Background: Musculoskeletal pain is a common and often complicated presenting complaint in the Emergency Department (ED). Exercise may be a targeted intervention. This is the first study of the feasibility of formally prescribing exercise to patients being discharged from the ED.
Methods: One hundred five patients and 49 emergency providers were enrolled in a prospective survey study at an academic urban medical center to determine the feasibility of treating the ED population with exercise. All ED providers were eligible, while eligible patients were those presenting to the ED between the ages of 18 and 65. Incarcerated or pregnant patients were ineligible. Patients were surveyed to determine interest in receiving an exercise prescription after discharge. ED providers were surveyed to determine willingness to prescribe formal exercise. The proposed exercise treatment included a 60-day membership to four wellness locations and an individualized fitness plan based on the physical activity guidelines for Americans. Binomial logistic regression was used to determine the influence of age, sex, and race on patient interest.
Results: Among ED providers (N=49), 96% were willing to formally prescribe exercise and 35% denied having any concerns prescribing exercise to patients being discharged from the ED. Among ED patients (N=105), 53% were female, 81% were white, and 27% indicated interest in receiving a formal exercise prescription as adjunctive treatment after discharge from the ED. The most common reasons for patient disinterest were: Aversion to exercise, inability to afford the program, and transportation difficulties. Among patients interested in the program, 71% were female and 29% were male. After controlling for age and race, female sex remained a significant predictor of interest in participating in a formal prescription exercise program from the ED (OR 3.52 [1.26,9.87], p=0.017).
Conclusion: A notable proportion of ED patients were willing to participate in a formal prescription exercise program. Female patients were more likely to be interested than male patients. Transportation remains a significant barrier, but an ED based prescription for a cost effective exercise program appears feasible given patient interest and overwhelming support from emergency providers. Compliance and patient benefit from such an ED based program merits investigation.