title: Description and implementation of U-Turn Medical, a comprehensive lifestyle intervention programme for chronic disease in the sport and exercise medicine setting: pre-post observations in 210 consecutive patients.
abstract: BACKGROUND
  Non-communicable disease (NCD) is increasing, but management remains mostly curative, disease-centred and focused on single interventions. We describe the development and implementation of a patient-centred, comprehensive, multidisciplinary lifestyle intervention programme (LIP) for patients with NCD in the sport and exercise medicine (SEM) setting (part 1) and present preliminary observational data (part 2).
  
  
  METHODS
  Part 1 is a description of the programme development and implementation. In part 2, 210 participants with NCD underwent a 12-week LIP (U-Turn Medical). Physiological, functional and metabolic outcomes were assessed at baseline and at completion.
  
  
  RESULTS
  84% of patients had two or more comorbidities, requiring additional considerations for exercise rehabilitation. On completion, there were decreases in % body fat (29.8±6.7% vs 28.5±6.6%), waist (100.2±16.2 vs 97.3±14.8 cm) and hip circumference (105.4±13 vs 104±12 cm), resting heart rate (74.2±13.4 vs 71.4±11.9 bpm), resting systolic blood pressure (125.7±16.1 vs 120.1±13 mm Hg) and cholesterol (4.7±1.2 vs 4.3±0.9 mmol/L), low-density lipoprotein (3±0.9 vs 2.7±0.8 mmol/L) and triglyceride (1.4±0.7 vs 1.3±0.6 mmol/L), and increases in flexibility (12.1±11.6 vs 16.1±10.8 cm) and 6 min walk distance (559.4±156.6 vs 652.3±193.6 m; all p<0.05).
  
  
  CONCLUSIONS
  A 12-week comprehensive, patient-centred LIP can be implemented successfully in the SEM setting in patients with NCDs with multiple comorbidities. Observed results show improvements in the majority of outcome variables.
authors: Clinical Sport and Exercise Medicine Research Group, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa International Olympic Committee (IOC) Research Centre, Cape Town, South Africa.
authors: Wayne
authors: W
authors: Derman
authors: Clinical Sport and Exercise Medicine Research Group, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa International Olympic Committee (IOC) Research Centre, Cape Town, South Africa.
authors: Martin
authors: M
authors: Schwellnus
authors: International Olympic Committee (IOC) Research Centre, Cape Town, South Africa.
authors: Fallon
authors: F
authors: Hope
authors: Biostatistics Unit, Medical Research Council, Parow, South Africa Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa.
authors: Esme
authors: E
authors: Jordaan
authors: Biostatistics Unit, Medical Research Council, Parow, South Africa.
authors: Trishanta
authors: T
authors: Padayachee
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D050218:Body Fat Distribution / Q000379:methods; D015992:Body Mass Index; D002908:Chronic Disease / Q000628:therapy*; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006293:Health Promotion; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods; D040242:Risk Reduction Behavior; D013178:Sports Medicine / Q000379:methods*; D049629:Waist-Hip Ratio
keywords: Cardiology prevention; Exercise rehabilitation; Health promotion through physical activity; Implementation