You don't need to be signed in to read BMJ Blogs, but you can register here to receive updates about other BMJ products and services via our site.

One small step for a human, and a giant leap for humankind

16 Aug, 17 | by atarazia

Introducing the Physical Activity and Population Health BJSM Blog Series 

By Sonia Cheng (@soniawmcheng)

As you’ve likely read from these previous posts on the BJSM blog, the case to increase population-wide participation in physical activity is stronger than ever. And, like the unsung space heroes at NASA, who crunched the numbers and successfully launched humans into orbit and to the moon1, we as health professionals, researchers, and students play a pivotal role in developing and implementing strategies to address one of the leading risk factors for chronic disease and disability worldwide.

It is an honour to launch the new ‘Physical Activity and Population Health’  BJSM Blog Series. Throughout this series, we’ll bring to you the latest developments in physical activity research, resources, and policy in the area of public health – a small step to raise awareness, discussion, and action amongst researchers and clinicians to address a major health priority.

Some vital stats

The statistics related to physical inactivity are not new to us, but still shocking. Physical inactivity is a key risk factor for non-communicable disease (NCDs) – including cardiovascular disease, type 2 diabetes, cancers, respiratory disease, dementia, and poor mental health. This places it as the fourth leading cause of global mortality, contributing to over five million preventable deaths each year2.

However, physical inactivity is also one of the key modifiable risk factors for NCDs, and the health benefits of regular physical activityare evident across the lifespan (click here for current PA recommendations). Maintaining regular physical activity levels helps to (1) promote growth and development in children and young adults, (2) prevent weight gain in mid-life, and (3) maintain independence and quality of life in older adults and in those living with chronic disease3.

Yet, despite high-quality evidence to implement effective strategies, global efforts to reduce physical inactivity have not been sufficient. It is estimated that one in three adults and more than 80% of adolescents do not meet current physical activity recommendations4.

The call to action

Increasing physical activity at a population level requires a whole-of-community approach. We need to effectively implement our knowledge through policy and practice changes in healthcare delivery, education, environment, infrastructure and media. We need to support individuals and communities to be physically active every day in ways that are enjoyable, accessible, and safe in this highly urbanised and digitalised world of ours. We need to advocate for the development, financing and implementation of evidence-informed national plans so that all countries can achieve the World Health Organisation global target to reduce physical inactivity in children and adults by 10% by 20255.These key messages have been distilled into a seven-point plan developed by the International Society for Physical Activity and Health (ISPAH) in 2012, ‘Best Investments for Physical Activity – What Works’6 and the infographic is published here7.

The Physical Activity and Population Health’ BJSM Blog series supplements the brand new BJSM Editorial articles Bright Spots, Physical Activity Investments that Work Jointly8 that feature exciting and novel physical activity programmes from around the globe. Expect both series to keep you updated on research, policy, education, and practice developments in increasing population levels of physical activity.

We invite you to share and support the Physical Activity and Population Health BJSM Blog Series. Join the conversation on ‘how change happens’ at #PAblogBJSM and #brightspotsBJSM.

If you have ideas for this series please contact:

Sonia Cheng graduated from The University of Sydney with a Bachelor of Applied Sciences (Physiotherapy) (Honours Class I) in 2014. Sonia is currently employed as a physiotherapist with Royal Prince Alfred Hospital and Westmead Hospital in Sydney. 


  1. The True Story of ‘Hidden Figures’ and the Women Who Crunched the Numbers for Nasa
  2. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT; Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219-29.
  3. World Health Organisation. Interventions on Diet and Physical Activity What Works? Summary Report Geneva, Switzerland: World Health Organization; 2009.
  4. Hallal PC, Andersen LB, Bull FC, Guthold R, Haskell W, Ekelund U. Global physical activity levels: surveillance progress, pitfalls, and prospects. The Lancet 2012;380(9838):247-57.
  5. World Health Organization. Global action plan for the prevention and control of NCDs 2013-2020. Geneva, Switzerland: World Health Organization; 2013.
  6. Investments that Work for Physical Activity. Br J Sports Med. 2012;46:709-712.
  7. Best Investments for Physical Activity – What Works
  8. Stamatakis E, Murray A Launch of new series: Bright Spots, Physical Activity Investments that Work Br J Sports Med Published Online First: 29 June 2017. doi: 10.1136/bjsports-2017-098096


World Health Organisation to develop Global Action Plan to Promote Physical Activity

22 May, 17 | by BJSM

By Charlie FosterTrevor ShiltonLucy Westerman, Justin Varney,  and Fiona Bull

More people moving more is central to a healthier world. Unfortunately, evidence tells us that people everywhere are less active than ever before, and the burden of chronic noncommunicable diseases rises unabated.

In response, the WHO has launched their strategy to develop a new Global Action Plan to Promote Physical Activity.

Years of advocacy have culminated in this unique opportunity; the development and comprehensive implementation of a global action plan to promote physical activity. This in many ways, will shape the future.

Why is WHO suddenly talking about physical activity?

WHO has encouraged member state governments to promote physical activity for over a decade. Since the 2004 WHO Global Strategy on Diet, Physical Activity and Health, and inclusion of physical activity as a key risk factor and opportunity in the 2013 Global Action Plan on NCDs, the International Society for Physical Activity and Health (ISPAH) has been a lead advocate to promote physical activity. Its numerous resources, including a policy framework (the Toronto Charter, 2010) and policy investment decision tool (What Works: The Seven Best Investments for Physical Activity, 2011) guide countries with the rationale and operational choices for physical activity promotion.

What’s helped get physical activity on the global agenda?

Recent progress toward a Global Action Plan to Promote Physical Activity comes thanks to the tireless work of various key individuals and organisations. This includes ThaiHealth. ISPAH, in partnership with the BJSM. These organizations, along with others, are leading the push for greater recognition of physical activity as a key component of health, and social and sustainable development. An inactive world is unhealthier, uneconomic and unsustainable.

Broader policy priorities have emerged highlighting the pivotal role of physical activity in: (i) achieving the Sustainable Development Goals (SDGs), (ii) making the Global Action Plan to Promote Physical Activity a catalytic opportunity across multiple sectors, and (iii) providing a framework for a truly embedded whole system approach to moving nations. The NCD Alliance, ISPAH and partners will mobilize civil society advocates from across sectors to contribute to the development of a strong Global Action Plan, to call for renewed commitment from governments to boost physical activity, and to enhance the feasibility, sustainability and accountability of its implementation.

How will the Bangkok Declaration on Physical Activity and Health help?

