EXERCISE PRESCRIPTION BY FAMILY DOCTORS CAN IMPROVE FITNESS OVER 12 MONTHS.
Bibliographic record
Abstract
Available evidence suggests that despite physicians' positive attitude toward regular exercise in promoting a healthy lifestyle, few actually prescribe exercise for their patients. PURPOSE To determine the effect of an exercise prescription instrument (STEP) compared to usual care (CONTROL) exercise counseling delivered by family doctors on fitness (VO2max and exercise self-efficacy (ESE) among older community-dwelling patients. METHODS A randomized controlled trial with baseline assessment, intervention delivery and post-intervention follow up at 3, 6 and 12 months. The setting was four large urban (3) and rural (1) academic family practices (2=STEP; 2=CONTROL). Individuals were randomly assigned to one of the two treatment conditions. Interventions included STEP exercise counseling using published recommendations of the ACSM and prescription of an exercise training heart rate using a self-paced stepping test. The primary outcome measure was VO2max and secondary outcomes included predicted VO2max from the step test, ESE, blood pressure, BMI, counseling time and adherence. RESULTS A total of 241 older subjects completed the trial (STEP = 131 vs CONTROL=110). VO2max was significantly increased in STEP (11%; 21.3 to 24ml/kg/min) vs CONTROL (4%; 22 to 23ml/kg/min) over 6 months (p < 0.001) and 17% (21.3 to 24.9ml/kg/min) and 3% (22.1 to 22.8ml/kg/min) respectively at 12 months (p < 0.001). Similarly, ESE increased (32%; 4.6 vs 6.8) in STEP vs CONTROL (22%; 4.2 vs 5.4) at 12 months (p < 0.001). Systolic blood pressure decreased 7.3% and BMI decreased 7.4% in STEP only (p < 0.05). Exercise counseling time was significantly (p < 0.02) longer in STEP (11.7± 3.0min) vs CONTROL (7.1±7.0min) but more (p < 0.05) subjects completed at least 80% of available exercise opportunities in STEP. CONCLUSIONS Family physicians can improve fitness and exercise confidence of their older patients using a tailored exercise prescription (STEP). Further, STEP appears to maintain benefit to 12 months and may improve exercise adherence. Sponsored by CIHR/PMAC
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".