Confusion and Conflict in Assessing the Physical Activity Status of Middle-Aged Men

Abstract

BackgroundPhysical activity (including exercise) is prescribed for health and there are various recommendations that can be used to gauge physical activity status. The objective of the current study was to determine whether twelve commonly-used physical activity recommendations similarly classified middle-aged men as sufficiently active for general health.Methods and FindingsWe examined the commonality in the classification of physical activity status between twelve variations of physical activity recommendations for general health in ninety men aged 45–64 years. Physical activity was assessed using synchronised accelerometry and heart rate.Using different guidelines but the same raw data, the proportion of men defined as active ranged from to 11% to 98% for individual recommendations (median 73%, IQR 30% to 87%). There was very poor absolute agreement between the recommendations, with an intraclass correlation coefficient (A,1) of 0.24 (95% CI, 0.15 to 0.34). Only 8% of men met all 12 recommendations and would therefore be unanimously classified as active and only one man failed to meet every recommendation and would therefore be unanimously classified as not sufficiently active. The wide variability in physical activity classification was explained by ostensibly subtle differences between the 12 recommendations for thresholds related to activity volume (time or energy), distribution (e.g., number of days of the week), moderate intensity cut-point (e.g., 3 vs. 4 metabolic equivalents or METs), and duration (including bout length).ConclusionsPhysical activity status varies enormously depending on the physical activity recommendation that is applied and even ostensibly small differences have a major impact. Approximately nine out of every ten men in the present study could be variably described as either active or not sufficiently active. Either the effective dose or prescription that underlies each physical activity recommendation is different or each recommendation is seeking the same prescriptive outcome but with variable success.

Physical Activity Recommendations in Patients with Chronic Obstructive Pulmonary Disease

“…Contrary, in the step-based and questionnaire-based recommendation, every step or minute counts. Our results are in line with a study in healthy men, which also showed huge differences between various recommendations [34]. …”

Physical inactivity in patients with COPD, a controlled multi-center pilot-study

“…Our data and that of others 11 suggest more important levels of inactivity in these milder stages in comparison with healthy controls which is probably related to the method of measuring. 23 …”

How Active are Patients Undergoing Total Joint Arthroplasty?: A Systematic Review

“…This was the result of the use of different questionnaires, the lack of sufficient information for transforming the reported physical activity in values with similar units (eg, METs), and untraditional ways to report physical activity compared with the specific literature. Therefore, future studies should try to standardize how physical activity results from questionnaires and motion sensors are reported, possibly following more common procedures so comparisons with the literature will be easier (Appendix) [5,48,67]. The only possible comparisons were with the amount of steps determined using pedometers (10,000 steps target) and with the data recently reported in a meta-analysis performed on studies examining physical activity in healthy people.…”