Physical activity on prescription in primary health care: a follow-up of physical activity level and quality of life.
ABSTRACT To examine whether physical activity on prescription in routine primary care patients would influence physical activity level and quality of life 6 months later. In 2001-2003, 13 Swedish primary health care units took part in an uncontrolled clinical study. If a patient in primary health care needed physical activity preventively or for treatment of a disease and patient-centered motivational counseling found physical activity to be suitable, individualized physical activity could be prescribed. Patients (n=481) of both sexes and all ages [75% women, mean age 50 (12-81)] participated in the study. Self-reported physical activity, readiness to change to a more physically active lifestyle and quality-of-life data were collected through questionnaires. The follow-up rate was 62% at 6 months. Intention-to-treat analysis showed a significant increase (P<0.01) in self-reported physical activity level, the stages of action and maintenance of physical activity as well as quality of life. Physical activity level, stages of change and quality of life increased analogically, indicating that physical activity on prescription may be suitable as a conventional treatment in an ordinary primary health care setting to promote a more physically active lifestyle.
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ABSTRACT: There is solid evidence that physical activity is essential to improve health as well as quality of life, and there is an urgent need to find effective strategies to implement this knowledge into health care delivery as well as to develop more effective strategies for the promotion of physical activity. A systematic literature review of methods of promoting physical activity from randomized controlled studies with at least 6months follow-up published 2007 showed that advice or counseling on physical activity given by health care professionals (15 studies) leads to an increase in physical activity of 12% to 50%. Studies on theory-based behavioral interventions (21 studies) demonstrated a 10% to 15% increase in physical activity compared to usual care. More recent studies performed within the health care system indicate that “physical activity on prescription” can be a feasible and effective way to increase patients’ physical activity levels. There is a great and urgent need to spread this new evidence-based knowledge as well as experiences and pedagogic skills to counteract the epidemic of a sedentary lifestyle. However, there are still major gaps in our knowledge about long-term effectiveness of various methods of promoting physical activity and about how to implement current knowledge into clinical practice. A focus on translational research and studies on implementation is needed. KeywordsPhysical activity–Exercise–Promotion–Prescription–Health careCurrent Cardiovascular Risk Reports 04/2012; 5(4):331-339.
Article: Efficacy of a referral and physical activity program for survivors of prostate cancer [ENGAGE]: rationale and design for a cluster randomised controlled trial.[show abstract] [hide abstract]
ABSTRACT: Despite evidence that physical activity improves the health and well-being of prostate cancer survivors, many men do not engage in sufficient levels of activity. The primary aim of this study (ENGAGE) is to determine the efficacy of a referral and physical activity program among survivors of prostate cancer, in terms of increasing participation in physical activity. Secondary aims are to determine the effects of the physical activity program on psychological well-being, quality of life and objective physical functioning. The influence of individual and environmental mediators on participation in physical activity will also be determined. This study is a cluster randomised controlled trial. Clinicians of prostate cancer survivors will be randomised into either the intervention or control condition. Clinicians in the intervention condition will refer eligible patients (n=110) to participate in an exercise program, comprising 12 weeks of supervised exercise sessions and unsupervised physical activity. Clinicians allocated to the control condition will provide usual care to eligible patients (n=110), which does not involve the recommendation of the physical activity program. Participants will be assessed at baseline, 12 weeks, 6 months, and 12 months on physical activity, quality of life, anxiety, depression, self-efficacy, outcome expectations, goals, and socio-structural factors. The findings of this study have implications for clinicians and patients with different cancer types or other chronic health conditions. It will contribute to our understanding on the potential impact of clinicians promoting physical activity to patients and the long term health benefits of participating in physical activity programs. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000609055Deakin University Human Research Ethics Approval 2011-085.BMC Cancer 06/2011; 11:237. · 3.01 Impact Factor
Article: Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (Part II).[show abstract] [hide abstract]
ABSTRACT: In a previous paper, as the first of a series of three on the importance of characteristics and modalities of physical activity (PA) and exercise in the management of cardiovascular health within the general population, we concluded that, in the population at large, PA and aerobic exercise capacity clearly are inversely associated with increased cardiovascular disease risk and all-cause and cardiovascular mortality and that a dose-response curve on cardiovascular outcome has been demonstrated in most studies. More and more evidence is accumulated that engaging in regular PA and exercise interventions are essential components for reducing the severity of cardiovascular risk factors, such as obesity and abdominal fat, high BP, metabolic risk factors, and systemic inflammation. However, it is less clear whether and which type of PA and exercise intervention (aerobic exercise, dynamic resistive exercise, or both) or characteristic of exercise (frequency, intensity, time or duration, and volume) would yield more benefit for each separate risk factor. The present paper, therefore, will review and make recommendations for PA and exercise training in the management of cardiovascular health in individuals with cardiovascular risk factors. The guidance offered in this series of papers is aimed at medical doctors, health practitioners, kinesiologists, physiotherapists and exercise physiologists, politicians, public health policy makers, and individual members of the public. Based on previous and the current literature overviews, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding type, volume, and intensity of PA and regarding appropriate risk evaluation during exercise in individuals with cardiovascular risk factors.European journal of preventive cardiology. 05/2012;