Milne Fiona, Leech-Porter Kalen, Atkinson Paul, Lewis David, Fraser Jacqueline, Hull Stephen
Internal Medicine, Queen's University, Kingston, CAN.
Family Medicine, Dalhousie Family Medicine, Halifax, CAN.
Cureus. 2020 Feb 21;12(2):e7071. doi: 10.7759/cureus.7071.
Introduction Emergency department (ED) patients with chronic disease are known to benefit from exercise; however, there are few studies examining the prescription of exercise in the ED. We asked, is exercise prescription in the ED feasible and effective? Methods In this pilot prospective block randomized trial, consented patients were divided into control and intervention groups. The control group received routine care. The intervention group received combined written and verbal prescriptions for moderate exercise of 150 minutes/week. Both groups were followed up by phone at two months. The primary outcome was achieving 150 minutes of exercise per week. Secondary outcomes included change in exercise and differences in reported median weekly exercise. Results Follow-up was completed for 23/28 patients (11 control; 12 intervention). Baseline reported median (with interquartile range) weekly exercise was similar between groups: control 0 (0-0) minutes, intervention 0 (0-45) minutes. There was no difference between groups for the primary outcome at two months (control 3/11; intervention 4/12, relative risk [RR] 1.33 (95% confidence interval [CI] 0.38-4.6; p=1.0). There was a significant increase in median exercise from baseline in both groups, but no difference between the groups (control 75 (10-225) minutes; intervention 120 (52.5-150) minutes; NS). A post hoc comparison of patients actually receiving intervention vs. no intervention revealed a significant increase in patients meeting the primary outcome (no intervention 0/8; intervention 7/15, RR 2.0 (95% CI 1.2-3.4); p=0.05). Conclusion The improvement seen in patients receiving the exercise prescription intervention, and the increase in reported exercise in both groups suggests that exercise prescription for ED patients may be beneficial.
引言 已知急诊科（ED）的慢性病患者可从运动中获益；然而，很少有研究探讨急诊科的运动处方。我们提出疑问，急诊科的运动处方是否可行且有效？方法 在这项前瞻性整群随机试验中，同意参与的患者被分为对照组和干预组。对照组接受常规护理。干预组接受每周150分钟中等强度运动的书面和口头联合处方。两组均在两个月时通过电话进行随访。主要结局是每周达到150分钟的运动量。次要结局包括运动量的变化以及报告的每周运动中位数的差异。结果 28例患者中有23例完成随访（11例对照组；12例干预组）。两组基线时报告的每周运动中位数（四分位间距）相似：对照组0（0 - 0）分钟，干预组0（0 - 45）分钟。两个月时两组的主要结局无差异（对照组3/11；干预组4/12，相对危险度[RR] 1.33（95%置信区间[CI] 0.38 - 4.6；p = 1.0））。两组的运动中位数均较基线有显著增加，但组间无差异（对照组75（10 - 225）分钟；干预组120（52.5 - 150）分钟；无显著性差异）。对实际接受干预与未接受干预的患者进行事后比较发现，达到主要结局的患者有显著增加（未接受干预组0/8；干预组7/15，RR 2.0（95% CI 1.2 - 3.4）；p = 0.05）。结论 接受运动处方干预的患者所呈现的改善以及两组报告的运动量增加表明，为急诊科患者开具运动处方可能有益。
