Prescribing exercise in general practice

Iliffe, Steve; Tai, Sharon See; Gould, Mairi; Thorogood, Margaret; Hillsdon, Melvyn

doi:10.1136/bmj.309.6953.494

Cited by 30 publications

(17 citation statements)

References 9 publications

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“…Further innovative strategies are needed to encourage regular physical activity in the sedentary population. 7 General practitioners have access to a large proportion of the sedentary population and are a respected source of advice.82 A prescription for exercise ("green prescription") from a general practitioner is an attractive paradigm because prescriptions represent a well-understood interaction between patient and doctor. '2 Such a prescription would provide a tangible reminder of the exercise goals jointly set by the general practitioner and the patient.…”

mentioning

confidence: 99%

The green prescription study: a randomized controlled trial of written exercise advice provided by general practitioners.

Swinburn¹,

Walter²,

Arroll³

et al. 1998

Am J Public Health

219

130

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OBJECTIVES: The purpose of this study was to determine whether written advice from general practitioners increases physical activity among sedentary people more than verbal advice alone. METHODS: Sedentary patients (n = 456) received verbal advice on increasing physical activity and were then randomized to an exercise prescription (green prescription) group or a verbal advice group. RESULTS: The number of people engaging in any recreational physical activity at 6 weeks increased substantially, but significantly more so in the green prescription group. Also, more participants in the green prescription group increased their activity over the period. CONCLUSIONS: A written goal-oriented exercise prescription, in addition to verbal advice, is a useful tool for general practitioners in motivating their parents to increase physical activity.

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mentioning

confidence: 99%

The green prescription study: a randomized controlled trial of written exercise advice provided by general practitioners.

Swinburn¹,

Walter²,

Arroll³

et al. 1998

Am J Public Health

219

130

View full text Add to dashboard Cite

show abstract

“…Physical ill-health was the most widely reported barrier to activity described by the study group and is a widely discussed in the literature (Crombie et al 2005;Illiffe et al 1994;Stead et al 1997). This is hardly surprising as chronic diseases such as osteoarthritis are commonplace within this age group (Young & Dinan 2005) and are bound to impact on activity levels.…”

Section: Discussionmentioning

confidence: 79%

“…Consequently recommendations in the literature (Young & Dinan 2005) and UK Government guidelines (NICE 2004) tend to involve structured activities such as instructor lead exercise groups. However, formal exercise programmes can be seen by older people at large as intimidating, competitive or boring and individuals may have difficulty accessing such interventions or even hearing about them in the first place (Illiffe et al 1994). In contrast, it is recognised that research which addresses the adoption of self-directed physical activity by older people in unsupervised community settings has been scarce (Faulkner & Biddle 2004;Craft et al 2007).…”

mentioning

confidence: 99%

Promoting Physical Activity in the Management of Depression The Perspectives of Older People

Wright¹,

Cattan

2009

MHLDRP

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While exercise has been widely proposed in the management of depression in older people, the subjective experiences of individuals participating in this intervention have been neglected. Similarly, little is known about the manner in which unsupervised physical activity is adopted by older people as they recover from an episode of depression. This qualitative study sought the views of 11 older people who had recently been admitted to hospital with depression and attended regular in-patient exercise groups. It was found that participants valued opportunities to exercise when in hospital and reported a range of benefits. Following discharge unsupervised physical activity played a crucial part in the recovery process and three typologies were defined which categorised participants' motivation to be physically active. It was concluded that opportunities for older people to join exercise groups when hospitalised with depression are likely to be valued and that individual factors should be acknowledged when promoting post discharge physical activity. Key words:Older people, depression, exercise, physical activity Depression is a leading cause of disability throughout the world (WHO 2001). It significantly impacts on the lives of millions of older adults (Snowden et al, 2008) and is expected to affect even greater numbers as the proportion of older people in the global population grows (Moussavi et al 2007). Recommended treatments for depression include anti-depressants and psychological therapies (WHO 2008; NICE 2004;Remick 2002). Medication, however, takes several weeks to be effective and concordance in the older population can be poor (Maidment et al, 2002). Accessing psychotherapy, on the other hand, is problematic due to the lack of suitably qualified professionals (MHF 2006b;Snowden et al 2008). Exercise provides another option and has been the focus of considerable interest in the field of mental health in recent years (Smith 2006). Evidence from randomised controlled trials which include clinically depressed older people suggests that it is useful in the management of low mood (Sjösten & Kivelä 2006). Regular physical activity is also important for older people irrespective of their mental health needs because it offers a range of physical health benefits and provides some protection from medical conditions they are at risk of, such as osteoporosis and hypertension ( Unfortunately, despite being aware of the positive effects of an active lifestyle (Crombie et al 2004), older adults in general are more likely than any other age group to lead a sedentary lifestyle (DOH 2003; CDC 2007; ABS 2007). For older people admitted to hospital due to severe depression, achieving the activity levels necessary to gain benefits can be particularly difficult. This is due to a combination of the reduced energy and greater fatigability (WHO 1992) associated with depression and the fact that they are likely to spend at least a month (Sitta et al 2006; HES 2007) in an environment where opportunities to be physical active...

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“…2 Perceptions of benefit of the scheme To explore beliefs about the benefits of exercise appropriate to certain paticnt groups and perceptions of the schcme's effectiveness in providing these benefits. 3 Selection criteria for referral To idcntify which paticnt subgroups were being targeted as appropriatc for exercise, what sort of rclationship thc practice members have with thc leisure centre, and how they monitor patients' progress during and after thc exercise programme. 4 Reported personal behaviour To report the extent to which GPs and practicc nurscs take exercise themselves.…”

Section: Methodsmentioning

confidence: 99%

Exercise as therapy? Results from group interviews with general practice teams involved in an inner-London 'prescription for exercise' scheme

Smith

Gould

Tai

et al. 1996

Health Education Journal

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As part of an inner-London 'prescription for exercise' scheme, group interviews were conducted with clinical and support staff from participating general practices. Interviews took place between August and November 1995 to identify the practices' reasons for joining the scheme, the perceived health benefits to patients of the scheme, and criteria for selection and referral of patients onto the scheme. The results showed that the referring practice members saw exercise promotion as a therapeutic option, rather than an instrument for primary prevention. They were cautious in their referral criteria because of family health services authority guidelines. If future schemes are to develop they must distinguish between these perspectives in their promotion of physical activity.

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Prescribing exercise in general practice

Cited by 30 publications

References 9 publications

The green prescription study: a randomized controlled trial of written exercise advice provided by general practitioners.

The green prescription study: a randomized controlled trial of written exercise advice provided by general practitioners.

Promoting Physical Activity in the Management of Depression The Perspectives of Older People

Exercise as therapy? Results from group interviews with general practice teams involved in an inner-London 'prescription for exercise' scheme

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