German recommendations for physical activity and physical activity promotion in adults with noncommunicable diseases

Karim Abu-Omar,Mayra Weege,Wolfgang Geidl,Klaus Pfeifer,Sven Messing

doi:10.1186/s12966-020-0919-x

Abstract

BackgroundExisting physical activity guidelines predominantly focus on healthy age-stratified target groups. The objective of this study was to develop evidence-based recommendations for physical activity (PA) and PA promotion for German adults (18–65 years) with noncommunicable diseases (NCDs).MethodsThe PA recommendations were developed based on existing PA recommendations. In phase 1, systematic literature searches were conducted for current PA recommendations for seven chronic conditions (osteoarthrosis of the hip and knee, chronic obstructive pulmonary disease, stable ischemic heart disease, stroke, clinical depression, and chronic non-specific back pain). In phase 2, the PA recommendations were evaluated on the basis of 28 quality criteria, and high-quality recommendations were analysed. In phase 3, PA recommendations for seven chronic conditions were deducted and then synthesised to generate generic German PA recommendations for adults with NCDs. In relation to the recommendations for PA promotion, a systematic literature review was conducted on papers that reviewed the efficacy/effectiveness of interventions for PA promotion in adults with NCDs.ResultsThe German recommendations for physical activity state that adults with NCDs should, over the course of a week, do at least 150 min of moderate-intensity aerobic PA, or 75 min of vigorous-intensity aerobic PA, or a combination of both. Furthermore, muscle-strengthening activities should be performed at least twice a week. The promotion of PA among adults with NCDs should be theory-based, specifically target PA behaviour, and be tailored to the respective target group. In this context, and as an intervention method, exercise referral schemes are one of the more promising methods of promoting PA in adults with NCDs.ConclusionThe development of evidence-based recommendations for PA and PA promotion is an important step in terms of the initiation and implementation of actions for PA-related health promotion in Germany. The German recommendations for PA and PA promotion inform adults affected by NCDs and health professionals on how much PA would be optimal for adults with NCDs. Additionally, the recommendations provide professionals entrusted in PA promotion the best strategies and interventions to raise low PA levels in adults with NCDs. The formulation of specific PA recommendations for adults with NCDs and their combination with recommendations on PA promotion is a unique characteristic of the German recommendations.

Highlights

The high prevalence of physical inactivity is a global problem [1, 2] that contributes to increasing morbidity, higher rates of premature death [3], and increased economic costs [4]
Following on from this, the purpose of this paper is to describe the methodology we used to develop the German national recommendations for physical activity and physical activity promotion in adults with Noncommunicable disease (NCD) and summarise the main results of this development
Physical activity recommendations Existing physical activity recommendations for adults with NCDs The PA recommendations for adults with NCDs were derived from a detailed content analysis of 59 source recommendations and texts: arthrosis [37,38,39,40,41,42,43,44,45,46,47,48,49,50,51]; type 2 diabetes mellitus [52,53,54,55]; chronic obstructive pulmonary disease (COPD) [56,57,58,59,60,61]; clinically stable ischemic heart disease [62,63,64,65]; stroke [66,67,68,69,70,71,72,73,74,75,76,77]; clinical depression [78,79,80,81,82,83,84]; and chronic non-specific back pain [85,86,87,88,89,90,91,92,93,94,95]

Summary

Introduction

The high prevalence of physical inactivity is a global problem [1, 2] that contributes to increasing morbidity, higher rates of premature death [3], and increased economic costs [4]. In this context, the development of strategies to promote physical activity (PA) is an important challenge, both globally and nationally. Existing physical activity guidelines predominantly focus on healthy age-stratified target groups. The objective of this study was to develop evidence-based recommendations for physical activity (PA) and PA promotion for German adults (18–65 years) with noncommunicable diseases (NCDs)

Objectives

Methods

Results

Discussion

Conclusion