Loss of body fat, lowering of blood pressure balanced by a gains in energy and self-esteem are the early results of the GP Exercise on Referral Scheme as its first participants graduate formally from the programme.
Launched in Cork three months ago in a partnership between the Southern Health Board, the Irish College of General Practitioners and a local leisure centre, participating GPs prescribe regular physical activity for selected patients to be taken with large doses of support.
Johann Hoey, a nurse with a masters in sport medicine, co-ordinates the scheme full-time in Leisureworld, Bishopstown, with more than 100 people participating in a three-month programme. A sign on her office wall reads: "Those who think they have no time for bodily exercise will sooner or later have to find time for illness."
Typical presenting medical conditions are osteoporosis, weight problems, risk factors for heart disease, as well as depression, stress and anxiety. Participants range in age from 22 to 85. After a 90-minute initial consultation, Johann draws up a programme to correspond with preferences, fitness and medical condition.
Some participants don't come to the gym at all: "A lot of the young people on the programme have a very busy life, always running round, their ear clutched to a mobile phone," she says. "I have to be real about where they are. So I could be suggesting a 10-minute walk at lunchtime every day. Just that. Or to sit in the park for 10 minutes at lunchtime with the mobile switched off. Some later do join [the gym], others not, so we would talk every week, and everyone has a six-week screening here."
The programme offers talks on healthy eating and simple ways of being more active ("getting off a bus stop earlier," says Johann, "using the stairs instead of the elevator"). Johann takes a group class each afternoon incorporating circuit training, pool sessions, group gym, low-impact aerobics and relaxation.
There is "about 20 per cent drop-out", says Johann. "This would be after spending a lot of time with them, listening, encouraging, working with them." It illustrates, she agrees, how difficult it can be to make and sustain life changes. However, she feels the project offers a good model of local co-operation in health promotion. There are already 200 such exercise referral schemes in Britain, and she sees no reason why the idea shouldn't catch on nationally here. "It is just brilliant to see how people come on and surprise themselves," she says. "This is a worthwhile approach."