Supporting Physical Activity in Patients and Populations During Life Events and Transitions: A Scientific Statement From the American Heart Association

Abstract

Achieving recommended levels of physical activity is important for optimal cardiovascular health and can help reduce cardiovascular disease risk. Emerging evidence suggests that physical activity fluctuates throughout the life course. Some life events and transitions are associated with reductions in physical activity and, potentially, increases in sedentary behavior. The aim of this scientific statement is to first provide an overview of the evidence suggesting changes in physical activity and sedentary behavior across life events and transitions. A second aim is to provide guidance for health care professionals or public health workers to identify changes and promote physical activity during life events and transitions. We offer a novel synthesis of existing data, including evidence suggesting that some subgroups are more likely to change physical activity behaviors in response to life events and transitions. We also review the evidence that sedentary behavior changes across life events and transitions. Tools for health care professionals to assess physical activity using simple questions or wearable devices are described. We provide strategies for health care professionals to express compassion as they ask about life transitions and initiate conversations about physical activity. Last, resources for life phase–specific, tailored physical activity support are included. Future research needs include a better characterization of physical activity and sedentary behavior across life events and transitions in higher-risk subgroups. Development and testing of interventions designed specifically to combat declines in physical activity or increases in sedentary behavior during life events and transitions is needed to establish or maintain healthy levels of these cardiovascular health–promoting behaviors.

Step Count, Self-reported Physical Activity, and Predicted 5-Year Risk of Atrial Fibrillation: Cross-sectional Analysis

“…Although the use of step counts may result in the overestimation or underestimation of intentional physical activity, step count targets may be more understandable to and practical for the general population than the abstract concepts of moderate and vigorous levels of physical activity. Additionally, evidence is evolving to suggest that ≥7000 daily steps in adults may be equivalent to the current public health recommendation of ≥150 minutes of moderate physical activity per week or ≥75 minutes of vigorous physical activity per week [ 34 ]. Studies that use invasive devices, such as implantable loop recorders or implantable cardioverter-defibrillators, are less applicable to the general population, and such devices are not regularly used [ 19 , 20 ].…”

Impact of critical illness and withholding of early parenteral nutrition in the pediatric intensive care unit on long-term physical performance of children: a 4-year follow-up of the PEPaNIC randomized controlled trial

“…Four years after PICU admission, we documented a worse quantitatively measured physical performance and activity of children who have been critically ill as compared with healthy children. This may have wide health implications in view of the importance of adequate physical activity for healthy growth, body composition, cardiorespiratory and musculoskeletal fitness, cardiovascular and metabolic health, motor development, cognitive development, academic achievement, emotional regulation, pro-social behaviors and overall quality of life, during childhood, but also later in life [ 35 , 36 ], many domains that are known to be affected in former PICU patients. Hence, these data should draw attention to the need of safely stimulating physical activity of these children, considering potential medical limitations and environmental factors [ 37 ].…”

Meanings Attributed to Physical Activity and Changes in Self-Reported and Accelerometer-Measured Physical Activity among Recent Retirees

“…Retirement transition has been recently identified as an important time point for promoting physical activity among older populations [ 3 , 4 ]. However, the current knowledge regarding the facilitators of increased physical activity following retirement transition is limited and mainly reliant on qualitative evidence [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ].…”

“…However, the levels of physical activity tend to decline with age [ 2 ]. Increasing attention has been recently directed towards transitional periods in life as potentially important time windows for promoting physical activity, retirement being the most common transition in late mid-life [ 3 , 4 ].…”