Paul Oh
MD, FRCPC

Harnessing the power of physical activity

When it comes to mending damaged hearts, exercise is powerful medicine. Dr. Paul Oh sees the benefits every day in his work at Toronto Rehab. “Simply put, exercise is as powerful a therapy as anything we can offer,” he says.

The statistics are persuasive. Participation in cardiac rehabilitation programs, which emphasize exercise, can lower chances of dying by about 20 per cent, says Dr. Oh, a Scientist and Medical Director of Toronto Rehab’s Cardiac Rehabilitation and Secondary Prevention Program.
 
In his research, Dr. Oh focuses on identifying ways to make cardiac rehabilitation even more effective for people who are recovering from various forms of heart disease and/or surgery. He has found that the right volume and intensity of exercise are important to maximize gains in function, minimize risk factors and ultimately change cardiovascular health.

“We know exercise promotes heart health,” he says. “Now we are refining what we do by looking at the effect of exercise on cardiovascular health and risk factors. We’re also studying ways of optimizing interventions―different doses, different intensities and different ways of delivering the exercise.”

The notion of prescribing exercise for people with heart problems is relatively new. Not so long ago, heart patients were advised to take it easy, rather than to get out there and walk. “There has been a shift from bed rest to increasing levels of activity,” says Dr. Oh. “Exercise is good―but only if it’s done in a safe and sensible manner. That’s where rehab programs can steer people in the right direction.”

Core components of Toronto Rehab’s year-long outpatient cardiac rehabilitation program, which is the largest of its kind in North America, include aerobic exercise, resistance training, and education. “People with heart disease can become fitter and function better than they have in years,” says Dr. Oh.

Unfortunately, many people are not signing up for cardiac rehabilitation programs. To address this problem, Dr. Oh is studying barriers to access, and considering different ways of delivering cardiac rehabilitation. “For instance, we’re looking at the potential of home-based programs and even web-based programs,” he explains.

Dr. Oh is also working to extend the successful model of cardiac rehabilitation to other at-risk populations. One major focus has been people with diabetes. Adults with diabetes are at a high risk of cardiovascular disease.

“We found that in people with diabetes, structured exercise improved fitness levels, blood sugar control and cholesterol values, while body weight and body fat went down,” says Dr. Oh. “Now we’re looking at optimal modes of delivery, and exploring other physiologic effects of exercise.”

Dr. Oh and colleagues are also applying Toronto Rehab’s cardiac rehabilitation model to stroke survivors, as well as women with breast cancer, especially those undergoing chemotherapy. The researchers will study the effects of exercise on these women by assessing fitness, function, quality of life and ultimately survival rates.

Dr. Oh is excited by the focus on health and wellness in his work. “Throughout my medical career, I’ve been interested in prevention. My training was in internal medicine with a focus on prevention, and also in clinical epidemiology, so this is a great fit.”

He believes that “exercise gets at the root of many of the issues that we face as a society. It can help manage chronic conditions, such as diabetes and high blood pressure, and assist people’s recovery from problems like heart attack or stroke.

“It’s the remedy for the industrialized lifestyle. Many people are interested in exercising, but as a society people walk less, work more, and often have to drive everywhere. We need to recapture physical activity to help regain our health.”

Curriculum Vitae