ABSTRACT
Background: Physical inactivity implies a significant individual and society health burden.Objectives: To assess the feasibility of implementing a preventive physical exercise (PE) programme for the general population and to analyse changes in fitness-related variables and quality of life.Methods: Pre-post comparison study in which general practitioners and nurses recommended PE to participants with sedentary behaviour and hypertension or dyslipidaemia attending in primary care for primary prevention of ischaemic cardiovascular disease. Eligible participants were referred to a PE programme (10 weeks, three days a week, a total of 30 sessions of one-hour duration). Data was collected for five years (2013-2017). Outcome measures were body weight, body mass index (BMI), physical condition (aerobic fitness, muscle strength, flexibility, balance), and quality of life (SF-36).Results: The PE programme was offered to 6,140 eligible subjects; 5,077 (82.7%) accepted to participate and received a recommendation; 3,656 (69.6% women) started the programme and 2,962 subjects (80.9% women) finished the programme. After 10 weeks, there were significant improvements (mean difference, 95% CI) in aerobic fitness (2.55 ml/min/kg, 2.32-2.79), muscle strength (0.62 m, 0.57 to 0.67), flexibility (2.34 cm, 2.06 to 2.63) and balance (-0.46 falls, -0.60 to -0.33) as well as significant decreases in body weight (-0.41 kg, -0.64 to -0.17) and BMI (-0.27 kg/m2, -0.34 to -0.20).Conclusion: Implementation of a government-supported PE programme for the general population recruited in the primary care setting and recommended by healthcare professionals is feasible, and was associated with health benefits, mainly improvements in physical fitness.
Subject(s)
Cardiovascular Diseases/prevention & control , Community Health Services/methods , Dyslipidemias/therapy , Exercise , General Practice , Hypertension/therapy , Primary Prevention/methods , Sedentary Behavior , Adolescent , Adult , Aged , Body Mass Index , Community Health Services/organization & administration , Feasibility Studies , Female , Heart Disease Risk Factors , Humans , Implementation Science , Male , Middle Aged , Muscle Strength , Physical Fitness , Postural Balance , Primary Prevention/organization & administration , Quality of Life , Range of Motion, Articular , Spain , Young AdultABSTRACT
INTRODUCTION: Movement disorders are a common reason for visits to outpatient neurology departments. This study has two objectives. The first is to analyse the diagnoses of patients referred to the neurology service due to tremor or Parkinsonism. The second aim is to analyse whether such patients are referred from primary care correctly or incorrectly. PATIENTS AND METHODS: The study examines patients referred from primary care to the neurology service in a medical specialty centre because of tremor or Parkinsonism. The final diagnoses established by the neurologist were analysed and patient referral was also analysed using a set of previously agreed criteria. RESULTS: The sample consisted of 425 consecutive patients who were referred from primary care due to tremor (n = 294) or Parkinsonism (n = 131). The most common diagnoses were Parkinson's disease (n = 211; 50%), essential tremor (n = 157; 37%) and pharmacological Parkinsonism (n = 23; 5%). Referral was considered to be incorrect in 39 patients and correct in 388 cases (91%). The causes of incorrect referrals were: pharmacological Parkinsonism (n = 23), anxiety that was not treated in primary care (n = 12) and hypothyroidism that went undiagnosed in primary care (n = 4). CONCLUSIONS: Parkinson's disease, essential tremor and pharmacological Parkinsonism are the most frequent diagnoses in patients who are referred from primary care because of tremor and Parkinsonism. Referral to a neurology service is correct in most cases, but there is still room for improvement.
Subject(s)
Ambulatory Care Facilities , Neurology , Parkinsonian Disorders/diagnosis , Referral and Consultation , Tremor/diagnosis , Tremor/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Diagnostic Errors , Humans , Male , Middle Aged , Parkinsonian Disorders/physiopathology , Primary Health Care , Young AdultABSTRACT
Análisis etiológico de 425 pacientes remitidos a una consulta extrahospitalaria de neurología por temblor o parkinsonismo (AU)
Introduction. Movement disorders are a common reason for visits to outpatient neurology departments. This study has two objectives. The first is to analyse the diagnoses of patients referred to the neurology service due to tremor or Parkinsonism. The second aim is to analyse whether such patients are referred from primary care correctly or incorrectly. Patients and methods. The study examines patients referred from primary care to the neurology service in a medical specialty centre because of tremor or Parkinsonism. The final diagnoses established by the neurologist were analysed and patient referral was also analysed using a set of previously agreed criteria. Results. The sample consisted of 425 consecutive patients who were referred from primary care due to tremor (n = 294) or Parkinsonism (n = 131). The most common diagnoses were Parkinsons disease (n = 211; 50%), essential tremor (n = 157; 37%) and pharmacological Parkinsonism (n = 23; 5%). Referral was considered to be incorrect in 39 patients and correct in 388 cases (91%). The causes of incorrect referrals were: pharmacological Parkinsonism (n = 23), anxiety that was not treated in primary care (n = 12) and hypothyroidism that went undiagnosed in primary care (n = 4). Conclusions. Parkinsons disease, essential tremor and pharmacological Parkinsonism are the most frequent diagnoses in patients who are referred from primary care because of tremor and Parkinsonism. Referral to a neurology service is correct in most cases, but there is still room for improvement (AU)
