Prescribing exercise interventions for patients with chronic conditions

Hoffmann, Tammy; Maher, Christopher G.; Briffa, Tom; Sherrington, Catherine; Bennell, Kim L; Alison, Jennifer A.; Singh, Maria Fiatarone; Glasziou, Paul

doi:10.1503/cmaj.150684

Cited by 120 publications

(85 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Following the workshop, physician attendees were asked how they would change their current practice as a result of the EIMC workshop and 87% reported they would; the most common themes were to prescribe more PAE (54% of respondents) and to perform more PAE counselling (38% of respondents). These results support the need to increase awareness of tools and resources that support PAE prescription (Joy et al 2013), while also providing insight into the importance of offering PAE training as part of continuing education, which is an untapped area of research (Hoffmann et al 2016). Hoffmann et al (2016) identified other factors that contribute to the under-prescription of exercise interventions in clinical care that include a lack of awareness among many clinicians and patients about the effectiveness of exercise interventions, poor knowledge about what comprises an effective exercise intervention, a lack of relevant training and educational opportunities available to medical practitioners, and inadequate descriptions of exercise interventions in published trials and reviews.…”

Section: Discussionsupporting

confidence: 61%

“…These results support the need to increase awareness of tools and resources that support PAE prescription (Joy et al 2013), while also providing insight into the importance of offering PAE training as part of continuing education, which is an untapped area of research (Hoffmann et al 2016). Hoffmann et al (2016) identified other factors that contribute to the under-prescription of exercise interventions in clinical care that include a lack of awareness among many clinicians and patients about the effectiveness of exercise interventions, poor knowledge about what comprises an effective exercise intervention, a lack of relevant training and educational opportunities available to medical practitioners, and inadequate descriptions of exercise interventions in published trials and reviews. The EIMC workshops provided with this national education program address these deficiencies and demonstrate an intention by participants to change practice as a result of this education to apply practical and specific exercise strategies in clinical practice.…”

Section: Discussionsupporting

confidence: 61%

See 1 more Smart Citation

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

O’Brien

Shields

et al. 2017

Appl. Physiol. Nutr. Metab.

View full text Add to dashboard Cite

Abstract:The Exercise is Medicine Canada (EIMC) initiative promotes physical activity counselling and exercise prescription within health care. The purpose of this study was to evaluate perceptions and practices around physical activity counselling and exercise prescription in health care professionals before and after EIMC training. Prior to and directly following EIMC workshops, 209 participants (physicians (n = 113); allied health professionals (AHPs) (n = 54), including primarily nurses (n = 36) and others; and exercise professionals (EPs) (n = 23), including kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)) from 7 provinces completed self-reflection questionnaires. Compared with AHPs, physicians saw more patients (78% > 15 patients/day vs 93% < 15 patients/day; p < 0.001) and reported lower frequencies of exercise counselling during routine client encounters (48% vs 72% in most sessions; p < 0.001). EPs had higher confidence providing physical activity information (92 ± 11%) compared with both physicians (52 ± 25%; p < 0.001) and AHPs (56 ± 24%; p < 0.001). Physicians indicated that they experienced greater difficulty including physical activity and exercise counselling into sessions (2.74 ± 0.71, out of 5) compared with AHPs (2.17 ± 0.94; p = 0.001) and EPs (1.43 ± 0.66; p < 0.001). Physicians rated the most impactful barriers to exercise prescription as lack of patient interest (2.77 ± 0.85 out of 4), resources (2.65 ± 0.82 out of 4), and time (2.62 ± 0.71 out of 4). The majority of physicians (85%) provided a written prescription for exercise in <10% of appointments. Following the workshop, 87% of physician attendees proposed at least one change to practice; 47% intended on changing their practice by prescribing exercise routinely, and 33% planned on increasing physical activity and exercise counselling, measured through open-ended responses.Key words: Exercise is Medicine, physical inactivity, exercise prescription, primary care.

show abstract

Section: Discussionsupporting

confidence: 61%

Section: Discussionsupporting

confidence: 61%

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

O’Brien

Shields

et al. 2017

Appl. Physiol. Nutr. Metab.