Actions on physical activity can contribute to achieving eight sustainable development goals

The BKKD will help more people from more sectors engage in elevating physical activity as a local, national and global priority. It:

  • advocates for investment and actions at country, regional and global levels
  • provides a case for partnerships with sectors inside and outside of health
  • details six actions which could advance progress toward achieving WHO targets of increasing physical activity and reducing NCD burden by 2025
  • contributes to mitigating climate change, reducing inequalities and supporting more sustainable cities and communities in a rapidly urbanising world.

Use the BKKD in your practice, teachings and advocacy, share it far and wide. Get it at

The more engaged we all are, the better the ultimate health of our planet.


Competing Interests

All authors were involved in developing and promoting the BKKD

Further Reading

  1. International Society for Physical Activity and Health. The Bangkok Declaration on Physical Activity for Global Health and Sustainable Development. Bangkok: ISPAH; 2017 [cited 2017 May 14]. Available from:
  2. Bull F, Gauvin L, Bauman A, Shilton T, Kohl H, Salmon A. The Toronto Charter for Physical Activity: a global call for action. 2010;7(4):421-2.
  3. Global Advocacy for Physical Activity (GAPA) the Advocacy Council of the International Society for Physical Activity and Health (ISPAH). NCD Prevention: Investments that Work for Physical Activity. Br J Sports Med2012;46:709–712


Figure 1           Actions on physical activity can contribute to achieving eight of the sustainable development goals

Authors: Charlie Foster1  Trevor ShiltonLucy WestermanJustin VarneyFiona Bull5

  1. Nuffield Department of Population Health, University of Oxford, UK & President of International Society of Physical Activity and Health (2016-2018),
  2. National Heart Foundation, Perth, Western Australia, Australia & Global Advocacy for Physical Activity (GAPA),
  3. NCD Alliance, Geneva, Switzerland,
  4. Healthy People Division, Public Health England, UK,
  5. Prevention of Noncommunicable Diseases and Mental Health, World Health Organisation, Geneva, Switzerland, Past President of ISPAH (2014-2016)

A historic celebration of World Physical Activity Day 2017, and partnership for sustained dissemination of the EuroFIT program

13 May, 17 | by BJSM

By Dr. Marcos Agostinho

A historic celebration of World Physical Activity Day 2017 took place in The City of Football, home of the Portuguese Football Federation (FPF), with a formal public presentation of the National Program for the Promotion of Physical Activity. The program was coordinated by the Health Ministry, in Portugal’s Directorate-General of Health (DGS), and was presented by its Director, Professor Pedro Teixeira, from The Faculty of Human Kinetics – University of Lisbon (FMH).

With the participation of Portugal’s Ministers of Health and Education, the celebration was also marked by the signing of a unique formal partnership between the FPF, DGS and FMH for the dissemination of The EuroFIT program, derived from a EU H2020 funded project. EuroFIT uses some of the biggest national and European football clubs’ venues for the fight against sedentary lifestyles and related problems.

EuroFIT (European Fans In Training) is a social innovation program aimed at improving physical activity and sedentary behaviour through elite European football clubs. Its overall objective is to build new social partnerships between football clubs, fans and researchers that harness the power of football to deliver an innovative public health programme. The innovation will address the problems of physical inactivity, sedentary behaviour and poor diet. More can be found here:

As for Portugal’s recent National Program for the Promotion of Physical Activity (PNPAF), four primary strategic objectives were created for the 2017-2020 period:

  1. Promote awareness, physical literacy and the readiness of the entire population to practice regular physical activity and reduce sedentary time;
  2. Promote the generalization of assessment, counseling and referral of physical activity at the primary health care level;
  3. Encourage environments that promote physical activity in leisure spaces, in the workplace, in schools and universities, in transportation and in health services;
  4. Promote epidemiological surveillance and research, and value and disseminate good practices in the field of physical activity promotion and sport.

More information can be found here at the official program’s website:


Dr. Marcos Agostinho, MD, PGDip (SEM), BASc (MB)

Primary Care Sports Medicine Physician (CUF Torres Vedras Hospital), Family Physician & General Practitioner (USF Santa Cruz), Collaborator for The National Program for the Promotion of Physical Activity (DGS Portugal), Associate Editor British Journal of Sports Medicine (BJSM), Associate Editor BMJ Open Sport & Exercise Medicine (BMJ)

#WeActiveChallenge: the WeCommunities launch fun, interactive social media campaign to promote activity

13 Jun, 16 | by BJSM

By Naomi McVey @NaomiMcVey

The case for increasing physical activity among the global population is compelling, but achieving this is far more complex. Despite comprehensive guidance from national and international organisations[1][2][3][4], and increasing emphasis on supporting the health of the NHS workforce[5][6][7], the reality of knowing how and where to start, and fitting exercise into busy lives, can be challenging for many people.

livestrong stairsExamples of high profile physical activity campaigns are those that inspire realistic, achievable change. Last year, influenced by our own experiences of juggling work and family life the @WeAHPs team developed a grassroots social media campaign focused on motivating ourselves, colleagues and families to get up and active.


The #AHPsActive campaign launched on twitter in July 2015. People taking part were asked to tweet a picture of them ‘getting active’. Inspired by Sport England’s This Girl Can campaign this was about being fun, realistic and achievable. We simply challenged our colleagues to be healthy role models and do a little more than they did before.

Support for the campaign took us by surprise and a blog from Exercise Works kick-started an online competition pitching allied health professionals head-to-head with nurses in the last two weeks in August. We wanted the #AHPsActive #NursesActive competition to:

  • raise the profile of the importance of peer support and role modelling in physical activity
  • help us practice what we teach as health care professionals
  • motivate, inspire and create a sense of community.rope pull

Activity and reach

raftingWe used twitter analytics to encourage the AHPs v nurses aspect of the competition and also promoted an award for the best photo, with the final decision made by FabNHSStuff.

Between July and September more than 800 people used the #AHPsActive hashtag in over 2500 tweets. In the 2-week competition alone over 1000 people got involved, with a twitter reach of over 7 million people. This included hundreds of photos of healthcare professionals, their teams, friends and families taking part in a huge range of activities around the world. Ice hockey in Finland, mountain climbing, cycling, skateboarding, wall-scaling, skydiving, mud running and much more: the campaign resulted in a vibrant online library of images showing nurses and allied health professionals taking part in physical activity. Smiling, sweaty and having fun.

How much did this cost? Nothing – just the time and enthusiasm of the people organising the campaign and taking part.

The 2016 campaign

This year we are planning to get bigger and better. This summer the campaign will expand across all the WeCommunities.  As a group of nurses, midwives, health visitors, AHPs, doctors, pharmacists, paramedics, finance professionals and commissioners with over 100,000 combined followers we feel well placed to influence the healthcare workforce as peers and colleagues.

