Physical Activity Prescription Research Articles

Physical Activity with Sports Scientist (PASS) programme to promote physical activity among patients with non-communicable diseases: a pragmatic randomised controlled trial protocol

Physical activity (PA) effectively prevents and treats non-communicable diseases in clinical settings. PA promotion needs to be more consistent, especially in busy primary care. Sports scientists have the potential to...

Development of a physical activity prescription course in a Doctor of Pharmacy program.

Pharmacists are increasingly becoming the healthcare professional who interacts most regularly with patients who have diseases or disorders for which exercise is an effective and recommended treatment. With the relative scarcity of clinical exercise physiologists in the United States, pharmacists are expected to provide lifestyle advice to their patients, especially in community (i.e. retail) pharmacy settings, but student pharmacists typically receive no formal or informal training in exercise physiology and prescription. To address this deficit, an elective course was developed to provide student pharmacists with the knowledge and skill set that will enable them to apply evidence-based physical activity guidelines in the pharmacy. The course utilized the Exercise is Medicine resources for chronic diseases and disorders that are routinely encountered in community pharmacies, in addition to analysis of interactions between exercise and medications commonly prescribed for these conditions. After completion of the course, students reported being significantly more comfortable discussing physical activity with their patients compared to the start of the course (P < 0.001). Similarly, at the end of the course, 99% of students reported that they felt confident in their ability to apply evidence-based recommendations of common diseases and disorders to their patients. Postcourse student evaluations clearly demonstrated that student pharmacists viewed the course positively and as essential in their professional training. These data highlight the feasibility and efficacy of improving self-perceptions for the provision of physical activity recommendations via an elective course in physical activity prescription in a Doctor of Pharmacy program.NEW & NOTEWORTHY This study describes a new elective course in physical activity prescription for Doctor of Pharmacy students. After completing the course, students reported improved self-perceptions for the provision of physical activity recommendations. This course fills a gap in pharmacy education and this study provides future directions to improve training in lifestyle modifications.

Feasibility of a Type 2 Diabetes Prevention Program at Nationwide Level in General Practice: A Pilot Study in Italy.

Lifestyle interventions halt the progression of prediabetes to frank type 2 diabetes (T2D). However, the feasibility of a diabetes prevention program promoting tailored interventions on a national scale and conducted by primary care physicians is unclear. General practitioners located in ten different regions throughout Italy enrolled random subjects without known metabolic diseases to identify individuals with prediabetes and prescribe them an intervention based on physical activity. Using a simple stepwise approach, people referring to their primary care physician for any reason were screened for their diabetes risk with a web-based app of the Findrisc questionnaire. Those at risk for T2D, i.e., with a Findrisc score >9, were invited to come back after overnight fasting to measure fasting glycaemia (FG). Those with 100 ≤ FG < 126 mg/dL were considered as people with prediabetes and compiled the Physical Activity Readiness Questionnaire (PAR-Q) to then receive a personalised prescription of physical activity. Overall, 5928 people were enrolled and compiled the questionnaire. Of these, 2895 (48.8%) were at risk for T2D. Among these, FG was measured in 2168 subjects (participation rate 75%). The numbers of individuals with undetected prediabetes and T2D according to FG were 755 and 79 (34.8% and 3.6% of those assessing FG), respectively. Of the 755 subjects in the prediabetes range, 739 compiled the PAR-Q and started a personalised program of physical activity (participation rate 97%). Physicians involved in the study reported a mean of 6 min to perform the screening. Overall, these data suggest the feasibility of a national diabetes prevention program developed by general practitioners using a simple stepwise approach starting from a web app to intercept individuals with prediabetes.

Implementation of Exercise Management Services Among Sports Medicine Physicians in the United States.

Assessment of physical activity and exercise prescription has been widely supported by many organizations, yet provision of such services remains limited in the United States. We sought to uncover why such services have not been widely adopted. The American Medical Society for Sports Medicine organized a task force to canvas physicians and survey the American Medical Society for Sports Medicine membership. Peer-to-peer and telecommunication discussions and web-based questionnaires. Sports medicine physicians in the United States. None. Percentage of sports medicine physicians who provide exercise management services and mechanisms of billing for exercise management, identify barriers to such services, and identify industry collaborations for promoting physical activity through physicians. Three of 4 sports medicine physicians spend at least 1 min encouraging exercise with patients, using Evaluation and Management codes to bill or receive credit. Exercise counseling is often bundled within other patient care. Few health plans leverage the patient's relationship with a primary care physician to promote exercise. Most employed sports medicine physicians do not receive incentives to incorporate exercise counseling into practice, and only 1 in 6 have decision-making authority to hire an exercise professional. Major obstacles are the lack of a business model and knowledge about exercise prescription. The existing E&M codes adequately characterize the work, but physicians desire greater payment or credit for providing exercise management services. Physicians desire to do more exercise prescription, but health system bureaucracy, inadequate support, and economic disincentives are barriers to the provision of exercise management services.

