Sports and exercise medicine clinic in public hospital settings: A real-life concept and experiences of the treatment of the first 1151 patients

Abstract

Exercise has been shown to have a multitude of health-promoting effects, including improvements in cardiorespiratory and muscular fitness, function, symptoms and risk factors. Furthermore, exercise may slow down, stop or even reverse the progression of various non-communicable diseases (NCDs). Despite the overwhelming evidence, exercise is still not comprehensively used as a treatment component either in primary care or in hospital settings. The outpatient Sports and Exercise Medicine Clinic (SEMC) is the first specialized clinic in Finland to use exercise as part of patient protocols in the public health care system. Patients needing specialist attention due to NCDs, usually combined with sedentary lifestyles, are referred to this central hospital clinic. The prerequisites for patient referral are the known efficacy of exercise intervention in the treatment of disease and the need for sports and exercise medicine expertise. The focus of the clinic is to implement regular physical activity into daily life and give guidance on other health-promoting habits such as diet, rest and the reduction of substance use. In addition, SEMC promotes the inclusion of exercise in several local treatment guidelines in the hospital district, such as the treatment paths of non-insulin-dependent diabetes, sleep apnoea, severe obesity indicating bariatric operation, and breast cancer. The advisory treatment protocol of SEMC consists of a primary evaluation, face-to-face controls with a physician and/or physiotherapist at 3, 6 and 9-12 months, and contacts via phone between hospital visits. Laboratory tests, body composition, walking tests, and measurements of muscle strength and balance are performed at the beginning of the treatment. Body composition and physical tests are repeated after 6 and 9-12 months. In addition, questionnaires on lifestyle and quality of life are completed prior to the first visit and at 6 months of control. At the core of the treatment is individualization, using motivational interviewing, considering the patients' personal interests and possibilities, and encouraging the patient to be an active member of our multi-professional team. In this article, our protocol is described and some preliminary data and experiences on the treatment of first 1151 patients are reported. Furthermore, strengths, challenges and future steps in the development of our protocol and outpatient clinic are discussed.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The ethics committee of the Central Finland Health Care District, Jyvaskyla, Finland, has evaluated the reporting of the treatment results of the SEMC patients and gave permission to the study through commenting that there is no need for a specific ethics committee statement as the study reports results of the hospital's accepted normal treatment praxis and only the hospital physician has access to patient data with patient identification codes. Then the Central Finland Central Hospital gave permission to this SEMC study.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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