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 Zealand.

Participants: 1089 women aged 40-74 not undertaking 30 minutes of moderate intensity physical activity on at least five days of the week.

Intervention: 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.