Physical activity levels and barriers to exercise referral among patients with cancer

2017 ◽  
Vol 100 (7) ◽  
pp. 1402-1407 ◽  
Author(s):  
Dorothy Daiyi Yang ◽  
Omar Hausien ◽  
Mohammed Aqeel ◽  
Alexios Klonis ◽  
Jo Foster ◽  
...  
Keyword(s):  
Physical Activity ◽  
Activity Levels ◽  
Patients With Cancer ◽  
Barriers To Exercise ◽  
Physical Activity Levels ◽  
Exercise Referral

scholarly journals Adapt or Perish: Exercise referral schemes’ operational changes during the Covid-19 pandemic.

2020 ◽  
Author(s):  
Nikita Rowley ◽  
Colin Shore ◽  
Benjamin Buckley ◽  
Katie Hesketh
Keyword(s):  
Physical Activity ◽  
Exercise Prescription ◽  
Health Condition ◽  
Activity Levels ◽  
Physical Activity Levels ◽  
Sport Industry ◽  
Exercise Referral

The Covid-19 pandemic is having detrimental effects on the leisure and sport industry at present. It is important to highlight the importance of UK-based exercise referral schemes for individuals medically referred to an exercise prescription to improve, manage and treat a long-term health condition and increase physical activity levels. There has been no research observing the effects the pandemic has had on exercise referral schemes, and their adjusted or halted operations. This editorial provides some insights into operational changes to exercise referral schemes.

scholarly journals Effects of Exercise Referral Schemes on Physical Activity Levels

2018 ◽  
Vol 50 (5S) ◽  
pp. 48 ◽  
Author(s):  
Nikita Price ◽  
T. Williams ◽  
Elizabeth Horton ◽  
Gary Liguori ◽  
Steve Mann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Activity Levels ◽  
Physical Activity Levels ◽  
Exercise Referral

scholarly journals Examining the Effects of Exercise Referral Schemes on Changes in Physical Activity Levels.

2019 ◽  
Vol 51 (Supplement) ◽  
pp. 130
Author(s):  
Nikita Z. Rowley ◽  
James Steele ◽  
Steve Mann ◽  
Gary Liguori ◽  
Alfonso Jimenez ◽  
...  
Keyword(s):  
Physical Activity ◽  
Activity Levels ◽  
Physical Activity Levels ◽  
Exercise Referral

scholarly journals The effect of exercise referral schemes upon health and wellbeing: Initial observational insights using individual patient data meta-analysis from The National Referral database

2019 ◽  
Author(s):  
Matthew Wade ◽  
Steven Mann ◽  
Robert J. Copeland ◽  
James Steele
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Activity Levels ◽  
Resting Heart Rate ◽  
Health And Wellbeing ◽  
Physical Activity Levels ◽  
Exercise Referral

