ABSTRACT
Physical activity has a clear role to play in the management and treatment of many chronic diseases. This chapter will review the health benets associated with participation in regular physical activity, focusing in particular on the psychological eects and issues concerned with adherence among people with diabetes and cancer. We have chosen these two exemplars because diabetes and cancer are, according to the World Health Organization, two of the main chronic diseases (https://www.who.int/mediacentre/factsheets/fs355/en/). Chronic diseases are also known as non-communicable diseases (NCDs) because they are not passed from person to person and often have risk factors that could be modied. These modiable factors include increased physical activity, reduced tobacco and alcohol use, and improved diet. NCDs are the main cause of death in all regions of the world except Africa (Lim et al., 2012). The contribution of physical activity and exercise to the management of these chronic disease states is increasingly being recognised. Initial interest in the role of exercise for clinical populations came from physicians and exercise physiologists. They used exercise tests as part of a medical diagnosis and sought physical improvements and decreased morbidity and mortality for their patients. More recently it has been recognised that longevity is perhaps not the key issue for exercise with these patient groups, but rather quality of life and the ability to function in everyday activities are more salient issues. The American College of Sports Medicine (ACSM) has produced a comprehensive text (now in its third edition) on managing exercise programmes for clinical populations to assist the increasing number of exercise specialists in this area (American College of Sports Medicine, 1997; American College of Sports Medicine with Durstine et al., 2009). Moore (1997, p. 3), in the introductory chapter of the rst edition of this text, summarised the short history of the rationale for exercise programmes with clinical populations as follows:
[I]n the 1980s, research and clinical applications for exercise expanded to populations with a variety of chronic diseases and disabilities, for whom exercise is perhaps more fundamentally related to quality of life rather than quantity of life. Perhaps the greatest potential benet of exercise is its ability to preserve functional capacity, freedom and independence.