Our aims build on those of last year. We know that awareness of physical activity guidelines can be lacking in healthcare professionals and students[8] as well as the general population[9] so we’re planning to promote recommendations as part of the campaign as well as resources to help achieve these. Taking place on twitter, we are asking people to share new and more photos. We’ll be using twitter analytics to encourage competition between the different communities, and with support from Public Health England we’ve teamed up with Virtual Runner UK to provide 500 WeCommunities medals as well. We’ll also develop ways to measure the impact of the campaign.

So, join us and #GetActive this summer and help us role model a healthy lifestyle with the #WeActiveChallenge.


Naomi McVey is a physiotherapist, community lead for the @WeAHPs and @Physiotalk twitter communities, and a fledgling runner.

The WeCommunities are an alliance of over 15 tweetchat communities including nurses, health visitors, midwives, doctors, AHPs and pharmacists. The communities are run by healthcare professionals, as volunteers, who believe passionately that through connecting people and sharing information, ideas and expertise we can improve health and healthcare. 


[1] NICE pathway on physical activity

[2] Department of Health UK Physical Activity guidelines 

[3] Murray etc al (2016) Scotland’s progress in putting policy about physical activity into practice. Br J Sports Med 2016;50:320-321  at

[4] Global recommendations on physical activity for health

[5] Physical activity in the workplace, NICE guideline PH13

[6] Simon Stevens announces major drive to improve health in NHS workplace

[7] White D, 2015. Promoting physical activity within Scottish hospital settings. Br J Sports Med 2015;49:1415-1416  at

[8] Dunlop M and Murray A, 2012. Major limitations in knowledge of physical activity guidelines among UK medical students revealed: implications for the undergraduate medical curriculum, Br J Sports Med 2013;47:718-720 at

[9] Knox E at al., 2013. Lack of knowledge of physical activity guidelines: can physical activity promotion campaigns do better? BMJ Open 2013;3 at

Training fürs Leben – Bewegung ist Medizin

20 May, 16 | by BJSM

von Nash Anderson B.Sc M.Chiro und James Steele, PhD, Dozent für angewandte Sportwissenschaften an der Southampton Solent University

Neulich, in der ärztlichen Praxis, hörte Nash die tolle Aussage eines Patienten, der sagte: „Die Leute fragen mich, warum ich die ganze Zeit ins Fitnessstudio gehe. Sie fragen mich, wofür ich trainiere. Ich trainiere fürs Leben! Quintessenz dieser Unterhaltung war, dass wir, auch wenn wir durch „Wehwehchen“ eingebremst werden, in Schwung und aktiv bleiben müssen, um uns richtig wohl zu fühlen.

Es ist immer schön zu sehen, wenn Patienten verstehen, dass Bewegung fürs Leben ist. Um die Früchte zu ernten muss man kein Profisportler sein, oder sich auf ein bestimmtes Ereignis vorbereiten. Wenn diese Auffassung doch nur weiter verbreitet wäre!

Dieser Artikel wurde durch die o.g. Erfahrung im klinischen Alltag angeregt, sowie durch die Teilnahme am Symposium „Exercise is Medicine“ („Training/Bewegung ist Medizin“) der Royal Society of Medicine in London im Juni 2015.
Der Austausch mit @BJSM_BMJ (Anm.: Account des British Journal of Sports Medicine) auf Twitter spornte mich dazu an, dies niederzuschreiben und die Erkenntnis über die Bedeutung und die Vorteile der körperlichen Bewegung zu teilen.

Verschiebung des Augenmerks weg von ästhetischen Aspekten zugunsten des gesundheitlichen Nutzens eines Trainings

Leider werden körperliche Aktivität und Training von Vielen lediglich als ein Mittel betrachtet auf potenzielle kurzfristige Ziele, in Bezug auf äußerliche Ergebnisse wie Leistungssteigerung oder Verbessern des Aussehens bezüglich der Körperzusammensetzung hin zu arbeiten. All diejenigen die sich durch Training körperlich betätigen, werden eines dieser Ziele auch bis zu einem gewissen Grad erreichen. Allerdings mag das Ergebnis am Ende nicht so aussehen wie erwartet. Dies führt zu Entmutigung und zur Frage nach dem eigentlichen Sinn des Trainings. Es kann frustrierend sein, wenn man zwei Monate lang 4-5 mal pro Woche trainiert mit dem Ziel, dadurch abzunehmen, wenn man am Ende sogar schwerer ist, aufgrund der Tatsache dass begleitend zum Fettabbau die fettfreie Masse ansteigt.

Eine weitere häufig beobachtete Enttäuschung besteht darin, am Ende eines Muskelaufbauprogramms nicht so muskulös zu erscheinen wie ursprünglich beabsichtigt, trotz der lebhaften Vorstellung der nächste Arnold Schwarzenegger zu werden. Es ist leider harte Realität, dass nicht jeder seine anfänglichen Ziele erreichen wird und dass bei vielen solchen Zielen die Aussicht auf Erfolg überbewertet wird. Der Eindruck, prominente Erfolgsgeschichten seien repräsentativ, ist leider ein Trugschluss. Sie stechen lediglich aus der Masse der vielen anonymen Misserfolge hervor. Aber beruht der Erfolg hier wirklich auf einer besonderen Form des Trainings, oder liegt das spezielle Ergebnis in den Genen?

In der Reaktion auf Training und körperliche Aktivität unterliegen wir alle interindividuellen Unterschieden, die vorrangig auf genetische Faktoren zurückzuführen sind (Hubal et al., 2005; Timmons, 2011). Andererseits weiß man, dass Training und körperliche Aktivität solch ein breit gefächertes Spektrum an möglichen positiven Effekten nach sich zieht, dass beinahe jeder in irgendeiner Form davon profitieren kann. Leider ist aber gesundheitlicher Nutzen und damit verbunden eine langfristige Eindämmung von Risikofaktoren schlichtweg nicht so sexy wie ein gut definierter, muskulöser Körper, oder auch das Erreichen eines prägnant hohen Leistungsniveaus.

