Global Physical Activity Transitions: Emerging Measurement and Therapeutic Opportunity?

Tremblay M.¹, Onywera V.², Obuchi S.P.³, Malkia E.⁴

¹Children's Hospital of Eastern Ontario Research Institute, Healthy Active Living and Obesity Research Group, Ottawa, Canada, ²Kenyatta University, Recreation Management and Exercise Science, Nairobi, Kenya, ³Tokyo Metropolitan Institute of Gerontology, Department for Prevention of Dependence on Long-term Care, Tokyo, Japan, ⁴University of Jyväskylä, Health Sciences, Jyväskylä, Finland

Learning objectives:

1. To describe the physical activity transitions occuring in high, medium and low income countries including the putative individual, societal and environmental factors contributing to the transition to sedentary living and the implications for injury and rehabilitation. 2. To discuss the importance of physical activity behaviours to therapeutic treatment and success. Concepts such as behavior compensation, sedentarism and non-exercise activity thermogenesis will be explored in the context of acute and chronic treatment and prevention strategies. 3. To describe methods for measuring and monitoring physical activity for individual patients, groups and populations including assessing sedentary, light, moderate, and vigorous physical activity at home, work, play and in transit. 

Description:

High income countries around the world have experienced dramatic increases in obesity and sedentary behaviors in both sexes, all income and ethnic groups, and at all ages. Low and middle income countries are showing similar transitions in lifestyle behaviors. Patients who have high levels of habitual physical activity, although at slightly elevated risk of acute injury, have lower risk of non-communicable disease, better prognosis after injury, and accelerated recovery times. The global physical activity transition forecasts an acceleration in lifestyle precipitated musculoskeletal and cardio-respiratory disorders manifested by excess sedentarism (sitting), poor posture, obesity and low fitness. This session proposes four speakers with integrated topics that begin with the global trend towards sedentarism, links with physical therapy scope of practice and emerging therapeutic opportunities, and provides practical guidance on how and why to carefully measure and monitor physical activity to optimize patient treatment and prevention strategies.

Prof. Mark Tremblay from the University of Ottawa in Canada will be the symposium convenor and will introduce the symposium and provide an overview of the global physical activity transition and its implications to population health and wellness, with a focus on middle and low income countries.

Prof. Mark Tremblay will describe the emerging problems of childhood obesity and inactivity in Kenya, problems that threaten the country's global dominance in endurance athletics while decreasing the productivity of the workforce and further straining a health care system already overwhelmed by communicable disease challenges. Prof tremblay will discuss the insidious diminution of non-exercise activity thermogenesis and incidental movements in a culture seduced by sedentary pursuits.

Dr. Obuchi from Tokyo Metropolitan Institute of Gerontology in Japan will discuss the importance of physical activity measurement and promotion to prevent frailty progression in the elderly population. Particular attention will be given to the importance of preventing geriatric syndrome that will be the main cause of dependency in the elderly among high income countries.

Prof. Esko Malkia from the University of Jyvaskyla in Finland will provide practical suggestions for physical activity measurement in therapeutic settings and will present a novel assessment system, anchored in the WHO International Classification of Function framework, for the measurement and monitoring of physical activity in physical therapy practice.

Active discussion with the audience will be encouraged within the session and afterwards. Prof. Tremblay will summarize the session and provide concluding remarks.  

Implications / Conclusions:

The scope of practice of physical therapists will increasingly involve healthy active living counseling and monitoring as populations around the world transition to more sedentary lifestyles (particularly sitting). Increasing daily physical activity, in addition to treatment specific activity will be necessary for successful recovery, the maintenance of health body weights and basic fitness, and the prevention of future clinical events. Physical therapists need to be prepared and equipped for this emerging challenge.

Keywords:

Physical activity; Measurement; Transitions

Funding acknowledgements:

None at this point - applications in progress.

Relevance to WCPT and expected audience:

A global increase in sedentarism and the commensurate increase in obesity and decline in musculoskeletal and cardiorespiratory fitness is impacting physical therapy practice at an accelerating rate, in low, middle and high income countries. Understanding the the precipitating factors of this trend, from an ecological model, and translating that into practice is essential for many practicing and academic physical therapists. Important concepts and tools for immediate translation into therapeutic settings will be provided.

Target audience:

This symposium, beginning broad and global and funneling in to very pragmatic practice advice will be attractive to WCPT delegates interested in any programme track.

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