Feasibility Assessment of the Let’s Walk Programme (CAMINEM): Exercise Training and Health Promotion in Primary Health-Care Settings

Exercise is related to many individual health outcomes but impact evaluations of exercise programmes are seldom conducted. The purpose of the study is to evaluate the feasibility of an exercise prescription intervention in primary health-care settings (CAMINEM Programme) located in two socially disadvantaged neighbourhoods. The CAMINEM was a pragmatic-driven intervention with opportunistic recruitment. It followed the 5As framework for health promotion and also the exercise training principles. Feasibility was evaluated using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Patients with non-communicable chronic diseases participated in a 12-month home-based moderate-intensity exercise program, counselled by exercise physiologists. Participants were grouped according to their physical activity behaviour at baseline and 6-month adherence. CAMINEM reached 1.49% (n = 229) of the eligible population (N = 15,374) and included a final sample of 178. Health outcomes for adhered participants followed positive patterns. Non-adhered participants visited their practitioner more compared to adhered participants. Thirty-three practitioners (40%) referred patients. Nurses referred four times more than physicians (81% and 19% respectively). The delivery of exercise prescriptions proved to be easy to complete and record by participants as well as easy to monitor and adjust by the exercise physiologists. One out of four participants adhered during the 12-month intervention. This intervention has been feasible in primary care in Catalonia, Spain, to safely prescribe home-based exercise for several conditions.This research was funded by the Secretaria General de l’Esport and the Departament d’Innovació, Universitats i Empresa, Generalitat de Catalunya with a competitive grant for junior researchers, grant number 006780 Ordre 001

Workplace physical activity practices in real life: a scoping review of grey literature for small- and medium-sized enterprises

Background: There is a need to scale-up effective physical activity (PA) programmes for small- and medium-sized enterprises (SMEs), where the uptake of PA interventions is low. Identifying real-life workplace practices in PA could contribute to a better understanding of what PA programmes might be most grounded in the ‘real world’. However, there is a scarcity of evidence showing what gets done. This study aimed to identify, describe and comprehensively summarize the real-life implementations of workplace PA initiatives, particularly in Europe, as a prior step to dissem inating future feasible PA practices for SMEs. Methods: A scoping review of grey literature included a systematic search in the Google advanced search platform that permuted a combination of key concepts (PA, workplace, interventions/programmes), internet domains, and search operators in six different languages (Catalan, Finnish, French, Dutch, English and Spanish) between 2015 and November 2020. The analysis process was iterative, and multiple methods were used to sort, group and categorize the initiatives. Results: There were a total of 713 real life workplace PA initiatives from different-sized organizations identified. These were categorized into five themes: active work and living, exercise and fitness programs, management and leadership, communication and dissemination, and facilities. Finally, feature trees showing a menu for real-life workplace PA practices were implemented. Conclusions: Identifying real-life practice providing a state-of-the-art snapshot of current PA practices in workplaces, which is a starting point to better understand feasible practices in the context of small- and medium-sized workplaces

Exercise on Prescription and Exercise Planning in Primary Health-Care Settings. An Approach by the 'Let's Walk Programme' (Programa CAMINEM)