Wir müssen einen Weg finden wie wir die Wahrnehmung, dass Training primär auf äußerliche, ästhetische Ergebnisse abzielt, aus den Köpfen der breiten Öffentlichkeit verschwinden lassen können. Die Botschaft muss vielmehr lauten, dass auch wenn primäre Trainingsziele nicht erreicht werden, man das Training deswegen nicht aufgeben, sondern fürs Leben trainieren sollte. Es ist bekannt, dass Sport und körperliche Aktivität in einer Dosis-Wirkungs-Beziehung (Lee & Skerret, 2001; Byberg et al., 2009) das allgemeine Sterblichkeitsrisiko senken (Paffenbarger et al., 1986; Nocon et al., 2008). Wird noch etwas intensiver und fleißiger trainiert, werden die positiven Effekte auf die Langlebigkeit sogar noch grösser (Lee et al., 2003; Wisloff et al., 2006; Laukkanen et al., 2010). Sich fit zu halten, basierend auf Training und körperlicher Aktivität, scheint einer der primären Faktoren zu sein, die Langlebigkeit nachhaltig beeinflussen. Kardiorespiratorische Fitness (Kokkinos et al., 2008; Lee et al., 2011; Wen et al., 2011), Kraft (Newman et al., 2006; Ruiz et al., 2008; Leong et al., 2015), Muskelmasse (Srikanthan & Karlamangla, 2014), oder eine Kombination dieser Aspekte (Artero et al., 2011) sind alle in der Lage, multiple Sterblichkeitsrisiken zu reduzieren, mit möglichen lebensverlängernden Folgen. Wir sprechen hier nicht über riesige Verbesserungen hinsichtlich messbarer Fitnesswerte, wie wir sie bei professionellen Sportlern beobachten können, sondern lediglich vom Erreichen der eigenen genetisch vorgegebenen Möglichkeiten aufgrund von Bewegung und körperlicher Aktivität.

Es geht aber nicht nur darum, für ein längeres Leben zu trainieren, sondern auch für verbesserte Körperfunktionen und eine gesündere Lebensqualität. Es existieren reichliche Hinweise, dass Training ein breites Feld an Vorzügen bezüglich gesundheitlicher Aspekte offeriert, einschließlich einiger der unten aufgelisteten Punkte. Mehr noch, mit einem solch breiten Spektrum möglicher positiver Resultate ist es hochgradig wahrscheinlich dass man sich zumindest etwas Gutes tut, selbst wenn man ästhetische oder leistungsbezogene Ziele, die sich leicht beobachten oder messen lassen, nicht erreicht. Tatsächlich schließt eine aktuelle Studie beinahe frech, dass „…es niemanden gibt, der nicht auf irgendeine Weise auf ein widerstandsgestütztes Trainingsprogramm reagiert…“ (Churchward-Venne et al., 2015). Was folgt ist eine kleine Auswahl möglicher Verbesserungen die durch Bewegung und körperliche Aktivität erreicht werden können, sei es mittels ausdauer- oder kraftbasierten Trainings, die im o.g. „Exercise is Medicine“ Symposium der Royal Society of Medicine im Juni angesprochen wurden.


  • Verbesserte Wahrnehmungsfähigkeit und u.a. längere Aufmerksamkeitsspannen, besseres Kurzzeitgedächtnis usw. bei älteren Erwachsenen und bessere Hirnleistung
  • Verlangsamte Abnahme kognitiver Fähigkeiten


  • Verringerter Hang zur Depression
  • Weniger Angst und Beklemmung
  • Mannschaftssportarten fördern die Beteiligung an Gemeinschaftsaktionen und steigern dadurch die allgemeine Gesundheit und Zufriedenheit
  • Verbessertes Selbstwertgefühl


  • Moderates Training ist gut für Gelenkknorpel
  • Häufig: Gewichtskontrolle
  • Häufig: Kraft, Ausdauer und Energie
  • Häufig: Beweglichkeit und Koordination
  • Erhöhte Knochendichte
  • Verringerte Schmerzen und Gelenkbeschwerden, Bewegung spielt eine wichtige Rolle beim Reduzieren Arthrose-bedingter Symptome
  • Reduzierte Schmerzen und Symptome bei Fibromyalgie
  • Verbesserte Beweglichkeit
  • Verbesserte Leistungsfähigkeit
  • Positive genetische Veränderungen in Bezug auf Alterungsprozesse
  • 30-60% verringertes Risiko einer Schenkelhalsfraktur
  • Positive Trainingseffekte überwiegen gegenüber den Risiken einer Osteoporose

Innere Organe


  • Verringertes Risiko von Herz-Kreislauf-Erkrankungen
  • Bewegung ist besser als eine perkutane koronare Intervention zur Gewährleistung des Überlebens ohne ein akutes kardiales Ereignis
  • Verringerter Ruheblutdruck
  • Jede Steigerung der körperlichen Aktivität um 200 Schritte pro Tag hilft, das Risiko einer Herz-Kreislauf-Erkrankung um 8-10% zu verringern
  • Regelmäßiges Training ist effektiver als ein Einsetzen von Stents


  • Verkürzte Zeit der Darmpassage
  • Verbesserte Ergebnisse nach Darmkrebs-Operationen
  • Weniger Nebenwirkungen bei einer Chemotherapie
  • Geringere Sterblichkeitsrate nach einem Jahr
  • Höhere Einjahres-Überlebensrate


  • Regelmäßiges Training kann das Brustkrebsrisiko bis zu 20% reduzieren


  • Verbesserter Glukose-/Insulinstoffwechsel


  • 30-prozentige Verringerung aller Sterblichkeitsursachen, verbunden mit einer höheren Lebenserwartung
  • Verringerter Körperfettanteil
  • Verringerter Bauchfettanteil
  • Verbesserte Blutfettwerte
  • Erhöhter Grundumsatz
  • Verbesserte Schlafqualität

Wir müssen uns vom Blick auf kurzfristige Trainingserwartungen lösen. Training ist viel mehr als nur abzunehmen oder Muskelmasse aufzubauen. Die breite Öffentlichkeit muss ein besseres Verständnis für die umfassenden Vorzüge körperlicher Aktivität erlangen. Jeder der diesbezüglich gefragt wird:

  1. Wenn Du ins Fitness-Studio gehst um Muskulatur aufzubauen, aber Dein Ziel nicht erreichst, warum gehst Du dann überhaupt? Wofür trainierst Du?
  2. Oder, wenn Du ins Fitness-Studio gehst um abzunehmen, aber Dein Ziel nicht erreichst, warum gehst Du dann überhaupt? Wofür trainierst Du?

sollte in der Lage sein zu antworten: “Ich trainiere fürs Leben!”

Daher empfehle ich eindringlich die Verwendung von motivierenden Infografiken bezüglich der Vorteile körperlichen Trainings wie z. B. diese hier in einem kürzlich veröffentlichen BJSM Blog von Andrew Murray et al. in unseren Auftritten in den sozialen Medien, um diese einem breiten Publikum zur Verfügung zu stellen.

