exercise referral schemes

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A system which links general practitioners and primary health care professionals to public leisure facilities. Referral schemes were developed in the UK as a means of promoting exercise as an adjunct to medical treatment. The schemes are based on the argument that 95 per cent of people will consult a medical practitioner within any three-year period and over 70 per cent of these people are likely to be insufficiently active. Health professionals are therefore ideally placed to promote physical activity since they are trusted by patients and an exercise prescription can be a valuable part of medical treatment. However, while time, facilities, and expertise are limited within a health care setting, they are available in leisure facilities where qualified professionals can lead structured exercise programmes. Exercise referral schemes are a partnership between health care and exercise professionals.

A typical scheme is designed around twice-weekly exercise for 12 weeks. It takes place at a leisure centre and includes gym activities, swimming, and aerobics. The nature and intensity of the exercise sessions are customized to the individual patient and his or her condition. The programme may also include educational sessions concerning diet and stress management. Referred patients are typically those with conditions such as hypertension, diabetes, osteoporosis, and a high risk of coronary heart disease. Exercise referral schemes have been enthusiastically received in the UK and hundreds of thousands of patients have participated. The fundamental structure of a referral scheme is sound but in practice their overall effectiveness is limited. Systematic reviews identify that referral schemes have only a small impact on increasing physical activity, with fewer than 1 in 10 referred patients becoming habitually active. The key problems are the low take-up rates of the exercise prescription and poor exercise adherence.

Subjects: Sport and Leisure.

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