There is evidence that referral schemes may increase physical activity of sedentary people, but the effects were small, partly due to the diversity in the nature and quality of included exercise schemes [ 16– 20].
While it was not a major concern in our study, the high dropout rate experienced by many exercise schemes has also raised questions about the appropriateness of referrals.
Isaacs and colleagues did not see any differences between the exercise referral schemes and usual care groups at follow-up on the SF-36 mental health scale.
None of the included trials separately reported outcomes in individuals with specific medical diagnoses.Substantial heterogeneity in the quality and nature of the exercise referral schemes across studies might have contributed to the inconsistency in outcome findings.
Quite the opposite of veering into "pregorexia" territory where pregnant women engage in extreme dieting and exercise schemes, I reveled in fat slices of coconut cream cake and developed an impressive appetite for hamburgers.
In addition, it appears that all resistance exercise schemes induce marked energy expenditure.
In line with other studies of GP exercise schemes [ 24], we have found that participants considered a medical recommendation to be important to their participation.
As a consequence, all participants were trained according to the same basic exercise scheme.
All participants started with the same basic exercise scheme, to which specific exercises could be added (web appendix 2).
One study of the exercise bonus scheme showed that participants' annual health costs grew 19% more slowly than those of non-participants.
