influence . Prevalence rates are dependent on the in- strument used to measure it . The process of selecting a suitable questionnaire is based on two fundamental criteria; validity and reliability of the instrument . The use of one valid and reliable tool across many countries would provide consistency and comparability of findings . Such an instrument would need to be simple and adept at assessing compliance with physical activity guidelines (PAGL) for health at a population level . In youth aged 5 – 18 years, the PAGL stand at a minimum of 60 minutes of moderate-to-vigorous physical activity (MVPA) on every day of the week . Although PAGL were developed using predominantly self-report data , due to the limitations of self-report measures in youth,
Mutrie, N and Standage, M and Pringle, AR and Smith, L and Strain, T and Kelly, P and Dall, P and Milton, K and Chalkley, A and Colledge, N (2018) UK physical activity guidelines: Developing options for future communication and surveillance. In: UK Chief Medical Officers Physical Activity Guidelines Review: Scientific Consensus Meeting 2018, 20 June 2018 - 20 August 2018, Edinburgh. (Unpublished)
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26.7%, with 30.5% of respondents reporting no weekly PA. This is lower than the adherence rates reported by patients with rheumatic conditions in the UK and the USA (55% and 38%, respectively) [6, 13]. This is also lower than rates of adherence reported in the general Irish population (55%) . Physical inactivity has been identified as the fourth leading risk factor for global mor- tality , and the relative inactivity of this cohort is a con- cern. Having accurate knowledge of the guidelines was positively associated with adherence to PA mod guidelines.
Based on the PAPM, it can be expected that people may only proceed to contemplation when they become aware that they engage in too little PA and/or that their PA is not of a suf ﬁ cient intensity. With the emergence of alter- native strategies to improve health, such as by breaking up sedentary time or increasing light activity, the differ- ence between actual and desired behaviour becomes less obvious. The bene ﬁ ts of engaging in more light activity and of reducing or breaking up sedentary time are evident. 33–35 Guidelines regarding sedentary behaviour have already been developed in Canada and Australia and the current UK PA guidelines recommend develop- ing sedentary behaviour guidelines as a priority. 8 36 37 The various discourses surrounding PA and health may cloud directives to the lay population (ie, ‘ Is desirable behaviour to be less sedentary, or to be more active, or to do more MVPA? ’ ). While research across the intensity continuum of PA is rapidly increasing, transmitting such knowledge to the general population may require more complex messages but an understanding of how to effectively develop such messages lags behind.
In addition to the continuing lack of education pertain- ing to the guidelines, the present research highlights two areas of concern. First, disparities in health knowledge continue to be evident. In both the 2007 and 2013 samples, those with lower education, lower employment status and older adults were less likely to know PA guide- lines. The Chief Medical Of ﬁ cers voiced concerns regard- ing the disproportionately low involvement in PA of disadvantaged groups in the society. 8 An improved provi- sion of information and opportunities for these groups to engage in PA was a target of the government-backed cam- paigns ‘ Change4Life ’ and ‘ HealthyPeople ’ . 28 29 Despite these pledges, PA campaigns appear to have been less suc- cessful in reaching these groups. The strategies to educate and reach disadvantaged groups within society, especially those with a low education or SES, are urgently required. Second, adults generally consider only the duration com- ponent of PA recommendations. While the 2007 HSE sample were asked speci ﬁ cally for the recommended dur- ation of PA, the 2013 survey sample was asked an open question which allowed them to include any aspects of the guidelines of which they were aware of. Despite this, only 11% of adults included an appropriate descriptor of inten- sity. Even when adults were prompted to provide a descrip- tor of intensity, only 13% did so. Only 2% provided a physiological parameter which could be practically used to monitor intensity.
