Do exercise referral schemes increase physical activity levels?

January 01, 0001

Do exercise referral schemes increase physical activity levels?

This group of UK researchers examined whether exercise referral schemes had an impact on physical activity and health outcomes. They performed a systematic review and meta-analysis using Medline, Embase, PsycINFO, Cochrane Library, ISI Web of Science, SPORTDiscus, and ongoing trial registries, along with combing reference lists. They were looking for controlled trials from peer reviewed journals that looked at whether referrals to third party providers increased the activity levels of sedentary individuals.

The researchers found: "Eight randomised controlled trials met the inclusion criteria, comparing exercise referral schemes with usual care (six trials), alternative physical activity intervention (two), and an exercise referral scheme plus a self determination theory intervention (one). Compared with usual care, follow-up data for exercise referral schemes showed an increased number of participants who achieved 90-150 minutes of physical activity of at least moderate intensity per week (pooled relative risk 1.16) and a reduced level of depression (pooled standardised mean difference -0.82). Evidence of a between group difference in physical activity of moderate or vigorous intensity or in other health outcomes was inconsistent at follow-up. We did not find any difference in outcomes between exercise referral schemes and the other two comparator groups. None of the included trials separately reported outcomes in individuals with specific medical diagnoses. Substantial heterogeneity in the quality and nature of the exercise referral schemes across studies might have contributed to the inconsistency in outcome findings."

The researchers concluded: "Considerable uncertainty remains as to the effectiveness of exercise referral schemes for increasing physical activity, fitness, or health indicators, or whether they are an efficient use of resources for sedentary people with or without a medical diagnosis."

This systematic review finds that exercise referral schemes do lead to a modest increase in moderate intensity exercise, but other outcomes are inconsistent.

For the full abstract, click here.

BMJ 343:d6462, 6 November 2011 © 2011 BMJ Publishing Group Ltd.
Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis. T G Pavey, A H Taylor, K R Fox, et al. Correspondence to T Pavey: toby.pavey@pcmd.ac.uk

Category: A. General/Unspecified. Keywords: exercise, referral, third party, intensity, health, systematic review and meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 2 December 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

COVID-19 Resources

WONCA webinars, journal links and more

WONCA position statements

WONCA statements on a variety of issues

PEARLS

577 Individual behavioural counselling helps people to quit smoking 575 Antioxidant vitamin and mineral supplements may be beneficial in age-related macular degeneration 574 Oral antifungals effective for toenail onychomycosis 570 Decision aids beneficial for people facing health treatment or screening decisions 569 Computer-generated reminders on paper benefit quality of care