Effects of Nurse Counseling on Walking for Exercise in Elderly Primary Care Patients

Abstract

Background. Counseling sedentary primary care patients can increase physical activity, but whether this approach will increase exercise and fitness in elderly adults with chronic diseases remains to be determined. Methods. After receiving individualized nurse counseling to begin a program of walking for health, 60- to 80-year-old primary care patients were randomized to one of three levels of telephone contacts over 10 months: (i) 20 nurse-initiated calls, (ii) 10 nurse-initiated calls plus 10 motivational calls programmed through an automated phone calling system, or (iii) no program-initiated phone contacts. Self-reported (diary) walking adherence was the primary outcome; other activity, social support, health quality of life, and measured walking performance, mobility, and body mass index and girths were also assessed during the initiation (months 1-6) and maintenance (months 7-10) phases of the trial. Results. Average adherence for the 181 participants to the goal of walking at least 20 minutes on 3 or more days per week was 44% for initiation and 42% for maintenance. Participants receiving the combination of nurse-initiated personal and automated phone calls walked significantly more frequently than those with no phone contacts. Fitness improved in all three groups; changes were generally correlated with self-reported walking. Having a companion was associated with more frequent walking. Perceived quality of physical and mental health did not change. Conclusions. Simple and relatively inexpensive nurse contacts can motivate elderly primary care patients to walk for exercise, and this activity is associated with measurable health benefits.

Chronic Osteoarthritis and Adherence to Exercise: A Review of the Literature

“…Consequently, for those attending formal exercise classes who are expected to continue these at home, ongoing group activities after these have terminated are indicated (McKelvie et al, 2002). Similarly, the importance of having an exercise companion (Dubbert, Cooper, Kirchner, Meydrech, & Bilbrew, 2002) and ongoing contacts with an empathetic professional have been stressed (KeeleSmith & Leon, 2003;Marks, 1994). Investigative work by Mazzucca et al (1997) has further suggested that in the context of knee osteoarthritis, sustained preservation of function and consistent effects of exercise on pain relief might require prolonged, proactive follow-up of patients by either a patient educator or a trained clinical assistant.…”

Exercise on prescription in general practice: A systematic review

“…Three of these studies concluded that more intensive intervention was required to increase physical activity [20,22,23]. Aerobic fitness was only assessed in three studies [17,24,25]. A high-quality study reported maximal oxygen uptake (VO 2 max) improvements of 14% among EoP patients and 3% among controls after 12 months (11% and 4% after six months) [24].…”

Prescribing Exercise in Clinical Practice

“…Fifteen studies on advice or counseling fulfilling the criteria were identified [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. They were all conducted in primary care settings with patients by ordinary health care professionals.…”