Every healthcare contact is an opportunity to positively influence a patient's health and this is often done pragmatically, through Brief Interventions. Brief Interventions for physical activity can be delivered in routine health care consultations, they have the potential to reach a large proportion of the adult population and have been shown to be cost effective. 10,11 Clinical guidance recommends the use of Brief Interventions in routine clinical contacts and this forms part of a wider Making Every Contact Count approach which is now embedded within National Health Service (NHS) delivery in the UK. 12,13
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We therefore aimed to estimate the prevalence of ad- herence to UK guidelines (which recommend carrying out 150 minutes of MVPA per week in bouts of at least 10 minutes), among community-dwelling older men and women. Secondly, we studied how altering the intensity of activity used to define MVPA (using 1040 and 1952 counts per minute [cpm]) and reducing bout-length (from 10 minutes to 5 minutes) impacted on attainment of 150 minutes of MVPA per week. We studied shorter bouts because the evidence for the total amount of PA re- quired to reduce risk of death and disease is better than evidence for the need to do exercise in spells of particular duration . We investigated different MVPA thresholds because there is limited data on this issue, particularly in the oldest old . The third aim was to identify correlates of adherence to the guidelines. From a policy perspective, it is important to estimate the prevalence of adherence to the MVPA guidelines and what modifiable factors predict adherence. We reviewed previously published evidence about correlates of participation in PA (i.e., not just adher- ence to guidelines) in older adults to select a range of corre- lates from physical and mental health, exercise self-efficacy, trips outside the home, dog walking, and neighbourhood characteristics [14-17]. This study extends previous work as it is the largest UK-based study using accelerometers in 70–93 year olds to examine prevalence of adherence to guidelines alongside a wide range of correlates.
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We identified positive findings in that most respondents integrate discussions about PA into most of their patient contacts. Further investigation is needed relating to the lack of formal assessment of PA status, relatively poor knowledge of the PA guidelines and a lack of consistent signposting to further PA support. Physiotherapists are ideally placed to contribute to the global efforts to reduce PI. However,support is required to ensure that effective and feasible PA interventions are integrated into routine care in order to maximise potential impact. To improve the reach of our study we have created a summary infographic (figure 3).
The generalisability of this study, to other schools and areas in England, is likely to have been affected by the low response rate of 33% (1869/5716). This study invol- ved only four schools in two regions, and is not a rand- om sample of pupils or schools, so therefore the results must be interpreted cautiously and cannot be wholly re- presentative of other schools in the NW and SW or ind- eed England. The low response rate may have poten- tially caused a bias in the estimated differences in outco- mes between the various groups. Unfortunately as this was an anonymous survey no information was collected on the characteristics of the non-respondents to the ques- tionnaire, therefore a comparison of respondents to non- respondents cannot be made. Also since this was an an- onymous survey we have no information on how many children completed the survey twice both in the winter and summer. So we cannot rule out that some bias may have been introduced into the sample. However, 23.5% of our survey participants were classified as obese which is similar to previous estimates for English school chil- dren aged 11-15 of 21%; although only 25% of our sam- ple met the physical activity guidelines compared to around 52% reported nationally . Our sample ap- peared to have similar levels for receipt of free school meals (18% vs. 16.5%) compared to school roll informa- tion.
People with knee and hip OA may have a fear of worsening disease progression when participating in physical activity. However, many studies have demonstrated that various types of physical activity such as aerobic fitness or resistance and endurance training are effective in the management and treatment of people with knee and hip OA (Hernández-Molina, Reichenbach et al. 2008; Fransen and McConnell 2009; Keysor and Heislein 2010; Pisters, Veenhof et al. 2010; Esser and Bailey 2011; Semanik, Chang et al. 2012). Participation in physical activity of moderate intensity exercise three to five times per week has been shown to decrease pain and disability and improve function and improve quality of life in people with knee and hip OA (Ettinger Jr, Burns et al. 1997; Lundebjerg 2001; Penninx, Messier et al. 2001; Fransen, McConnell et al. 2003; Talbot, Gaines et al. 2003; Roddy, Zhang et al. 2005; Fontaine and Haaz 2007; Li, Zhang et al. 2008; Ng, Heesch et al. 2010). Furthermore, participation in physical activity has also been found to increase or maintain muscle mass, power, and strength in men and women of all ages (Karlsson 2004; Kirk, Washburn et al. 2007; Ferreira, Sherrington et al. 2012), as well as increasing bone density and reducing hip fractures in the general population (Karlsson 2002; Karlsson, Nordqvist et al. 2008; Babatunde, Forsyth et al. 2012) which resulted in better quality of life outcomes and higher levels of performance in quantified daily living activities. Epidemiological studies have shown a reduction of risk hip fracture ranging from 3.6 to 6.4 % (Babatunde, Forsyth et al. 2012), osteoarthritis from 22-80 % (Physical Activity Guidelines Advisory Committee 2009), and falls in older people from 30-50% (Paterson and Warburton 2010) among active people compared with low activity populations.