Exploring potential reach and representativeness of a self-weighing weight gain prevention intervention in adults with overweight and obesity.

Most adults with obesity do not enrolin comprehensive weight loss interventions when offered. For these individuals, lower burden self-weighing interventions may offer an acceptable alternative, though data is lacking on the potential for reach and representativeness of such interventions. Health system patients with BMI ≥30 kg/m2 (or 25-30 kg/m2 with an obesity comorbidity) completed a general health survey. During the survey, patients were given information about comprehensive weight loss interventions. If they denied interest or did not enrol in a comprehensive intervention, they were offered enrolment in a low-burdenweight gain prevention intervention focused on daily self-weighing using a cellular network-connected in-home scale without any dietary or physical activity prescriptions. Enrolment in this program was documented. Among patients offered the self-weighing intervention (n = 85; 55.3% men; 58.8% White; BMI = 34.2 kg/m2), 44.2% enrolled. Compared to those who did not enrol, enrollers had higher educational attainment (57.1% vs. 42.9% with bachelor's degree p = .02), social anxiety (5.8 vs. 2.8, p < .001), and perceptions of the effectiveness of the self-weighing intervention (25.8 vs. 20.9 on 35, p = .007). The most highly endorsed reason for not enrolling in the self-weighing intervention was that it would make individuals overly focused on weight. A low-intensity weight gain prevention intervention may serve as a viable alternative to comprehensive weight loss interventions for the substantial portion of patients who are at risk for continued weight gain but would otherwise not enrol in a comprehensive intervention. Differential enrolment by education, however, suggests potential for inequitable uptake.

Curricular and pedagogical approaches for physical activity prescription training: a mixed-methods study of the “Exercise is Medicine” workshops in Colombia

BackgroundThe physical activity (PA) prescription workshop for physicians, through the global health initiative “Exercise is Medicine” (EIM), has trained more than 4000 health care professionals (HCPs) in Latin America. It has shown to be effective in increasing PA prescription knowledge and awareness among HCPs. The purpose of this paper is to evaluate the curricular and pedagogical approach used by EIM Colombia at the PA prescription workshops implemented between 2014 and 2015.MethodsA mixed methods study, with a sequential explanatory design was implemented among a convenience sample of HCPs attending twenty-six PA prescription workshops. HCPs health status, PA personal habits, and medical practices were collected using a questionnaire at baseline among 795 participants (pre-test measurement), and subsequently quantitatively analyzed. A workshop satisfaction survey was administered after the completion of the workshop among 602 HCPs. The curricular and pedagogical approach of the workshop, the designers’ and students’ contextual factors, and perceptions about the workshop were measured using qualitative methods (analysis of the procedures manual, two workshop observations, three semi-structured interviews, and one focus group including 8 HCPs).ResultsThe workshop is student-centered and guided by an expert with an academic and clinical background. Learning was achieved with theoretical and practical components using authentic performance and collaborative learning. An active teaching and learning approach was used with strategies such as interactive lectures, hands-on elements, and role-playing (patient-counselor). The workshop emphasized an individual approach when prescribing PA integrating in clinical practice not only health benefits but also patient´s beliefs, motivations, needs, and barriers.ConclusionsEvidence-based practices and authentic performance were the most salient pedagogical elements used by EIM Colombia at the PA prescription workshop. A knowledge assessment that includes the practical aspect is suggested for future workshops. The curricular and pedagogical approach of the PA prescription workshop implemented in Colombia is well received by the medical community and a useful continuing medical education intervention with a potential contribution to current, and future health promotion needs.

