.

Johannes Zwerver

Johannes Zwerver MD PhD (Nickname Hans) is a Professor of Sports & Exercise medicine at the University of Groningen in the Netherlands. He works as a registered sports medicine physician in the University Medical Center Groningen. As a former team physician for professional football, basketball and Dutch cyclo-cross teams he has ample experience in working with both elite and recreational athletes. Promoting 'Healthy active ageing' and prescribing 'Exercise is medicine' to patients with chronic disease is one of his actual tasks as well.  He is also member of the Groningen Transplantoux team and is involved in the exercise testing and training guidance of transplant athletes and patients with chronic diseases.

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