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It is speciﬁcally this issue, coupled with the multiple interpretations of the NASPE guidelines, that makes it difﬁ- cult to determine the extent to which preschoolers are meeting national recommendations for accumulation of daily health-promoting physical activ- ity. If physical activity guidelines are established and compliance is moni- tored, their interpretation and mea- sure require uniformity. Furthermore, there a no US-based estimates on the proportion of preschoolers meeting physical activity guidelines. The pur- pose of this study, therefore, was to describe the prevalence of preschool- ers that meet the NASPE physical activ- ity guidelines using multiple interpre- tations of the guidelines and how the prevalence estimates vary across dif- ferent sets of widely used accelerome- ter cut points for classifying pre- schooler’s time spent in physical activity of different intensities (ie, light-to-vigorous physical activity).
than low-active patients). However, given that only 2 participants in our sample met the 60 min MVPA guide- line, this is unlikely. Future studies should evaluate phys- ical activity levels in larger, more representative samples of children with bronchiectasis. Samples should be sufficiently large and diverse to determine how physical activity levels vary by demographic, socioeconomic status and health characteristics. The assessment of physical activity in indigenous children with bronchiec- tasis is also a priority for future research. Second, no healthy child control group was included. However, nor- mative data from two population-representative health surveys was used to compare physical activity levels and daily step counts to healthy children. This showed that the children from the current sample were substantially less active than healthy children and that fewer children with bronchiectasis meet physical activity guidelines. Im- portantly, because estimates from one survey were based on self-reported physical activity and prone to recall and Table 3 Means and 95% confidence intervals for physical activity and sedentary behaviors on weekday vs weekend days
Background: Mass-media campaigns such as Change4Life use messaging to promote physical activity guidelines. Raising knowledge of MVPA guidelines within UK adults is a main goal of current mass media campaigns aimed at increasing engagement in MVPA. As this may help to inform accurate perceptions of adults ’ own MVPA level it is an important area of investigation. Subjective norms, health status and normal walking intensity may also influence adult ’ s awareness of their own MVPA behaviour. The aim of this study was to examine the hypothesis that greater knowledge of MVPA guidelines, supportive subjective norms, lower self-reported health status and intensity of typical walking pace are associated with accurate awareness of MVPA engagement within a sample of UK adults. Methods: A cross-sectional study of UK adults was conducted. UK adults who subscribed to the National Academic Mailing List Service (JISCMail) were sent an invitation to complete an online survey. 1,724 UK adults completed the online survey which included items on minutes spent in MVPA, awareness of MVPA using constructs highlighted by the precaution adoption process model, subjective norms, knowledge of guidelines, health status and demographics. Results: The sample was 70% female, 57% aged under 45, 93% White and 69% in full-time employment. 62% reported their health to be above average, while 62% demonstrated accurate awareness of their own physical activity level, only 18% correctly reported the MVPA guidelines and 51% reported high subjective norms towards MVPA. Logistic regression analyses identified high subjective norms (OR = 1.84, CI: 1.29, 2.63, p = .001), average or below average health status (OR = .71, CI: .53 .97, p = .001), and a self-reported regular walking pace of moderate-to-vigorous (OR = 1.31, CI: 1.05, 1.63, p = .02) to be associated with accurate MVPA awareness. Knowledge of MVPA guidelines was not associated with MVPA awareness.
