Approaches to increase physical activity: reviewing the evidence for exercise-referral schemes.

OBJECTIVE: To review current evidence of effectiveness for exercise-referral schemes.
METHODS: Studies were identified from MEDLINE 1966-2002, EMBASE 1980-2002 and CINHAL 1982-2002 and bibliographies of relevant papers. INCLUSION CRITERIA: Interventions providing access to exercise activities and/or facilities, experimental or quasi-experimental studies, studies with a control group, interventions based in a primary care setting, and interventions including an exercise component with measures of physical activity levels.
CONCLUSIONS: Exercise-referral schemes appear to increase physical activity levels in certain populations, namely individuals who are not sedentary but already slightly active, older adults and those who are overweight (but not obese). However, increases in the level of physical activity may not be sustained over time. Further studies are required to assess effectiveness in a range of populations and for different activities, and to find strategies to increase long-term adherence.