Study | Design | Comparison | Time points | N, age (mean, SD) | Disorder | Length weeks | Prescription | Measures | Effect | Outcomes |
---|---|---|---|---|---|---|---|---|---|---|
Anokye, et al. 2011 [42] | Decision analytic model, Quantitative | Retrospective | Completion | N = 701 40–60 years Mean age = 50 SD = n/a | Cardiovascular Mental health | 12 | Gym based exercise, 2× weekly | QLAY | ⇑ 51–88% cost-effective | ERS is associated with modest increase in lifetime costs and benefits. Cost-effectiveness of ERS is highly sensitive to small changes in the effectiveness. ERS cost is subject to significant uncertainty mainly due to limitations in clinical effectiveness evidence base. |
Duda, et al. 2014 [25] | RCT, Quantitative | ERS SDT (N = 184) vs. Standard ERS (N = 163) | Baseline 3 months 6 months | N = 347 30–65+ Mean = n/a SD = n/a | Cardiovascular Mental health | 10–12 | Gym based exercise, 2× weekly | 7D PAR BP (mmHg) BMI (kg/m2) Weight (kg) HADS anxiety HADS depression | ⇑a 120 *** ⇔a ⇓a − 0.24* ⇓a -0.77* ⇓a-0.24 ⇓a-0.47* | Standard ERS: No sig. Changes in BP, but reductions in weight and BMI (reduced sig. at 6 months compared to baseline). 3 months’ follow-up: increase of 187 min (from baseline) in self-reported moderate/vigorous PA. 6 months’ follow-up: increase of 120 min. Sig. reduction in HADS depression scores, no sig. Diff. in anxiety. SDT-ERS: 3 months’ follow-up: increase of 196 min in self-reported moderate/vigorous PA compared to baseline. Sig. improvements in HADS anxiety and depression scores. 6 months’ follow-up: No sig. Diff. from baseline to 6 months’ in BP, BMI or weight. Increase of 114 min in self-reported moderate/vigorous PA. Sig reduction in HADs anxiety and depression. |
Edwards, et al. 2013 [24] | RCT, Quantitative | Between time points | Baseline 6 months 12 months | N = 798 16+ years Mean = n/a SD = n/a | Cardiovascular Mental health | 16 | Gym based exercise & exercise classes, 1–2 x weekly | EQ-5D Adherence | ⇑a ⇑a | Participants with risk of CHD, were more likely to adhere to the full programme than those with mental health conditions/combination of mental health and risk of CHD. Those living in areas of high deprivation were more likely to complete the programme. Results of cost-effectiveness analyses suggest NERS is cost saving in fully adherent participants. Adherence at 16 weeks was 62%. |
Hanson, et al. 2013 [44] | Observational cohort study, Quantitative | Between time points | Baseline 12 weeks Completion | N = 2233 Mean = 53 SD = 15.9 | Cardiovascular | 24 | Gym based exercise, 2× weekly | GLTEQ Adherence | ⇑a*** ⇑a*** | ERS was more successful for over 55 s, and less successful for obese participants. Completers increased PA at 24 weeks. Leisure site attended was a significant predictor of uptake and length of engagement. Uptake n = 181, 12-week adherence n = 968, 24-week adherence n = 777. |
Littlecott, et al. 2014 [40] | RCT, Quantitative | Between time points and ERS vs. usual care | Baseline 6 months 12 months | N = 2160 16–88 years Mean = n/a SD = n/a | Cardiovascular Mental health | 16 | Group aerobic exercise sessions, 2× weekly | Adherence BREQ | ⇑a, ⇓b ⇑a | Improved adherence and improved psychosocial outcomes. Significant intervention effects were found for autonomous motivation and social support for exercise at 6 months. No intervention effect was observed for self-efficacy. Greatest improvements in autonomous motivation observed among patients who were least active at baseline. Individuals with CHD risk in the control group participated in more PA per week than those in the intervention group with CHD risk factors. |
