A new consensus statement, led by the Faculty of Sport and Exercise Medicine UK and developed through review of the scientific evidence and expert clinical and patient consensus, has concluded that the benefits of physical activity far outweigh the risks for people living with long-term health conditions. The statement finds that physical activity is safe – even for people living with symptoms of multiple long-term conditions.
Physical activity has a key role to play in the management of long-term conditions, including diabetes, heart disease and cancer. The International Society for Physical Activity and Health (ISPAH) identifies the integration of physical activity into healthcare as one of the eight best investments to combat inactivity. However, there are many barriers to getting active for people living with long-term health conditions – including fears that physical activity may worsen their symptoms, and requirements to gain medical clearance prior to increasing activity levels. This means that people with long-term conditions, who have much to gain from being active, are twice as likely to be inactive than those who do not have a health condition.
The new consensus statement aims to break down these barriers by clarifying fundamental safety considerations and bridging the gap between evidence, clinical and public health guidelines and people’s lived experience. It seeks to equip healthcare professionals with the knowledge they need to discuss physical activity with symptomatic people in a person-centred way, addressing the understandable concerns that patients have about the impact of physical activity on symptoms. It also recognises that pre-participation medical clearance is an unnecessary barrier to physical activity and challenges the need for it.
As part of a system-wide approach to promoting physical activity, consistent messaging from healthcare professionals around the benefits balanced with risks will also help reduce the barriers to engagement. Sport England, the Office for Health Improvement and Disparities, the Richmond Group of charities and the Faculty of Sport and Exercise Medicine UK will now work with partners in the health, sport and physical activity sectors to empower and support people living with long-term health conditions to have the confidence to become more active.
The five ’impact statements’ that make up the consensus statement conclude that:
- for people living with long term conditions, the benefits of physical activity far outweigh the risks and physical activity is safe, even for people living with symptoms of multiple long-term conditions,
- despite the risks of serious events being very low, perceived risk is high,
- It is not as easy as just telling someone to move more; person-centred conversations are essential for addressing perceived risk,
- everybody has their own starting point and
- people should stop and seek medical attention if they experience a dramatic increase in symptoms.
In addition, in response to patient recommendation, eight symptom-based statements discuss specific risks for musculoskeletal pain, fatigue, shortness of breath, cardiac chest pain, palpitations, poor blood sugar control, cognitive impairment and frailty. These are discussed further in this BJSM podcast:
Dr Jeanelle de Gruchy, Deputy Chief Medical Officer, said:
“There has previously been some concern that long-term conditions could be made worse by physical activity. However, the evidence is that physical activity has an important role to play in preventing and treating many conditions and that, for most people with long-term conditions, the benefits outweigh the risks. This expert consensus, supported by the Office for Health Improvement and Disparities, will help healthcare professionals to have informed, personal conversations with their patients living with long-term conditions.”
Tim Hollingsworth, CEO of Sport England, said:
“Breaking down the barriers that make it harder for the 15 million people living with long-term health conditions in England to get active is critical to tackling health inequalities: a key aim of our Uniting the Movement strategy. This new consensus statement is a really positive step – it will play a vital role in supporting healthcare professionals to empower their patients to get active in a way that is right for them. In future, our ambition is for this work to be embedded into the sport and physical activity sector too, ensuring a joined-up approach between the different sectors that support people’s health.”
Dr Natasha Jones, President-Elect of the Faculty of Sport and Exercise Medicine UK said:
“We need to build our patients’ confidence and motivation to move more, because moving more makes nearly everybody feel better. The medical professions and the fitness industry will work together to create and support a new generation of empowered people, living with long term conditions, confident in their own ability to be more active.”
Authors and Affiliations:
Sport England is a public body and invests up to £300 million National Lottery and government money each year in projects and programmes that help people get active and play sport. It wants everyone in England, regardless of age, background, or level of ability, to feel able to engage in sport and physical activity. It wants everyone in England, regardless of age, background, or level of ability, to feel able to engage in sport and physical activity. That’s why a lot of its work is specifically focused on helping people who do no, or very little, physical activity and groups who are typically less active – like women, disabled people and people on lower incomes.
The Faculty of Sport and Exercise Medicine (UK) is the UK membership body responsible for the governance and development of sport and exercise medicine. We promote better health by setting and maintaining professional standards for the specialty and all those working within it. Our Moving Medicine initiative helps healthcare professionals support people to move more. The award-winning programme provides free evidence-based training and practical resources that support doctors, AHPs and other health professionals to help patients live more active lives. Moving Medicine was developed as part of the national Moving Healthcare Professionals Programme led by PHE and Sport England. Find out more at www.movingmedicine.ac.uk
For press enquiries, please contact Ian Williamson, PR & Communications Officer, Faculty of Sport and Exercise Medicine at I.Williamson@fsem.ac.uk OR Sport England’s press office at mediateam@sportengland.org.uk