Promoting physical activity for health benefits via a 10-week mobile-application-based personal training programme

ABSTRACT Mobile-application-based interventions promoting engagement in regular physical activity have been shown to afford weight loss, although the wider health benefits remain unknown. This exploratory intervention study quantified the effects of a 10-week mobile-application-based personal training programme combined with nutritional education content, considering physical and psychosocial health-related outcomes. Eleven healthy individuals completed the intervention, comprising physical activity prescription (resistance and high-intensity interval training), nutritional education, a daily step target and online personal trainer support. Outcomes included anthropometrics, circumferential measurements, resting heart rate, blood pressure, aerobic capacity, self-rated health, physical activity enjoyment scale, and the Pittsburgh sleep quality index. Significant improvements in body mass, circumferential measurements and aerobic capacity (p < 0.05) were observed amongst participants. Mobile-application-based interventions promoting physical activity may elicit improvements in physical health outcomes. Although healthy individuals were recruited for the purpose of this study, further research is now warranted to explore the potential health-related benefits of such mobile-applications amongst targeted groups such as disengaged, inactive populations, or individuals with long-term health conditions.

A Review of Educational Interventions on Physicians’ Exercise Counseling and Prescription Practices

ABSTRACT Context Physicians report various barriers to providing patients with physical activity (PA) counseling and prescriptions. Implementing educational interventions among physicians could be an effective method for the promotion of PA counseling in primary care. Objective The purpose of this study was to review the impact and efficacy of different educational intervention modalities on physicians’ PA promotion outcomes. Design Twenty-one articles were included in this systematic review and were of moderate quality (6.8 ± 3.3 of 14 controlled trials and 6.3 ± 2.3 of 12 uncontrolled trials), assessed via the National Institutes of Health quality assessment tools. Studies ranged in sample size from 9 to 12,945 participants (n = 16,283). Eligibility Criteria For inclusion, studies had to have had interventional experimental design and performed an educational intervention aiming to improve PA counseling or exercise prescription practice, and most of the sample comprised physicians. Study Selection Sources were searched in May 2022 (n = 3422 citations without duplicates) via Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier (Prospero ID: CRD42022331755). Main Outcome Measures Physician PA practice outcomes across studies were categorized in terms of frequency of counseling and prescription, knowledge, and confidence. Results Most studies measuring PA counseling (8 of 13 studies) and prescription practices (8 of 10 studies) exhibited an increased frequency of PA prescription before and after the intervention. Physician confidence surrounding PA increased in most studies (10 of 12 studies), as well as knowledge of PA (6 of 7 studies). Conclusions Studies that were most effective in increasing physician PA promotion outcomes incorporated a practical component (i.e., hands-on) in addition to a theoretical session (i.e., lecture-based) to meet specific goals (e.g., accredited PA guidelines, prescription strategies). This review outlines the strengths and weaknesses of present educational intervention modalities and provides insight into future directions for education models to promote PA counseling and exercise prescription practices among physicians.

Physical activity in Parkinson's disease: examining prescription sources, patterns, and the influence of quality of life and disease severity.

Limited research has explored the influence of quality of life (QoL) and disease severity on physical activity (PA) in Parkinson's disease (PD) patients, and the sources of PA prescription and advice for this population. This study aims to expand scientific knowledge on these topics. Two-hundred eleven PD patients were personally interviewed to collect data on PA levels using the International Physical Activity Questionnaire-Short Form and QoL using the Parkinson's Disease Questionnaire-8. An ad hoc questionnaire gathered information on disease severity (Hoehn and Yahr stages), PA behaviors, and PA recommendations. Weak but significant associations were found between PA levels, disease severity (r: -0.218; p = 0.004), and QoL (r: -0.244; p = 0.001). Most participants (85%) received PA counselling, predominantly from neurologists, either at diagnosis (52%) or shortly after (28%). Before PD onset, ~86% engaged in PA, decreasing to 66% post-diagnosis. Approximately 78% reported changes in PA, including reduced frequency (18.4%) and duration (32.8%), with walking as the primary activity. Disease severity and QoL significantly affect PA levels in PD patients. Diagnosis is associated with decreased PA frequency and duration, and walking is the preferred activity. Neurologists primarily provide PA advice.

