A topic in Clinical Evidence 1 summarizes the evidence on counselling for increasing physical activity in sedentary people. Two systematic reviews (n=1 699 and 420) and eight subsequent RCTs were found. Interventions that encourage moderate rather than vigorous exercise, and do not require attendance at a special facility, may be more successful. Increases in walking in previously sedentary women can be sustained over at least 10 years. Brief advice from a physician is probably not effective in increasing physical activity. There was limited evidence that primary care consultation with an exercise specialist may increase physical activity at 1 year compared with no advice. We found limited evidence that in primary care, more intensive and prolonged advice programmes are likely to be more effectivet than brief advice alone, at least in women. Clinical evidence category: Likely to be beneficial.
One RCT (n=233) in women aged over 80 years found that four visits from a physiotherapist who advised a course of 30 minutes of home based exercises three times a week resulted in more activity at 1 year than controls, with 42% still completing the recommended exercise programme at least three times a week. The mean annual rate of falls in the intervention group was 0.87 compared with 1.34 in the control group, a difference of 0.47 falls a year (95% CI 0.04 to 0.90). Clinical evidence category: Beneficial.
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