The quality of physical activity guidelines, but not the specificity of their recommendations, has improved over time: a systematic review and critical appraisal

2021 ◽  
Vol 46 (1) ◽  
pp. 34-45
Author(s):  
Madelin R. Siedler ◽  
Priscila Lamadrid ◽  
Megan N. Humphries ◽  
Reem A. Mustafa ◽  
Yngve Falck-Ytter ◽  
...  
Keyword(s):  
Physical Activity ◽  
Nonprofit Organizations ◽  
Agree Ii ◽  
Physical Activity Guidelines ◽  
External Review ◽  
Assessment Development ◽  
Public Representation ◽  
Guideline Quality ◽  
Over Time

While numerous guidelines for the prescription of physical activity are released each year, the quality and practicability of these guidelines is unknown. We assessed the quality of 95 guidance documents published since 2000 that included recommendations about physical activity for the promotion of general health and prevention of cardiometabolic disease. We used 3 tools: Appraisal of Guidelines for Research and Evaluation (AGREE II), the National Academy of Medicine’s (NAM) Standards for Trustworthy Clinical Practice Guidelines, and the Frequency, Intensity, Time, and Type (FITT) score. Average AGREE II domain scores ranged from 38%−84%, and the portion of criteria fulfilled per NAM domain ranged from 7%–39%. The average FITT score for all recommendations was 2.48 out of 4. While guidelines improved according to both AGREE II and the NAM standards over time, their practicability as assessed by FITT score did not improve. Guidelines produced by governmental agencies or other nonprofit organizations, using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, or fulfilling a higher number of NAM criteria tended to be of higher quality. Organizations producing physical activity guidelines can improve their quality by establishing and reporting processes for public representation, external review, and conflict of interest (COI) management. Future recommendations about physical activity should be more specific and include strategies to improve implementation. Registration no.: PROSPERO CRD42019126364. Novelty: Most physical activity recommendations are not sufficiently specific to be practically implemented. The overall quality of guidelines has improved over time, but the specificity of recommendations has not. Improved public representation, external review, and COI disclosure and management processes would improve guideline quality.

A Systematic Review of the Relationships Between Physical Activity and Sleep in Early Childhood

2021 ◽  
pp. 1-17
Author(s):  
Christine W. St. Laurent ◽  
Katrina Rodheim ◽  
Rebecca M.C. Spencer
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Evaluation Framework ◽  
Outcome Studies ◽  
Study Quality ◽  
Assessment Development ◽  
High Prevalence ◽  
Study Characteristics ◽  
Study Designs

The aim of this systematic review was to examine the associations between physical activity and sleep in children aged less than 6 years. Articles were included if participants were primarily aged less than 6 years and study designs were observational or experimental. Study characteristics were extracted, and the Grading Recommendations Assessment, Development and Evaluation framework was used to assess study quality. Thirty-six studies (16 sleep, 16 physical activity, and three fitness outcomes) from 18 countries reported in 29 articles were included. The majority of sleep and physical activity outcome studies reported mixed effects with very low to low quality of evidence. Fitness outcome studies were limited, and therefore, evidence was insufficient. The high prevalence of mixed and null results could be related to study limitations. Importantly, this review points to the critical need for higher quality studies of sleep and physical activity in young children, which would support health recommendations and intervention strategies for healthier child development.

scholarly journals Physical activity trajectories following gynecological cancer: results from a prospective, longitudinal cohort study

2020 ◽  
Vol 30 (11) ◽  
pp. 1784-1790
Author(s):  
Steven Fleming ◽  
Tamara Jones ◽  
Monika Janda ◽  
Dimitrios Vagenas ◽  
Leigh Ward ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Endometrial Cancer ◽  
Gynecological Cancer ◽  
Activity Levels ◽  
Physical Activity Levels ◽  
Low Levels ◽  
The Relationship ◽  
Over Time