RELATIVE AND ABSOLUTE METABOLIC COST OF DAILY PHYSICAL ACTIVITIES ACROSS THE LIFESPAN

Abstract Americans spend over 90% of their activity related energy expenditure performing common daily activities. However, there is a gap in knowledge pertaining to potential age-related differences in the metabolic cost of performing these activities which diminishes proper physical activity prescription. We hypothesized age differences in both the absolute and relative metabolic cost of performing common daily physical. Participants (n=248, age: 20-94 yrs) performed 33 activities (e.g. dressing, walking, making a bed, gardening, computer work) in a standardized setting. A portable indirect calorimeter was worn for approximately 6-10 minutes to achieve steady-state metabolic rate. A graded exercise treadmill test was performed to quantify peak metabolic rate. A metabolic equivalent (MET as a function of 3.5 milliliter•min-1•kg-1) and percentage of peak were used to express absolute and relative metabolic rate, respectively. Watching television (1.0+/-0.36 METs; 15.6+/-5.7% of peak) produced the lowest and climbing stairs (6.2+/-2.2 METs; 84.8+/-17.0% of peak) elicited the highest metabolic rate. Results from mixed effect regression models adjusting for health conditions, demographics and anthropometry showed no association between absolute MET and age. However, when expressed relative to peak, adjusted models showed a strong association with age (0.66+/-0.33% per year, p=0.006). As an example, adults &amp;lt; 40 yrs old worked at 34.1+/-14.8% of peak during a leisurely walk while those 80+ years old worked at 64.2+/-16.3%. Aging is associated with a substantial increase in the relative metabolic cost of performing common daily physical activities. These results could have implications on prescribing physical activity older adults to achieve higher fitness.

Evaluating consistency of physical activity and exercise prescription in the UK for people with diabetes - a Delphi study.

Increased physical activity is recommended as a cost-effective measure to tackle long-term management of people with diabetes, but research on interventions lacks consistency in terms of effective duration and modality. The aim of this study was to evaluate expert consensus on exercise and physical activity prescription via a three-round Delphi study conducted with 45 UK-based health and fitness professionals experienced in prescribing exercise or physical activity to people with diabetes. The majority of items put forward to the panel reached consensus with 70% or above voting these items as important, but the details of the type, duration and/or modality of exercise or physical activity prescription within these items often contradicted each other, suggesting that patients are receiving inconsistent advice. The range of different exercise prescription found in this study suggests that patients are being given inconsistent and potentially confusing advice, which may affect their participation in exercise and long-term lifestyle change. More consistent promotion of advice from healthcare and fitness professionals may help with increasing physical activity in this participant group and achieving long term behavior change, reducing patient symptoms as well as reducing the cost to the National Health Service (NHS).

Mobile applications to prescribe physical exercise in frail older adults: review of the available tools in app stores.

Different remote interventions, such as applications (apps), have been used to continue promoting healthy ageing and preventing disability during the COVID-19 pandemic. The growing trend of apps in health is exponential and may facilitate scaling up physical activity prescription. Numerous tools are available, but little is known regarding their appropriateness, validation and recommendation, especially for frail older adults. In-house, we developed an application that makes both the Apple app Store and the Google Play Store searchable using topic-related keywords and facilitates the extraction of basic app-information of the search results. The study was aimed at apps available to an English-speaking market. The resulting apps were filtered using various inclusion and exclusion criteria. The resultant apps underwent a more in-depth characterisation and searches for scientific publications on each app website and PubMed. From an initial search result of >2,800 apps, 459 met the initial inclusion criteria. After a more in-depth review of their features, 39 apps remained for possible app in older frail patients. After testing them, 22 apps were excluded. Seventeen apps fit the inclusion and exclusion criteria and were deemed appropriate after peer review. Of these, only one app, Vivifrail, had any type of publication/published evidence. Apps can be valuable tool in prescribing exercise for frail older adults living in the community. However, few apps seem useful on a large scale, and there is limited evidence to support their effectiveness. It is important to invest in adapting Information and Communication Technologies to this population group.

Physical activity for patients with chronic low back pain: What are physical therapists prescribing?

