The heterogeneity in reported effects was reduced in higher quality studies , when physical activity was self-directed with some professional guidance and when there was on-going professional support .
Our review suggests that physical activity interventions have a moderate effect on self reported physical activity and cardio-respiratory fitness , but not on achieving a predetermined level of physical activity .
Due to the clinical and statistical heterogeneity of the studies , only limited conclusions can be drawn about the effectiveness of individual components of the interventions .
BACKGROUND Little is known about the effectiveness of strategies to enable people to achieve an increase in their physical activity .
OBJECTIVES To assess the effects of interventions for promoting physical activity in adults aged 16 years and older , not living in an institution .
Can primary care doctors prescribe exercise to improve fitness? The Step Test Exercise Prescription (STEP) project.
BACKGROUND Sedentary lifestyle is associated with adverse health outcomes . Available evidence suggests that , despite positive attitudes toward regular exercise in promoting a healthy lifestyle , few physicians actually prescribe exercise for their patients . Barriers include lack of skills and st and ard office instruments . Because primary care physicians have regular contact with a large proportion of the population , the impact of preventive health interventions may be great . OBJECTIVES To determine the effect of an exercise prescription instrument ( i.e. , Step Test Exercise Prescription [ STEP ] ) , compared to usual-care exercise counseling delivered by primary care doctors on fitness and exercise self-efficacy among elderly community-dwelling patients . DESIGN R and omized controlled trial ; baseline assessment and intervention delivery with postintervention follow-up at 3 , 6 , and 12 months . SETTING Four large ( > 5000 active patient files ) academic , primary care practice s : three in urban setting s and one in a rural setting , each with four primary care physicians ; two clinics provided the STEP intervention and two provided usual care control . PARTICIPANTS A total of 284 healthy community-dwelling patients ( 72 per clinic ) aged > 65 years were recruited in 1998 - 1999 . INTERVENTION STEP included exercise counseling and prescription of an exercise training heart rate . MAIN OUTCOME MEASURES The primary outcome measure was aerobic fitness ( VO(2max ) ) . Secondary outcomes included predicted VO(2max ) from the STEP test , exercise self-efficacy ( ESE ) , and clinical anthropometric parameters . RESULTS A total of 241 subjects ( 131 intervention , 110 control ) completed the trial .  VO(2max ) was significantly increased in the STEP intervention group ( 11 % ; 21.3 to 24ml/kg/min ) compared to the control group ( 4 % ; 22 to 23ml/kg/min ) over 6 months ( p < 0.001 ) , and 14 % ( 21.3 to 24.9ml/kg/min ) and 3 % ( 22.1 to 22.8ml/kg/min ) , respectively , at 12 months ( p < 0.001 ) . A similar significant increase in ESE ( 32 % ; 4.6 vs 6.8 ) was observed for the STEP group compared to the control group ( 22 % ; 4.2 vs 5.4 ) at 12 months ( p < 0.001 ) . Systolic blood pressure decreased 7.3 % and body mass index decreased 7.4 % in the STEP group , with no significant change in the control group ( p < 0.05 ) . Exercise counseling time was significantly ( p < 0.02 ) longer in the STEP ( 11.7+/-3.0 min ) compared to the control group ( 7.1+/-7.0 min ) , but more ( p < 0.05 ) subjects completed > or = 80 % of available exercise opportunities in the STEP group . CONCLUSIONS Primary care physicians can improve fitness and exercise confidence of their elderly patients using a tailored exercise prescription ( e.g. , STEP ) . Further , STEP appears to maintain benefits to 12 months and may improve exercise adherence . Future study should determine the impact of combining cognitive/behavior change strategies with STEP
The heterogeneity in reported effects was reduced in higher quality studies , when physical activity was self-directed with some professional guidance and when there was on-going professional support .
Our review suggests that physical activity interventions have a moderate effect on self reported physical activity and cardio-respiratory fitness , but not on achieving a predetermined level of physical activity .
Due to the clinical and statistical heterogeneity of the studies , only limited conclusions can be drawn about the effectiveness of individual components of the interventions .
BACKGROUND Little is known about the effectiveness of strategies to enable people to achieve an increase in their physical activity .
OBJECTIVES To assess the effects of interventions for promoting physical activity in adults aged 16 years and older , not living in an institution .