PATIENTS most likely to benefit from taking physical exercise are those least likely to take part in organised exercise schemes, according to research.

The study, which involved 353 middle-aged patients registered with an inner-city GP practice in Newcastle, suggests that doctors face a real challenge in ensuring exercise programmes reach the patients who most need it.

Doctors with Newcastle University's Department of Epidemiology and Public Health asked 629 patients, aged between 40 and 64, whether they would be interested in taking part in an exercise programme.

Of the 276 who would not - 44 per cent - the refusal rate was much higher in men than women.

It was also higher in smokers and men living in more deprived areas.

Compared to those who took part in the scheme, non-participants had less knowledge of the health benefits of exercise and attached less importance to it.

Nearly two-thirds of non-participants said they did enough to stay healthy, compared to 28 per cent of participants.

Among the reasons given for not taking part were dislike of exercise, fear of leaving their home unattended, carer responsibilities and poor health.

Among the participants the main barriers were negative self-image, lack of exercise partner and lack of time.

In a paper presented at the annual Northern Primary Care Research Network day at Collingwood College, Durham, the researchers said: "Although the potential health benefits from an increase in physical activity are high this study has shown that those most likely to benefit from interventions are least likely to take part of them."

"The challenge for primary care based health promotion practitioners is considerable and to recruit those 'hard to engage' individuals into a physical activity programme will require careful phrasing of the message to focus on their personal goals and to address the principal barriers they perceive."