Mills, et al. 2013 [45] | Observational cohort study, Mixed method | Prediction of completion | Baseline | N = 1315 31–68 years Mean = 54 SD 12.4 | Cardiovascular | 26 | Group, 1-to-1, gym, studio, swimming, 1–2 x weekly | BP (mmHg) Body mass (kg) Adherence | ⇓a 1.87*** ⇓a 3.541*** ⇑a | Increased confidence and self-esteem. Link between age and attendance. Increased age, increased likelihood of adherence. 57% completed scheme, 33% achieved weight loss, 49% reduced BP. Those with CVD, more likely to attend and adhere, compared to pulmonary disorders. |
Murphy, et al. 2012 [41] | RCT, Quantitative | ERS vs. usual care | 12 months | N = 2160 16–88 years Mean = 52 SD = 14.7 | Cardiovascular (N = 1559) Mental Health (N = 522) | 16 | 1-to-1, aerobic and resistance exercise, 1–2 x weekly | 7D PAR Adherence HADS depression HADS anxiety | ⇑b 1.19* ⇑a, b1.46* ⇓a − 0.71* ⇓a − 0.54 | Increase PA observed among those randomised to ERS intervention compared to usual care, and those referred with CHD only. For those referred for MH alone, or in combination with CHD, there were sig. Lower levels of anxiety/depression, but no effect on PA. |
Rouse, et al. 2011 [46] | Exploratory, Quantitative | SDT theory based program | Baseline | N = 347 Mean = 50.4 SD = 13.51 | Cardiovascular Mental Health | 12 | Gym based exercise sessions, 1× weekly | IOCQ BREQ-2 SVS HADS | ⇑a ⇑a 0.24 ** ⇑a 0.17 * ⇓a ** | Autonomy support increased intrinsic motivation. Autonomous motivation was positively associated with vitality and PA intentions. Those who scored high on HADS, had high scores for PA intentions. Regression analyses revealed that the effects of autonomy support on mental health and PA intentions differed as a function of who provided the support (offspring, partner or physician), with the offspring having the weakest effects. Autonomy support and more autonomous regulations led to positive mental health outcomes. |
Tobi, et al. 2012 [43] | Retrospective, Quantitative | Adherers vs. non-adherers | 13 weeks Completion | N = 701 Mean age = 46.4 SD = 13.85 | Cardiovascular (n = 111) Musculoskeletal (orthopaedic n = 164) Mental health (n = 141) Respiratory (n = 34) Other (n = 23) Metabolic (n = 228) | 20–26 | 1-to-1, aerobic and resistance exercise, 1–2 x weekly | Adherence (DV) BMI (kg/m2) BP (mmHg) | ⇑b ** - - | Longer term schemes increased adherence. Longer-term adherence was found for increasing age and medical condition. For every 10-year increase in age, the odds of people continuing exercise increased by 21.8%. Participants referred with metabolic conditions were more likely to adhere than those with orthopaedic, CV and other disorders. Longer-term schemes offer the opportunity to maintain adherence to exercise. |
Webb, et al. 2016 [47] | Evaluation, Quantitative | NERS vs. community-based exercise vs. continuously monitored exercise programme | Baseline Completion | N = 107 Mean = 44.6 SD = 11.4 | Cardiovascular | 8 | Group exercise sessions, 2× weekly | IPAQ (min/week) BMI (kg/m2) Systolic BP (mmHg) Diastolic BP (mmHg) Adherence | ⇑a, b 540*** ⇓a, b 0.4 + 0.1** ⇓a, b -6.1 + 2.6* ⇓a -0.6 + 1.8 ⇑b * | CV health benefits were observed in all three interventions. CV health benefits achieved in laboratory based studies were achieved in ERS settings. BMI had bigger reductions in NERS compared to the other two conditions. Systolic BP and Diastolic BP were also reduced more in NERS compared to the other two conditions. |