View full text Add to dashboard Cite

show abstract

“…While the presence of a physical comorbidity may compound the perceived barriers to engaging in physical activity/exercise, a few recent reviews have strongly recommended the prescription of physical ac tivity/exercise for the treatment and management of a large number of physical chronic conditions, as long as the type and intensity of physical activity/exercise are tailored to the condition. 40,41 Although lack of will power/self-discipline was cited as a barrier by only 15% of those not engaging in physical activity/ exercise, it has been shown previously that those with depression lack motivation and energy in a number of activities, particularly those requiring a certain level of effort and regularity. 42,43 This is supported by our study, which showed that those with a mood disorder (with or without a concurrent anxiety disorder) were less likely to exercise than those with an odds ratio of having exercised "1 to 3 times a week" or "4 or more times a week" compared to "did not anxiety disorder only.…”

Section: Discussionmentioning

confidence: 99%

Self-management of mood and/or anxiety disorders through physical activity/exercise

Pelletier

Shanmugasegaram

Patten

et al. 2017

Health Promot Chronic Dis Prev Can

View full text Add to dashboard Cite

Introduction: Physical activity/exercise is regarded as an important self-management strategy for individuals with mental illness. The purpose of this study was to describe individuals with mood and/or anxiety disorders who were exercising or engaging in physical activity to help manage their disorders versus those who were not, and the facilitators for and barriers to engaging in physical activity/exercise.

show abstract

“…Regarding individualised adaptation of exercise prescription to specific chronic disease, the reader is referred to the free online textbook provided by the Swedish Institute of Public Health10 and two recent review articles 9 85. In general, as mentioned earlier, if the patient has one or two stable chronic diseases and is otherwise healthy, PA can be self-administered, with a gradual progression towards the adult PA guidelines.…”

Section: Introductionmentioning

confidence: 99%

Physical activity prescription: a critical opportunity to address a modifiable risk factor for the prevention and management of chronic disease: a position statement by the Canadian Academy of Sport and Exercise Medicine

et al. 2016

View full text Add to dashboard Cite

Non-communicable disease is a leading threat to global health. Physical inactivity is a large contributor to this problem; in fact, the WHO ranks it as the fourth leading risk factor for overall morbidity and mortality worldwide. In Canada, at least 4 of 5 adults do not meet the Canadian Physical Activity Guidelines of 150 min of moderate-to-vigorous physical activity per week. Physicians play an important role in the dissemination of physical activity (PA) recommendations to a broad segment of the population, as over 80% of Canadians visit their doctors every year and prefer to get health information directly from them. Unfortunately, most physicians do not regularly assess or prescribe PA as part of routine care, and even when discussed, few provide specific recommendations. PA prescription has the potential to be an important therapeutic agent for all ages in primary, secondary and tertiary prevention of chronic disease. Sport and exercise medicine (SEM) physicians are particularly well suited for this role and should collaborate with their primary care colleagues for optimal patient care. The purpose of this Canadian Academy and Sport and Exercise Medicine position statement is to provide an evidence-based, best practices summary to better equip SEM and primary care physicians to prescribe PA and exercise, specifically for the prevention and management of non-communicable disease. This will be achieved by addressing common questions and perceived barriers in the field.Author noteThis position statement has been endorsed by the following nine sport medicine societies: Australasian College of Sports and Exercise Physicians (ACSEP), American Medical Society for Sports Medicine (AMSSM), British Association of Sports and Exercise Medicine (BASEM), European College of Sport & Exercise Physicians (ECOSEP), Norsk forening for idrettsmedisin og fysisk aktivite (NIMF), South African Sports Medicine Association (SASMA), Schweizerische Gesellschaft für Sportmedizin/Swiss Society of Sports Medicine (SGSM/SSSM), Sport Doctors Australia (SDrA), Swedish Society of Exercise and Sports Medicine (SFAIM), and CASEM.

show abstract

Prescribing exercise interventions for patients with chronic conditions

Cited by 120 publications

References 50 publications

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

Self-management of mood and/or anxiety disorders through physical activity/exercise

Physical activity prescription: a critical opportunity to address a modifiable risk factor for the prevention and management of chronic disease: a position statement by the Canadian Academy of Sport and Exercise Medicine

Contact Info

Product

Resources

About