Exercise referral schemes not as effective as hoped, research suggests

Exercise referral schemes may not make any ‘clinically meaningful’ difference to participants’ health, a study has found.

More careful thought is needed on the activities the schemes include and who would benefit the most, the UK researchers concluded.

Analysis of information from 23,731 participants who had taken part in 13 different schemes across the country found that while there were changes in aspects of health including BMI, blood pressure, mental wellbeing and exercise-related quality of life, the differences were too small to be ‘clinically meaningful’.

The researchers pointed out that the schemes looked at varied widely in terms of length of time patients were enrolled – which was between six weeks and three months – and what was on offer.

Overall BMI was found to reduce significantly by 0.55kg/m², as did systolic and diastolic blood pressure which fell by 2.95 mmHg and 0.93 mmHg respectively. In all cases, there was wide variation in results among the schemes.

There were significant but small changes in several measures related to mental wellbeing and quality of life but no change in resting heart rate.

The team, which included researchers from Solent University and Sheffield Hallam University, pointed out that adoption of exercise referral schemes, first introduced in the 1990s, was widespread but very little evidence existed on how effective they actually are.

Writing in the Journal of Epidemiology & Community Health, they concluded that a more critical approach is needed to understand how to make best use of them.

Study author Dr James Steel from ukactive told Pulse: ‘We should have a much stronger focus on rigorous evaluation and standardised data collection to understand what’s working best, and for whom, and why.’

He said at the moment there was no clear data on exactly what the schemes are doing.

Dr Steel said: ‘There is clearly a lot of variation between schemes which could be explained by some delivering exercise prescriptions that are more efficacious, or that there is better fidelity to this delivery, or possibly that certain schemes are recruiting individuals that are more or less likely to benefit.

‘Our plans are to develop our database to try and understand these characteristics and how they might influence effectiveness of schemes.’