Should Physical Activity be Tracked Just like Baseline Vital Signs?
According to new guidelines from the American Heart Association (AHA), physical activity should be considered a vital health measurement and tracked on a regular basis just like other modifiable cardiovascular risk factors such as blood pressure, resting heart rate, and smoking. "The deleterious effects of physical inactivity are associated with many of the most common chronic diseases and conditions, including heart disease, type 2 diabetes mellitus, hypertension, obesity, osteoporosis, depression, and breast and colorectal cancers," Scott J. Strath, PhD, chair of the AHA's Physical Activity Committee and colleagues wrote in a scientific statement published in Circulation. "Risk identification, benchmarks, efficacy and evaluation of physical activity behavior change initiatives for clinicians and researchers all require a clear understanding of how to assess physical activity."
The organization reviewed options for assessing daily physical activity and presented a decision-making tool for clinicians and researchers to use to help them select the best method for assessment during any given scenario. The researchers explained that physical activity encompasses multiple dimensions as well as domains – which should all be accounted for when tracking and assessing total.
Current methods for assessing physical activity are either subjective, via self-reports based on questionnaires or physical activity diaries; or objective, via measures of energy expenditure, physiological measures or motion sensors. The decision-making tool previously mentioned takes all of these factors into account and employs a systematic approach that focuses on individualized primary outcomes. It also provides information for comparing the characteristics, features, strengths and limitations of assessment options. Before using the decision-making matrix developed by the AHA, clinicians must first identify specific outcome measures for each patient or patient population.
The decision-making process then consists of the following components:
- Understanding the dimensions of physical activity that need to be measured to attain a given outcome
- Determining how data will be used/quantified to answer the question at hand, as the level of accuracy required will vary in different settings (e.g., clinical, research, or public health)
- Differentiating between available methods based on resource availability, processing requirements and the need to provide immediate feedback to patients/participants
"In summary, physical activity assessment should be considered a vital health measure that is tracked regularly over time," Strath and colleagues wrote. "The present scientific statement provides a guide to allow professionals to make a goal-specific selection of a meaningful physical activity assessment method." (Circulation, 2013)