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Could you sit 30 minutes less? (Guest Editorial).
The benefits of exercise are indisputable, patients want advice on exercise, and yet most physicians do not routinely counsel their patients to become more active.
If you doubt the impact of encouraging your patients to exercise, you should take to heart the findings from the Activity Counseling Trial (ACT). Even a brief intervention gives patients the incentive to exercise more.
Designed to test various patient education and counseling approaches for physical activity in the primary care setting, ACT is a randomized, controlled trial that compared two types of interventions with recommended advice, and with each other, in terms of their effects on physical activity and cardiorespiratory fitness.
Our subjects were 395 women and 479 men aged 35-75 years, who had no clinical cardiovascular disease. All were sedentary and overweight or obese.
They were assigned to one of three groups: "advice," which included physician advice and written materials with recommended care; "assistance," which added interactive mail and behavioral counseling to the recommended care; and "counseling," which included all of the components of the first two groups, plus regular telephone counseling and behavioral classes.
At the end of 24 months, maximal oxygen volume ([VO.sub.2] [max]), which we used as a measure of physical fitness, was higher in women in the assistance and counseling groups than in the advice group. No difference in [VO.sub.2] (max) was seen in men.
However, nearly 10%-30% of these previously sedentary adults were now meeting the recommended goals for weekly physical activity, depending on sex and the group to which they were assigned.
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