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Exercise interventions delivered by health professionals in primary care settings appear to boost levels of physical activity and increase weight loss, according to new research.
While such an increase appears modest, the authors of the study say that even a small increase in moderate to vigorous physical activity (MVPA) can help to reduce the risk of diseases and death.
Researchers analysed data from 37 trials
The study, published by The British Medical Journal (BMJ), reviewed 51 trials involving more than 16,000 adults comparing aerobic based physical activity interventions delivered in primary care with usual care (controls).
General practitioners, nurses, and physiotherapists delivered the interventions in most trials, with others also involving health educators or counsellors, exercise specialists, dieticians, and researchers.
MVPA was measured using self-reports in 37 trials and using a device in 14, with the length of follow-up ranging from one month to five years.
Participants in the intervention group lost more weight than the control group
The researchers found that overall, participants in the intervention groups were more likely than the control group to meet guideline targets for physical activity and increased MVPA by 14 minutes a week on average relative to controls.
While trials that measures physical activity with devices found no significant difference in MVPA between groups, those that relied on self-reports showed an increase of 24 minutes per week in intervention groups.
Greater improvements were shown in trials that saw patients have five or more appointments/contacts with a healthcare professional and had longer follow-up periods. Trials that where advice was delivered by primary care plus other professionals also had the best results.
As well as increasing physical activity levels, participants in intervention groups also lost more weight than the control group. On average, intervention participants weighed 1 kg less than controls at follow-up, and while this may seem like a small amount, the researchers point out that this amount of weight loss is important because typically adults gain around 0.5-1 kg a year, which can contribute to the development of obesity over time.
Future research should focus on identifying the most effective exercise interventions
The researchers say the study has merit as it was a large, comprehensive review that enables direct comparisons with the World Health Organization (WHO) physical activity guidelines to inform health policy decisions across the world.
However, they do point out that self-reporting might overestimate physical activity, but say their results do not appear to be implausibly inflated. They also highlight that the design and quality of each trial was different, although these factors were adjusted for in the analyses.
For this reason, the authors say the study “could help health professionals, policy makers, and healthcare commissioners make evidence-based decisions about implementing physical activity interventions during consultations delivered in primary care.”
They acknowledge that the interventions most powerfully associated with improvements are not yet clear, but say digital innovation and tailored solutions are likely to be more effective at helping people meet activity targets.
Future research, they suggest, should therefore “focus on identifying the most effective interventions, optimising outcomes for all population groups, and evaluating how best to decrease sedentary time as well as increasing physical activity.”