The Evidence: Why Exercise Works

The AIHW’s 2024 Diabetes report found that type 2 diabetes is now the 12th leading cause of disease burden in Australia, responsible for 128,000 years of healthy life lost annually. Physical inactivity is identified as one of the three leading risk factors contributing to that burden — alongside overweight/obesity and dietary risk. Exercise is a first-line clinical treatment for both type 1 and type 2 diabetes. Regular physical activity improves insulin sensitivity, helps regulate blood glucose levels, supports healthy weight management and reduces cardiovascular risk. Exercise & Sport Science Australia (ESSA) has a formal position statement on exercise in prediabetes and diabetes management. For my patients with diabetes, I design programs calibrated to your specific type, current medications, and fitness level — with blood glucose monitoring integrated into session planning where needed.

Exercise training is an established first-line treatment for cardiovascular conditions. ESSA’s position statement on chronic heart failure confirms that regular exercise is “safe and effective” for people living with heart failure. The Cardiac Society of Australia and New Zealand released a Clinical Guide on exercise prescription in cardiac rehabilitation in 2023. For conditions including atrial fibrillation, heart failure, hypertension, and post-cardiac event recovery, structured exercise programs improve aerobic capacity, reduce symptoms, lower hospital readmission rates and improve long-term survival outcomes. All cardiac exercise programs at ExHealth begin with a clinical assessment to establish your safe exercise threshold before any load is applied.

Falls are the leading cause of injury hospitalisation in Australia for people over 65. The evidence strongly supports structured exercise programs — particularly combining balance, strength and functional training — as the most effective intervention for reducing falls risk. ESSA has a formal position statement on exercise and falls prevention in older people, confirming that exercise programs targeting balance, lower limb strength and functional mobility significantly reduce both falls frequency and fall-related injuries. Programs at ExHealth are designed to be progressive, safe, and focused on the specific activities that matter to you — whether that’s walking safely, getting up from a chair, or maintaining the independence to live at home.

Exercise is an evidence-based intervention for a range of neurological conditions. Research published in Frontiers in Physiology (2022) confirms that regular exercise is protective against neurological diseases including Parkinson’s disease, multiple sclerosis and dementia, and that exercise training is effective in managing symptoms and slowing progression. For Parkinson’s disease specifically, high-intensity exercise programs have been shown to reduce motor symptoms and improve quality of life. For MS, exercise improves fatigue, mobility and mental health. For stroke survivors, graded exercise programs accelerate functional recovery. All neurological programs at ExHealth are designed with condition-specific load management and safety monitoring.

Research continues to show that targeted resistance and weight-bearing exercise can play an important role in improving bone health for people with osteopenia and osteoporosis. The LIFTMOR (Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation) trial demonstrated that supervised high-intensity resistance and impact training, including exercises such as deadlifts, squats, overhead presses and controlled impact loading, significantly improved lumbar spine and femoral neck bone mineral density, strength, balance, and functional performance in postmenopausal women with low bone mass.

The Onero™ program was developed from this research and applies the same evidence-based principles in a clinically supervised setting. By progressively loading bone through resistance training and weight-bearing exercise, the program aims to stimulate bone adaptation, improve muscle strength, reduce falls risk, and support long-term skeletal health. Importantly, the LIFTMOR study reported high adherence rates and very low adverse events when training was appropriately supervised, highlighting that exercise can be both safe and effective for individuals with osteoporosis.

Exercise Physiology is a funded under Capacity Building under the NDIS. ESSA’s formal submission to the NDIS Evidence Advisory Committee presents clinical evidence that accredited exercise physiologists improve functional capacity outcomes for participants across a wide range of disability types — including neurological conditions, intellectual disabilities, musculoskeletal conditions and metabolic disorders. 2024 NDIS outcomes data shows that participants who engage in regular capacity-building physical activities report higher levels of social participation and improved wellbeing. ESSA’s submission also recommends that NDIS planners receive ongoing education about the clinical role of exercise physiologists — a recommendation Chelsea contributed to through her case study input into the current NDIS review. I am a registered NDIS provider and design programs directly aligned with your NDIS goals and plan categories.

The evidence for exercise as a treatment for anxiety and depression is robust and well-established. ESSA, the Dietitians Association and the Australian Psychological Society have a joint consensus statement on addressing the physical health of people with mental illness, recognising exercise physiology as an integral part of mental health care. For WorkCover patients specifically, exercise has documented benefits for mood regulation, stress reduction and rebuilding self-efficacy — factors that directly affect return-to-work readiness. Exercise programs for mental health at ExHealth are designed to be gradual, non-threatening and focused on building a sustainable long-term habit — not achieving fitness benchmarks.

WorkSafe Victoria’s exercise physiology services policy confirms that accredited exercise physiologists are approved providers within the Victorian Workers’ Compensation Scheme. WorkSafe’s Clinical Framework requires all treating practitioners to measure and demonstrate the effectiveness of treatment, use evidence-based practice, and support return to work as a health outcome in itself. The evidence supports early return to appropriate work as part of recovery — not something to delay until pain has fully resolved. Studies consistently show that prolonged work absence is associated with worse long-term physical and mental health outcomes, and that graded return-to-work programs coordinated with an exercise physiologist significantly improve functional recovery. I am a registered WorkSafe exercise physiology provider and I work directly with your GP, treating specialist, case manager and employer.