Physical therapy, physical activity and health

Physical therapists work with a wide range of people to optimise their physical activity, from elite athletes to older people seeking to remain active as they age.  More than any other profession, they prevent chronic disease by helping people become more active.

This information resource has been prepared to help physical therapists inform others about their role and the health benefits they bring wherever in the world they work.  It complements other resources on the WCPT website and will be updated regularly.


Physical activity facts

  • Each year at least 1.9 million people die as a result of physical inactivity.
  • At least 30 minutes of moderate-intensity physical activity on five days of the week reduces the risk of several common non-communicable diseases (NCDs).
  • More than 35 million people died of NCDs in 2005 - this represented 60% of all deaths worldwide.
  • 80% of deaths from NCDs occur in low- and middle-income countries.
  • Without action to address the causes, deaths from NCDs will increase by 17% between 2005 and 2015.
Source: World Health Organization

Benefits of physical activity

The health benefits of physical activity include primary and secondary prevention of cardiovascular disease, diabetes, specific cancers (in particular breast and colon cancer) and osteoporosis.

Source: www.cmaj.ca/cgi/content/full/174/6/801

 
The association between independent living and musculoskeletal fitness has been illustrated in Warburton DE, Gledhill N, Quinney A.  Musculoskeletal fitness and health.  Can J Appl Physiol 2001;26:217-37.

How much physical activity is enough?

The World Health Organization recommends 60 minutes of moderate to vigorous intensity physical activity every day for children aged 5-18.  Moderate activity includes brisk walking and cycling.  Vigorous activity is exercise that makes people huff and puff - and could include dancing and household chores, as well as sports like running and football.

Source: World Health Organization

 
Visit the WHO website for more information on physical activity and young people.

 
Adults (18-65 years old) should undertake:

  • 30 minutes of moderate-intensity physical activity five days per week;
    or
  • 20 minutes of vigorous-intensity physical activity three days per week;
    or
  • an equivalent combination of moderate/vigorous-intensity physical activity;
    and
  • 8-10 muscular strengthening exercises (8-12 repetitions) at least two days per week.

Older adults (65+) should undertake:

  • the same recommendations as described for adults (outlined above) but considering the intensity and type of physical activity appropriate for older people;
    and
  • exercises to maintain flexibility;
    and
  • balance exercises.
Source: World Health Organization

 
Visit the WHO website for more information on physical activity and older adults.

Global physical activity recommendations are under development by the World Health Organization.

Sources on the WCPT website

Physical therapy and physical activity

Physical therapy exercise prescriptions help people who experience osteoporosis.  The National Osteoporosis Foundation in the United States recommends that people at high risk of having a fracture "work with a physical therapist to develop a safe exercise program".

Source: National Osteoporosis Foundation

 
The American Physical Therapy Association has produced a brochure called What You Need to Know About Osteoporosis.

Sleep

Evidence-based recommendations for optimising sleep include regular exercise and relaxation.  These can be addressed by physical therapists together with other life style risk factors associated with sleeplessness.

Source: Coren S.  Sleep health and its assessment and management in physical therapy practice: the evidence.  Physiotherapy Theory and Practice, 25(5):442-452, 2009.

Physical activity and ageing

Increased levels of physical activity has been shown to reduce risk of Alzheimer's disease.  Together with cognitively stimulating activities, exercise is recommended to reduce some of the symptoms of the disease.

Sources:
  • Penrose FK.  Can exercise affect cognitive functioning in Alzheimer's disease?  A review of the literature.  Activities, Adaptation & Aging 2005:29(4):15-40
  • Christofoletti G, Oliani MM, Gobbi S, Stella F, Bucken Gobbi LT, Renato Canineu P.  A controlled clinical trial on the effects of motor intervention on balance and cognition in institutionalized elderly patients with dementia.  Clin Rehabil. 2008 Jul:22(7):618-26.

 
Exercise prescribed by a physical therapist is also a cost-effective intervention to help reduce emergency re-admissions to hospital.