Abschließend noch zwei schöne Zitate vom “Exercise is Medicine” Symposium:

“Man ist nie zu alt um etwas Neues anzufangen” – Dr. Charles Eugster (95 Jahre jung!)

“Bewegungsmedizin muss sich vom gängigen medizinischen Modell lösen. Vorbeugen ist besser als Heilen!” Prof. John Buckley.

Sowohl die Quintessenzen und Zitate des “Exercise is Medicine” Symposiums der Royal Society of Medicine in London im Juni 2015, als auch der Austausch mit @BJSM_BMJ auf Twitter haben mich veranlasst, diesen Artikel zu schreiben und die Botschaft zu weiterzuverbreiten.

Die betreffenden Tweets und Informationen sind hier nachzulesen:

Artikel übersetzt aus dem Englischen von:

Isabel Schneider

M.A. Englisch als Fremdsprache

MA Sportwissenschaften

Dozent an der H:G Hochschule für Gesundheit und Sport, Technik und Kunst

Physio-Motion – Beratung und Dienstleistungen rund um Sport, Bewegung und Gesundheit


Der Artikel wurde im Original auf Englisch publiziert bei BJSM blog ( Hier können Sie den Artikel im Original lesen:


  1. Artero, E.G., et al., 2011. A prospective study of muscular strength and all-cause mortality in men with hypertension. J Am Coll Cardiol. 57(18), pp 1831-1837
  2. Byberg, L., et al., 2009. Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort. Br J Sports Med. 43(7), pp 482
  3. Churchward-Venne, T.A., et al., 2015. There are no nonresponders to resistance-type exercise training in older men and women. J Am Med Dir Assoc. 16(5), pp 400-411
  4. Hubal, M.J., et al., 2005. Variability in muscle size and strength gain after unilateral resistance training. Med Sci Sports Exerc. 37(6), pp 964-972
  5. Kokkinos, P., et al., 2008. Exercise capacity and mortality in black and white men. Circulation. 117(5), pp 614-622
  6. Laukkanen, J.A., et al., 2010. Cardiorespiratory fitness, lifestyle factors and cancer risk and mortality in Finnish men. Eur J Cancer. 46(2), pp 355-363
  7. Lee, I., and P. J. Skerrett, 2001. Physical activity and all-cause mortality: what is the dose-response relation? Med Sci Sports Exerc. 33(6), S459 – S471
  8. Lee, I., et al., 2003. Relative intensity of physical activity and risk of coronary heart disease. Circulation. 107(8), pp 1110 – 1116
  9. Lee, D. C., et al., 2011. Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women. Brit J Sports Med. 45, pp 504 – 510
  10. Lee, D.C., et al., 2011. Long-term effects of changes in cardiorespiratory fitness and body mass index on all-cause and cardiovascular disease mortality in men: the Aerobics Center Longitudinal Study. Circulation. 124(23), pp 2483-2490
  11. Leong, D. P., et al., 2015. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology Study. Lancet. 386(9990), pp 266-273
  12. Newman, A. B., et al., 2006. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol. 61A(1), pp 72 – 77
  13. Nocon, M., et al., 2008. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil. 15(3), pp 239 – 246
  14. Paffenbarger, R.S. et al., 1986. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med. 314(10), pp 605-613
  15. Ruiz, J.R., et al., 2008. Association between muscular strength and mortality in men: prospective cohort study. BMJ. 337, pp a439
  16. Srikanthan, P., & Karlamangla, A.S., 2014. Muscle mass index as a predictor of longevity in older adults. Am J Med. 127(6), 547-553
  17. Timmons, J.A., 2011. Variability in training-induced skeletal muscle adaptation. J Appl Physiol. 110(3), pp 846-853
  18. Wen, C. P, et al., 2011. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. The Lancet. 378, pp 1244 – 1253
  19. Wisloff, U., et al., 2006. A single weekly bout of exercise may reduce cardiovascular mortality: how little pain for cardiac gain? ‘The HUNT study, Norway’. Eur J Cardiovasc Prev Rehabil. 13(5), pp 798 – 804

An unlikely candidate, a year as Professor of Physical Activity for Health

27 Apr, 16 | by BJSM

By Prof Chris Oliver

chris oliverAfter losing over 12 stone in weight, cycling across America, becoming a cycle campaigner, writing some policy on active travel and starting a few physical activity projects I became honorary professor physical activity for health at the University of Edinburgh. The “Sit Less, Walk More” message had finally come home to me. I had certainly lost my work life balance and after writing hundreds of numerous papers and passing an alphabet soup of post nominals, I was seriously ill with metabolic syndrome and diabetes. Although I was a successful trauma orthopaedic surgeon at the Royal Infirmary of Edinburgh, my life was collapsing around me. I had a gastric band in 2007 and got physically active, a shopping list of things to do to recover my life and get back to the things I did as a medical student got seriously out of hand. I never expected to get back to expedition whitewater kayaking or to ride 3,415 miles across the USA, this was a surprise. Coming off call in 2013 allowed me to recover from considerable professional burnout, I never should have gone back on call after having my gastric band. After all this, neither did I expect to become a professor or be in the media. I really just wanted to pay back to everyone the second chance at life I had been given. In 2013 the BBC Scotland Adventure Show made a mini-documentary about my weight loss and advocacy roles. I had hit the national media.

Meeting Professor Nanette Mutrie at the Physical Activity for Health Research Centre, University of Edinburgh was a life changing event and in the spring of 2015 I was conferred as honorary professor, a job with no exact role or even title, just to be available! With my somewhat nerd like computer skills I deliberately intended to grow my social media networks as much as possible to enable me to meet and network with as many physical activity advocates as possible. I grew my Twitter, Facebook, LinkedIn, Klout and Wikipedia profiles to engage. Certainly press, TV and radio occurred, often by initial engagement with Twitter. A consistent professional message on the positive aspects of physical activity has grown networks well. I had some professional media training. I had useful engaging radio interviews on BBC Radio Scotland on weight-loss surgery, sugar tax and various aspects of obesity. In January 2016 I featured in a BBC Scotland News documentary, “Car Sick” on the relationship between cars, bicycles, pollution and physical activity. Television seems easier to control than radio call-ins!

My initial university project was to develop the University of Edinburgh Undergraduate Medical Teaching Resource. Engagement with developing the curriculum in Edinburgh has been slow but editorials in the BJSM have helped develop physical activity teaching throughout the United Kingdom. In Edinburgh all medical students will take a six-year undergraduate course with compulsory intercalated BSc, so it’s planned from 2018 to have a course for medical students in physical activity. It would be hoped these doctors would become leaders in physical activity advocacy. We undertook a review of the knowledge of medical student knowledge of the CMO guidelines for physical activity and not surprisingly discovered that 85% of Edinburgh medical students did not know the guidelines, we’ll shortly be publishing a detailed paper. We now have significant plans to redesign and redevelop our university educational resource for physical activity.

