App Ex Psych week 3

bethdrysdale94's version from 2017-05-14 16:57

Section 1

Question Answer
What is exercise referral?when a primary care professional (typically a GP) refers a patient to an organised, community-based exercise programme (typically local leisure facility).
How long do exercise schemes last and what are they designed for?Exercise schemes last 12 weeks and are designed to increase exercise levels and improve the health of the patient. A formal relationship will exist between the primary care provider and the exercise scheme.
Four part process of exercise referralprimary care assessment: meeting PA guidelines? > referral to an exercise service or specialist > personal PA assessment at service > opportunity to participate in exercise at service
SDT and exercise referralintrinsic motivation, basic needs ie autonomy
HBM and exercise referralnon-clinical population, exercise maintenance

Section 2

Question Answer
Pavey et al 2011: study designsystematic review and meta-analysis. amalgamation of peer evidence
Pavey at al 2011: included studies8 RCTs, control = usual care (exercise advice or nothing). outcomes = PA, fitness, clinical outcomes, QoL
RCTsmost stringent way of determining whether a cause-effect relationship exists between an intervention and an outcome - gold standard of whether something works
Pavey et al 2011: results6-12 month follow up significant higher number of participants achieving 90-150mins moderate exercise/week AND reduced level of depression. BUT no PA diff when drop outs were included in analysis. NO diff in moderate-vigorous intensity exercise OR health outcomes (e.g. blood pressure)
Pavey et al 2011: conclusionssome support but its weak. Considerable uncertainty remains as to the effectiveness of exercise referral schemes for increasing physical activity, fitness, or health indicators, or whether they are an efficient use of resources for sedentary people with or without a medical diagnosis. impact on clinical subgroups unknown.

Section 3

Question Answer
NICE recommndation: exercise referral number 1should not be funded for those who are sedentary or inactive but otherwise healthy. should not refer these people to existing schemes
NICE recommendation: exercise referral 2Policy makers and commissioners should only fund exercise referral schemes for people who are sedentary or inactive and have existing health conditions or other factors that put them at increased risk of ill health. Schemes must incorporate key behaviour change techniques

Section 4

Question Answer
what is "exercise is medicine?"global initiative promoting exercise for health
referral vs prescriptionreferral trumps the idea of prescription
support from NICE?evaluations show limited evidence resulting in limited support from NICE