Saturday, December 13, 2008

Prescriptions for Exercise Effectively Increase Activity in Older Women

Prescriptions for exercise seem to have a positive impact on middle-age women, up to age 79. According to a study published online Dec. 12 in BMJ the, 'green prescription' programme’ has been shown to produce significant improvements in levels of physical activity and quality of life among 'relatively inactive' adults aged 40-79 in primary care over a 12 month period.” The program is currently used in New Zealand by primary care physicians, and has proven successful for improving quality of life.

When inactive women ( those who do not engage in thirty minutes of exercise at least five days per week), were given a written prescription outlining recommended exercises, the study authors saw a “10% incremental increase in adherence to physical activity among those receiving the intervention compared with the control group”.

Beverley A. Lawton, from the University of Otago in Wellington, New Zealand, and colleagues point out the cost effectiveness of the program, and note that women show better adherence when they are given written exercise instructions. The program, led by a nurse, includes interventions regarding specific exercise activities, followed by a six-month visit, and phone support for nine months.

The study showed revealed improved quality of life, and better physical function scores. One drawback was that the women who exercised experienced more falls than the control group, an area that needs improvement. The authors say, “Because encouraging brisk walking and other general physical activity can increase the risk of falls (particularly in people with a history of falls), we need a pragmatic approach. The next round of research and development needs to look at managing this risk."

Physical exercise is necessary to combat obesity and reduce risk our risk of a wide array of diseases. Steve Iliffe, from University College London, United Kingdom, and colleagues note, "the health benefits of exercise are so great that it is probably the most important self help treatment available”, in an editorial that accompanied the results of the exercise prescription program.

To get the women involved, a visit to the office helps the nurse identify exercise goals. The visit averaged seven to thirteen minutes. A hand-written prescription is then given to the patient. Telephone support is provided over a nine-month period. A visit to the physician is then provided at six months. At 12 months, then 24 months - 93% of the women given an exercise prescription remained in the study, versus 89% of those who were not given an exercise prescription. Average age of the women was 58.9 ± 7 years, and included 1089 women, followed over a two-year period.

The authors concluded, "Reducing physical inactivity by 10% across a primary care population of less active adults could have considerable health impact,” especially when combined with media support, dietary and physical activity programs.

The study shows that older women may need extra motivation and support to remain physically active. Implementing a prescription based exercise program appears to have genuine value for improving strength and quality of life in women over age 58.

BMJ. Published online December 12, 2008.

WALKING & ACTIVE LIFE- Trim, Fit & Healthy