I experimented with Lego as a tool to understand the mind maps of physical activity and inspired Nathan Stephens NHS Leadership Fellow at the Royal College of Surgeons of Edinburgh to develop some innovative physical activity infographics One of my students wrote a short blog on physical activity infographics.

I was invited to join the NHS Scotland Health and Social Care Physical Activity Delivery Group, this group delivers the Physical Activity Policy for the Scottish Government. It’s notable that the recent Scottish budget did not deliver any extra funding for active travel and even a 1% transfer of funding from roads to active travel was ignored. Being a member of the Cross Party Group for Cycling at Holyrood I see access to ministers a key for developing good bold physical activity policy. I’ve attended several NHS Scotland physical activity events. I conclude that it would be good to see a Physical Activity Cross Party Group evolve at Holyrood. Government funding needs to be placed in the correct places and not encased in silos. There needs to be an increased “political will” to support physical activity and negate the effects of physical inactivity. We all know the ticking economic time bomb that is being caused by physical inactivity. Senior government policy makers and leading ministers must quickly engage with vigorous physical activity policy, however unpalatable it may seem.

Throughout the year I gave various lectures: I was told to find out about altmetrics and give a lecture to the department. I was doubled billed with the Scottish CMO, Catherine Calderwood to give a “Health and Wellbeing” lecture to a secondary school in Glasgow, I particularly enjoyed this and would hope that one of the pupils one day would perhaps cycle across the USA, perhaps decades away. I presented results of a small survey on cycling and coffee and wrote some more scientific articles on caffeine and coffee. My inaugural institute professorial lecture “How not to be a surgeon, cycling to physical activity” was started with my entrance cycling into the lecture theate on a Brompton bike, a serious example of active travel.

With members of PAHRC we have a multiagency grant submission into investigate the effects of 20mph speed limits on active travel in Edinburgh; walking, cycling and the built environment in Edinburgh, the results are awaited.

There are some great people in PAHRC. Sharing an office with Dr Andrew Murray, the ultramarathon runner has been interesting and we have both worked to promote physical activity as much as we can, however we both have day jobs! With Dr Danijela Gasevic and her team at PAHRC are developing a MOOC, Massive Online Open Course in Physical Activity and Assessment. The MOOC will launch in May 2016 and has over 13,000 people signed up, we are currently signing up about 100 people a day. You can join here, no idea what the final numbers joining will be.

The surgery I currently perform is complex hand and wrist reconstruction surgery. The technical details of the surgery is still so much fun and I spend most of my time now teaching operative surgery. I cannot do surgery forever so a longer term career in physical activity post retirement in the next five years or so looks a great opportunity. The first year has been fun! Thanks Nanette!

Prof Chris Oliver

Honorary Professor Physical Activity for Health, University of Edinburgh


Twitter @CyclingSurgeon



‘Australasian College of Sport and Exercise Physicians’ release new name to better reflect scope of practice

8 Apr, 16 | by BJSM

By Dr. Adam Castricum

Aus college of sport and exercise phys

The Board of the Australasian College of Sports Physicians is proud to announce that a special resolution was passed at the Annual General Meeting on Sunday, February 14, 2016 to change the name of the College to the Australasian College of Sport and Exercise Physicians (ACSEP).

Since its humble beginnings in 1985, from a small group of nineteen passionate like minded individuals, as the Australian College of Sports Physicians, the College has always been progressive in its thinking. In 1991, the College awarded its first Fellowships. In 1992, the College began training its own registrars in private practice, a pioneering training model which continues to this day. In 1993, our New Zealand colleagues joined the College, with the name changing to Australasian College of Sports Physicians in 2005.

Specialty recognition

Importantly, the College gained specialty recognition in New Zealand in 1998 and then finally in Australia in 2009. The College now numbers 159 Fellows practicing in all corners of the globe and a record 55 trainees, undergoing a robust training program in all regions of Australia, New Zealand and beyond.

The College has also recently moved to a new skills based Board structure, with a new Chairman, Professor Jon Watson, the Dean of Deakin University Medical School in Geelong, Australia.

The Australasian College of Sport and Exercise Physicians is the pre-eminent professional body for Sport and Exercise Medicine in Australasia. Their vision is to provide the world’s best training, standards and research in the specialty of Sport and Exercise Medicine. The College supports its doctors in clinical practice in order to improve the health and well-being of individuals and communities through the enabling and promotion of physical activity.

The members of the College felt a name change was needed to accurately reflect who they are and their scope of practice. Sport and Exercise Physicians work closely with General Practitioners, Physicians, Radiologists, Psychiatrists and Surgeons, particularly Orthopaedic Surgeons, as well as Allied Health professionals to lead and co-ordinate rehabilitation and exercise programs to not only treat but prevent chronic diseases.

The goal of all Sport and Exercise Physicians should be to facilitate all members of the community to exercise safely well into their next century, at the same time warding off the burden of chronic disease. Not only does this benefit all individuals, families and communities, but it also reduces the ballooning costs on an already overstretched health system.

Exercise medicine – incontrovertible benefits

We know from an increasing number of studies that regular physical activity has a powerful effect on reducing the burden of non-communicable chronic disease. A February 2015 report from the UK’s Academy of Royal Colleges described the “miracle cure” of performing 30 minutes of moderate exercise, five times a week, as more powerful than many drugs administered for chronic disease prevention and management. Such regular physical activity reduces the risk of developing cardiovascular disease, type 2 diabetes, dementia and some cancers by at least 30%[i]. There is also increasing evidence that regular exercise is effective in the early management of mental illnesses such as depression[ii]. These diseases are among the leading public health issues facing the world in the 21st century[iii].

In light of the current Australian Federal Government evidence based review of the Medical Benefits Scheme (MBS), it prompted the current Vice-President of the Australian Medical Association, Dr. Stephen Parnis, an Emergency Physician, to recently state that “if physical activity were a drug, the community would demand that it be listed on the PBS (Pharmaceutical Benefits Scheme)”.

Significantly, ACSEP follows a number of other international Sports Medicine organisations to have similarly incorporated Exercise into their names, including BASEM – The British Association of Sport and Exercise Medicine, CASEM – The Canadian Academy of Sport and Exercise Medicine and ECOSEP – The European College of Sport and Exercise Physicians.

