Long-term physical activity on prescription intervention for patients with insufficient physical activity level—a randomized controlled trial

Trials

Mats Börjesson¹  Johan Sjöström²  Camilla Bylin Ottehall²  Åsa Cider³  Stefan Lundqvist⁴  Maria E. H. Larsson⁵  Lars Hagberg⁶ 

[1] Center for Health and Performance (CHP), University of Gothenburg, Gothenburg, Sweden;Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Sahlgrenska University Hospital/Östra, Gothenburg, Region Västra Götaland, Sweden;Centrum för fysisk aktivitet Göteborg, Gothenburg, Region Västra Götaland, Sweden;Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Centrum för fysisk aktivitet Göteborg, Gothenburg, Region Västra Götaland, Sweden;Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Research and Development Primary Health Care, Gothenburg, Region Västra Götaland, Sweden;University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden;

关键词: Primary health care;    Physical activity;    Metabolic syndrome;    Quality of life;    Health behaviour;    Physical therapy;   

DOI  :  10.1186/s13063-020-04727-y

来源: Springer

【 摘 要 】

BackgroundPhysical activity (PA) can be used to prevent and treat diseases. In Sweden, licensed healthcare professionals use PA on prescription (PAP) to support patients to increase their PA level. The aim of this randomized controlled trial was to evaluate a 2-year intervention of two different strategies of PAP treatment for patients with insufficient PA level, after a previous 6-month period of ordinary PAP treatment in a primary health care setting.MethodsWe included 190 patients, 27–77 years, physically inactive with metabolic risk factors where the patients were not responding to a previous 6-month PAP treatment with increased PA. The patients were randomized to either enhanced support from a physiotherapist (PT group) or continued ordinary PAP treatment at the health care centre (HCC group). The PAP treatment included an individualized dialogue; an individually dosed PA recommendation, including a written prescription; and a structured follow-up. In addition to PAP, the PT group received aerobic fitness tests and more frequent scheduled follow-ups. The patient PA level, metabolic health, and health-related quality of life (HRQOL) were measured at baseline and at 1- and 2-year follow-ups.ResultsAt the 2-year follow-up, 62.9% of the PT group and 50.8% of the HCC group had increased their PA level and 31.4% vs. 38.5% achieved ≥ 150 min of moderate-intensity PA/week (difference between groups n.s.). Over 2 years, both groups displayed increased high-density lipoproteins (HDL) (p = 0.004 vs. baseline), increased mental health status (MCS) (p = 0.036), and reduced body mass index (BMI) (p = 0.001), with no difference between groups.ConclusionDuring long-term PAP interventions, the PA level, metabolic health, and HRQOL increased in patients at metabolic risk without significant differences between groups. The results indicate to be independent of any changes in pharmacological treatment. We demonstrated that the PAP treatment was feasible in ordinary primary care. Both the patients and the healthcare system benefitted from the improvement in metabolic risk factors. Future studies should elucidate effective long-term PAP-treatment strategies.Trial registrationClinicalTrials.gov NCT03012516. Registered on 30 December 2016—retrospectively registered.

【 授权许可】

CC BY