CE Course

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Effectiveness of Physical Activity Advice and Prescription by Physicians in Primary Care

After 6 months, the advice-only group did not show a meaningful increase in activity compared to the control group. The group that received individualized counseling with an exercise prescription more than doubled their level of physical activity over baseline. This is both statistically significant and highly relevant on a clinical basis. 80 minutes of moderate –to – aggressive activity per week is in line with the American Diabetes Association’s recommendations for physical activity.

•This demonstrates beyond a shadow of a doubt the value of going “above and beyond” the usual and customary method for increasing physical activity in our patients with diabetes. Taking a few minutes to work with your patients to develop a customized plan means the difference between success and failure in implementing a physical activity program.

Type of advice

Incr. in moderate/ vigorous activity (min/week)

Incr. in moderate/

vigorous activity (MET h/week)

Control

31.3

2.05

Advice Only

36.4

2.41

Advice + Prescription

79.7*

5.49*

A study by Harris et al. evaluated the benefits of providing individualized recommendations to patients who were fitted with pedometers. It was a randomized, multi-center study conducted over a period of three years. The purpose was to see if customized instruction, in addition to simply providing patients with a pedometer, had an effect on overall activity levels.

681 adult patients

10 UK primary care practices

Randomized

3-year follow-up

3 Study Arms
The control group simply received a pedometer and logbook. The “postal” group received a pedometer and logbook along with printed material on how to use the pedometer and how to increase physical activity. The “nurse advice” group received the pedometer, logbook and training instruction, as well as individualized 1-on-1 strategies for increasing physical activity.

•After 3 years, those who received printed instructional materials increased their daily steps by more than 600 per day. Those who received 1-on-1 guidance increased their daily steps by nearly 700 per day. This equates to about 1/3 mile per day of extra walking – a statistically significant increase over baseline.

•This study also demonstrated the value of going “above and beyond” the usual and customary method for increasing physical activity in our patients with diabetes.