BackgroundParticipating in physical activity after a diagnosis of cancer is associated with reduced morbidity and improved outcomes. However, declines in, and low levels of, physical activity are well documented in the broader cancer population, but with limited evidence following gynecological cancer.ObjectiveTo describe physical activity levels from before and up to 2 years after gynecological cancer surgery; to explore the relationship between physical activity patterns and quality of life; and to describe characteristics associated with physical activity trajectories post-gynecological cancer.MethodsWomen with gynecological cancer (n=408) participated in a prospective study that assessed physical activity and quality of life pre-surgery (baseline), at 6 weeks, and 3, 6, 9, 12, 15, 18 and 24 months post-surgery. Validated questionnaires were used to assess physical activity (Active Australia Survey) and quality of life outcomes (Functional Assessment of Cancer Therapy-General). Generalized estimating equation modeling, group-based trajectory analysis, and analysis of variance were used to identify physical activity levels over time, to categorize women into physical activity trajectory groups, and to assess the relationship between physical activity levels and quality of life, respectively.ResultsWomen had a mean±SD age of 60±11.4 years at diagnosis, with the majority diagnosed with endometrial cancer (n=235, 58%) or stage I disease (n=241, 59%). Most women (80%) started with and maintained low levels of physical activity (1–10 metabolic equivalent task hours per week), reported no physical activity throughout the follow-up period, or reduced physical activity levels over time. Only 19% of women maintained or doubled physical activity levels, so that by 24 months post-diagnosis they were engaging in sufficient levels of physical activity. Women with endometrial cancer (58% of the sample) were more likely to be overweight or obese and to report low levels of physical activity or none at all. Higher physical activity levels were associated with higher quality of life (p<0.05).ConclusionThe low baseline and surveillance levels of physical activity show that the vast majority of gynecological cancer survivors have the ability to improve their physical activity levels. Integration of physical activity advice and support into standard care could lead to gains in quality of life during gynecological cancer survivorship.

scholarly journals Adhering to the 2017 Dutch Physical Activity Guidelines: A Trend over Time 2001–2018

2020 ◽  
Vol 17 (3) ◽  
pp. 681
Author(s):  
Marjolein Duijvestijn ◽  
Saskia W. van den Berg ◽  
G. C. Wanda Wendel-Vos
Keyword(s):  
Physical Activity ◽  
Multiple Logistic Regression Analysis ◽  
Positive Trend ◽  
Time Data ◽  
Physical Activity Guidelines ◽  
Muscle Strengthening ◽  
Nationally Representative ◽  
Health Enhancing Physical Activity ◽  
Changes Over Time ◽  
Over Time

Recently, new physical activity (PA) guidelines were adopted in the Netherlands consisting of two components: (1) addressing duration of moderate and vigorous PA, (2) bone and muscle strengthening activities. The aim of this study is to retrospectively assess the long-term trend in fulfilling the criteria of the new PA guidelines and to gain insight into which activities contribute to changes over time. Data were available for 2001–2018 of a nationally representative sample of approximately 7000 Dutch citizens aged 12 years and over using the Short Questionnaire to Assess Health-enhancing physical activity (SQUASH). Multiple logistic regression analysis was performed by age, sex, and level of education. Overall, a positive trend was found from 39.9% adherence in 2001 to 46.0% in 2018. Adherence levels among adolescents decreased and increased among adults and seniors. Intermediate and higher educated groups showed positive trends over time whereas a stable trend was observed among lower educated. Activities contributing most to changes over time were sports, leisure time walking, and strenuous occupational activities. In the period 2001–2018, though an increasing trend was found, less than half of the population was sufficiently active. Special effort is necessary to reach adolescents, seniors, and lower educated groups in PA promotion programs.

scholarly journals Critical appraisal and comparison of recommendations of clinical practice guidelines for treatment of schizophrenia in children and adolescents: a methodological survey protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038646
Author(s):  
Maíra Ramos Alves ◽  
Cristiane de Cássia Bergamaschi ◽  
Flávia Blaseck Sorrilha ◽  
Izabela Fulone ◽  
Silvio Barberato-Filho ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Children And Adolescents ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Future Research ◽  
High Quality ◽  
Agree Ii ◽  
Ethical Approval ◽  
Over Time

IntroductionThe number of clinical practice guidelines (CPGs) have increased substantially mainly in the paediatric area of mental health. However, little is known about the quality or how recommendations for the treatment of disorders such as schizophrenia in children and adolescents have changed over time. The aim of this study will be to assess the quality of the development of CPGs for the treatment and management of schizophrenia in children and adolescents over time using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool and to compare the recommendations and interventions described in these documents.Methods and analysisCPGs will be identified using a prospective protocol through a systematic search of multiple databases (Medline, Embase, Health Systems Evidence, Epistemonikos, Lilacs, etc) and guideline websites from 2004 to December 2020. The quality of the guidelines will be assessed by three reviewers, independently using the AGREE II. CPGs will be considered of high-quality if they scored ≥60% in four or more domains of the AGREE II instrument. Non-parametric tests will be used to test for the change of quality over time. We will summarise the different evidence grading systems and compare the recommendations.Ethics and disseminationEthical approval is not required since it is a literature-based study. Future results of the research can be submitted for publication in scientific journals of high impact, peer reviewed and also published in national and international conferences. The results derived from this study will contribute to the improvement of health institutions and policies, informing about existing recommendation guidelines and about deficiencies and qualities found in those. This study may also identify key areas for future research. This study may guide the search and choice for high quality CPGs by health policy makers and health professionals and subsidise future adaptations.Protocol registration numberCRD42020164899.

