Facebook
Twitter
LinkedIn
Email
 |
Checking for direct PDF access through Ovid | |
Excerpt
Physicians have the potential to improve aerobic fitness (VO2max) through counseling; however, no study has yet evaluated both the physiological and psychological effects of an exercise prescription combined with counseling in older adults. PURPOSE: To examine the change in VO2max over 12 months in a primary care exercise intervention delivered by family physicians to their older patients. METHODS: The Step Test Exercise Prescription (STEP) is a 24-month, stratified, clustered randomized clinical trial, with 360 older adults aged 50 to 86 years from 40 family practices (21 intervention and 19 control) in four provinces of Canada (British Columbia, Alberta, Ontario, and Nova Scotia). Intervention physicians were trained to deliver an exercise prescription and counseling program based on the STEP model and the transtheoretical model of behaviour change. Control physicians prescribed exercise as usual care. The primary outcome was the change in predicted VO2max as determined by the step test at 12 month follow-up. RESULTS: Patients (intervention, n = 193; control, n = 167) were healthy community dwelling older men (42.8%) and women (57.2%) with a mean age of 64.9 ± 7.1 years. In both groups, VO2max significantly increased (p<.001) for the intervention (95% confidence Interval [CI] = 3.02 (range 2.40 to 3.65) ml·kg−1·min−1, 10%) and control (CI = 2.21 (1.27 to 3.15) ml·kg−1·min−1, 7.5%) groups from baseline to 12 months; however, there was no difference between groups. Men in both the intervention (CI = 2.81 (1.80 to 3.82) ml·kg−1·min−1) and control (CI = 3.38 (1.95 to 4.80) ml·kg−1·min−1) groups significantly increased (p<.001) VO2max at 12 months, but the change in VO2max did not significantly differ between treatment groups. Among the women, only the intervention group significantly increased (p<.001) VO2max at 12 months; therefore, the change in VO2max was significantly different between the intervention and control groups (CI = 3.20 (2.41 to 4.00) and 1.23 (0 to 2.46) ml·kg−1·min−1, respectively). CONCLUSIONS: Overall, no difference was observed between the intervention and usual care in improving aerobic fitness among older adults over 12 months, however the women in the intervention group improved more than the control group. Support by CIHR.
