Physical activity prescription for general practice patients with cardiovascular risk factors–the PEPPER randomised controlled trial protocol

Abstract

Background The health benefits of physical exercise have been shown to be important in the prevention of cardiovascular diseases in patients with hypertension, dyslipidaemia or diabetes. However, few strategies have demonstrated efficacy and practicality in the promotion of physical exercise among this group of patients in general practice. Methods The PEPPER clinical study is a randomised controlled trial to evaluate the efficacy over a period of 12 months, in terms of physical activity level, of an intervention based on structured information delivery, a personalised written physical activity prescription in number of steps per day, a pedometer and a pedometer logbook, in 35 to 74-year-old patients with cardiovascular risk factors. 140 patients will be recruited in 15 GP practices and randomised in the intervention group or in the control group where patients will receive verbal advice of physical exercise. The primary outcome is the change at three months in total energy expenditure measured by an accelerometer over a 7-day period. Secondary outcomes include changes at 3 and 12 months in physical activity levels (accelerometer and International Physical Activity Questionnaire), quality of life (SF-36), blood pressure, weight, waist circumference, perceived obstacles to physical activity and patient compliance with the recommended strategy. Both groups will be compared using mixed models. Discussion The results are expected at the end of 2019. If the intervention proves effective in durably increasing the level of physical activity, this strategy could be tested in a larger trial to examine its impact on cardiovascular diseases. Trial registration US National Institutes of Health Clinical Trials Registry NCT02317003 , December 15, 2014.

<p>Optimal Body Fat Percentage Cut-Off Values in Predicting the Obesity-Related Cardiovascular Risk Factors: A Cross-Sectional Cohort Study</p>

“…2 Other CRFs: age, gender, hypertension, dyslipidemia, diabetes mellitus, smoking, unhealthy diet, physical inactivity, and family history. [3][4][5][6] In 2016, 11% of men and 15% of women in the world population were obese. 7 According to the World Health Organization (WHO), prevalence of obesity in the world population is an epidemic and causes more deaths than underweight.…”

Feasibility of a theoretically grounded, multicomponent, physiotherapy intervention aiming to promote autonomous motivation to adopt and maintain physical activity in patients with lower-limb osteoarthritis: Protocol for a single-arm trial

“…The accelerometer will be tted securely over the right anterior superior iliac spine. [45][46][47] Following a standardised and widely used protocol, 48 participants will be asked to wear accelerometers for 7 consecutive days [49][50][51][52] with removal only for sleep or when in water (e.g. swimming or shower).…”

The association between nurses’ physical activity counselling and patients’ perceptions of care quality in a primary care facility in Ghana

“…The health benefits of physical activity (PA) have been reported by many researchers in different disciplines [ 1 – 4 ]. Specifically, PA has been evidenced to protect against cardiovascular diseases [ 5 , 6 ], neurodegenerative diseases [ 1 , 3 , 4 ] and other non-infectious diseases [ 7 , 8 ] PA has also been found in research to reduce the risk of mortality in the general population [ 9 , 10 ] and benefit healthy aging [ 11 ]. The promotion of PA as a healthy behavior in all segments of the population is, therefore, a top agenda in public health.…”

“…Secondly, the adoption of PA counselling in clinical practice in many European countries has been based on the framework’s recommendation [ 12 , 14 ]. Despite these and similar efforts, the global prevalence of insufficient PA is still high [ 7 , 8 , 14 ], with developed countries including Kuwait, Canada, and Iceland accounting for a PA insufficiency rate of more than 50% [ 14 ]. This trend has dire implications for global health, including an increased burden of disease and healthcare expenditure [ 13 , 14 ].…”

“…In these programs, nurses discuss PA with patients, focusing on standard PA recommendations and the general health benefits of PA [ 15 – 17 ]. Some researchers have, however, opposed this program, contending that nurses are not well suited for PA counselling [ 7 , 8 , 13 ]. Others in agreement to this argument opined that the program has nothing or little to do with the mission of healthcare facilities and will shift the focus of healthcare [ 13 , 18 ].…”