NIHR Themed Review
Moving Forward - Physiotherapy for musculoskeletal health and wellbeing
Muskuloskeletal problems are the leading cause of pain and disability in the UK. Characterised by pain and loss of function, these conditions can diminish quality of life, impact on family and social relationships, make everyday activities difficult and limit a person’s capacity to work. Physiotherapy is important for preventing and reducing the negative impacts of musculoskeletal conditions.
Moving Forward provides an overview of research funded by the NIHR and others, focusing on physiothera...
Group-based diet and exercise programmes can lead to weight loss
The evidence is growing that group-based weight loss programmes can offer effective and acceptable options for overweight people, particularly men. On average, people in group dietary advice and exercise programmes lose 3.5kg more than non-participants by six months – a modest 4% weight loss overall but less than the 5% that is often regarded as clinically important.
In this systematic review on the group weight loss approach, participants in the 47 trials were adults from the general pop...
Yoga-based exercise can improve well-being for older people
Yoga-based exercise offers a safe and accessible way to improve health-related quality of life and mental well-being for people over 60. Evidence for a moderate benefit of yoga in later life now extends beyond improved balance and flexibility.
Yoga includes stretches, poses, breathing routines and meditation. This review focused on the physical exercise/activity components. Most of the 12 included trials took place in Western countries and classes were all run by qualified yoga instructors as i...
People maintain increases in physical activity three years after receiving pedometers
Middle-aged to older adults given pedometers and a walking programme as part of two NIHR trials continued to be active three years later. In one trial they were walking around 650 extra steps a day. In both trials, they spent about 30 minutes per week extra in moderate-to-vigorous physical activity compared to controls.
Brisk walking is a good way for older adults to achieve physical activity recommendations. This is the long-term follow-up of two large NIHR-funded trials that recruited adults ...
A school-based obesity prevention programme was ineffective
A school-based healthy lifestyle programme delivered to 6-7-year-old children and their parents made no difference to children’s weight, diet or activity levels. Around 1 in 4 remained overweight or obese.
The NIHR-funded year-long programme was delivered in 54 primary schools in one region of England. Teachers were trained to provide an additional 30 minutes of physical activity a day and deliver cookery workshops with parents each term. It also included activities with a local football ...
Exercise improves intermittent claudication leg pain on walking
People with intermittent claudication who participate in structured exercise programmes can walk about 80 metres further without experiencing leg pain than those who do not do the programme. They can also walk about 120 metres further overall.
Intermittent claudication is a cramp-like pain in the legs caused by narrowing of the arteries, which restricts blood flow to the muscles. There’s increasing evidence that maintaining physical activity can help. This updated systematic review combin...
Physiotherapy education before major abdominal surgery reduces lung complications
A physiotherapy session before planned abdominal surgery, explaining the importance of breathing exercises and sitting out of bed as soon after surgery as possible, halves the risk of pneumonia.
This trial compared the physiotherapy session with usual care which was provided to all 432 participants. This consisted of a leaflet given in the pre-operative outpatient clinic outlining the exercises, and physiotherapy input in the days after surgery. Just seven people would need to receive the addit...
Pulmonary rehabilitation improves exercise tolerance in pulmonary fibrosis
People with idiopathic pulmonary fibrosis who received pulmonary rehabilitation could walk 44 metres further in six minutes than those who did no exercise. Quality of life also improved.
Pulmonary fibrosis is a rare condition where scar tissue builds up in the lungs making them stiff and causing breathing difficulty. The term idiopathic means there is no known cause. It tends to get worse over time, reducing a person’s activity levels.
Pulmonary rehabilitation is a core part of care, but...
Mat Pilates probably improves balance and strength in older adults
Mat Pilates appears to improve muscle strength, flexibility, balance and cardiovascular fitness in older people compared to no exercise. There are limitations to the reliability of the evidence, but the consistent effect across all the aspects of fitness suggests this is probably a useful option for the increasing number of older people who wish to maintain their fitness.
This review pooled the results of nine trials of 415 older adults from around the world, though not the UK. Pilates sessions...
Free entry for leisure centres may increase physical activity across all social groups
Removing access fees from gyms and leisure centres with a strong marketing campaign and five extra community health trainers gave 26,400 more physical activity “swim and gym” visits per quarter in a borough of 150,000 people.
Re:fresh, a subsidised access scheme implemented in a socially disadvantaged local authority in England, Blackburn and Darwen, also found increases in monthly gym and swim activity from 3 to 15%, and overall levels of participation were more pronounced in disad...