The Australasian College of Sport and Exercise Physicians will continue to uphold and advance world leading training and practice in the specialty of Sport and Exercise Medicine. We are perfectly positioned to lead and promote incorporation of exercise and physical activity into the daily lives of all members of the community, whether healthy or unwell. We will continue to work closely with our peak sporting bodies and teams, medical and allied health colleagues, as well as the greater community to keep us all active and healthy.


Dr. Adam Castricum is a Sport and Exercise Physician and President of the Australasian College of Sport and Exercise Physicians (ACSEP)


[i] Exercise – the miracle cure. Report from the Academy of Medical Royal Colleges. Feb 2015.

[ii] Dwan K, Grieg CA et al. Exercise for Depression (Review); Cochrane Review, 2015:1-160.

[iii] Murray CJL, Lopez AD. Measuring the global burden of disease. New England Journal of Medicine, 2013;369:448-57.

Glasgow Medical School leading the way on physical activity education: our three steps to success!

27 Mar, 16 | by BJSM

By Dr John Paul Leach

Like many clinicians and medical educators, I am convinced of the need to energetically promote physical activity to all strata of society, but especially students and patients.

I am lucky, in that my joint role as an educator and clinician, I have a chance to do just this – promote physical activity for individual patients, and also l educate our future doctors that exercise is a vital [clinical] sign thus, laying the foundations of a grassroots approach to enhance physical activity.

March 28 Glasgow Med Students

Used with permission from Glasgow Medical School

I am a consultant neurologist in Glasgow, and for the last year I have been Head of Fifth Year in the University of Glasgow’s School of Medicine, UK. It is rewarding and productive to wear both hats, in the fight to get people moving more.

One of the main challenges in the campaign to make physical activity part of everyday life, is its inclusion in everyday medical practice. The Scottish Government has rightly become convinced that changing how our population engages with regular physical activity, will secure the long term benefit across all aspects of society and life. The Academy of Medical Royal Colleges has also been unequivocal in its support for promotion of physical activity: recognising the efficacy, and cost effectiveness of physical activity, and its long term benefits in treatment and prevention of many chronic illnesses.

If the notion of increasing counselling and prescription in physical activity in primary and secondary care is to have any chance, it must become part of clinical thinking and practice, and at the earliest stages of medical training.

The School of Medicine at the University of Glasgow has led the way in implementing changes to enhance consideration of physical activity by its students in both personal and professional settings. Three central considerations for Glasgow Medical School are:

  • Physical activity promotion became a new theme for one of our sessions in Preparation for Practice and also for a fourth year Academic Day. It was great to see the students respond to the leadership and exhortations by Ann Gates (@exerciseworks) on a “movement for movement” by standing for the entire 45-minute talk! The Twitter and other social media feedback showed their engagement as they heard about the evidence base for the benefits of exercise in medical conditions and rehabilitation, as per the World Health Organization and Chief Medical Officers’ guidance.

This taught material was directly examined in the written finals of the medical school – we suspect anther first for Glasgow!

  • If healthcare professionals are to be credible advocates for healthy lifestyles, they need to be visible exponents. Further, the evidence for exercise in preventing career burnout for healthcare workers is developing. For both reasons, we sought to encourage our students to exercise more, including drafting a statement produced by our senior management group, encouraging staff and students to continue regular exercise during term time, unless prevented by fixed teaching commitments.
  • Is this making a difference? It is naive to think practice is changing already, but we have begun to audit physical activity discussions in our neurology unit. We suspect this is rarely discussed or documented, but if things keep on like this we expect more such discussions and interventions in coming years!

We see these as the first steps in providing comprehensive advice for patients. The only way to guarantee future positive moves for physical activity promotion is to have continued buy-in by all doctors, especially at a junior level.

The next step is: “it’s time to get the profession and the public, moving”.

We hope that Glasgow Medical School continues to champion the way!


Dr John Paul Leach, Consultant Neurologist, Honorary Associate Clinical Professor, Head of Fifth Year, Glasgow Medical School, Glasgow, Scotland, UK. and @jpleach246

Lifestyle Medicine – helping individuals and families adopt and sustain healthy behaviors : A practitioner’s unexpected Journey

24 Mar, 16 | by BJSM

By Dr. Bobby Masocol

March 25meditationI’m a new sports medicine doctor, fresh out of training and now in academic practice teaching family medicine residents and sports medicine fellows. Prior to this job, I was asked by one of my mentors to develop a Lifestyle Medicine Clinic to compliment the unique curriculum at the University of South Carolina-School of Medicine Greenville. After collaborating with faculty at the medical school and attending a few conferences, we started a lifestyle medicine clinic that integrates medical students and residents to the clinical practice. I know, I know… we’re still working on the website. Lifestyle medicine (LM) is in its infancy and is steadily growing throughout the United States. In my practice, I see athletes as well as patients with chronic diseases such as obesity, diabetes and hypertension… and I love it!

Obesity and inactivity are discussed frequently in the BJSM and it excites me to read about all the ways people are getting their patients to be more physically active. Personally, I have adopted the #makeyourdayharder campaign, which is so simple, but gets me to consciously think about moving my body while I’m in the hospital or I’ve been sitting at my desk for a long time. The simplest ideas are often the best and Lifestyle medicine is simple. It has completely changed the way I practice medicine, and the purpose of this blog is to share some of these ideas.

What is lifestyle medicine? Is it really just” eat better” and “get exercise”?

In a word…yes! However, just like characterizing family medicine physicians as simply seeing colds and treating hypertension, there is much more to the story. The same goes for Lifestyle medicine.

Lifestyle medicine is the evidence-based practice of helping individuals and families adopt and sustain healthy behaviors that affect health and quality of life. It’s not only a way to prevent non-communicable disease but a great way to treat chronic disease. The body has a tremendous ability to heal itself, and with the right changes, can often reverse disease. That’s right, if you have coronary artery disease, we know that by adopting intensive lifestyle modifications, a person can actually reverse atherosclerosis, which has better outcomes than getting stents placed. Lifestyle medicine gets at the root cause of chronic disease and treats the problem, not the symptoms.

How does Sports Medicine fit with Lifestyle Medicine?

Sports medicine providers play a unique role in patient care in that we frequently prescribe physical therapy and exercise for many of the common issues that we see. As many of the readers here probably know, there are sports medicine leaders advocating exercise as medicine. Exercise and movement are at the core of how we practice medicine on a daily basis and making it part of our patient counseling should be second nature. We are knowledgeable about injury prevention and rehabilitation so when our patients start getting those aches and pains from starting an exercise program, who better to see than a sports medicine provider.

