German Recommendations for Physical Activity and Physical Activity Promotion in Adults with Noncommunicable Diseases

Abstract

Background: 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). Methods: The PA recommendations were developed based on existing PA recommendations and using a three-phased process. 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. High-quality recommendations were identified, and a content analysis was conducted on these recommendations. In phase 3, the findings of the content analysis were summarised, and PA recommendations for seven chronic conditions were deducted. The seven recommendations were then synthesised to generate generic German PA recommendations for adults with noncommunicable diseases (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. Results: The German Recommendations for Physical Activity state that adults with NCDs should, over the course of a week, should do at least 150 minutes of moderate-intensity aerobic PA, or 75 minutes 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. Conclusion: The 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.

Dose–response relationship between physical activity and mortality in adults with noncommunicable diseases: a systematic review and meta-analysis of prospective observational studies

“…Our findings reinforce low-dose physical activity recommendations that clearly demonstrate there is no minimum dose of physical activity and that effects on longevity occur at a volume of physical activity significantly below the recommended minimum dose of 150 min per week [65]. The "+10 minutes of physical activity per day" from Japan [66] or the "Every Step Counts" message from Germany [67] might be more feasible and efficient physical activity recommendations. Third, for physicians, our results illustrate the medical potential of exercise as medicine and encourage initiatives to anchor assess to and promotion of physical activity in routine medical care [68].…”

A Cross-sectional Study of Nutritional Status and Cardiovascular Health Status among Housewives in Tegal Regency, Central Java

“…Physical activity (exercise) recommendation for adults with non-communicable disease are: 1) Aerobic with moderate intensity must be done no less than 150 minutes each week, and 75 minutes with vigorous intensity or a combination of both. 2) Muscle-strengthening activities must be done at least twice a week, (Geidl, Abu-Omar, Weege, Messing, & Pfeifer, 2020).…”

“…Type 2 diabetes mellitus is confirmed has strong association with physical in-activity, and it is regardless of sex, age, ethnics, or BMI. Further, two of ten people in this modern lifestyle are physically in-active, (González, Fuentes, & Márquez, 2017). Since BMI has different cut-off values among ethnics especially for Asian population, waist circumference measurement is needed to confirm action levels based on BMI.…”

Physical Activity Among Rural Residents in Eastern, Central and Western Provinces of China: A Cross-Sectional Survey

“…The main types of NCDs include cardiovascular diseases, cancers, musculoskeletal diseases, chronic respiratory diseases, mental illness and diabetes. The ever-growing prevalence of NCDs has become a global health concern [22]. According to the World Health Organization (WHO) report in 2019, the top 10 causes of death accounted for 55% of the 55.4 million deaths worldwide and 7 of the 10 leading causes of deaths were NCDs [23].…”