Clinical Inquiries

What’s the best way to motivate patients to exercise?

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References

Pedometers. A systematic review using meta-regression to calculate summary effects evaluated the use of pedometers by study participants for an average of 18 weeks.4 Pedometer users increased their physical activity significantly, by 2491 steps per day compared with controls (95% confidence interval [CI], 1098-3885 steps per day).4 In adults, walking normally and walking briskly for an average of 2500 steps burns 100 and 150 kcal, respectively.5

Here’s what works with kids
A British systematic review of 24 high-quality controlled trials involving adolescents and children reported significant improvements with interventions that were school-based and either community- or family-based. Multidimensional outcomes included a 42% increase in participation in regular physical activity and an increase of 83 minutes weekly in moderate-to-vigorous physical activity.6

A US meta-analysis of 11 after-school programs with an average contact time of 275 minutes per week showed a positive standardized mean difference effect size for physical activity (0.44; 95% CI, 0.28-0.60).7

Evidence for other interventions is lacking
Insufficient evidence exists to support other interventions, such as classroom-based informational health education, mass media campaigns, college-based health and physical education, and classroom-based education focused on reducing television viewing and video-game playing.2

Recommendations

The British National Institute for Health and Clinical Excellence (NICE) has found sufficient evidence to recommend brief interventions in primary care. They include:

  • using a validated tool to identify inactive patients
  • recommending at least 30 minutes of patient-specific exercise at least 5 days per week
  • establishing exercise goals
  • presenting patients with written material on the benefits of exercise and local exercise opportunities
  • following up several times over a 3-to 6-month period.8

Acknowledgments
The opinions and assertions contained herein are the private views of the authors and not to be construed as official, or as reflecting the views of the US Air Force Medical Service or the US Air Force at large.

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