L’exercici físic provoca efectes beneficiosos per a la salut en persones sanes però també amb certes patologies cròniques. L’objectiu d’aquesta tesi fou valorar els efectes i l’aplicabilitat d’un programa de prescripció i planificació d’exercici físic per a la salut a dos centres d’atenció primària per a pacients amb patologia crònica reclutats durant visites rutinàries al seu equip d’atenció primària. El disseny de l’estudi fou d’una intervenció pragmàtica de 18 mesos avaluada seguint les dimensions RE-AIM. Els protocols establerts per a la intervenció, emmarcada en el Programa CAMINEM, han demostrat ser aplicables en els dos centres i els efectes de l’exercici físic pels participants adherits mostraren una tendència favorable, tot i que els resultats no són estadísticament significatius. Aquesta intervenció en prescripció d’exercici físic per a la salut possiblement hagi estat la primera basada en els principis de l’entrenament esportiu i en promoció de salut pública on un professional no sanitari treballà conjuntament amb professionals sanitaris d’atenció primària.El ejercicio físico provoca efectos beneficiosos para la salud en personas sanas pero también con ciertas patologías crónicas. El objetivo de esta tesis fue valorar los efectos y la aplicabilidad de un programa de prescripción y planificación de ejercicio físico para la salud en dos centros de atención primaria para pacientes con patología crónica reclutados durante visitas rutinarias a su equipo de atención primaria. El estudio fue diseñado como una intervención pragmática de 18 meses evaluada siguiendo las dimensiones RE-AIM. Los protocolos establecidos para la intervención, basada en el Programa CAMINEM, han demostrado ser aplicables en los dos centros y los efectos del ejercicio físico para los participantes adheridos reflejaron una tendencia favorable, a pesar de que los resultados no sean estadísticamente significativos. Esta intervención en prescripción de ejercicio físico para la salud posiblemente haya sido la primera basada en los principios de entrenamiento deportivo y de promoción de salud pública en el cual un profesional no sanitario trabajó conjuntamente con profesionales sanitarios de atención primaria.Regular exercise has many health benefits for apparently healthy people and also for people suffering determinant chronic diseases. The main aim of this thesis was to assess the effects and feasibility of a health-enhancing exercise prescription and exercise planning in two primary health-care settings for regular patients suffering from chronic conditions attending their health practitioner. The study was developed as a pragmatic-driven trial for 18 months. It was evaluated following the dimensions of the RE-AIM framework. Health-enhancing physical activity (HEPA) intervention procedures, designed within the framework of the Let’s Walk Programme, have been found to be feasible in both centres. Positive trends may be found in health indicators for adhered participants even though results were not statistically significant. This intervention has probably been the first based on exercise training principles and public health promotion in which exercise specialists were working alongside primary care practitioners

Promoción de la salud y prescripción de ejercicio físico desde centros de atención primaria. Justificació y diseño del Programa CAMINEM

L’activitat física regular comporta molts beneficis per a la salut, però els aspectes tècnics i organitzatius de les interven­cions centrades en la millora d’activitat física saludable són rarament difoses. L’objectiu d’aquest treball és justificar i descriure els protocols del Programa Caminem. Aquest estudi pragmàtic de prescripció d’exercici físic des de centres d’atenció primària valora la seva aplicabilitat, una intervenció més intensiva que el mer consell sobre activitat física, basat en els principis de l’entrenament esportiu i en el marc de les cinc “as”, 5As (en anglès), de promoció de la salut. L’aplicabilitat s’hi avaluarà mitjançant el marc RE-AIM, que contempla variables a nivell individual i de centre (representativitat i abast, eficàcia o efectivitat, adopció, implementació i manteniment). Pacients amb malalties cròniques no transmissibles que visitin el seu centre d’atenció primària podran participar en el programa d’exercici aeròbic d’intensitat moderada durant 12 mesos, assessorats per especialistes en exercici físic. El Caminem podria servir com a exemple d’un programa d’exercici físic amb evidència basada en la pràctica, portat a terme en un context real, a més de poder comparar els seus resultats amb altres intervencions. L’equip interdisciplinari i els protocols detallats de la intervenció són les pedres angulars que poden servir per dur a terme aquest programa en altres contexto

Promoció de la salut i prescripció d’exercici físic des de centres d’atenció primària. Justificació i disseny del Programa CAMINEM

