Work

Physical Activity as a Vital Sign: A Systematic Review

Year: 2017

Type: review

Abstract: IntroductionPhysical activity (PA) is strongly endorsed for managing chronic conditions, and a vital sign tool (indicator of general physical condition) could alert providers of inadequate PA to prompt counseling or referral.This systematic review examined the use, definitions, psychometric properties, and outcomes of brief PA instruments as vital sign measures, with attention primarily to studies focused on arthritis. MethodsElectronic databases were searched for English-language literature from 1985 through 2016 using the terms PA, exercise, vital sign, exercise referral scheme, and exercise counseling.Of the 838 articles identified for title and abstract review, 9 articles qualified for full text review and data extraction. ResultsFive brief PA measures were identified: Exercise Vital Sign (EVS), Physical Activity Vital Sign (PAVS), Speedy Nutrition and Physical Activity Assessment (SNAP), General Practice Physical Activity Questionnaire (GPPAQ), and Stanford Brief Activity Survey (SBAS).Studies focusing on arthritis were not found.Over 1.5 years of using EVS in a large hospital system, improvements occurred in relative weight loss among overweight patients and reduction in glycosylated hemoglobin among diabetic patients.On PAVS, moderate physical activity of 5 or more days per week versus fewer than 5 days per week was associated with a lower body mass index (-2.90kg/m 2 ).Compared with accelerometerdefined physical activity, EVS was weakly correlated (r = 0.27), had low sensitivity (27%-59%), and high specificity (74%-89%); SNAP showed weak agreement (κ = 0.12); GPPAQ had moderate sensitivity (46%) and specificity (50%), and SBAS was weakly correlated (r = 0.10-0.28),had poor to moderate sensitivity (18%-67%), and had moderate specificity (58%-79%). ConclusionFew studies have examined a brief physical activity tool as a vital sign measure.Initial investigations suggest the promise of these simple and quick assessment tools, and research is needed to test the effects of their use on chronic disease outcomes.Recent efforts (eg, American College of Sports Medicine's Exercise is Medicine, Surgeon General's Step It Up!) encourage the medical community to promote PA for disease prevention and management (11).These programs urge primary care physicians and other health care professionals to assess PA during patient encounters and prescribe exercise in treatment plans.To fulfill this initiative, the first line of action from the health care community is The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions.www.cdc.gov/pcd/issues/2017/17_0030.htm• Centers for Disease Control and Prevention 1

Source: Preventing Chronic Disease

DOI: 10.5888/pcd14.170030