The effect of exercise prescription of primary care physician on the quality of life in patients

Abstract

PurposeThe aim of this study was to examine the effect of exercise prescribed by primary care physicians (PCPs) on the quality of life (QoL) of elderly people.MethodRandomisation was performed at PCPs level from 16 primary healthcare centers. Patients were divided into intervention and control groups. Both groups of physicians received theoretical training (14 h), and the intervention group received additional practical training on exercise prescription (10 h). Patients in the intervention group were prescribed endurance, flexibility, balance, and strength exercises and were given training packs. QoL was measured using Short Form-36. Measurements were taken at the beginning of the study, after the 3rd month, and at the end of the 6th month to evaluate the effectiveness of the intervention.ResultsThe age of participants (Intervention group n = 69, Control group n = 110) was 57.68 ± 5.08 years. At the end of the study, physical function, physical role function, social role function, mental health, vitality, general health perception, and emotional role function scores increased and body pain scores decreased in the intervention group. Significant differences (p < 0.05) between the intervention and control groups were observed for physical function, physical role function, body pain, mental health, vitality, and emotional role function scores but not for social role function or general health perception scores.ConclusionsExercise prescriptions given by PCPs containing endurance, strength, flexibility, and balance exercises improve QoL in elderly people.

ABC of prescribing exercise as medicine: a narrative review of the experiences of general practitioners and patients

“…Twenty-three studies were selected for review. The studies, summarised in table 1, involved: 6 trials [28][29][30][31][32][33] ; 13 observational [34][35][36][37][38][39][40][41][42][43][44][45][46] ; 3 qualitative [47][48][49] ; and 1 mixed methods. 50 Studies originated in eight different regions: 7 from Canada 28 30 31 38 43 44 50 ; 7 from Sweden 34 35 41 42 46 48 49 ; 2 from New Zealand 36 47 ; 2 from the UK 32 33 ; 2 from France 37 39 ; 1 each from the USA 29 and Australia 45 and a single study from 12 Latin-American countries.…”

“…48 Another qualitative study of GPs, conducted in New Zealand, using one-to-one interviews, found a much more enthusiastic attitude towards EP. 47 The main barrier reported was time, and the support of an exercise professional with the expertise and protected time 37 Lack of time 37 Perceived barriers to prescribing 39 Training, eg, workshop and validated tools 33 37 38 40 43 44 EP materials and training packs for patients 33 Patient Physically inactive at baseline 34 Seasonality and weather 50 Medical conditions 50 Lack of purpose after the study ended 50 Lack of clarity on the purpose of the EP and what is expected of them specifically 49 Education and messaging from family physician 50 Prevalence of comorbidity 45 Higher levels of self-efficacy and confidence in one's readiness to change; lower BMI and lower baseline PA levels and those who had self-reported better health were more likely to attain improvements in PA levels 46…”

“…There is no tradition of prescribing exercise in family practice 48 EP deliverable in a 15-minute appointment 28 Support from an exercise professional who provides motivational interviewing and some of the prescribing 35 EP from a practice nurse 36 Phone support from a exercise professional 36 PA counsellor who would have the time and skills to help initiate and maintain PA 47 Nurse prescriber and ongoing support 41 Exercise coordinator to assist with motivation, goal setting, support and follow-up 42 Postal support 32 Prescription Contains higher proportion of home-based exercises 34 Walking prescription carried out individually and in everyday life 46 Preceded by motivational interviewing, including readiness to change, motivation, self-efficacy and PA preferences 41 Use of mHealth, including pedometers 32 50 EP for older adults should contain endurance, strength, balance and flexibility components 33 Monthly renewal of prescription 33…”

“…28 The third step, 'continued support', involves a regular process conducted in-person or via telephone. 36 The support involves adjusting or 'renewing' the prescription 33 and offering motivation 29 and counselling, 28 and could be implemented by a physiotherapist, other exercise professional 35 36 41 42 47 or the GP or nurse. 36 41 The process is enabled by practice-based supports, including: the availability of validated training and resources 33 37 38 40 43 44 ; tools for assessment and prescription 37 ; and the use of mHealth, including pedometers.…”

“…48 These studies had very small sample sizes and were conducted in single regions, limiting their generalisability. Other research has found GPs more positively disposed, but in need of training, validated tools and collaboration with other exercise professionals, 54 including physiotherapists and This review included studies of various types of EP, from walking only 33 to multicomponent, 46 and most studies had very little detail on the content of the EP. Researchers have recommended more standardised reporting on how the EPs are described.…”