La actividad física regular conlleva muchos beneficios para la salud, pero los aspectos técnicos y organizativos de las intervenciones centradas en la mejora de actividad física saludable son raramente difundidas. El objetivo de este trabajo es justificar y describir los protocolos del Programa Caminem (andemos). Este estudio pragmático de prescripción de ejercicio físico desde centros de atención primaria valora su aplicabilidad, una intervención más intensiva que el mero consejo sobre actividad física, basado en los principios del entrenamiento deportivo y en el marco de las cinco “as”, 5A (en inglés), de promoción de la salud. La aplicabilidad se evaluará mediante el marco RE-AIM, que contempla variables a nivel individual y de centro (representatividad y alcance, eficacia o efectividad, adopción, implementación y mantenimiento). Pacientes con enfermedades crónicas no transmisibles que visiten su centro de atención primaria podrán participar en el programa de ejercicio aeróbico de intensidad moderada durante 12 meses, asesorados por especialistas en ejercicio físico. Caminem podría servir como ejemplo de un programa de ejercicio físico con evidencia basada en la práctica, llevado a cabo en un contexto real, además de poder comparar sus resultados con otras intervenciones. El equipo interdisciplinario y los protocolos detallados de la intervención son las piedras angulares que pueden servir para llevar a cabo este programa en otros contextos

Determination of functional fitness age in women aged 50 and older

Background: The construction of useful and attainable indicators of fitness assessment deserves special attention in clinical practice. We aimed to construct an indicator of the functional fitness age (FFA) of women aged 50 and older by an equation using fitness outcomes and its correlation with chronological age (CA) and to analyze the external validity of our results by comparing our sample to others. Methods: Participants (n = 459, age: 70.3 ± 7.9 years, mean ± SD) were evaluated using the Senior Fitness Test battery. We applied a multiple regression and a subsequent Holt's exponential smoothing to analyze the outcomes. Results: We obtained a statistically significant expression of F(6, 452) = 328.384; p < 0.0005 in which the coefficients of the equation explain 81% of variability (R2corrected = 0.813). The equation correlates fitness assessment in women aged 50 and over with regards to CA: FFA = 40.146 + 0.350 × CS (stand) − 0.714 × AC (rep) − 0.110 × ST (step) − 0.177 × CSR (cm) − 0.101 × BS (cm) + 8.835 × FUG (s) where CS means chair stand test, AC means arm curl test, ST means 2-min step test, CSR means chair sit-and-reach test, BS means back scratch test, FUG means 8-foot up-and-go test. We compared this index with percentiles distribution from our sample and from other studies. Conclusion: We suggest the use of FFA as a valid indicator of fitness in adult and senior women as well as a useful motivational tool to undertake exercise programs. Keywords: Disability, Elderly, Exercise, Fitness assessment, Health outcomes, Senior Fitness Tes

Determination of functional fitness age in women aged 50 and older

Background: The construction of useful and attainable indicators of fitness assessment deserves special attention in clinical practice. We aimed to construct an indicator of the functional fitness age (FFA) of women aged 50 and older by an equation using fitness outcomes and its correlation with chronological age (CA) and to analyze the external validity of our results by comparing our sample to others. Methods: Participants (n = 459, age: 70.3 ± 7.9 years, mean ± SD) were evaluated using the Senior Fitness Test battery. We applied a multiple regression and a subsequent Holt’s exponential smoothing to analyze the outcomes. Results: We obtained a statistically significant expression of F = 328.384; p < 0.0005 in which the coefficients of the equation explain 81% of variability (R 2corrected = 0.813). The equation correlates fitness assessment in women aged 50 and over with regards to CA: FFA = 40.146 + 0.350 × CS (stand) − 0.714 × AC (rep) − 0.110 × ST (step) − 0.177 × CSR (cm) − 0.101 × BS (cm) + 8.835 × FUG (s) where CS means chair stand test, AC means arm curl test, ST means 2 min step test, CSR means chair sit-and-reach test, BS means back scratch test, FUG means 8-foot up-and-go test. We compared this index with percentiles distribution from our sample and from other studies. Conclusion: We suggest the use of FFA as a valid indicator of fitness in adult and senior women as well as a useful motivational tool to undertake exercise programs