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AEP Exercise Referral Reading

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bethdrysdale94's version from 2017-05-29 16:43

Section 1

Question Answer
Stallis 2014: what is the stated goal of the exercise is medicine initiative?to make physical activity assessment and exercise prescription a standard part of the disease prevention and treatment paradigm for all patients
Stallis 2014: How should patients be treated when prescribing exercise?like athletes
Stallis 2014: What is the exercise vital sign? (EVS)two questions as part of initial assessment - how many days/week do you engage in MVPA? How many minutes when you do? If anyone does less than 150 mins, flagged up to be counseled on activity levels
Stallis 2014: Physicians rolecongratulate those getting more than 150 mins. Encourage those who are doing less. off generic prescription based on FITT mnemonic. If long consultation time, assess patients readiness for change regarding exercise.
Stallis 2014: FITT mnemonicFrequency, Intensity, Type, Time.
Stallis 2014: common barriers to exercise job hours, children, physical limitation ie arthritis
Stallis 2014: walking should be the default exercise precription - why?accessible for all ages and fitness levels, very cost-saving and environmentally friendly
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Section 2

Question Answer
Pavey et al 2011: detailsexercise referral schemes effectiveness. systematic review and meta-analysis.
Pavey et al 2011: inclusion criteriapopulation: sedentary individuals with or without medical diagnosis. Referral schemes defined as: referrals to primary care professionals to third part services, to increase PA and exercise, with initial assessment and monitoring throughout. Included 8 different trials
Pavey et al 2011: three categories of comparator groupusual care; alternative exercise interventions; referral plus behaviour change interventions
Pavey et al 2011: resultsweak evidence to say that short term increase and depression reduction. No evidence for changes to physical fitness, BP, TC, BM etc. no difference in outcomes when comparing with alternative interventions.
Pavey et al 2011: NICE stanceNICE has previously commented that there was insufficient evidence to support the widespread adoption of exercise referral schemes, and recommended that the UK’s National Health Service (NHS) should only make these schemes available as part of a controlled trial.11 Although we have identified four additional trials since the NICE review, there remains very limited support for the potential role of exercise referralschemes on increasing physical activity and consequently improving public health. Arguably, such an uncertain impact provides a case for the disinvestment in exercise referral schemes. We also found little evidence of how the exercise referral scheme interventions sought to develop a sustainable active lifestyle in participants, as recommended in the NHS National Quality Assurance Framework
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Section 3