Re: Promoting physical activity in primary care
We agree with Nefyn Williams’ editorial emphasising the importance of promoting exercise in primary care and believe that secondary care should shoulder some of this responsibility. Patients attending outpatient appointments in hospital often have the most to gain from improving physical activity. Outpatient waiting times in primary and secondary care are ideal educational opportunities when patients may be most receptive to lifestyle advice. Many patients sit in waiting rooms for more than fifteen minutes before their appointment. Hillsdon et al. note that even brief consultations of three to ten minutes may have a moderate effect on physical activity. In a hospital rheumatology outpatient department, we have created an "exercise walkway" along a corridor consisting of nine breathing, balance and stretching exercises which are simple, and feasible to perform whilst sitting or standing. The exercises are illustrated by photograph collages of patients and are reinforced with an exercise sheet. Hospital volunteers were trained to go through the exercises with the patients, also making sure that nobody missed their appointments.
We surveyed 94 patients who took part in the walkway. The mean (SD) BMI was 29.4 (5.6). Of the patients, 92% said they preferred the exercise walkway to sitting in the waiting room, 94% reported that they would continue the exercises at home, and the mean (SD) overall wellbeing VAS (measured with the Arizona integrative outcomes scale) improved from 52.1 (21.3) before the walkway to 59.2 (23.8) afterwards (P<0.05).
This simple model is an efficient, enjoyable and cost-effective method of promoting exercise and could be used in both primary and secondary care.
Competing interests: No competing interests