While we are rightfully ambassadors of exercise, we are also learning that diet cannot be ignored in the treatment of chronic disease. This is an area that sports medicine providers likely need to improve. I am slowly getting to know the literature and am kind of disturbed that I did not get training in this during medical school or residency. Diet can be complex and confusing. I will share more about diet in future posts.

How do you get patients to change their behavior?

This is the heart of Lifestyle medicine. I use motivational interviewing which has been discussed on this blog. It really empowers patients to take an active role in their health and allows the physician to not feel discouraged when some goals are not met. It has made my interactions with patients more positive and I believe that we accomplish more with each session. Working in a team of providers also helps sustain behavior change. I utilize medical students to call our patients and to follow up on whether patients are meeting their goals

There is nothing necessarily sexy about lifestyle medicine. The beauty is that you can adopt it and start advocating for your patient immediately. If you’re a sports doctor giving an obese type 2 diabetic patient a steroid injection into the knee, take 2 minutes to counsel the patient about how diet changes can dramatically improve their diabetes. Try it. You might just get hooked like I did.


Ornish, D, et al. Intensive lifestyle changes for reversal of coronary Heart disease, JAMA 1998 : 280: 2001-2007

Boden, W. et al. Optimal medical therapy with or without PCI for stable coronary disease, NEJM 2007: 356:1503-1516


Dr. Bobby Masocol is faculty at the Greenville Health System Family Medicine Residency and Sports Medicine Fellowship in Greenville, South Carolina.

Physical Inactivity and the Clinical Champions Programme

4 Jan, 16 | by BJSM

Sport and Exercise Medicine: The UK trainee perspective – A BJSM blog series

By Dr Dane Vishnubala @danevishnubala

Earlier this year, Public Health England (PHE) put out a job advert for GP Clinical Champions. The job involved educating clinicians on: (i) the benefits of physical activity in primary and secondary prevention of disease and (ii) the harms of inactivity.

As I was just finishing GP training and about to embark on Sport and Exercise Medicine training, the idea of teaching and talking about exercise and health sounded perfect. So I applied and got the role as a Clinical Champion.

The clinical champion network is definitely an interesting initiative and one worth sharing with you.

So lets start at the beginning- why is there a need for the physical activity champions network?

Inactivity in the UK

Inactivity is a major problem in the UK. The statistics do not paint a pretty picture. As well as GPs, this is a great opportunity for the SEM community to make a difference and show a different side to our specialty.

Key facts

* I have taken most of the statistics from the Every body Active, Every day document by PHE that is well worth a read.

1 clinical champion

45% of women are not active enough for good health


2 clinical champion

19% of men and 26% women are physically inactive.

We also know that as well as females, ethnic minorities and those who identify as lesbian, gay or transgender are all likely to be less active. As you can see inactivity is a major issue and we must look at ways of tackling this whilst ensuring we also involve these harder to reach subsections of the populations.

Graph in terms of risk to mortality:

3 clinical champion

How do we compare to other countries?

4 clinical champions

Poorly would be the answer! *Note the definition of inactivity in this study is different to the one used previously.


Here is the recent info graphic launched in England at the last PHE conference to get across the key messages of the UK CMOs’ guidelines. An infographic for children 5-18 years is currently under development.

5 clinical champion

The Clinical Champion Programme


We know from research that we as clinicians in all specialties can make a bigger impact. We have a lot of patient contacts and opportunities to change behaviour.

The aim of the Clinical Champion Programme is to educate clinicians around the following:

  • Physical activity and it’s benefits
  • Risks of inactivity
  • Current inactivity statistics.
  • Exercise physiology in primary and secondary prevention
  • Making every contact count
  • Motivational interviewing
  • Local provisions for physical activity

To do this PHE decided to recruit GPs in various areas with an interest in physical activity to deliver the education. GPs were selected after an interview process which including assessing their teaching and presentation skills.

Here is our promotional flyer:

 5 clinical champion


As part of the role, I attended a two day training session, which brought the Champions together for sessions on teaching skills and to review, discuss and practice the materials; it also provided the opportunity to gel as a cadre of professionals. In addition the Champions all attend a national PHE physical activity conference.

The physical activity champions

It was great to see the range of Clinicians in the GP Clinical champion team. As well as the Public Health England team, we have a range of GPs with considerable physical activity experience, some with an MSc in Sport and Exercise medicine, others dually trained in SEM and GP, and even RCGP Physical Activity leads. This range of people has led to some interesting discussions on our team forum and further in team education. I have learned a lot about the public health side of this problem since joining the initiative, as much from the other champions as well as the training.

Delivery Experience

The education has been tailored to be either 30min to 2-3 hours approximately. I have delivered to VTS groups, GP groups, hospital specialty and trainee groups and grand rounds amongst others so far. The variety of specialties and the length of time can be a challenge however PHE has presentation and lesson plans for different groups. There has been some travelling to do and I have delivered in Yorkshire, Lancashire region and even one in London. The general feedback from the physical activity champions is that the training has been well received and that we are providing education in an area not provided at medical school or usually further training unless you happen to be a sport and exercise medicine or public health trainee!

Top 5 tips for clinicians

  1. Understand the patient, their motivations and barriers- softer GP skills are definitely useful here.
  2. Motivational interviewing or elements of it can be helpful in behaviour change.
  3. Understand local provisions so that you can signpost appropriately for that individual.
  4. Remember that even if you don’t make a change today, you may cause a change later- don’t underestimate the impact we can have.
  5. MAKE EVERY CONTACT COUNT! Prevention is always better than finding a cure!

Further resources

  1. PHE- Clinical Champion Teaching session– Contact
  2. Motivational interviewing- BMJ
  3. BMJ Learning Modules.
  4. Intelligent health
  5. Motivate to Move:
  6. Exercise Works

Can you help?

Can you help us spread the message? If you feel any groups of clinicians, you are involved with would benefit from the session then…email us to get a free education session booked in and delivered by one of our Physical Activity Clinical Champions. Contact us at


Dr Dane Vishnubala MBBS PGCME MRCGP FHEA, is a Sport and Exercise Medicine Registrar in Yorkshire, GP and part time lecturer at Leeds Beckett University in Physical Activity and Health. He has a strong interest in exercise medicine and still actively works in the Exercise Referral industry as a BASES/REPs Level 4 Certified Exercise Professional.

Twitter: @danevishnubala


Farrah Jawad is an ST5 doctor in Sport and Exercise Medicine in London.  She co-ordinates the BJSM Trainee Perspective blog.

BJSM blog homepage


A peer review journal for health professionals and researchers in sport and exercise medicine. Visit site

Creative Comms logo

Latest from British Journal of Sports Medicine

Latest from British Journal of Sports Medicine