scholarly journals A cross-sectional study analysing the association between habitual physical activity levels and quality of life in adults with asthma

2015 ◽  
Vol 7 (1) ◽  
pp. 29-41
Author(s):  
ADEEL NAZIR AHMAD ◽  
KIMBERLEY L. EDWARDS
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Positive Association ◽  
Habitual Physical Activity ◽  
Activity Levels ◽  
Cross Sectional ◽  
Physical Activity Guidelines ◽  
Life Score ◽  
Physical Activity Levels

Background: People with asthma believe their condition prevents them from undertaking physical activity. The objective was to determine the association between habitual physical activity levels and the quality of life in adults with asthma and meeting the physical activity guidelines. Material/Methods: A cross-sectional survey of adults (aged >18) with asthma was conducted in three general practices in Nottingham, UK (n = 128). A self-reported short form International Physical Activity Questionnaire, mini Asthma Quality of Life Questionnaire and a demographic questionnaire (age, gender, ethnicity and BMI) were used to collect data. Physical activity was provided in minutes for different activities to enable the habitual weekly MET-minutes to be calculated, and the quality of life score was determined. Results: Among 128 respondents, 22% met the physical activity guidelines. Mostly younger, white, male, normal weight participants had higher physical activity levels and better asthma quality of life. Mean total asthma quality of life score was 4.5. Linear regression modelling showed a positive association between the total physical activity and the quality of life score (p < 0.001); thus higher physical activity levels were associated with less/no asthma quality of life impairment (higher score). Conclusions: The majority of asthmatics in this study had low physical activity levels, did not meet the recommended physical activity guidelines and had impaired quality of life. A strong positive association between physical activity and asthma quality of life supports the view that adults with asthma should be encouraged to be sufficiently physically active, which could be associated with a better asthma related quality of life.

scholarly journals Association Between Meeting Physical Activity Guidelines with Ambulation and Quality of Life in Claudication

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 681-681
Author(s):  
Andrew Gardner ◽  
Polly Montgomery ◽  
Ming Wang ◽  
Biyi Shen ◽  
Shangming Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Moderate Intensity ◽  
Health Related Quality ◽  
Physical Activity Guidelines ◽  
Related Quality ◽  
Health Related ◽  
Group 2 ◽  
Group 1

Abstract We determined if meeting the 2018 physical activity guidelines was associated with better ambulatory function, health-related quality of life, and inflammation than failing to meet the guidelines in patients with peripheral artery disease and claudication. Secondly, we determined the optimal number of total daily steps that are needed to meet the physical activity guidelines. Five hundred seventy-two patients were assessed on their daily ambulatory activity for one week with a step activity monitor, and were grouped according to whether they achieved less than 150 minutes of moderate intensity physical activity per week (Group 1=Do Not Meet Guidelines; n=397), or whether they were above this threshold (Group 2=Meet Guidelines; n=175). Treadmill peak walking time (mean±SD) was significantly higher (p&lt;0.001) in Group 2 (709±359 sec) than in Group 1 (427±281 sec). The health-related quality of life score for physical function was significantly higher (p&lt;0.001) in Group 2 (61±22%) than in Group 1 (44±21%). High sensitivity C-reactive protein was significantly lower (p&lt;0.001) in Group 2 (3.6±4.5 mg/L) than in Group 1 (5.9±6.1 mg/L). Finally, 7,675 daily steps was the optimal threshold associated with meeting the physical activity guidelines, with a sensitivity of 82.9% and a specificity of 88.4%. In conclusion, patients with claudication who meet the 2018 physical activity guidelines for US adults had better ambulation, HRQoL, and inflammation outcomes than those who failed to meet the guidelines. From a practical standpoint, patients with claudication best achieved the physical activity guidelines by taking a total of 7,675 daily steps.

