scholarly journals Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions

2021 ◽  
pp. bjsports-2021-104281
Author(s):  
Hamish Reid ◽  
Ashley Jane Ridout ◽  
Simone Annabella Tomaz ◽  
Paul Kelly ◽  
Natasha Jones
Keyword(s):  
Physical Activity ◽  
Adverse Events ◽  
Perceived Risk ◽  
Healthcare Professionals ◽  
Medical Attention ◽  
Activity Levels ◽  
Long Term Conditions ◽  
Starting Point ◽  
Physical Activity Levels

IntroductionThe benefits of physical activity for people living with long-term conditions (LTCs) are well established. However, the risks of physical activity are less well documented. The fear of exacerbating symptoms and causing adverse events is a persuasive barrier to physical activity in this population.This work aimed to agree clear statements for use by healthcare professionals about medical risks of physical activity for people living with LTCs through expert consensus. These statements addressed the following questions: (1) Is increasing physical activity safe for people living with one or more LTC? (2) Are the symptoms and clinical syndromes associated with common LTCs aggravated in the short or long term by increasing physical activity levels? (3) What specific risks should healthcare professionals consider when advising symptomatic people with one or more LTCs to increase their physical activity levels?MethodsStatements were developed in a multistage process, guided by the Appraisal of Guidelines for Research and Evaluation tool. A patient and clinician involvement process, a rapid literature review and a steering group workshop informed the development of draft symptom and syndrome-based statements. We then tested and refined the draft statements and supporting evidence using a three-stage modified online Delphi study, incorporating a multidisciplinary expert panel with a broad range of clinical specialties.ResultsTwenty-eight experts completed the Delphi process. All statements achieved consensus with a final agreement between 88.5%–96.5%. Five ‘impact statements’ conclude that (1) for people living with LTCs, the benefits of physical activity far outweigh the risks, (2) despite the risks being very low, perceived risk is high, (3) person-centred conversations are essential for addressing perceived risk, (4) everybody has their own starting point and (5) people should stop and seek medical attention if they experience a dramatic increase in symptoms. In addition, eight symptom/syndrome-based statements discuss specific risks for musculoskeletal pain, fatigue, shortness of breath, cardiac chest pain, palpitations, dysglycaemia, cognitive impairment and falls and frailty.ConclusionClear, consistent messaging on risk across healthcare will improve people living with LTCs confidence to be physically active. Addressing the fear of adverse events on an individual level will help healthcare professionals affect meaningful behavioural change in day-to-day practice. Evidence does not support routine preparticipation medical clearance for people with stable LTCs if they build up gradually from their current level. The need for medical guidance, as opposed to clearance, should be determined by individuals with specific concerns about active symptoms. As part of a system-wide approach, consistent messaging from healthcare professionals around risk will also help reduce cross-sector barriers to engagement for this population.

scholarly journals Long-Term Effect of Different Physical Activity Levels on Subclinical Atherosclerosis in Middle-Aged Men: A 25-Year Prospective Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e85209 ◽  
Author(s):  
Magdalena Kwaśniewska ◽  
Anna Jegier ◽  
Tomasz Kostka ◽  
Elżbieta Dziankowska-Zaborszczyk ◽  
Ewa Rębowska ◽  
...  
Keyword(s):  
Physical Activity ◽  
Prospective Study ◽  
Subclinical Atherosclerosis ◽  
Term Effect ◽  
Activity Levels ◽  
Middle Aged ◽  
Long Term Effect ◽  
Physical Activity Levels

scholarly journals Long-Term Bed Rest Delays the Circadian Phase of Core Body Temperature

2021 ◽  
Vol 12 ◽  
Author(s):  
Stefan Mendt ◽  
Katharina Brauns ◽  
Anika Friedl-Werner ◽  
Daniel L. Belavy ◽  
Mathias Steinach ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Temperature ◽  
Circadian Rhythms ◽  
Core Body Temperature ◽  
Bed Rest ◽  
Phase Delay ◽  
Activity Levels ◽  
Physical Activity Levels ◽  
Core Body

Spaceflight can be associated with sleep loss and circadian misalignment as a result of non-24 h light-dark cycles, operational shifts in work/rest cycles, high workload under pressure, and psychological factors. Head-down tilt bed rest (HDBR) is an established model to mimic some of the physiological and psychological adaptions observed in spaceflight. Data on the effects of HDBR on circadian rhythms are scarce. To address this gap, we analyzed the change in the circadian rhythm of core body temperature (CBT) in two 60-day HDBR studies sponsored by the European Space Agency [n = 13 men, age: 31.1 ± 8.2 years (M ± SD)]. CBT was recorded for 36 h using a non-invasive and validated dual-sensor heatflux technology during the 3rd and the 8th week of HDBR. Bed rest induced a significant phase delay from the 3rd to the 8th week of HDBR (16.23 vs. 16.68 h, p = 0.005, g = 0.85) irrespective of the study site (p = 0.416, g = −0.46), corresponding to an average phase delay of about 0.9 min per day of HDBR. In conclusion, long-term bed rest weakens the entrainment of the circadian system to the 24-h day. We attribute this effect to the immobilization and reduced physical activity levels associated with HDBR. Given the critical role of diurnal rhythms for various physiological functions and behavior, our findings highlight the importance of monitoring circadian rhythms in circumstances in which gravity or physical activity levels are altered.

