# Exercise capacity after long-term physical activity on prescription provided by physiotherapists

## TL;DR

A long-term study shows that physical activity on prescription by physiotherapists improves exercise capacity in patients with metabolic risk factors over 4.5 years.

## Contribution

This study provides evidence of long-term improvements in exercise capacity from physiotherapist-led PAP in primary healthcare.

## Key findings

- Patients showed a significant increase in exercise capacity (9.1 W) after 4.5 years of PAP treatment.
- The effect size was small (r = 0.27), and no significant differences were found by age or gender.
- The study highlights the feasibility of continuous exercise testing in primary care with physiotherapist support.

## Abstract

Background: Research has shown that physical activity on prescription (PAP), used in Swedish healthcare, increases patients’ physical activity, but data are lacking regarding the long-term effects of PAP on exercise capacity. Therefor exercise capacity was evaluated in patients with metabolic risk factors, after 4.5 years of PAP treatment provided by physiotherapists in primary healthcare.

Method: This study included 98 patients (49% women; mean age, 56 years) with metabolic risk factors, who were still physically inactive after a previous 6-month PAP treatment. The patients received physiotherapist-provided PAP treatment for 4.5 years, including 11 follow-ups and 6 exercise capacity tests.

Results: After 4.5 years, 41 patients completed the final exercise capacity test (58% drop-out rate). Compared to baseline, the whole cohort exhibited a significantly increased exercise capacity (9.1 W, p = 0.014) with a small effect size (r = 0.27), with no significant differences associated with age or gender.

Conclusion: The increased exercise capacity may indicate positive effects on longevity, and consolidates previous findings that long-term behavior change is possible among physically inactive patients. It also demonstrates the feasibility of continuous exercise capacity testing with physiotherapist support in an ordinary primary care setting. The drop-out rate and lack of control group complicate the interpretation of the effects of PAP treatment on the increased exercise capacity. Further research should strive for an RCT study design.