Despite the extensive evidence supporting physical activity (PA) for managing chronic low back pain (CLBP), little is known about PA prescription by physical therapists treating patients with CLBP. 1) Explore how PA prescriptions provided by outpatient physical therapists treating patients with CLBP align with PA guidelines. 2) Examine the barriers and facilitators of PA prescription among physical therapists working with patients with CLBP. We conducted a qualitative study with outpatient physical therapists who treat CLBP. Semi-structured interviews provided an understanding of physical therapist experience with PA prescription among patients with CLBP. The interviews were transcribed, coded, and analyzed thematically. The 18 participants had an average of 13.4 (6.4) years of clinical experience in outpatient physical therapy. Thematic analysis revealed: 1) Physical therapists' articulate knowledge of PA guidelines and importance of physical activity; 2) Patient factors take priority over the PA guidelines for people with CLBP; and 3) The importance of building and maintaining a strong patient-therapist relationship influences physical therapist prescription of PA for patients with CLBP. When providing PA recommendations for patients with CLBP, general movement recommendations are emphasized in place of explicit PA prescriptions. Our findings highlight factors for consideration when prescribing movement and PA for patients with CLBP.

Abstract 12491: Impact of Augmented Treatments on Physical Activity Outcomes in a Sequential Multiple Assignment Randomized Trial

Background: Nearly half of women do not meet aerobic physical activity (PA) guidelines. Despite proven efficacy of PA interventions, response varies. Little is known about when treatment should be augmented. The Working Women Walking Program is a Sequential Multiple Assignment Randomized Trial testing two initial treatments (Fitbit vs. Fitbit+text messages) for eight weeks and two augmented treatments (personal calls vs. group meetings) added at eight weeks for non-responders to the initial treatments. Aims: We aim to compare the two augmented treatments among non-responders to the initial treatments on PA after 34 weeks of the program. Methods: Participants ( N = 301; women ages 18-70) were randomly assigned to an initial treatment of either Fitbit ( n = 149) or Fitbit+text messages ( n = 152). Both groups received a Fitbit and PA prescription (increase daily steps by ≥600 above baseline). Response to treatment was defined as (a) wearing the Fitbit 10 hours per day 3 of 7 days weekly in weeks 6-8 and (b) reaching a step goal ≥600 steps above baseline for 2-3 weeks in weeks 6-8. Non-responders were randomly assigned to an augmented treatment with personal calls ( n = 72; 50.7%) or group meetings ( n = 70; 49.3%). Objective PA was assessed with the waist-worn ActiGraph accelerometer (≥4 days with one weekend day and ≥10 hours daily wear time) at baseline and 34 weeks to assess daily steps and minutes of light and moderate-vigorous intensity PA (MVPA). Self-report PA was measured with the International PA Questionnaire to assess daily MVPA and walking. Results: Across all PA measures, there were no significant differences between augmented treatments (personal calls vs. group meetings). Overall, both treatments showed non-significant increases in objective PA, including steps ( d = .15; p = .30), light PA ( d = .11; p = .39), and MVPA ( d = .22; p = .15), but showed significant increases in self-report PA, including ( d = 1.02; p &lt; .001) and walking ( d = .73; p = .30). Conclusion: In this sample of working women who were non-responsive to an initial PA treatment (Fitbit or Fitbit+texts), augmenting with personal calls or group meetings did not yield a difference in PA outcomes. Next, we will explore participant characteristics that may differentiate response to augmented treatments.

Exercise as medicine: Physicians’ perceptions of physical activity and exercise for chronic diseases

Abstract Background Although physical activity and exercise (PAE) offer several health advantages in the management of non-communicable diseases (NCDs), its systematic implementation in medical practice remains questionable. The aim of the study was to investigate Greek physicians’ knowledge, attitudes, intentions, abilities, and behavior (KAIAB) towards PAE in the management of NCDs. Methods A nationwide, cross-sectional, online study was conducted (October 2022 - March 2023) in Greece via a new questionnaire, which was developed and pilot-tested at an earlier stage of the study. The questionnaire's link was distributed to participants by email through their Medical Association. We computed physicians’ KAIAB total scale score as the sum of their responses. The three levels of Bloom's cut-off points were modified and were used to classify physicians’ KAIAB levels towards PAE. Results The physicians’ KAIAB levels in PAE were expressed as mean values (MV) and standard deviations (SD) respectively (MV/SD), as follows: 11.5/3.32 (low knowledge), 134.8/17.20 (moderate attitudes), 33.8/5.63 (high intentions), 19.48/5.76 (low abilities), and 30.81/7.23 (moderate behavior). Cronbach's alpha varied from 0.796 to 0.930 to achieve a high internal consistency to the scales of the new questionnaire. Conclusions Greek physicians definitely are willing to advise and prescribe PAE and demonstrate moderate attitudes and behavior on these issues that need further improvement. However, their knowledge and self-reported abilities are apparently low, particularly on PAE prescription. These results suggest that, in order to include PAE in medical practice, are needed future policies to develop strategies to promote physicians’ education and training to improve their knowledge and skills on PAE, the adoption of exercise prescription strategies, and the integration of PAE into health care services as an alternative way of preventing and treating chronic diseases and promoting public health. Key messages • The Greek physicians’ level of Knowledge and abilities in physical activity and exercise is low rendering their implementation in medical practice difficult for patients with non-communicable diseases. • Empowerment of physicians is crucial in order to integrate physical activity and exercise prescription into the standard medical care of non-communicable diseases and thus promote public health.

