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02 Dec 2019
BMJ research: benefits of exercise referral schemes 'not as large as hoped'
By Tom Walker
BMJ research: benefits of exercise referral schemes 'not as large as hoped'
The study drew on data from 23,731 active participants in 13 different exercise referral schemes
Photo: Shutterstock
The improvements in health and wellbeing associated with exercise referral schemes aren’t as large as hoped, according to a new study.

A team of researchers looked at data from 23,731 active participants in 13 different exercise referral schemes in the UK, lasting between six weeks and three months, which had been entered into the dedicated National Referral Database.

They looked at measurements recorded at the beginning and end of the schemes in weight (BMI), blood pressure, resting heart rate – as well as scores on internationally-validated mental health, wellbeing, quality of life and exercise confidence scales.

An analysis of the data, Published in the Journal of Epidemiology & Community Health, revealed significant improvements in most of the included measures – the exceptions being resting heart rate (a known risk factor for death from cardiovascular disease) and diastolic blood pressure (the bottom number in a blood pressure reading, signifying the pressure in the arteries between heartbeats).

But when these figures were compared with thresholds for clinical “meaningfulness”, the changes didn’t reach these thresholds. In other words, the size of the changes was so small that it made rendering their impact unclear.

The study also found that the referral schemes varied considerably in length and content, as did the characteristics of the participants, so it’s not clear which combination of activities and length of scheme might be most effective, or for whom.

"This is an observational study, and as such, can’t establish cause," the study reads.

"And there were considerable differences in outcomes between individual schemes.

"Currently there is a lack of agreement of what constitutes ‘impact’ with respect to the evaluation of exercise referral schemes and the evidence presented here from one of the largest databases of them does little to support the use of them."

The researchers also suggest that, given how widely used the exercise referrals are, a more critical approach is needed.

“These findings support the need to consider exercise referral schemes, particularly their implementation, more critically, using real world data to understand how best to maximise their potential, particularly considering the known benefits of exercise and the research of [exercise referral schemes] across the UK,” the study reads in its conclusion.

Click here to download and read the full study, titled Effect of exercise referral schemes upon health and well-being: initial observational insights using individual patient data meta-analysis from the National Referral Database.

The Journal of Epidemiology and Community Health is published by the BMJ Group, a wholly-owned subsidiary of the British Medical Association.

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