Does outpatient physical therapy with the aim of improving health-related physical fitness influence the level of physical activity in patients with long-term musculoskeletal conditions?

  • I. Holm
    Division of Surgery and Clinical Neuroscience, Orthopaedic Department, Section of Research, Oslo University Hospital, Oslo, Norway

    Institute of Health and Society, Medical Faculty, University of Oslo, P.O. Box 1089, Blindern, NO-0318 Oslo, Norway
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  • A.T. Tveter
    Corresponding author at: University of Oslo, Institute of Health and Society, Pb 1089 Blindern, N-0317 Oslo, Norway. Tel.: +47 91115550.
    Institute of Health and Society, Medical Faculty, University of Oslo, P.O. Box 1089, Blindern, NO-0318 Oslo, Norway
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  • T. Moseng
    Institute of Health and Society, Medical Faculty, University of Oslo, P.O. Box 1089, Blindern, NO-0318 Oslo, Norway
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  • H. Dagfinrud
    Institute of Health and Society, Medical Faculty, University of Oslo, P.O. Box 1089, Blindern, NO-0318 Oslo, Norway

    National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmets Hospital, P.O. Box 23, Vinderen, NO-0319 Oslo, Norway
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Published:December 22, 2014DOI:



      To evaluate any change in self-reported level of physical activity in patients receiving a general physical exercise programme in addition to disease-specific physiotherapy treatment.


      Pre–post-intervention study.


      Outpatient physiotherapy clinics.


      One hundred and ninety patients with long-term musculoskeletal conditions attending outpatient physiotherapy were recruited from seven physiotherapy clinics.


      Physiotherapy including disease-specific modalities and a general individually tailored exercise programme. Patients were evaluated at baseline and at the end of the programme.

      Main outcome measures

      International Physical Activity Questionnaire short form (IPAQ-sf) and COOP WONCA functional assessment charts.


      Forty-two patients were excluded from the analysis because they did not complete the IPAQ-sf correctly or dropped out during the treatment period. There was a significant increase in the number of metabolic equivalent task (MET)-min/week for vigorous and moderate-intensity activities, walking and total physical activity. The number of exercise sessions per week increased from 1.8 [standard deviation (SD) 0.9] to 2.2 (SD 1.2) (P = 0.001). The proportion of patients with a low level of physical activity decreased by 12%, and the proportion of the participants who did not/could not exercise decreased from 26% to 8%. The COOP WONCA charts showed significant improvements in the physical fitness, feelings, daily activities and social activities items.


      A significant increase was found in the number of MET-min/week for all activity levels. Therefore, a general physical exercise programme initiated by a physiotherapist led to a positive change in level of physical activity.


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        • Law K.H.
        • How C.H.
        • Ng C.S.
        • Ng M.C.W.
        Prescribing health: exercise.
        Singap Med J. 2013; 54: 303-308
        • Dangardt F.J.
        • McKenna W.J.
        • Luscher T.F.
        • Deanfield J.E.
        Exercise: friend or foe?.
        Nat Rev Cardiol. 2013; 10: 495-507
        • Wen C.P.
        • Wai J.P.
        • Tsai M.K.
        • Yang Y.C.
        • Cheng T.Y.
        • Lee M.C.
        • et al.
        Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study.
        Lancet. 2011; 378: 1244-1253
        • Moseng T.
        • Tveter A.T.
        • Holm I.
        • Dagfinrud H.
        Patients with musculoskeletal conditions do less vigorous physical activity and have poorer physical fitness than population controls: a cross-sectional study.
        Physiotherapy. 2014; 100: 319-324
        • Centers for Disease Control and Prevention
        Physical activity guidelines.
        CDC, Atlanta, GA2011 (Available at: html, 12th of September 2014)
        • Shirley D.
        • van der Ploeg H.P.
        • Bauman A.E.
        Physical activity promotion in the physical therapy setting: perspectives from practitioners and students.
        Phys Ther. 2010; 90: 1311-1322
        • Vollestad N.
        Primary care research – new opportunities.
        Public Serv Rev Technol. 2011; 13: 110-111
        • Craig C.L.
        • Marshall A.L.
        • Sjostrom M.
        • Bauman A.E.
        • Booth M.L.
        • Ainsworth B.E.
        • et al.
        International Physical Activity Questionnaire: 12-country reliability and validity.
        Med Sci Sports Exerc. 2003; 35: 1381-1395
        • Kinnersley P.
        • Peters T.
        • Stott N.
        Measuring functional health status in primary care using the COOP–WONCA charts: acceptability, range of scores, construct validity, reliability and sensitivity to change.
        Br J Gen Pract. 1994; 44: 545-549
        • Holm I.
        • Risberg M.A.
        • Steen H.
        Outpatient physical therapy influences the patients’ health-related quality of life.
        Adv Physiother. 2005; 7: 40-47
        • Verhagen E.
        • Engbers L.
        The physical therapist's role in physical activity promotion.
        Br J Sports Med. 2009; 43: 99-101
        • Prince S.A.
        • Adamo K.B.
        • Hamel M.E.
        • Hardt J.
        • Connor G.S.
        • Tremblay M.
        A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review.
        Int J Behav Nutr Phys Act. 2008; 5: 56
        • Dyrstad S.M.
        • Hansen B.H.
        • Holme I.M.
        • Anderssen S.A.
        Comparison of self-reported versus accelerometer-measured physical activity.
        Med Sci Sports Exerc. 2014; 46: 99-106
        • Verlaet A.
        • Moreira A.
        • Sa-Sousa A.
        • Barros R.
        • Santos R.
        • Moreira P.
        • et al.
        Physical activity in adults with controlled and uncontrolled asthma as compared to healthy adults: a cross-sectional study.
        Clin Transl Allergy. 2013; 3: 1
        • Silva-Batista C.
        • Urso R.P.
        • Lima Silva A.E.
        • Bertuzzi R.
        Associations between fitness tests and the International Physical Activity Questionnaire-short form in healthy men.
        J Strength Cond Res. 2013; 27: 3481-3487
        • Bauman A.
        • Ainsworth B.E.
        • Bull F.
        • Craig C.L.
        • Hagstromer M.
        • Sallis J.F.
        • et al.
        Progress and pitfalls in the use of the International Physical Activity Questionnaire (IPAQ) for adult physical activity surveillance.
        J Phys Act Health. 2009; 6: S5-S8
        • Baker M.K.
        • Atlantis E.
        • Fiatarone Singh M.A.
        Multi-modal exercise programs for older adults.
        Age Ageing. 2007; 36: 375-381
      1. National Center for Technology Innovation, Quasi-experimental study, 12th of September 2014.