Prescribing statin therapy in physically (in)active individuals vs prescribing physical activity in statin-treated patients: A four-scenario practical approach

Statins are among the most commonly prescribed medications worldwide. Statin-associated muscle symptoms (SAMS) represent a frequent statin-related adverse effect associated with statin discontinuation and increased cardiovascular disease (CVD) events. Emerging evidence indicate that the majority of SAMS might not be actually caused by statins, and the nocebo/drucebo effect (i.e. adverse effects caused by negative expectations) might also explain SAMS. Physical activity (PA) is a cornerstone in the management of CVD risk. However, evidence of increased creatine-kinase levels in statin-treated athletes exposed to a marathon has been generalized, at least to some extent, to the general population and other types of PA. This generalization is likely inappropriate and might induce fear around PA in statin users. In addition, the guidelines for lipid management focus on aerobic PA while the potential of reducing sedentary behavior and undertaking resistance training have been overlooked. The aim of this report is to provide a novel proposal for the concurrent prescription of statin therapy and PA addressing the most common and clinically relevant scenarios by simultaneously considering the different stages of statin therapy and the history of PA. These scenarios include i) statin therapy initiation in physically inactive patients, ii) PA/exercise initiation in statin-treated patients, iii) statin therapy initiation in physically active patients, and iv) statin therapy in athletes and very active individuals performing SAMS-risky activities.

Implementation determinants of physical activity interventions in primary health care settings using the TICD framework: a systematic review

BackgroundTranslation into practice of effective physical activity interventions in primary care is difficult, due to a complex interaction of implementation determinants. We aimed to identify implementation barriers and facilitators of four primary care interventions: physical activity assessment, counselling, prescription, and referral.MethodsA systematic review of qualitative, quantitative and mixed-methods studies published since 2016 was conducted. The “Tailored Implementation for Chronic Diseases” (TICD) framework was adapted to extract and synthesize barriers and facilitators.ResultsSixty-two studies met the inclusion criteria. Barriers (n = 56) and facilitators (n = 55) were identified across seven domains, related to characteristics of the intervention, individual factors of the implementers and receivers, organizational factors, and political and social determinants. The five most frequently reported determinants were: professionals’ knowledge and skills; intervention feasibility/compatibility with primary health care routine; interventions’ cost and financial incentives; tools and materials; and professionals’ cognitions and attitudes. “Social, political and legal factors” domain was the least reported. Physical activity counselling, prescription, and referral were influenced by determinants belonging to all the seven domains.ConclusionThe implementation of physical activity interventions in primary care is influenced by a broader range of determinants. Barriers and facilitators related with health professionals, intervention characteristics, and available resources were the most frequently reported. A deep understanding of the local context, with particularly emphasis on these determinants, should be considered when preparing an intervention implementation, in order to contribute for designing tailored implementation strategies and optimize the interventions’ effectiveness.

Knowledge and practice of the physical activity prescription by generalists and specialist physicians of the city of Kinshasa: a cross-sectional study

