New findings published in the BMJ show that exercise interventions delivered in primary care boost levels of moderate to vigorous intensity activity in adults by an average of 14 minutes a week.
This effect might seem modest, but the researchers say that even small increases in moderate to vigorous intensity physical activity are important in helping to reduce the risk of diseases and death.
World Health Organization guidelines recommend a minimum of 150-300 minutes of moderate intensity physical activity (such as brisk walking, dancing or mowing the lawn etc.) or 75-150 minutes of vigorous intensity physical activity (such as running, swimming or climbing stairs) and encourage people to exceed these targets.
However, evidence suggests that physical activity programmes have been ineffective in most countries, with one in four adults insufficiently physically active and no improvement in participation rates evident over the past two decades.
As most adults visit their general practice once a year, health professionals in primary care are well placed to routinely prompt and provide physical activity interventions to patients. However, previous studies of physical activity interventions delivered in primary care have reported mixed results, and few have investigated their effect on increasing moderate to vigorous intensity physical activity.
A team of researchers reviewed 51 trials involving over 16,000 adults comparing aerobic-based physical activity interventions delivered in primary care with usual care (controls). General practitioners, nurses, and physiotherapists delivered the interventions in most trials, with others also involving health educators or counsellors, exercise specialists, dieticians, and researchers.
Overall the researchers found that participants in the intervention groups increased moderate to vigorous physical activity by a modest 14 minutes a week on average relative to controls and were also more likely than controls to meet guideline targets.
Trials that measured physical activity with devices found no significant difference in moderate to vigorous physical activity between groups, while trials relying on self-reported activity showed an increase of 24 minutes a week in intervention groups. Interventions involving five or more contacts with health professionals, longer follow-up, or those delivered by primary care plus other professionals were associated with greater improvements. In trials that measured weight, intervention participants weighed 1 kg less than controls at follow-up.
The researchers conclude that physical activity interventions delivered by health professionals in primary care settings can effectively increase participation in physical activity. These findings could help health professionals, policymakers, and healthcare commissioners make evidence-based decisions about implementing physical activity interventions during consultations delivered in primary care.
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