Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial

Abstract

Objective To assess the effectiveness of a primary care based programme of exercise on prescription among relatively inactive women over a two year period.Design Randomised controlled trial.Setting 17 primary care practices in Wellington, New ZealandParticipants 1089 women aged 40-74 not undertaking 30 minutes of moderate intensity physical activity on at least five days of the weekIntervention Brief physical activity intervention led by nurse with six month follow-up visit and monthly telephone support over nine months.Main outcome measure Physical activity assessed at baseline and 12 and 24 months. Secondary outcomes were quality of life (SF-36), weight, waist circumference, blood pressure, concentrations of fasting serum lipids, glycated haemoglobin (HbA1c), glucose, insulin, and physical fitness.Results Mean age was 58.9 (SD 7) years. Trial retention rates were 93% and 89% at 12 and 24 months, respectively. At baseline, 10% of intervention participants and 11% of control participants were achieving 150 minutes of at least moderate intensity physical activity a week. At 12 months rates increased to 43% and 30% and at 24 months to 39.3% and 32.8% (P<0.001), respectively. SF-36 physical functioning (P=0.03) and mental health (P<0.05) scores improved more in intervention compared with control participants, but role physical scores were significantly lower (P<0.01). There were no significant differences in clinical outcomes. More falls (P<0.001) and injuries (P=0.03) were recorded in the intervention group.Conclusions This programme of exercise on prescription increased physical activity and quality of life over two years, although falls and injuries also increased. This finding supports the use of exercise on prescription programmes as part of population strategies to reduce physical inactivity.Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) ANZCTRN012605000490673.

Associação entre atividade física e qualidade de vida em adultos

“…Two studies found an inverse association between PA and any domain of QoL. 8,27 Most studies examined the association between PA and overall QoL score. But as the instruments used were different, different domains of QoL were included.…”

“…To be continued Lawton et al 27 Individuals were divided into control and intervention groups. Both were assessed at the baseline, at 12 months and 24 months.…”

Fall-related factors among less and more active older outpatients

“…In contrast, some studies revealed an increase in falls and injuries among an intervention group which was encouraged to become more physically active 22,23 . Therefore, clinical studies with a multifactorial approach that investigate the characteristics of fallers with different levels of physical activity could offer some insight for rehabilitation and preventive interventions in older adults.…”

Identifying content-based and relational techniques to change behaviour in motivational interviewing

“…In addition, reporting of the content of interventions adopting MI is often brief and lacking in specific detail making it difficult to replicate or pinpoint the precise techniques that may be affecting behavior change. Many MI studies lack detail in their descriptions of the precise techniques adopted, how they were delivered, practitioner training and competency in MI (Douaihy, Kelly, & Gold, 2014) and some do not provide any detailed description of the MI intervention components at all (e.g., Ackerman, Falsetti, Lewis, Hawkins, & Heinschel, 2011;Armit et al, 2009;Harland et al, 1999;Kerse, Elley, Robinson, & Arroll, 2005;Lawton et al, 2008;Penn et al, 2009;Whittemore et al, 2009). …”