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?
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.
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).
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.