People who lead a physically active life or are in good physical shape have a lower mortality rate and a longer life expectancy [1, 2]. The regular practice of physical activity (PA) has a positive effect in reducing obesity and preventing cardiovascular pathologies [3, 4], reducing the risk of stroke , reducing the deterioration of the pulmonary function and the risk of suffering EPOX , prevents diabetes , increases HDL cholesterol and decreases triglycerides and total cholesterol . It is also important in preventing falls in the elderly , generates a sensation of well-being, reduces anxiety and symptoms of depression, increases self-esteem , and improves the perception of quality of life related to health [11, 12]. The World Health Organisation (WHO) has published a report in which physical inactivity is cited as one of the principle risk factors in the development of chronic illness and cause of death, especially in industrialised countries . Even so, only 18% of the European population claims to practice moderate physical activity on a daily basis . According to the National Health Survey of 2001, 46.6% of the Spanish population over the age of 15 does not exercise in their free time and only 8.5% exercise on a regular basis . Furthermore, data from the Catalan Health Survey of 2006 indicate that less than 48% of the Catalan population exercises sufficiently to improve their health, a percentage which has increased since the surveys of 1994 and 2002 . The virtual absence of a public health practice infrastructure for the promotion of PA at a local level presents a critical challenge to control policy for chronic disease, particularly obesity. Translating the increasing evidence of the value of PA into practice will require systemic, multilevel, and multisectorial intervention approaches that build individual capability and organisational capacity for behaviour change, create new social norms, and promote policy and environmental changes that support higher levels of energy expenditure across the population .
In 2005, the Spanish Ministry for Health and Consumption designed the Strategy for Nutrition, Physical Activity and Prevention of Obesity (NAOS) with the aim of promoting a healthy lifestyle . To the same end, in Catalonia, the Department of Health of the Catalan Government launched an integrated plan for the Promotion of Health through Physical Activity and Healthy Diet (PAAS) .
Within this plan, encouraging PA promotion in PHC is outlined as a priority , as in Spain the high proportion of inactive primary care patients (at least 70%) justifies the need to develop a targeted strategy for physical activity promotion in general practices . There is contradictory evidence about the effectiveness of including the usual advice on the practice of regular physical activity in the consulting rooms of PHC [21–23], and it is not certain if it is even applicable in our country .
In Catalonia, Puig-Ribera, McKenna and Riddoch (2005) indicated that medical recommendations for physical activity were limited, basically due to lack of time, unfavourable working conditions in healthcare centres and lack of knowledge on the part of the healthcare professionals, making it clear that the task of promoting physical activity was not seen as effective; concluding with the importance of establishing working protocols for consultants to integrate the promotion of physical activity in their work on a daily basis in the clinical practice .
Several types of intervention for the promotion of PA in Primary Care have been reported. It has been demonstrated that those which combine written instructions, an exercise programme and strategies to change behaviour, and which are accompanied by several training sessions, are more effective . Thus it appears that the highest success rate is seen in those interventions which are not limited to professional advice given at the PHC [26, 27]. In the same way a systematic review concluded that advice in routine primary care consultations was not an effective strategy means of producing sustained increases in physical activity .
Various authors have indicated the importance of referring patients to professionals specialised in the design of healthy exercise programmes outside the healthcare environment, making use of the local resources available in each area as a strategy for effective integration of the promotion of exercise in Primary Care [17, 29]. In this context, a recent systematic review  assessed whether exercise-referral schemes were effective in improving exercise participation in sedentary adults. These schemes showed a small effect on increasing physical activity in sedentary people, partly due to poor rates of uptake and adherence to the exercise schemes . Therefore, further studies are required to find strategies to increase long-term adherence  by addressing the participation barriers such as lack of social support, intimidating environments to practice a regular physical activity and inadequate supervision .
A systematic review of interventions based on the promotion of walking found only two studies in which there was a significant increase in the time spent walking and which improved the clinical risk indicators . Finally, a Cochrane review (2005) showed moderate but positive utility regarding the interventions based on self informed physical activity, such as the effect on the cardio respiratory state . The effect of the interventions in achieving a predetermined threshold of physical activity was not significant with an odds ratio of 1.30 (Confidence interval 95%: 0.87 to 1.95) . In better quality studies, exercise was self directed with some professional guidance and with constant professional support .
In 2006, Giné-Garriga and Martin developed a pilot study in Barcelona (with a control group) of the Programme for the Promotion of Physical Activity in the PHC in which they offered patients the possibility of participating for a three month period in an exercise programme carried out in their own healthcare centre . Patients were recruited in the healthcare centres, and physical activity specialists designed programmes which were specifically aimed at the patients' needs [34, 35]. The sessions were carried out together with nurses and physical therapists from the centre. The programme was carried out in the centre itself, making use of nearby outdoor public spaces in order to offer the patients convenient and familiar surroundings. During the last sessions of the programme all the participants were given information about the nearest municipal facilities and the activities offered, and a visit to these facilities was organized. Thus, the programme acted as a means for incorporating participants in local facilities once they had experienced the benefits of doing regular exercise and at the same time used behavioural strategies , accompanied by people from the same neighbourhood with similar needs .
In order to achieve this objective, establishing a link between the PHC and the central offices of the various municipal districts was considered essential, as was contact with local sports centres, civic centres and other health centres, in order to facilitate the incorporation of the patient in a programme or exercise session, either individual or group, outside the environment of the healthcare centre. Facilitating access to the existing local resources in the area would contribute considerably to the continuity of the initiatives and programmes being developed by Primary Care. Furthermore, it would encourage a greater number of citizens to establish a common protocol of action .