Physician Prompting Patients to Exercise

A major challenge facing cancer patients is to undertake some level of physical exercise during treatment-and to maintain an exercise program throughout recovery and beyond. However, a new study sponsored by the National Heart, Lung and Blood Institute, a division of the National Institutes of Health, has found that a little encouragement from their doctor can make all the difference.

Results of the two-year, multi-center study, "A Randomized Trial of Physical Activity Counseling in Primary Care for Inactive Adult Patients," were published in the Journal of the American Medical Association.

The study compared three types of education and counseling: simple doctor advice about the need to exercise; doctor advice plus counseling from a health educator; and doctor advice, health counseling plus intensive follow-up via classes, newsletters, etc.

The results showed that doctor advice and behavioral counseling worked better than advice alone in encouraging female patients to begin a physical fitness program, while all three measures had an equal impact for men. Importantly, even minimal input from a doctor or health professional had a dramatic impact on patients eventually undertaking-and maintaining-regular physical exercise.

"The study shows that doctors and their medical staff can help their patients, especially women, increase their physical fitness and that such an effort doesn't take much time," said NHLBI Director Dr. Claude Lenfant. "For women, such counseling could make a crucial difference because national surveys show they are less likely to be physically active than men."

Studies have shown that even moderate physical activity can accelerate recovery times from cancer treatment as well as boost emotional wellbeing. Physical inactivity is also a major risk factor for heart disease and high blood pressure, and contributes to overweight and obesity.

Federal recommendations call for adults to engage in at least 30 minutes of moderate-intensity physical activity, such as brisk walking, on five or more days of the week. But, according to the 1996 Surgeon General's Report, Physical Activity and Health, 26.9 percent of women and 21.4 percent of men age 18 or older engage in no leisure-time physical activity.

The study involved 874 men and women, ages 35 to 75, who were inactive at the start of the trial and had no clinical cardiovascular disease. Forty-five percent of participants were women and 55 percent men. About 33 percent were minorities.

"The surprise was that the two more intensive interventions worked equally well for women," said Dr. Denise Simons-Morton of the NHLBI. "We had thought it would take the more intensive counseling interventions to boost physical fitness. This is a positive message. With fitness, a little help yields an important improvement."

SOURCES:
Journal of the American Medical Association, August 8, 2001; 286:677-687
The National Heart, Lung, and Blood Institute (http://www.nhlbi.nih.gov)

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