Per-protocol investigation of a best practice exercise referral scheme.
Swinton, Paul Alan
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STEWART, L., DOLAN, E., CARVER, P. and SWINTON, P.A. 2017. Per-protocol investigation of a best practice exercise referral scheme. Public health [online], 150, pages 26-33. Available from: https://doi.org/10.1016/j.puhe.2017.04.023
Objectives - To investigate the effects of an exercise referral scheme (ERS) aligned to the UK best practice guidelines on a range of outcomes including those associated with key health concerns of the Scottish population. Study design - A longitudinal design with data collection at three time points (baseline, midway and post) during a 12-week ERS intervention was employed. Methods - Health-related physical fitness was assessed through measurement of resting heart rate, blood pressure, FEV1:FEV6 (ratio of forced expiratory volume over one [FEV1] and six [FEV6] seconds), body mass and peak oxygen uptake (VO2 peak), whilst functional capacity was assessed through the five times sit to stand test. Psychosocial well-being and quality of life were measured using the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and the Profile of Mood State questionnaires. Growth curve analyses were used to model each outcome variable across the three time periods. Results - A range of effects were obtained with significant linear improvements in physical performance tests (P < 0.001) and psychosocial assessments (P < 0.002). Additionally, significant quadratic effects of time were obtained for body composition variables and physical activity levels (P < 0.001) with the greatest improvements obtained between baseline and midway assessments. Conclusions - An ERS aligned to the UK best practice guidelines can positively influence a range of health outcomes including those associated with lung function and cardiovascular fitness which are prevalent medical conditions in Scotland. In addition, results indicate that ERS can positively affect outcomes related to functional capacity as well as mental well-being and perceptions of health. The findings of the study identify the need for further investigation including consideration of the initial health status of referred clients.