Physical Activity

Original Editor - Anna Lowe

Top Contributors - Ann Gates, Admin, Michelle Lee, Chelsea Mclene, Anna Lowe, Kim Jackson, Lucinda hampton, Mariam Hashem, Tarina van der Stockt, Jess Bell, Robin Tacchetti, Naomi O'Reilly, WikiSysop, Candace Goh, Shaimaa Eldib and Rucha Gadgil  

Definitions

Physical activity (PA) is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity includes exercise as well as other activities which involve bodily movement and are done as part of playing, working, active transportation, house chores and recreational activities.

Exercise, is a subcategory of physical activity that is planned, structured, repetitive, and purposeful in the sense that the improvement or maintenance of one or more components of physical fitness is the objective (Casperson 1985) 

Physical inactivity (PI) is described as doing no or very little physical activity at work, at home, for transport or during discretionary time and not reaching physical activity guidelines deemed necessary to benefit public health (Bull et al 2004).

Sedentary behaviour refers to any waking activity characterized by an energy expenditure ≤ 1.5 metabolic equivalents and a sitting or reclining posture. In general this means that any time a person is sitting or lying down, they are engaging in sedentary behaviour. Common sedentary behaviours include TV viewing, video game playing, computer use (collective termed “screen time”), driving automobiles, and reading. (Sedentary Behaviour Research Network)

Physical activity as a public health priority

Physical inactivity has a major health effect worldwide.  It has been identified as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally.

Key facts on physical activity from The World Health Organization (WHO, 2015)

• Insufficient physical activity is 1 of the 10 leading risk factors for death worldwide.
• Insufficient physical activity is a key risk factor for noncommunicable diseases (NCDs) such as cardiovascular diseases, cancer and diabetes.
• Physical activity has significant health benefits and contributes to prevent NCDs.
• Globally, 1 in 4 adults is not active enough.
• More than 80% of the world's adolescent population is insufficiently physically active.
• Policies to address insufficient physical activity are operational in 56% of WHO Member States.
• WHO Member States have agreed to reduce insufficient physical activity by 10% by 2025.

Benefits of Physical Activity The benefits of physical activity are far reaching and cover both prevention and management of long term conditions.  The British Heart Foundation has published a <a href="http://www.bhfactive.org.uk/resources-and-publications-item/40/419/index.html">document</a> that summarises the research that supports the use of physical activity to: </p>

• prevent ill health and reduce the number of people dying prematurely
• enhance mental health, quality of life and self-reported wellbeing
• delay the need for care in older adults (age 65+)
• reduce health inequalities and improve wider factors influencing health and wellbeing

Global Strategy 

Recognising the unique opportunity that exists to formulate and implement an effective strategy for substantially reduce deaths and disease burden worldwide by improving diet and promoting physical activity, WHO has adopted, in May 2004, the "Global Strategy on Diet, Physical Activity and Health".

The Global Strategy has 4 main objectives:

1. Reduce risk factors for chronic diseases that stem from unhealthy diets and physical inactivity through public health actions.
2. Increase awareness and understanding of the influences of diet and physical activity on health an the positive impact of preventive interventions.
3. Develop, strengthen and implement global, regional, national policies and action plans to improve diets and increase physical activity that are sustainable, comprehensive and actively engage all sectors.
4. Monitor science and promote research on diet and physical activity.
   

Physical Activity Guidelines (PAGs)

WHO developed the "Global Recommendations on Physical Activity for Health" with the overall aim of providing national and regional level policy makers with guidance on the dose-response relationship between the frequency, duration, intensity, type and total amount of physical activity needed for the prevention of NCDs.  They can be read here. 

WHO Europe recommends that regular physical activity, throughout the life course, enables people to live better and longer lives. This infographic summarises the opportunities of a "life course approach" to making physical activity part of every day life: for nations, communities, individuals and especially patients with long term health conditions.

Many countries have created their own recommendations, the UK guidelines have recently been summarised in both an infographic for adults and an infographic for children.

Physiotherapy/Physical Therapy (PT) and Physical Activity (PA)

PTs have always had a close relationship with exercise, the profession was founded on the work of remedial gymnasts and the profession has a rich history of prescribing rehabilitative exercise. Despite this, literature on physiotherapy as promoters of physical activity, is scant.

The global physical inactivity crisis, and the epidemic of life-style related diseases (non-communicable diseases or NCDs) has created an urgent need to build on our rich history of prescribing exercise and develop our approaches for prescribing PA. Creating a more active population requires joined up thinking and action from many stakeholders; PTs need to be active in engaging with individuals and communities.

PTs have a lot to offer: access to people living with long term conditions, repeat consultations, exercise facilities, credibility with patients, injury or illness often creates "teachable moments", expert knowledge, and behaviour change skills to name a few.

Resources

• Verhagen (2008) The physical therapist’s role in physical activity promotion
• Aweto (2013) Knowledge, attitude and practice of physiotherapists towards promotion of physically active lifestyles in patient management.
  
• Holm et al (2015) Does outpatient physical therapy with the aim of improving health-related physical fitness influence the level of physical activity in patients with long-term musculoskeletal conditions?
  
• Mulligan (2011) Promoting physical activity for people with neurological disability: perspectives and experiences of physiotherapists.
• Shirley et al (2010) Physical activity promotion in the physical therapy setting: perspectives from practitioners and students

Related Physiopedia Pages

• physical activity in specific long-term conditions
• return on investment for PA interventions
• brief interventions for PA
• barriers to change (for PTs and service users)