Implementation Of An Exercise Prescription Clinic Within The Italian National Health System: Preliminary Data

BACKGROUND: Implementing interventions to increase physical activity (PA) levels within health systems is challenging, partly due to the lack of facilities where patients can exercise safely. We present preliminary data collected from an exercise prescription (EP) clinic within the Italian public National Health System, where physicians and kinesiologists cooperate to prescribe and administer adapted PA for patients with different chronic diseases. PURPOSE: Assess changes in health-related quality of life (HRQoL), PA levels, and strength following 6-8 months of training in a sample from our patients population, including two groups: patients living with obesity and cancer survivors. Assess the impact of supervised exercise training on the observed changes. METHODS: In 70 patients, HRQoL was assessed with the Short Form-36 questionnaire and its physical (PSC) and mental (MSC) summary components, PA levels with the International Physical Activity Questionnaire and strength values with the Handgrip Strength Test (HG). The tests were administered at baseline and an average of 209 days after the EP. Each EP was tailored to the patient, who was then referred to various kinds of activities. Data about training modalities (supervised or unsupervised) were collected at the follow-up visit. Statistical analysis was conducted using non-parametric tests. RESULTS: The mean age was 54.5 (13.2) years, mean BMI 29.3 (7.7) kg/m2 and females represented 91% of the sample. Baseline PA levels were low in 48.6%, moderate in 45.7%, high in 5.7% of the population. After 7 months of training, a significant improvement of PSC (57.2 vs 67.5, p 0.01), MSC (63.3 vs 70.3, p 0.04), PA levels (748 vs 963 MET-minutes/week, p < 0.01) and HG (26.3 vs 29.3 Kg, p < 0.01) was observed. Even if PA did not shift significantly from the low level to the higher ones, in patients living with obesity a significant effect of the supervised training was detected on the PA level improvement (p 0.03). CONCLUSION: Our preliminary data support the need to pursue the implementation of a structured clinical pathway, from exercise prescription to supervised training, leading to improved HRQoL, PA levels and strength values. Further data and longer observation are needed to understand the clinical relevance of the changes obtained in our patient population.