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.

scholarly journals Low Physical Activity Levels Are Linked to Early Hypertension Risk in College-Going Young Adults

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1258
Author(s):  
Kalyana Chakravarthy Bairapareddy ◽  
Mariam Mhd Salem Kamcheh ◽  
Ranim Jihad Itani ◽  
Mirna Mohamed ◽  
Heba Ayman Eid Abdellatif Zahran ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Young Adults ◽  
Waist Circumference ◽  
Body Mass ◽  
Activity Levels ◽  
Hypertension Risk ◽  
College Going ◽  
Physical Activity Levels ◽  
Weekly Physical Activity

Background: Sedentary behaviour and physical inactivity along with body mass are identified as critical determinants of vascular health along with body mass in young adults. However, the relationship between potential physical health and anthropometric variables with high blood Eid pressure remain unexplored in young adults from the United Arab Emirates region. Methodology: We administered a cross-sectional study in young adults assessing their self-reported physical activity levels, anthropometric variables (body mass index and waist circumference) and ambulatory blood pressure. The associations among potential physical health, anthropometric variables and high blood pressure were analysed through logistic regression after necessary transformation. Results: Of 354 participants (176 males, 178 females), we found 17.79% (n = 63) had higher mean arterial pressure. Males (n = 40; 22.73%) had higher risk of hypertension than females (n = 12.92%). Weekly physical activity levels (β = −0.001; p = 0.002), age (β = −0.168; p = 0.005) and gender (β = −0.709; p = 0.028) were found to be more strongly associated with hypertension risk than the body mass index (β = 0.093; p = 0.075), waist circumference (β = 0.013; p = 0.588) and the weekly sitting time (β = 0.000; p = 0.319) of the individuals. Conclusions: Lower physical activity was associated with hypertension risk compared to other modifiable risk factors such as waist circumference, body mass index and sedentary time in college-going young adults. Public health measures should continue to emphasise optimisation of weekly physical activity levels to mitigate vascular health risks at educational institution levels.

Exploring the Relationship Between Fundamental Motor Skill Interventions and Physical Activity Levels in Children: A Systematic Review and Meta-analysis

2018 ◽  
Vol 48 (8) ◽  
pp. 1845-1857 ◽  
Author(s):  
Alexander C. Engel ◽  
Carolyn R. Broderick ◽  
Nancy van Doorn ◽  
Louise L. Hardy ◽  
Belinda J. Parmenter
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Motor Skill ◽  
Meta Analysis ◽  
Activity Levels ◽  
Physical Activity Levels ◽  
The Relationship

scholarly journals Use of pedometers as a tool to promote daily physical activity levels in patients with COPD: a systematic review and meta-analysis

2019 ◽  
Vol 28 (154) ◽  
pp. 190039 ◽  
Author(s):  
Matthew Armstrong ◽  
Andrew Winnard ◽  
Nikolaos Chynkiamis ◽  
Spencer Boyle ◽  
Chris Burtin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Physical Activity Promotion ◽  
Daily Physical Activity ◽  
Cochrane Library ◽  
Activity Levels ◽  
Activity Promotion ◽  
Physical Activity Levels

The aim of this study was to examine the use of pedometers as a tool to promote daily physical activity levels in patients with COPD.A systematic review meta-analysis of pedometer physical activity promotion in patients with COPD was conducted. Medline/PubMed, Cochrane Library, Web of Science and CINAHL were searched from inception to January 2019. The search strategy included the following keywords: physical activity promotion, pulmonary rehabilitation and daily physical activity. The eligibility criteria for selecting studies were randomised controlled trials reporting pedometer physical activity promotion in patients with COPD.Improvements in steps per day were found with pedometer physical activity promotion either standalone (n=12, mean 0.53 (95% CI 0.29–0.77); p=0.00001) or alongside pulmonary rehabilitation (n=7, 0.51 (0.13–0.88); p=0.006). A subgroup analysis reported significant differences in the promotion of physical activity based on baseline physical activity levels and the type of instrument used to assess levels of physical activity.Future trials should consider the way in which pedometers are used to promote physical activity to inform clinical practice in the setting of pulmonary rehabilitation.

scholarly journals Global physical activity levels among people living with HIV: a systematic review and meta-analysis

2016 ◽  
Vol 40 (4) ◽  
pp. 388-397 ◽  
Author(s):  
Davy Vancampfort ◽  
James Mugisha ◽  
Marc De Hert ◽  
Michel Probst ◽  
Joseph Firth ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Activity Levels ◽  
Physical Activity Levels ◽  
Living With Hiv
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