Active video games (AVGs) can be described as computer games which are designed to be controlled by a players' movement rather than by pressing buttons. Five reviews have been published on the energy cost of video game play among healthy children [16 – 20]. All reviews concluded that playing AVGs require more energy than playing sedentary games and that playing interactive consoles has the potential to lead to health benefits and the accrual of physical activity in children and youth. Furthermore, reviews stated that certain AVGs are capable of engaging children in moderate intensity physical activity. Therefore playing AVGs could present an effective, novel, and child friendly form of physical activity for children with CF. Many hospitals have a Wii console specifically for children with CF. However, the exercise intensity associated with playing these games has not been examined in this population. Kuys et al.  measured the heart rate, estimated energy cost, and rate of perceived exertion of adults with CF playing active video games on the Wii console. Gaming was found to result in moderate to vigorous intensity physical activity, and was comparable to exercise on both treadmill and cycle ergometers . Participants in the study by Kuys et al. also rated the feasibility for including an AVG into exercise regimens as 8 out of 10, indicating that AVG play as a form of exercise appeals to adults with CF . The energy cost of AVG play among children with CF is unknown. As the response to exercise in children may not mirror that in adults , there was a need to measure the exercise response of children with CF to AVG play. The aim of this study was to measure the energy cost and exercise intensity of AVG play among children with CF and healthy age and gender matched controls. Exercise intensity is an important consideration since only moderate and vigorous intensity exercise contributes to daily physical activity guidelines. Secondary aims were to compare results with recommended guidelines for moderate intensity activity, and to investigate the relationship between percentage predicted forced expiratory volume in one second (FEV 1 % predicted) and the energy expended and exercise
Recent studies have found that between 4% - 10% of children aged under five years are not meeting physical activity guidelines that suggest engaging in 180 minutes of physical activity a day (Goldfield et al., 2012; Hnatiuk et al., 2012). There is an assumption that toddlers and young children are naturally active, however, the vast majority of physical activity that young children engage in is low intensity and, therefore, children may not be meeting physical activity re- quirements (Hnatiuk et al., 2012; Gubbels et al., 2012). Consequently, it may be important for physical activity guidelines, for both parents and practitioners, to specify the required intensity and duration of physical activity to ensure the benefits of improved bone properties, aerobic fitness and motor and cognitive skills are gained. In New Zealand, where there are currently no specific physical activity guidelines for preschool children, it is particularly important to develop appropriate and specific guidelines to support preschool children’s physical ac- tivity. Furthermore, the links between fundamental movement skills and physi- cal activity are less well understood and so a review in this area is warranted. Although there is limited research in regards to New Zealand preschool child- ren’s physical activity and most studies are small scale and qualitative (Ste- phenson, 1999; Lockie & Wright, 2002; Oliver & McLachlan, 2006), research and statistics related to childhood obesity, and the rising obesity rates in New Zeal- and, indicate that sedentary behavior is a mitigating factor. There is recent evi- dence from the “Growing up in New Zealand” study that two year olds are spending at least 1.5 hours per day in sedentary screen watching (Morton et al., 2014). Furthermore, children living in socioeconomically deprived areas are more likely to engage in sedentary behaviors, such as watching two or more hours of television each day, and are more likely to be obese (NZ Ministry of Health, 2014).
