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December 2019

Health improvements from exercise referral schemes 'disappointing'



Exercise referral schemes are associated with improvements in health and wellbeing, but the changes aren’t as large as hoped, an analysis of outcomes data in the Journal of Epidemiology & Community Health has found.

Researchers say the roll-out of these schemes needs to be rethought to maximise their effectiveness.

Exercise referral schemes were first introduced in primary care in England in the 1990s to boost physical activity levels among those with, or at risk of, long term conditions.

Usually a GP refers the patient to a programme that often includes both cardio exercises and resistance training at a sports or leisure centre, and that lasts up to 16 weeks.

To date, most of the studies evaluating these schemes have focused on whether they increase physical activity levels, rather than improvements in health and wellbeing, say the researchers.

The new study looked at measurements recorded at the beginning and end of the schemes for weight, blood pressure, resting heart rate, and scores on mental health, wellbeing, quality of life and exercise confidence scales.

They found improvements in most of the measures, except resting heart rate, a known risk factor for cardiovascular death, and diastolic blood pressure. But the changes were small and did not reach thresholds for clinical meaningfulness.

The authors said their findings meant exercise referral schemes needed to be evaluated more critically to establish how their potential could be maximised.


Wade M, et al. J Epidemiol Community Health 2019 https://jech.bmj.com/content/early/2019/10/28/jech-2019-212674