Skip to main content

Advertisement

SpringerLink
Log in

A hospital to community exercise referral pathway: results of a pilot project

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

People living with chronic disease should ideally engage with community-based exercise services following hospital-based rehabilitation. However, transition from hospital to community exercise settings is extremely challenging and strategies to support this transition are underdeveloped.

Aims

The aims of this study were to develop and explore the feasibility of a pilot exercise referral pathway between an acute hospital and community gyms for patients with chronic health conditions and to evaluate patient satisfaction with the exercise referral pathway.

Methods

A stakeholder-informed exercise referral pathway was developed and offered to patients following completion of a hospital-based exercise programme for a chronic health condition. The pathway was evaluated using a mixed-methods approach. Quantitative data examining participant engagement was used to examine feasibility. Quantitative survey data and qualitative data from semi-structured interviews examined satisfaction with the pathway.

Results

Forty-nine people living with chronic conditions (mean age 72 ± 7.8 years) participated (recruitment rate 59%). The average number of community gym visits over 4 months was 17.4 (range 0–51). Twenty-nine (78%) participants reported that they planned to continue their gym membership when the programme ended. Themed responses from participant interviews (n = 12) highlighted the benefits of a supported transition from hospital to gym membership and the need for more structured exercise support in community gyms.

Conclusion

A structured exercise referral pathway to support exercise transition between hospital and community settings in populations with chronic health conditions appears feasible. Participants reported high levels of satisfaction with the referral pathway.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author (GS) upon reasonable request.

References

  1. Hamilton AL et al (1995) Muscle strength, symptom intensity, and exercise capacity in patients with cardiorespiratory disorders. Am J Respir Crit Care Med 152(6):2021–2031

    Article  CAS  PubMed  Google Scholar 

  2. Durstine JL et al (2013) Chronic disease and the link to physical activity. J Sport Health Sci 2(1):3–11

    Article  Google Scholar 

  3. Moore G, Durstine JL, Painter P, American College of Sports Medicine (2016) ACSM’s exercise management for persons with chronic diseases and disabilities, 4E. Human Kinetics

  4. Stuart M et al (2008) Community exercise: a vital component to healthy aging. Healthcarepapers 10(1):23–28

    Article  Google Scholar 

  5. Thornton JS et al (2016) Physical activity prescription: a critical opportunity to address a modifiable risk factor for the prevention and management of chronic disease: a position statement by the Canadian Academy of Sport and Exercise Medicine. Br J Sports Med 50(18):1109

    Article  PubMed  Google Scholar 

  6. Yohannes AM et al (2010) The long-term benefits of cardiac rehabilitation on depression, anxiety, physical activity and quality of life. J Clin Nurs 19(19–20):2806–2813

    Article  PubMed  Google Scholar 

  7. Jiménez-Navarro MF et al (2017) Benefits of cardiac rehabilitation on cardiovascular outcomes in patients with diabetes mellitus after percutaneous coronary intervention. J Am Heart Assoc 6(10):e006404

    Article  PubMed  PubMed Central  Google Scholar 

  8. McCarthy B et al (2015) Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev (2)

  9. Scott DA et al (2013) Multidimensional rehabilitation programmes for adult cancer survivors. Cochrane Database Syst Rev (3)

  10. Bock BC et al (2003) Program participation and physical activity maintenance after cardiac rehabilitation. Behav Modif 27(1):37–53

    Article  PubMed  Google Scholar 

  11. Emery CF et al (2003) Cognitive and psychological outcomes of exercise in a 1-year follow-up study of patients with chronic obstructive pulmonary disease. Health Psychol 22(6):598

    Article  PubMed  Google Scholar 

  12. Ries AL et al (2007) Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest 131(5):4S-42S

    Article  PubMed  Google Scholar 

  13. Brooks D et al (2002) The effect of postrehabilitation programmes among individuals with chronic obstructive pulmonary disease. Eur Respir J 20(1):20–29

    Article  CAS  PubMed  Google Scholar 

  14. Spruit MA, Singh SJ (2013) Maintenance programs after pulmonary rehabilitation: how may we advance this field? Chest 144(4):1091–1093

    Article  PubMed  Google Scholar 

  15. Campbell F et al (2015) A systematic review and economic evaluation of exercise referral schemes in primary care: a short report. Health Technol Assess 19(60)

  16. Morgan F et al (2014) Exercise referral schemes to promote physical activity

  17. Organization WH (2009) Interventions on diet and physical activity: what works: evidence tables

  18. Sheill G (2020) Exercise and chronic health conditions in the community: a qualitative study of patients and fitness instructors

  19. Desveaux L et al (2016) Barriers to physical activity following rehabilitation: perspectives of older adults with chronic disease. J Aging Phys Act 24(2):223–233

