• Daniel Karsberg Zotterman, Åsa Cider, and Stefan Lundqvist.
• Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
• Scand J Prim Health Care. 2025 Jan 23: 1111-11.

AbstractBackground: Research has shown that physical activity on prescription (PAP), used in Swedish healthcare, increases patients' physical activity, but data are lacking regarding the long-term effects of PAP on exercise capacity. Therefor exercise capacity was evaluated in patients with metabolic risk factors, after 4.5 years of PAP treatment provided by physiotherapists in primary healthcare. Method: This study included 98 patients (49% women; mean age, 56 years) with metabolic risk factors, who were still physically inactive after a previous 6-month PAP treatment. The patients received physiotherapist-provided PAP treatment for 4.5 years, including 11 follow-ups and 6 exercise capacity tests. Results: After 4.5 years, 41 patients completed the final exercise capacity test (58% drop-out rate). Compared to baseline, the whole cohort exhibited a significantly increased exercise capacity (9.1 W, p = 0.014) with a small effect size (r = 0.27), with no significant differences associated with age or gender. Conclusion: The increased exercise capacity may indicate positive effects on longevity, and consolidates previous findings that long-term behavior change is possible among physically inactive patients. It also demonstrates the feasibility of continuous exercise capacity testing with physiotherapist support in an ordinary primary care setting. The drop-out rate and lack of control group complicate the interpretation of the effects of PAP treatment on the increased exercise capacity. Further research should strive for an RCT study design.

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