Source: US National Library of Medicine National Institutes of Health

Physical activity and mental health

Stress can be a primary or secondary contributor to ill health.  Exercise may improve mental health by helping the brain cope better with stress.  There is strong evidence that exercise has an effect on depression.

Source:
  • Daley A, Jolly K, MacArthur C.  The effectiveness of exercise in the management of post-natal depression: systematic review and meta-analysis Family Practice 2009 Apr 26(2):154-162
  • Rethorst CD, Wipfli BM, Landers DM.  The antidepressive effects of exercise: a meta-analysis of randomized trials.  Sports Medicine 2009 Jun 39(6):491-511
  • Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA.  Exercise for depression.  Cochrane Database Syst Rev. 2009 Jul 8:(3):CD004366

 
It is important that clients adhere to exercise programmes prescribed by physical therapists, if they are to benefit.  Motivation and sustainability can be built into programmes.

Source: Rhodes RE. Fiala B.  Building motivation and sustainability into the prescription and recommendations for physical activity and exercise therapy: The evidence.  Physiotherapy Theory and Practice, 25(5):424-441, 2009.

Campaigns

WCPT member organisations

Many WCPT member organisations have embraced the ‘Movement for Health’ initiative in their own national programmes to encourage physical activity and the role of physical therapists.

The UK’s Chartered Society of Physiotherapy’s (CSP) ‘Move for Health’ campaign encourages people to improve their health and wellbeing by increasing their levels of physical activity with regular exercise. A series of information sheets are freely available. Physiotherapist Move for Health advocates have been recruited and the CSP has partnered with other organisations to promote physical therapy in other related campaigns.

The American Physical Therapy Association’s ‘Move Forward: Physical Therapy brings motion to life’ campaign includes resources for health care professionals as well as for the public.

Move4Health is the campaign of the Irish Society of Chartered Physiotherapists (ISCP). Campaigns run for an entire month with Chartered physiotherapists visiting schools or workplaces depending on the target audience of the campaign.

‘Move well, Stay well’ is the Australian Physiotherapy Association’s catchphrase. The APA website includes general tips on exercise for the public.

Global Strategy on Diet, Physical Activity and Health

The aim of the WHO global strategy on diet, physical activity and health is to provide guidance to WHO member states on monitoring and evaluating national diet and physical activity policies.

The WHO report, A Framework to Monitor and Evaluate the Implementation: Global Strategy on Diet, Physical Activity and Health includes the framework, examples of monitoring, surveillance and evaluation activities and key reference materials.

A compendium of interventions that work on diet and physical activity was produced in 2009.

A healthy city is an active city: a physical activity planning guide

The Healthy Cities movement, initiated by WHO in 1986 aims to maximise disease prevention through the creation of health-supportive environments.  The nature of the environment in which people live can determine the amount of physical activity they undertake.  A healthy city is an active city: a physical activity planning guide describes why people need active living opportunities, who is involved and how to create healthy cities.  It was designed for all who may be involved in the process.  Physical therapists involved in movement for health activities may find this guide useful in assessing their environments and to identify potential opportunities to influence developments in their communities.

The WHO Move for Health initiative

The recommendation for an annual "Move for Health" day was made by the 55th World Health Assembly (May 2002) in its Resolution WHA55/23 on Diet, Physical Activity and Health.  This called for the development of global and national strategies on diet, physical activity and health within an integrated approach to NCD prevention and health promotion.

"Move for Health" day is the responsibility of each WHO member state and provides a focal point to generate public awareness of the benefits of physical activity in the prevention of NCDs.  Physical therapists' involvement in these days might increase awareness of the role of physical therapy in improving physical activity.

International professional organisations

International Society for Physical Activity and Health (ISPAH)

ISPAH is an international professional society of individual members who are interested in advancing the science and practice of physical activity and health.

International Society for Aging and Physical Activity (ISAPA)

ISAPA is an international not-for-profit society promoting research, clinical practice, and public policy initiatives in the area of aging and physical activity.

International Society for Behavioral Nutrition and Physical Activity (ISBNPA)

ISBNPA advances and fosters excellence in research on nutrition behaviour and physical activity.