Background: Physical activity is widely considered to be effective in the prevention, management, and treatment of many chronic health disorders. Yet, population physical activity levels are relatively low and have changed little in recent years. Sufficient physical activity levels for health and wellbeing often do not arise as result of typical activities of daily living. As such, specific exercise has been argued to be necessary for many, and one approach to providing this has been through exercise referral schemes (ERS). Schemes are aimed at increasing physical activity levels in sedentary individuals with chronic disease, however, evidence is currently lacking as to whether ERSs are effective as currently implemented. Thus, it is of interest to consider broadly whether meaningful changes in health and wellbeing outcomes are observed in people undergoing and ERS. Purpose: To examine if ERSs are associated with meaningful changes in health and wellbeing in a large cohort of individuals throughout England, Scotland and Wales from The National Referral Database. Method: Data were obtained from 23731 participants from 13 different ERSs. Average age was 51±15 years and, 68% of participants were female. Health and wellbeing outcomes were examined including body mass index, blood pressure, resting heart rate, short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS), World Health Organization Well-Being Index (WHO-5), Exercise Related Quality of Life scale (ERQoL), and Exercise Self-Efficacy Scale (ESES). Two stage individual patient data random effects meta-analysis was performed on the change scores, (i.e. post- minus pre-ERS scores) and interval estimates were compared to null intervals for meaningfulness. Results: Estimates and 95%CIs revealed that statistically significant changes occurred when compared to point nulls of zero for body mass index (-0.55 kg.m2 [-0.69 to -0.41]), systolic blood pressure (-2.95 mmHg [-3.97 to -1.92]), SWEMWBS (2.99 pts [1.61 to 4.36]), WHO-5 (8.78 pts [6.84 to 10.63]), ERQoL (15.26 pts [4.71 to 25.82]), ESES (2.58 pts [1.76 to 3.40]), but not resting heart rate (0.22 fc [-1.57 to 1.12]), diastolic blood pressure (-0.93 mmHg [-1.51 to -0.35]). However, comparisons of estimates and intervals against null intervals for meaningfulness of changes suggested that the majority of outcomes may not improve meaningfully. Conclusion: The analyses performed here were with the intention of considering broadly; do we observe a meaningful effect in people who are undergoing ERSs? With respect to this broad question the present results demonstrate that, although many health and wellbeing outcome changes are statistically significant when compared to point null estimates (i.e. they differ from a change of zero) our analysis revealed there may be a general lack of meaningful change over time in participants undergoing ERSs, though results varied widely across different schemes. These findings suggest the need to consider the implementation of ERSs more critically in order to discern how best to maximize their effectiveness such that it reflects the efficacy often evidence in the literature.

scholarly journals Are exercise referral schemes associated with an increase in physical activity? Observational findings using individual patient data meta-analysis from The National Referral database

2019 ◽  
Author(s):  
Nikita Rowley ◽  
James Steele ◽  
Matthew Wade ◽  
Robert J. Copeland ◽  
Steven Mann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Random Effects ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Activity Levels ◽  
Random Effects Model ◽  
Physical Activity Levels ◽  
The Impact ◽  
Exercise Referral

Background: Exercise referral schemes (ERSs) within clinical populations offer inactive individuals the opportunity to increase physical activity levels over the length of scheme. Schemes are also intended to support the treatment of specific health conditions of medically referred individuals through increased physical activity behaviours. The extant literature concerning the impact of exercise referral on physical activity levels is inconsistent. It is of interest researchers, policy makers, commissioners and practitioners to to consider broadly whether meaningful change in physical activity levels are observed in people who undergo exercise referral, to identify potential effective policy actions in supporting active living. Purpose: To examine if ERSs increase physical activity levels in a large cohort of individuals throughout England, Scotland and Wales from The National Referral Database. Method: Data were obtained from 5246 participants from 12 different referral schemes. Average age was 53±15 years and, 68% of participants were female. Participants self-reported International Physical Activity Questionnaire (IPAQ) scores pre- and post- scheme, to determine if exercise referral had any impact on change in physical activity levels. Two stage individual patient data meta-analysis was performed on the both pre-ERS, and change scores, (i.e. post- minus pre-ERS scores) for MET-minutes/week calculated from IPAQ. Analyses were conducted on the continuous data collected using the IPAQ. Results: For pre-ERS MET-minutes/week the estimate and 95%CI from random effects model was 676 MET-minutes/week [539 to 812 minutes]. For change in MET-minutes/week the estimate and 95%CI from random effects model for was an increase of 540 MET-minutes/week [396 to 684 minutes]. Significant heterogeneity was evident among the schemes (I2 > 80%). Changes in total PA levels occurred as a result of increases in vigorous activity of 17 minutes [95%CI 9 to 24 minutes], increases in moderate activity of 29 minutes [95%CI 22 to 36 minutes], and reductions in sitting of -61 minutes [95%CI -78 to -43 minutes], though little change in walking (-5 minutes [95%CI -14 to 5 minutes]). Conclusion: Observation of participants undergoing ERSs suggests that most are already ‘moderately active’ upon entering an ERS. Changes in physical activity behaviour associated with ERS participation were varied and primarily facilitated by increased moderate-to-vigorous physical activity and reduced sitting. However, this was not sufficient to result in IPAQ categorical change and participants where thus on average still classed as ‘moderately active’. Further work is required to ensure ERSs are implemented to targeting the appropriate populations where they may result in the greatest benefit.

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