Exercise Evaluation Randomised Trial (EXERT): a randomised trial comparing GP referral for leisure centre-based exercise, community-based walking and advice only

• Published in: Health technology assessment (Winchester, England) England), 2007-03, Vol.11 (10), p.1-165
• Main Authors: Isaacs, A J, Critchley, J A, Tai, S See, Buckingham, K, Westley, D, Harridge, S D R, Smith, C, Gottlieb, J M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Community Health Services - organization & administration; Community Health Services - statistics & numerical data; Counseling; Energy Metabolism; Evaluation Studies as Topic; Exercise; Humans; Middle Aged; Referral and Consultation; Surveys and Questionnaires; Walking
• ISSN: 1366-5278; 2046-4924; 1366-5278
• DOI: 10.3310/hta11100

To evaluate and compare the effectiveness and cost-effectiveness of a leisure centre-based exercise programme, an instructor-led walking programme and advice-only in patients referred for exercise by their GPs. A single-centre, parallel-group, randomised controlled trial, consisting of three arms, with the primary comparison at 6 months. Assessments were carried out at Copthall Leisure Centre in Barnet, an outer London borough, and exercise programmes conducted there and at three other leisure centres and a variety of locations suitable for supervised walking throughout the borough. Participants were aged between 40 and 74 years, not currently physically active and with at least one cardiovascular risk factor. The 943 patients who agreed to participate in the trial were assessed in cohorts and randomised to one of the following three arms: a 10-week programme of supervised exercise classes, two to three times a week in a local leisure centre; a 10-week instructor-led walking programme, two to three times a week; an advice-only control group who received tailored advice and information on physical activity including information on local exercise facilities. After 6 months the control group were rerandomised to one of the other trial arms. Assessments took place before randomisation, at 10 weeks (in a random 50% subsample of participants), 6 months and 1 year in the leisure centre and walking arms. The control participants were similarly assessed up to 6 months and then reassessed at the same intervals as those initially randomised to the leisure centre and walking groups. The primary outcome measures were changes in self-reported exercise behaviour, blood pressure, total cholesterol and lipid subfractions. Secondary outcomes included changes in anthropometry, cardiorespiratory fitness, flexibility, strength and power, self-reported lifestyle behaviour, general and psychological health status, quality of life and health service usage. The costs of providing and making use of the service were quantified for economic evaluation. There was a net increase in the proportion of participants achieving at least 150 minutes per week of at least moderate activity in the sport/leisure and walking categories in all three study groups: at 6 months, the net increases were 13.8% in the leisure centre group, 11.1% in the walking group and 7.5% in the advice-only group. There were significant reductions in systolic and diastolic blood pressure in all groups at each assessmen