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elements of current guidelines, including volume, intensity, duration and frequency of physical activity, into pedometer-based messages has therefore become an area of increased research. Such research continues to strengthen so as to ensure congruency between pedometer-based recommendations and physical activity guidelines. Recent advancements in pedometry create the opportunity for its use in providing more detailed information on physical activity patterns, rather than simply recording a tally of steps/day, even though it is limited to ambulatory physical activity. For example, the ability to provide information on intensity-based steps  may provide a more
The 2017 Youth Risk Behavior Survey (YRBS) revealed that only 26.1% of American adolescents reported levels of activity consistent with current guidelines, and 15.4% of students reported not being physically active for at least 1 hour on a single day in the previous week. 1 With the exception of increased sports participation among high school female students, overall youth physical activity levels have decreased. 2 The lowest rates of physical activity occur among adolescent girls, children and youth with special health care needs (CYSHCN), and youth of minority status; rates of inactivity increased with age. 1,3 Although only approximately one-fourth of children report meeting physical activity guidelines, objective measurement of activity by accelerometer reveals that less than half of children and 8% of adolescents were meeting the 2008 Physical Activity Guidelines from the US Department of Health and Human Services of 60 minutes daily of moderate-to-vigorous physical activity (MVPA) as
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Our own assessment of RA guidelines has its own limitations. Firstly, some of the guidelines were devel- oped over 10 years or longer and the older ones cannot have included the more recent clinical evidence. There- fore comparisons need to take this into account. Sec- ondly, there are different types of guidelines. We have included general ones. Many others focus on single drugs or treatment modalities including surgery. It is dif- ficult to draw a clear line between which ones to include and which to omit. Not all experts would necessarily agree with our approach to inclusion. Thirdly, we have only provided a narrative assessment of them. They are too diverse in their approaches to allow any synthesis of their various conclusions and recommendations. Fourthly we have focussed on issues in the guidelines we consider to be of most importance. Other experts may have considered different aspects of the guidelines in more detail and overlooked some of the matters we have dealt with. Finally, systematic reviews of guidelines are not one of the current PRISMA extensions  though we anticipate they will be included in subsequent updates. Consequently we did not register our protocol; however, several other recent systematic reviews have
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Research has indicated that the child care center is a very strong predictor of preschool-aged children’s physical activity levels, making this an important setting to help young children obtain physical activity that is appropriate for their health and development. However, some evidence suggests that organized child care may not adequately sup- port children’s physical activity needs. Although many organizations provide recommendations, guidelines, or standards for motor skill development and physical activity opportunities, no set of guidelines exist that directly target the overall physical activity environment at child care. Because of the lack of comprehensive recommendations, the Nutrition and Physical Activity Self-assessment for Child Care best- practice guidelines for healthy weight development were created on the basis of an extensive review of existing guidelines, research evi- dence, and expert review. The purpose of this article is to present these physical activity best-practice guidelines and provide data on how these guidelines compare to current practice in a large sample (N ⫽ 96) of child care centers in North Carolina. These best-practice guide- lines include recommendations for 8 unique components of the child care environment, including active opportunities, ﬁxed play environ- ment, portable play environment, sedentary opportunities, sedentary environment, staff behavior, staff training/education, and physical ac- tivity policies. Our results showed that only a few of the best-practice guidelines were achieved by a majority of the 96 North Carolina child care centers that participated in this study. Establishing comprehen- sive guidelines for physical activity at child care could result in higher activity levels and healthier children, but more research is needed. Pediatrics 2009;124:1650–1659
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Methods/Design: The Treatment Perspective involves a 16 week supervised training intervention including motivational counselling. The Preventive Perspective only involves motivational counselling. The study is an evaluation of best practice and is accomplished by the use of a combination of quantitative (collected by questionnaires) and qualitative (collected by the use of semi structured interviews) measures. Comparison of The Treatment Perspective and The Preventive Perspective are performed at baseline and after 16 months. Development within the groups is measured at 4, 10, and 16 months. Self-reported measures describe physical activity, health-related quality of life, compliance with national guidelines for physical activity, physical fitness, self-efficacy, readiness to change, decisional balance, and processes of change. To elaborate self-efficacy, readiness to change, decisional balance, and processes of change, these issues were elucidated by interviews.