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For centuries infectious diseases such as malaria, tuberculosis and cholera were the main causes of death worldwide and any advances against infection have been reversed by the rise of the HIV-related disorders [1]. Against this gloomy background, noncommunicable diseases (e.g. cancer, cardiovascular disease, diabetes) are emerging as major problems as well [1]. Non communicable diseases are now the biggest global killers today [2, 3].

NCDs are collectively responsible for almost 70% of all deaths worldwide. Almost three quarters of all NCD deaths, and 82% of the 16 million people who died prematurely, or before reaching 70 years of age, occur in low- and middle-income countries [4].   NCDs also account for 48% of the healthy life years lost (Disability Adjusted Life Years–DALYs) worldwide (versus 40% for communicable diseases, maternal and perinatal conditions and nutritional deficiencies, and 1% for injuries) [5].

What are NCDs?

Non-communicable diseases are a diverse group of chronic diseases that are not communicable, meaning you can’t catch them from another person. They are defined as diseases of long duration, generally slow progression and they are the major cause of adult mortality and morbidity worldwide [6].   Non-communicable diseases are identified by WHO as “Group II Diseases,” a category that aggregates (based on ICD-10 code) the following conditions/causes of death: Malignant neoplasms, other neoplasms, diabetes mellitus, endocrine disorders, neuropsychiatric conditions, sense organ diseases, cardiovascular diseases, respiratory diseases (e.g. COPD, asthma, other), digestive diseases, genitourinary diseases, skin diseases, musculoskeletal diseases (e.g. rheumatoid arthritis), congenital anomalies (e.g. cleft palate, down syndrome), and oral conditions (e.g. dental caries). These are distinguished from Group I diseases (communicable, maternal, perinatal and nutritional conditions) and Group III diseases (unintentional and intentional injuries) [4].

Four main diseases are generally considered to be dominant in NCD mortality and morbidity:

  • Cardiovascular diseases (including heart disease and stroke).
  • Diabetes
  • Cancer
  • Chronic respiratory diseases (including chronic obstructive pulmonary disease and asthma.

These account for around 80% of all deaths from NCDs, of which there are more than 36 million each year. Cardiovascular disease accounts for 17.3 million deaths, followed by some forms of cancer (7.6 million), respiratory diseases (4.2 million), and diabetes (1.3 million) of deaths [6].

NCD Risk Factors

These disease groups are linked by common risk factors:

  1. Social Determinants of Health (this is the environment in which we are born, live and grow and the opportunities we are given in those environments)
  2. Tobacco
  3. Alcohol
  4. Poor Nutrition
  5. Physical Inactivity

Non-modifiable Risk Factors refer to characteristics that cannot be changed by an individual (or the environment) and include age, sex, and genetic make-up. Although they cannot be the primary targets of interventions, they remain important factors since they affect and partly determine the effectiveness of many prevention and treatment approaches [7].

Modifiable Risk Factors refer to characteristics that societies or individuals can change to improve health outcomes. WHO typically refers to four major ones for NCDs: poor diet, physical inactivity, tobacco use, and harmful alcohol use [7].

The role of physiotherapy in NCDS

For physical therapists, the official recognition that a global strategy is required to reduce this burden of disability and deaths is significant. Physical therapists help millions of people every year prevent these conditions and their risk factors – most importantly obesity. They also manage their effects, along with the effects of aging, illness, accidents, and the stresses and strains of life [8].

Physical therapists specialize in human movement and physical activity, promoting health, fitness, and wellness. They identify physical impairments, activity limitations, and disabilities that prevent people from being as active and independent as they might be, and then they find ways of overcoming them. They maximize people’s movement potential[8].

So when the World Health Organization points out that physical inactivity is one of the leading risk factors for global mortality, causing 3.2 million deaths annually, and that physical activity can reduce non-communicable diseases, it is clear that the profession has a major part to play. Physiotherapists are the movement, physical activity, and exercise experts and a resource in the battle against non-communicable disease that should never be overlooked. There is clear evidence that preventive interventions work and that improved access to health care can reduce the burden of mortality, disability and premature mortality. Physiotherapy can play an im­portant role in preventing and managing NCDs [8].

Physiotherapy doesn’t just mean more healthy people, but more productive people who can contribute to countries’ economies [5].

 

References

  1. Frantz Jose (2005) Physiotherapy in the management of non-communicable diseases: facing the challenge. South African Journal of Physiotherapy 61 (2): 7-8.
  2. World Health Organization (2008) 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Non communicable Diseases Geneva.
  3. Mahboob ur Rahman, Rameen Habib, Amin Ul Haq, Farkhanda Rahman (2014). Prevalence of non communicable diseases and the role of physiotherapy as its treatment, related to gender and socioeconomic status. Kaohsiung Journal of Medical sciences 7(2): 254-257.
  4. WHO. Noncommunicable diseases and their risk factors http://www.who.int/ncds/en/ accessed 28 June 2018.
  5. Bloom, D.E., Cafiero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A.Z., & Weinstein, C. (2011). The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum.
  6. Physiotherapists have a vital part to play in combatting the burden of noncommunicable diseases. Physiotherapy 100 (2014) 94–96
  1. https://www.physio-pedia.com/Non-Communicable_Diseases retrieved 27/06/2018.
  2. Marilyn Moffat (2012). Physical Therapy and Noncommunicable Diseases.