The recent pandemic, with associated lockdowns and subsequent behavioural change, has meant that many people have become less active and disparities in physical activity among women, ethnic minorities, and people with disabilities have worsened. Existing tools to measure physical activity in primary care such as the general practice physical activity questionnaire (GPPAQ) are poorly validated and not reliable. The World Health Organization’s message that ‘every move counts’ is important: patients can be advised that any duration counts towards their daily and weekly total. The benefits of physical activity outweigh the risks in those with long-term health conditions, and medical clearance is unnecessary except for those with absolute contraindications.
There are four main ways of improving physical activity:
Clinician-led ABC approach: (A)ssessing physical activity, using a (B)rief intervention, and (C)ontinuing support. A physical activity prescription can be provided by being specific about the Frequency, Intensity, Time, and Type (FITT). Digital interventions such as a pedometer, activity tracker, or mobile app with goal setting can increase step counts. Physical activity referral schemes (PARS) have the highest patient-to-physical activity connection rate. Barriers to PARS include lack of time, long travel distances, and worries about safety for women. Facilitators include, for example, flexible scheduling and women-only spaces. Community interventions such as volunteer-led weekly 5 km runs via Parkrun or outdoor walking groups. These are likely to be the cheapest options.
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