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In
general, our society has a bias toward curative rather than palliative
medicine, toward making the disease go away rather than finding
ways to cope with disease. An unfortunate consequence of this perspective
is that for persons with chronic disease or disability, we devalue
the palliative benefits of preserving functionality and well-being.
Recent improvements in societal awareness of persons with disabilities,
of the elderly, and of persons with terminal or end-stage disease
have brought attention to medical issues surrounding individual
rights of autonomy and self-determination. Since the 1960's, exercise
has been promoted as a method of extending life, largely through
prevention and moderation of cardiovascular disease. But in 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 than to quantity of life. Perhaps the greatest
potential benefit of exercise is its ability to preserve functional
capacity, freedom and independence.
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