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An ever growing number of studies have shown that regular physical activity (PA) lowers the risk for cardiovascular and metabolic disease, as well as lowering the risk of cardiovascular and all-cause mortality.1 ,2 Furthermore, PA has positive treatment/and or preventive effects on a multitude of other conditions such as mental health, colon and breast cancer, osteoporosis, risk of falls and quality of life. Today, the great challenge is to translate the known health and well-being benefits of PA into practical use, ultimately making PA a regular treatment and prevention modality in the healthcare system.3

Existing approaches to promoting increased levels of PA in patients vary from providing simple oral advice to more structured advice. The Swedish Council on Technology Assessment in Health Care (SBU) report4 concluded that general ‘short’ advice on PA could increase the level of PA up to 50% at 6 months. With more intense counselling, supported by pedometers, written advice and/or follow-ups, the level of PA may increase a further 15–50% in 6 months’ time.4 Unfortunately, only a minority of patients seem to obtain additional support beyond the traditional advice on PA.

More structured advice uses established behavioural strategies to help individuals change their lifestyle behaviour. PA could also be delivered as part of an exercise referral scheme, provided ‘on …