Guide to the Assessment of Physical Activity: Clinical and Research Applications A Scientific Statement From the American Heart Association
Guide to the Assessment of Physical Activity: Clinical and Research Applications A Scientific Statement From the American Heart Association
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DOI：
10.1161/01.cir.0000435708.67487.da
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发表时间：
2013-11-12
期刊：
影响因子：
37.8
通讯作者：
Swartz, Ann M.
中科院分区：
文献类型：
--
作者：
Strath, Scott J.;Kaminsky, Leonard A.;Swartz, Ann M.
2260循环2013年11月12日每周进行中等强度或每周150分钟的剧烈运动，或两者相当的组合；(4)中强度至高强度的肌肉强化活动应每周≥两天进行。尽管积极运动的生活方式对个人有益，降低慢性病风险和过早死亡对公共健康也有更广泛的影响，但仍有太多美国成年人缺乏运动。对成人体力活动水平和患病率的估计各不相同。例如，2005年全国健康访谈调查的数据显示，31%的美国成年人进行了有规律的体力活动(定义为每周5天≥30分钟中等强度体力活动或≥每周3天20分钟剧烈体力活动)15；然而，2007年行为风险因素监测系统电话调查显示，49%的美国成年人获得了相同的推荐量的体力活动。16这些调查得出的结果不同于2003年至2004年国家健康和营养检查调查的基于加速度计的评估，该评估报告称5%的成年人经常运动(定义为在一周中的5天中有一天≥在≥中积累了30分钟的中等强度或更高强度的活动8-10分钟)。17这些差异突出表明，需要在研究和临床环境中对体力活动进行常规和一致的评估，以改进风险因素识别，最大限度地减少体力活动，并进一步加深我们对与健康相关的影响的理解。可以理解的是，研究与临床环境的差异对体力活动的常规评估提出了独特的挑战，但两种环境都有许多工具(主观和客观)可以使这种评估可行和可持续。最近，主观(如自我报告)18和客观(如加速计)测量对体力活动的评估方法进行了综述。虽然这些报告为所审查的方法提供了基于证据的评估和应用信息，但它们没有提供明确的使用建议。目前，可用于指导选择适合于各种潜在应用的体力活动评估方法的信息很少。考虑一个例子，其中临床医生希望评估体力活动作为健康指标，类似于对所有其他心血管疾病风险因素所做的标准评估。体力活动的评估是必要的，以使临床医生能够为被确定为活动不足的患者提供具体的建议。在选择适当的体力活动评估方法时，必须考虑几个问题，例如所需的体力活动维度和领域、将接受评估的患者数量、成本、人员要求以及需要结果的速度。在不同的情况下，可以使用相同的基本问题来指导选择可行、实用、足够敏感以发现变化并在这些情况下可持续的最佳衡量工具。
2260 Circulation November 12, 2013 week at moderate intensity or 150 minutes per week at vigorous intensity or an equivalent combination of both; and (4) muscle-strengthening activities of moderate to high intensity should be performed≥ 2 days per week. Despite the well-established individual benefit of leading a physically active lifestyle and the broader public health impact of reducing chronic disease risk and premature mortality, too many US adults are insufficiently physically active. Estimates of adult physical activity levels and prevalence vary. For example, data from the 2005 National Health Interview Survey reported 31% of US adults obtained regular physical activity (defined as≥ 30 minutes of moderate-intensity physical activity on 5 days of the week or≥ 20 minutes of vigorousintensity physical activity on 3 days of the week) 15; however, the 2007 Behavioral Risk Factor Surveillance System telephone survey suggested 49% of US adults were obtaining the same recommended amount of physical activity. 16 These survey-derived findings differ from the 2003–2004 National Health and Nutritional Examination Survey’s accelerometerbased assessment that reported< 5% of adults were regularly active (defined as having accumulated≥ 30 minutes of moderate or greater intensity activity in≥ 8–10-minute bouts during a day on≥ 5 days of 1 week). 17 These discrepancies highlight the need for routine and consistent assessment of physical activity in research and clinical settings to improve risk factor identification, minimize physical inactivity, and further advance our understanding of the health-related impact. Understandably, research versus clinical setting differences present unique challenges to the routine assessment of physical activity, but there are numerous tools (subjective and objective) available to both settings that may make such assessment feasible and sustainable.Recently, subjective (eg, self-report) 18 and objective (eg, accelerometer) measurement19 methods for assessing physical activity were reviewed. Although these reports provide evidenced-based appraisals and application information for the methods reviewed, they do not provide clear recommendations for use. At present, there is little information available to guide the selection of a physical activity assessment method that is appropriate for the wide variety of potential applications. Consider an example in which a clinician desires to assess physical activity as a health indicator, similar to the standard assessments made for all other cardiovascular disease risk factors. The assessment of physical activity is needed to allow the clinician to provide specific recommendations for patients identified as insufficiently active. In selecting the appropriate physical activity assessment method, several questions must be considered, such as the physical activity dimensions and domains that are desired, the number of patients who will be assessed, the costs, the personnel requirements, and how quickly the results are needed. In different settings, the same underlying questions could be used to guide the selection of the best measurement tool that is feasible, practical, sensitive enough to detect change, and sustainable in those settings.