Contemporary national and international guidelines on physical activity and sedentary behaviour for people living with chronic conditions, disability and advanced age: a scoping review.

Stephen Gilbert, Rochelle Davis, Monique Francois, Paddy C Dempsey, Mark P Ranasinghe, Catherine Sherrington, Harrison Andersen, Ruby K Dempsey, Noah Wexler, Anthony David Okely

Journal: British journal of sports medicine 2025;59(6):385-408

PMID: 39332845

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Abstract

OBJECTIVES

Physical activity guidelines inform policy and practice in promoting healthier lifestyles. The WHO advocates for distinct recommendations for each country to address variation in needs, resources and context. Specific regional recommendations for three underactive populations facing unique barriers to movement are lacking-people with chronic conditions, disability and advanced age. We review which countries/regions provide specific physical activity guidelines for these populations to identify deficiencies in meeting WHO recommendations and inform future directions for guideline development.

DESIGN

Scoping review.

DATA SOURCES

OVID Medline, PubMed, Scopus, Embase, Web of Science, Google Scholar, ProQuest, CINAHL, Google searches, targeted websites.

ELIGIBILITY CRITERIA

Data sources were searched from database inception to September 2023 to identify community-facing physical activity guidelines at the national/international level for these populations. We recorded, summarised and analysed physical activity guideline recommendations extracted from published guideline documents, organised by population and country/region.

RESULTS

66 articles were identified, addressing 28 distinct countries/regions, including four international guidelines, published from 2009 to 2023. The WHO guidelines were adopted by 19 countries and the European Union. Across all regions, a lack of specific advice was identified for individuals with chronic conditions (46%), disability (46%) and advanced age (11%). Advice for chronic conditions and disability commonly replicated general adult population advice.

CONCLUSION

Many countries/regions do not produce physical activity guidelines specific to populations with chronic conditions and disability. As such, a large proportion of countries/regions failed to meet WHO recommendations, highlighting a lack of customised advice to address unique barriers faced by vulnerable populations.

Address: Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia [email protected].; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.; School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.; Department of Cardiology, Western Health, Footscray, Victoria, Australia.; School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.; Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.; Sydney Local Health District, Camperdown, New South Wales, Australia.; The University of Sydney, Sydney, New South Wales, Australia.; School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia.; Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia.; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.; Diabetes Research Centre, University of Leicester, Leicester, UK.; MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.

DOI: 10.1136/bjsports-2024-108247

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MeSH Terms: Humans, Chronic Disease, Persons with Disabilities, Exercise, Sedentary Behavior, Aged, Practice Guidelines as Topic, Guidelines as Topic