Doctors Should Promote More Exercise In Women 40-74

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Exercise on prescription increases physical activity and quality of life and should become part of wider population strategies to promote exercise, concludes a study published on bmj.com today.

Regular exercise reduces the risk of heart and lung disease, type 2 diabetes, some cancers and death from all causes by an estimated 20-30%. The UK government wants at least 70% of the population to be active (30 minutes of moderate physical activity five times a week) by 2020. Currently, only 40% of men and 28% of women in the UK are meeting this target.

Previous studies have reported some success from "exercise on prescription" programmes, but it is not known if increases in physical activity are maintained for longer than a year.

Dr Beverley Lawton and colleagues from New Zealand examined the effectiveness of a primary care based programme of "exercise on prescription" in 1089 less active women (not doing the recommended 150 minutes of moderate physical exercise a week) aged 40-74, over two years. The participants were recruited from 17 primary care practices in New Zealand between 2004-5, and randomised to receive either the programme intervention or no intervention.

The intervention programme included an initial counselling session of motivating techniques to increase physical activity and telephone support over nine months to help with choice of activity, goal setting and general support.

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Participants completed self-report questionnaires about physical activity and quality of life, and had their weight, blood pressure and physical fitness measured at regular intervals.

At the start of the study just 10% of intervention participants and 11% of control participants were achieving 150 minutes of moderate exercise a week. The researchers found that both groups increased their physical activity over the two years, but activity was significantly higher in the intervention group. At 12 months rates increased to 43% in the prescription programme and 30% in the control group, and at 24 months to 39.3% and 32.8% respectively.

Physical functioning and mental health were also significantly better in the intervention group, but there were no real improvements in clinical outcomes such as blood pressure, weight and cholesterol.

Interestingly, more falls and injuries were reported in the intervention group.

Prescribing exercise can significantly increase physical activity for up to two years. Reducing physical inactivity at population level would have considerable health benefits, but would require a number of measures including legislation, public health messages, as well as dietary and physical activity programmes, conclude the authors.

This study shows that exercise promotion through general practice can change behaviour if it is "based on continued contact and dialogue, and tailored to individual needs," says Professor Steve Iliffe and colleagues in an accompanying editorial.

More serious attention should be given to exercise promotion to improve health and reduce costs, they add.

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