Physical Activity Recommendations for Adults with a Chronic Disease: Methods, Database and Rationale

Abstract

This paper describes the development of generic physical activity recommendations for adults (18-65 years) with a chronic disease. The physical activity recommendations were developed based on existing recommendations using a 3-phased process. Phase 1: Systematic literature searches for current physical activity recommendations for 7 chronic diseases. Phase 2: Evaluation of physical activity recommendations on the basis of 28 quality criteria; identification and content analysis of high-quality recommendations. Phase 3: Summary of content analysis and deduction of physical activity recommendations for 7 chronic diseases. Synthesis of the 7 recommendations to generate generic German physical activity recommendations for adults with chronic diseases. The quality rating identified 37 high-class physical activity recommendations (n = number); 18 reviews of physical activity recommendations and meta-analysis regarding health effects of physical activity were additionally included (number in brackets): osteoarthrosis of the hip and the knee n=9 (+6), chronic obstructive pulmonary disease (COPD) n=4 (+1), stable ischemic heart disease n=2 (+2), stroke n=8 (+5), major clinical depression n=6 (+0), chronic unspecific low back pain n=5 (+4). Synthesis of content analysis (available recommendations, health effects, dosage and dose-response-effects, risk assessment) led to the development of generic physical activity recommendations for adults with a chronic disease. Physical activity enhances the health of adults with chronic diseases. The benefits of regular physical activity include improved physical functioning, maintenance of independence, enhanced psychosocial well-being and quality of life, improved symptoms and reduced comorbidities. But, people with chronic diseases who have enhanced physical activity levels may also be at increased risk. Nevertheless, adapted, individualized physical activity is safe and with little risk. The generic physical activity recommendations for adults with chronic conditions provide an evidence-based and quality-controlled basis for physical activity promotion of the target group.