scholarly journals GRADE-ADOLOPMENT Process to Develop 24-Hour Movement Behavior Recommendations and Physical Activity Guidelines for the Under 5s in the United Kingdom, 2019

2020 ◽  
Vol 17 (1) ◽  
pp. 101-108 ◽  
Author(s):  
John J. Reilly ◽  
Adrienne R. Hughes ◽  
Xanne Janssen ◽  
Kathryn R. Hesketh ◽  
Sonia Livingstone ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behavior ◽  
Sedentary Time ◽  
De Novo ◽  
Movement Behavior ◽  
Physical Activity Guidelines ◽  
Assessment Development ◽  
The United Kingdom ◽  
The Uk ◽  
First Time

Background: This article summarizes the approach taken to develop UK Chief Medical Officers’ physical activity guidelines for the Under 5s, 2019. Methods: The Grading of Recommendations Assessment, Development and Evaluation (GRADE)-Adaptation, Adoption, De Novo Development (ADOLOPMENT) approach was used, based on the guidelines from Canada and Australia, with evidence updated to February 2018. Recommendations were based on the associations between (1) time spent in sleep, sedentary time, physical activity, and 10 health outcomes and (2) time spent in physical activity and sedentary behavior on sleep outcomes (duration and latency). Results: For many outcomes, more time spent in physical activity and sleep (up to a point) was beneficial, as was less time spent in sedentary behavior. The authors present, for the first time, evidence in GRADE format on behavior type–outcome associations for infants, toddlers, and preschoolers. Stakeholders supported all recommendations, but recommendations on sleep and screen time were not accepted by the Chief Medical Officers; UK guidelines will refer only to physical activity. Conclusions: This is the first European use of GRADE-ADOLOPMENT to develop physical activity guidelines. The process is robust, rapid, and inexpensive, but the UK experience illustrates a number of challenges that should help development of physical activity guidelines in future.

scholarly journals From SARS and MERS to COVID-19: a review of the quality and responsiveness of clinical management guidelines in outbreak settings

2021 ◽  
Author(s):  
Samuel Lipworth ◽  
Ishmeala Rigby ◽  
Vincent Cheng ◽  
Peter Bannister ◽  
Eli Harriss ◽  
...  
Keyword(s):  
Supportive Care ◽  
Clinical Management ◽  
Guideline Development ◽  
Specific Treatment ◽  
Health Agency ◽  
Agree Ii ◽  
Eligibility Criteria ◽  
Management Guidelines ◽  
Over Time

AbstractObjectiveTo assess the responsiveness and quality of clinical management guidelines (CMGs) in SARS, MERS and COVID-19 and determine whether this has improved over time.DesignRapid literature review, quality assessment and focus group consultation.Data Sources– Google and Google Scholar were systematically searched from inception to 6th June 2020.This was supplemented with hand searches of national and international public health agency and infectious disease society websites as well as directly approaching clinical networks in regions where few CMGs had been identified via the primary search.Eligibility CriteriaCMGs for the treatment of COVID-19/SARS/MERS providing recommendations on supportive care and/or specific treatment.MethodsData extraction was performed using a standardised form. The Appraisal of Guidelines for Research and Evaluation (AGREE-II) tool was used to evaluate the quality of the CMGs. Six COVID-19 treatments were selected to assess the responsiveness of a subset of guidelines and their updates to 20th November 2020. We ran two sessions of focus groups with patient advocates to elicit their views on guideline development.ResultsWe included 37 COVID-19, six SARS, and four MERS CMGs. Evidence appraisals in CMGs generally focused on novel drugs rather than basic supportive care; where evidence for the latter was provided it was generally of a low quality. Most CMGs had major methodological flaws (only two MERS-CoV and four COVID-19 CMGs were recommended for use by both reviewers without modification) and there was no evidence of improvement in quality over time. CMGs scored lowest in the following AGREE-II domains: scope and purpose, editorial independence, stakeholder engagement, and rigour of development. Of the COVID-19 CMGs, only eight included specific guidance for the management of elderly patients and only ten for high-risk groups; a further eight did not specify the target patient group at all. Early in the pandemic, multiple guidelines recommended unproven treatments and whilst in general findings of major clinical trials were eventually adopted, this was not universally the case. Eight guidelines recommended that use of unproven agents should be considered on a case-by-case basis. Patient representatives expressed concern about the lack of engagement with them in CMG development and that these documents are not accessible to non-experts.ConclusionThe quality of most CMGs produced in coronaviridae outbreaks is poor and we have found no evidence of improvement over time, highlighting that current development frameworks must be improved. There is an need to strengthen the evidence base surrounding basic supportive care and develop methods to engage patients in CMG development from the beginning in outbreak settings.Systematic review registrationPROSPERO CRD42020167361

scholarly journals Evaluation of clinical practice guideline quality: comparison of two appraisal tools