    Article  PubMed  Google Scholar 

  20. Wolin KY et al (2012) Implementing the exercise guidelines for cancer survivors. J Support Oncol 10(5):171–177

    Article  PubMed  PubMed Central  Google Scholar 

  21. Pavey TG et al (2011) Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis. BMJ 343:d6462

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Williams NH et al (2007) Effectiveness of exercise-referral schemes to promote physical activity in adults: systematic review. Br J Gen Pract : J Royal College of General Practitioners 57(545):979–986

    Article  Google Scholar 

  23. Gidlow C et al (2005) Attendance of exercise referral schemes in the UK: a systematic review. Health Educ J 64(2):168–186

    Article  Google Scholar 

  24. Excellence NIfC (2014) Physical activity: exercise referral schemes. London: National Institute for Clinical Excellence

  25. Devenney KE et al (2017) The effects of an extensive exercise programme on the progression of mild cognitive impairment (MCI): study protocol for a randomised controlled trial. BMC Geriatr 17(1):75

    Article  PubMed  PubMed Central  Google Scholar 

  26. O’Neill LM et al (2018) The RESTORE randomized controlled trial: impact of a multidisciplinary rehabilitative program on cardiorespiratory fitness in esophagogastric cancer survivorship. Ann Surg 268(5):747–755

    Article  PubMed  Google Scholar 

  27. Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101

    Article  Google Scholar 

  28. Killingback C, Tsofliou F, Clark C (2017) Older people’s adherence to community-based group exercise programmes: a multiple-case study. BMC Public Health 17(1):115

    Article  PubMed  PubMed Central  Google Scholar 

  29. Clark AM et al (2011) Participation in community-based exercise maintenance programs after completion of hospital-based cardiac rehabilitation: a mixed-method study. J Cardiopulm Rehabil Prev 31(1):42–46

    PubMed  Google Scholar 

  30. Taket A, Crichton N, Gauvin S (2006) DOROTHEA: diabetes on referral option to healthy exercise for adults. Evaluating the effects of DOROTHEA: a pilot activity promotion scheme for adults with type 2 diabetes in Lambeth and Southwark

  31. Rowley N (2019) Exercise referral schemes in the UK. ACSMs Health Fit J 23(6):6–8

    Article  Google Scholar 

  32. Rowley N et al (2018) The effects of exercise referral schemes in the United Kingdom in those with cardiovascular, mental health, and musculoskeletal disorders: a preliminary systematic review. BMC Public Health 18(1):949

    Article  PubMed  PubMed Central  Google Scholar 

  33. The Health Foundation (2015) Shine 2014 Final Report Social Prescribing: Integrating GP and Community Assets for Health [Internet] 33. Available at : https://www.health.org.uk/sites/default/files/City%20and%20Hackney%20CCG%20final%20report.pdf (7 Dec 2022, date last accessed)

  34. Schmitz KH et al (2019) Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA: Cancer J Clin 69(6):468–484

    PubMed  Google Scholar 

  35. De Lyon ATC, Neville RD, Armour KM (2017) The role of fitness professionals in public health: a review of the literature. Quest 69(3):313–330

    Article  Google Scholar 

  36. Weinrich M, Stuart M, Benvenuti F (2014) Community-based exercise for chronic disease management: an Italian design for the United States? Neurorehabil Neural Repair 28(8):729–732

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge the assistance and support of the Wellcome Trust/HRB Clinical Research Facility at St. James’ Hospital in providing a dedicated environment for the conduct of high-quality clinical research activities. The research team would like to thank the community gyms that participated in this study. 

Funding

This work was supported by a grant from the Health Research Board (KEDS-2017–038).

Author information

Authors and Affiliations

  1. Wellcome HRB Clinical Research Facility at St James’s Hospital, Dublin, Ireland

    Gráinne Sheill, Martina Hennessy & Jeremy Towns

  2. School of Medicine, Trinity College Dublin, Dublin, Ireland

    Gráinne Sheill, Martina Hennessy, Kate Devenney, Sophie Reynolds, Michael Gill & Emer Guinan

  3. Discipline of Physiotherapy, Trinity Centre for Health Sciences, St James’s Hospital, Dublin 8, Ireland

    Gráinne Sheill

  4. Department of Psychiatry & Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland

    Michael Gill

Authors
  1. Gráinne Sheill
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martina Hennessy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kate Devenney
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sophie Reynolds
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jeremy Towns
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael Gill
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Emer Guinan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Grainne Sheill, Sophie Reynolds, Emer Guinan and Kate Devenney. The first draft of the manuscript was written by Grainne Sheill and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Gráinne Sheill.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sheill, G., Hennessy, M., Devenney, K. et al. A hospital to community exercise referral pathway: results of a pilot project. Ir J Med Sci 192, 2051–2058 (2023). https://doi.org/10.1007/s11845-022-03257-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-022-03257-7

Keywords

Search

Navigation