Promoting graded exercise as a part of multimodal treatment in patients diagnosed with stress‐related exhaustion

AIMS AND OBJECTIVES: The purpose of this study was to examine, by using patient cohort data, the changes in exercise habits during a 12-month multimodal treatment period, in patients seeking specialist care for stress-related exhaustion. BACKGROUND: Randomised controlled trials have greatly contributed to the fact that both physicians and patients regard regular exercise participation as a highly valuable and effective treatment for mental health disorders. Nevertheless, little is known about the adherence to physical activity recommendations for patients with stress-related mental problems in a clinical setting. Knowledge about what can be achieved within the clinical context, and how current treatments can be improved, is crucial for clinicians, researchers, educators, managers and policy makers involved in nursing practice. DESIGN: Longitudinal analysis of patient cohort data. METHODS: The sample consisted of 169 patients (79% women; mean age = 42·7 years) who were referred to a stress clinic due to stress-related exhaustion. All patients received multimodal treatment with similar components. Two different approaches to promote exercise were used in the clinical work (general comprehensive instruction either with or without an 18-week coached exercise programme). The self-reported overall exercise level was assessed at baseline and at three, six and 12 months after the first visit. Group by time effects were examined with repeated measures analyses of variance. RESULTS: The frequency, duration and intensity of exercise increased substantially during the first three months of multimodal treatment. Although exercise levels tended to decrease thereafter, there was still a significant time effect at the 12-month follow-up showing that follow-up exercise levels were higher than at baseline. CONCLUSION: Both general exercise instructions and coached exercise were effective in promoting exercise involvement. RELEVANCE TO CLINICAL PRACTICE: Exercise can be successfully promoted as a part of multimodal treatment in patients with stress-related exhaustion.