2020 ◽  
Vol 32 (10) ◽  
pp. 663-670
Author(s):  
Esra Meltem Koc ◽  
Hilal Aksoy ◽  
Duygu Ayhan Baser ◽  
Aylin Baydar Artantas ◽  
Rabia Kahveci ◽  
...  
Keyword(s):  
Clinical Practice ◽  
International Diabetes Federation ◽  
Clinical Excellence ◽  
Agree Ii ◽  
Rapid Appraisal ◽  
Significant Difference ◽  
Scale Scores ◽  
Guideline Quality ◽  
Appraisal Tool

Abstract Objective The tools used for critically appraising the quality of clinical practice guidelines are complex and not suitable for the busy end users. So rapid, effective and simple instruments are more preferred. The aim of this study is to compare two critical appraisal tools: iCAHE as a rapid instrument and AGREE II as a complex instrument on guideline quality assessment. Material and Methods The diabetes mellitus guidelines of the Scottish Intercollegiate Guidelines Network (SIGN), the National Institute for Health and Clinical Excellence (NICE), the International Diabetes Federation (IDF) and the Society of Endocrinology and Metabolism of Turkey (SEMT) were assessed separately by four appraisers using the iCAHE and AGREE II instruments. The mean iCAHE criteria scores and the total and domain AGREE II scores given by the four appraisers are presented for each guideline. Results No statistically significant difference was detected between the iCAHE scale scores of the guidelines evaluated (P = 0.063). The rank of the guidelines according to their average total iCAHE and AGREE II instrument scores was similar. The iCAHE mean scores of the guidelines were as follows: NICE, 92.85%; SIGN, 92.85%; IDF, 66.07% and SEMT, 73.21%. The AGREE II mean scores of the guidelines were as follows: NICE, 87.13%; SIGN, 78.25%; IDF, 53.44% and SEMT, 53.22%. Conclusions In addition to being a quality scale, the iCAHE checklist is easy, practical and short to implement. It also helps the users to understand the quality of the guideline in a shorter time. To increase the use of guidelines, it is important that users with little experience and time use the iCAHE scale as a rapid appraisal tool, but more studies are needed to decide the best appraisal tool.

scholarly journals A systematic review of physical activity and quality of life and well-being

2020 ◽  
Vol 10 (5) ◽  
pp. 1098-1109 ◽  
Author(s):  
David X Marquez ◽  
Susan Aguiñaga ◽  
Priscilla M Vásquez ◽  
David E Conroy ◽  
Kirk I Erickson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Systematic Review ◽  
Well Being ◽  
Evidence Base ◽  
Committee Report ◽  
High Quality Research ◽  
Physical Activity Guidelines ◽  
Meta Analyses

Abstract Maintaining or improving quality of life (QoL) and well-being is a universal goal across the lifespan. Being physically active has been suggested as one way to enhance QoL and well-being. In this systematic review, conducted in part for the 2018 U.S. Health and Human Services Physical Activity Guidelines for Americans Scientific Advisory Committee Report, we examined the relationship between physical activity (PA) and QoL and well-being experienced by the general population across the lifespan and by persons with psychiatric and neurologic conditions. Systematic reviews, meta-analyses, and pooled analyses from 2006 to 2018 were used for the evidence base. Strong evidence (predominantly from randomized controlled trials [RCTs]) demonstrated that, for adults aged 18–65 years and older adults (primarily 65 years and older), PA improves QoL and well-being when compared with minimal or no-treatment controls. Moderate evidence indicated that PA improves QoL and well-being in individuals with schizophrenia and Parkinson’s disease, and limited evidence indicated that PA improves QoL and well-being for youth and for adults with major clinical depression or bipolar disorder. Insufficient evidence existed for individuals with dementia because of a small number of studies with mixed results. Future high-quality research designs should include RCTs involving longer interventions testing different modes and intensities of PA in diverse populations of healthy people and individuals with cognitive (e.g., dementia) and mental health conditions (e.g., schizophrenia) to precisely characterize the effects of different forms of PA on aspects of QoL and well-being.

Sign in / Sign up

Export Citation Format

Share Document