More research needed on effective GP interventions to promote physical activity in later life

An older woman swimming

Aging may be inevitable for us all but the way in which we look after our bodies can impact dramatically on the rate at which we age. One of the key ingredients to a long and healthy lifestyle is exercise. We’re living longer than ever before and if we want to spring into our autumn years we have to take responsibility and get physically active. Our more sedentary lifestyles mean we have to work harder at fitting exercise into our routine but the health benefits are well worth sweating over. We can strengthen our bones and reduce back pain, heart disease, high blood pressure, diabetes, dementia, depression and the risk of falling.

The Department of Health (2011) states:

Given population ageing, we need to promote regular physical activity in order to reduce the impact of diseases, restore and maintain function, increase quality of life and contain the use of health and social services.

An older man exercising

Intervention through general practise-based physical activity promotion is thought to have the potential to reach out to significant numbers as it can reduce barriers to physical activity, such as lack of money and poor health.  Much of this is done through education materials with general physical activity recommendations. A recent systematic review, however, aimed to evaluate the effectiveness of general practise-based tailored programmes for older adults that go beyond generalised advice.

Methods

The study participants had their baseline physical activity levels assessed and were then provided with individual recommendations to increase physical activity.

After a search of relevant databases they identified six randomised controlled trials (RCTs) that were suitable for inclusion involving 1522 participants. The interventions ranged from six weeks to six months and included aerobic, strength and balance exercises. Four interventions were delivered through the general practise site, one through a local leisure centre and one by telephone. The number of contacts the participants had with the intervention deliverer varied between fortnightly to once in every two months.

Results

An older person using a mobile phone

Meta-analyses of the findings could not be conducted due to the heterogeneity of the outcomes measured.

  • One study, providing 3 months of physical activity counselling, fortnightly over the telephone, found a statistically significant increase in physical activity in the intervention participants compared with controls
  • One study found statistically significant increases in quality of life scores for vitality and general health in participants who received exercise on prescription and telephone follow-up
  • One study showed a statistically significant increase in aerobic capacity in the intervention group compared to controls
  • The review shows some evidence of the effectiveness of physical activity promotion for older adults through general practise but not enough to warrant widespread implementation

But:

  • The six studies included were heterogeneous in design and as such difficult to compare
  • The study methodologies were poorly reported making it difficult to replicate the interventions and determine their quality
  • All studies had self-reported physical activity outcomes which may be over estimated

Conclusions

The authors concluded:

Large-scale developmental projects with long follow-up (beyond two years), objective measures of physical activity and comprehensive documentation of resource use, should now be conducted.

We’re all responsible for our own health but a little push and a shove here and there might help some of us to become more motivated. Looks like more work is needed in this area to understand the most effective type of intervention. In the meantime, come on people go and dig out that shell suit, dust off those trainers and get moving!

Reference

Zoe Stevens, Cate Barlow, Denise Kendrick, Tahir Masud, Dawn A. Skelton, Susie Dinan-Young and Steve Iliffe. Effectiveness of general practice-based physical activity promotion for older adults: systematic review. Primary Health Care Research & Development, available on CJ02013 doi:10.1017/S1463423613000017.