BackgroundThe health benefits of regular physical activity (PA) are well documented. However, several people in both developed and developing countries do not meet PA recommendations. Health professionals are believed to be potential PA promoters. The purpose of this study is to gain insight into general and specialist practitioners’ knowledge, practices and PA prescription-related factors in private and public hospitals in Kinshasa.MethodsA multicenter cross-sectional analytical study was conducted among general and specialist practitioners in the Democratic Republic of the Congo’s capital using a declarative and anonymous questionnaire.ResultsOverall, 40.2% of the participants were interested in their patient’s PA, 2.3% prescribed PA, and 0.9% did it correctly. Specialist physicians (SPs) prescribed PA more frequently than general practitioners (GP), and private hospital physicians prescribed PA more frequently than public hospital physicians. Five factors were independently associated with participants in prescribing PA: being in a private hospital increased the likelihood of prescribing PA by twofold (aOR, 1.83; 95% CI, 0.99–3.39; p = 0.055), being an SP increased the likelihood by sixfold (aOR, 6.22; 95% CI, 3.78–10.51; p = 0.000), being an internist increase the likelihood by sixfold (aOR, 5.81; 95% CI, 3.45–9.78; p = 0.000), being cardiologist by a factor of 12 (aOR, 12.91; 95% CI, 4.37–38.15; p = 0.000) and knowing the benefits of PA by a factor of 2 (aOR, 2.29; 95% CI, 1.29–4.08; p = 0.006). The most common reason given for a lack of interest in patients’ PA, followed by a lack of knowledge about current PA prescribing recommendations and a lack of time.ConclusionsSPs and professionals in the private health sector were the most interested in their patients’ PA. A small portion of them actually prescribed it, and only a tiny proportion did it correctly. This bleak picture highlights a need to rethink the undergraduate medical curricula, especially about teachings on the importance and use of PA as a medicine in its own right in disease prevention and treatment.

Assessing the efficacy of duration and intensity prescription for physical activity in mitigating cardiometabolic risk after spinal cord injury.

Spinal cord injury (SCI) heightens susceptibility to cardiometabolic risk (CMR), predisposing individuals to cardiovascular disease. This monograph aims to assess the optimal duration and intensity of physical activity (PA) for managing CMR factors, particularly obesity, after SCI and provide modality-specific PA durations for optimal energy expenditure. PA guidelines recommend at least 150 min/week of moderate-intensity activity. However, non-SCI literature supports the effectiveness of engaging in vigorous-intensity PA (≥6 METs) and dedicating 250-300 min/week (≈2000 kcal/week) to reduce CMR factors. Engaging in this volume of PA has shown a dose-response relationship, wherein increased activity results in decreased obesity and other CMR factors in persons without SCI. To optimize cardiometabolic health, individuals with SCI require a longer duration and higher intensity of PA to achieve energy expenditures comparable to individuals without SCI. Therefore, individuals with SCI who can engage in or approach vigorous-intensity PA should prioritize doing so for at least 150 min/wk. At the same time, those unable to reach such intensities should engage in at least 250-300 min/week of PA at a challenging yet comfortable intensity, aiming to achieve an optimal intensity level based on their abilities. Given the potential to decrease CMR after SCI, increasing PA duration and intensity merits careful consideration in future SCI PA directives.

S11-4 Physical activity prescription in the municipality of Camarena in Castilla-La Mancha, Spain

Abstract Purpose A pilot study of the Physical Activity (PA) Prescription (PAP) Plan in the municipality of Camarena (Castilla-La Mancha - CLM, Spain) was conducted to evaluate the incorporation of the exercise units which work together with General Practitioner (GP) to make “PA practice the easy option”. Target group is inactive people with or without chronic disease. Project or policy description The High Council for Sports of Spain launched a national PAP plan developed by the creation of exercise units that will work together with PA referral (PAR) in all autonomic Communities in Spain. The plan is using digital tools to improve the accessibility and efficacy of the Community Sport and Health systems to provide PA for the inactive population with or without chronic disease. This investment is part of the Sports Sector Digitization Plan, one of the three axes of the Component 26, of the Recovery, Transformation and Resilience Plan, aimed at promoting the sports sector. A pilot study in PAP was implemented in Camarena designed by PAFS research group from the University of CLM. The pilot study started with a local meeting including all agents in the community: local nurses and general practitioners (GP), all staff involved in the community PA and Sports offer, and town hall members. The pilot study included: (i) developing a both-ways communication system between GP practice and the exercise unit, (ii) developing a Physical Fitness and Health assessment battery tool for all patients, (iii) developing individualized exercise programs using digital tools, (iv) analyzing all opportunities to be physically active at the community, (v) quantitative and qualitative evaluation analyses of the implementation of the PAP in Camarena. This pilot study aimed to be the seed to scale-up PAP plan in CLM region. Conclusions The PAP plan had a good acceptance by the community of Camarena. The response rate of patients was high (85% of referred patients came to the exercise unit). Patients’ adherence to the exercise program was excellent. An educational plan is now developed as a policy-implication, for nurses, doctors, and PA educators in CLM, including all outcomes from PAP plan in Camarena.