scholarly journals Physical Activity in Cardiac Rehabilitation: Towards Citizen-Centered Digital Evidence-Based Interventions

2020 ◽  
Author(s):  
Johanna Gutenberg ◽  
Stefan Tino Kulnik ◽  
Rada Hussein ◽  
Thomas Stütz ◽  
Josef Niebauer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Cardiac Rehabilitation ◽  
Exploratory Study ◽  
Survey Methods ◽  
Digital Evidence ◽  
Evidence Based ◽  
Activity Levels ◽  
Physical Activity Levels

Physical activity is a vital part of cardiac rehabilitation (CR). However, heart-healthy physical activity levels in people with cardiovascular disease drop significantly after CR. This exploratory study employs qualitative and survey methods within a co-creation approach. The aim is to understand the mechanisms of healthy behavior and habit formation in order to create a novel evidence-based (post-)rehabilitation approach that employs digital means to sustain long-term physical activity levels in people with cardiovascular disease.

The role of the health professional

2018 ◽  
pp. 293-297
Author(s):  
Robert Zarr ◽  
William Bird
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Healthcare Professionals ◽  
Medical Model ◽  
Holistic Approach ◽  
Rapid Rise ◽  
Long Term Conditions ◽  
Prevention And Health Promotion

There is a shift in healthcare from treatment of diseases based on the medical model, to a more holistic approach based on prevention and health promotion, using social and environmental factors that impact on an individual to improve their health and prevent disease. This shift is in response to the rapid rise in long-term conditions such as obesity, diabetes, dementia, and mental illness. Healthcare professionals are only slowly adjusting to this shift of healthcare and in this chapter we will look at how the healthcare professional can connect patients with green space to help them increase physical activity and reduce stress. Four initiatives have been used to illustrate how healthcare professionals can engage patients with nature to help tackle the main disease burden.

Long-Term Physical Activity Levels After the End of a Structured Exercise Intervention in Adults With Type 2 Diabetes and Prediabetes: A Systematic Review

2020 ◽  
Vol 44 (8) ◽  
pp. 680-687.e2
Author(s):  
Jane E. Booth ◽  
Jamie L. Benham ◽  
Laura E. Schinbein ◽  
Samantha K. McGinley ◽  
Doreen M. Rabi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Exercise Intervention ◽  
Activity Levels ◽  
Physical Activity Levels

Working with healthcare professionals to promote physical activity

2021 ◽  
pp. 175791392097825
Author(s):  
D Vishnubala ◽  
A Pringle
Keyword(s):  
Physical Activity ◽  
Physical Inactivity ◽  
Healthcare Professionals ◽  
Medical Officer ◽  
Convincing Evidence ◽  
Long Term Conditions ◽  
Physical Activity Advice ◽  
The Uk

The UK Chief Medical Officer guidelines provide convincing evidence of the role of physical activity (PA) in the prevention and management of a number of long-term conditions. Yet physical inactivity remains an important public health priority. Healthcare professionals (HCP) have been identified as being very important for the promotion of PA to their patients. Yet a number of barriers are faced by HCP in this respect including awareness, knowledge, self-efficacy, perceived competence, and time. This paper aims to share current projects and practices and reflect on the challenges of changing the behaviour of HCP to provide physical activity advice.

scholarly journals Assessing Physical Activity among Canadian Healthcare Professionals

2020 ◽  
Vol 4 (3) ◽  
pp. 69-72
Author(s):  
Ravneet Sandhu ◽  
Gurnoor Kaur Pannu
Keyword(s):  
Physical Activity ◽  
Healthcare Professionals ◽  
Activity Levels ◽  
Multiple Logistic Regression ◽  
Validated Questionnaire ◽  
Significant Difference ◽  
Physical Activity Levels ◽  
Males And Females ◽  
Canadian Healthcare

INTRODUCTION: Physical Activity is well known to keep illness at bay and promote healthy living among people. In today’s fast paced life, obesity is increasing amongst people and this can be eliminated through proper physical activity. AIM: To assess the physical activity among various Canadian healthcare professionals. MATERIALS AND METHOD: The present study was a multi-institution based observational study using a pre-tested, pre-validated questionnaire distributed among various colleges and privately practicing healthcare professionals in Canada using a close-ended questionnaire divided into five sections and containing 28 questions. Data analysis was done using SPPS version 19.0 and the independent samples t-test and multiple logistic regression was applied. Data was only considered significant when p was less than or equal to 0.05.RESULTS: Most males belonged to the “overweight” category (56.3%), while females belonged to the “normal” category (56.3%). A lesser number of females reported being obese (5.4%) as compared to their male counterparts; significant difference (p=0.05) was observed between males and females in the underweight category. Males were found to be insufficiently active (41.8%), while 44.8% females were found to be in the active category. Statistical differences were observed while comparing the physical activity levels between the males and females belonging to the Insufficiently Active category(p=0.02).CONCLUSION: Healthcare professionals should be reminded regarding their general health and the role of physical exercise in keeping them healthy.

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