Article type
Year
Abstract
Background:Physical activity can reduce the risk of a number of diseases including heart disease, diabetes, and stroke, which are among the top ten leading causes of death worldwide. Numerous guidelines for the prescription of physical activity are published each year, but the quality and practicability of these guidelines is currently unknown.
Objectives:This systematic review and critical appraisal of physical activity guidelines summarizes the current quality of these guidelines and provides suggestions to improve their development.
Methods:We searched Ovid MEDLINE, EMBASE, Scopus, and Cochrane Central from January 2000 through October 2019 for physical activity guidelines that included recommendations about physical activity for the prevention of cardiometabolic disease. We systematically reviewed and critically appraised 95 guidance documents using 3 tools: AGREE II, the National Academy of Medicine (NAM) Standards for Trustworthy Clinical Practice Guidelines, and the Frequency, Intensity, Time and Type (FITT) score.
Results:For the average guideline, AGREE II domain scores ranged from 38% - 84% (median: 47%) while the portion of criteria fulfilled within each NAM domain ranged from 7% – 39% (median: 28%). Of the AGREE II domains, guidelines scored highest on Scope and Purpose and Clarity of Presentation and lowest on Applicability and Editorial Independence (Figure 1). Of the NAM criteria, guidelines scored highest on Articulation of Recommendations and lowest on External Review (Figure 2).
The average FITT score for all recommendations was 2.48 of 4. Recommendations for aerobic activity were more likely to have a higher FITT score (3.01) than recommendations for resistance training (2.21), balance/flexibility (1.89), unstructured play (2.4), or activities of unspecified modality (1.94). While guidelines improved according to both AGREE II and NAM standards over time, their FITT scores did not improve. Guidelines produced by governmental or other non-profit agencies or using the GRADE approach were of higher quality.
Conclusions:Organizations producing guidelines about physical activity should improve processes for public representation, external review, and conflict of interest management. Future recommendations about physical activity should also be more specific and include strategies for implementation.
Patient or healthcare consumer involvement:No
Objectives:This systematic review and critical appraisal of physical activity guidelines summarizes the current quality of these guidelines and provides suggestions to improve their development.
Methods:We searched Ovid MEDLINE, EMBASE, Scopus, and Cochrane Central from January 2000 through October 2019 for physical activity guidelines that included recommendations about physical activity for the prevention of cardiometabolic disease. We systematically reviewed and critically appraised 95 guidance documents using 3 tools: AGREE II, the National Academy of Medicine (NAM) Standards for Trustworthy Clinical Practice Guidelines, and the Frequency, Intensity, Time and Type (FITT) score.
Results:For the average guideline, AGREE II domain scores ranged from 38% - 84% (median: 47%) while the portion of criteria fulfilled within each NAM domain ranged from 7% – 39% (median: 28%). Of the AGREE II domains, guidelines scored highest on Scope and Purpose and Clarity of Presentation and lowest on Applicability and Editorial Independence (Figure 1). Of the NAM criteria, guidelines scored highest on Articulation of Recommendations and lowest on External Review (Figure 2).
The average FITT score for all recommendations was 2.48 of 4. Recommendations for aerobic activity were more likely to have a higher FITT score (3.01) than recommendations for resistance training (2.21), balance/flexibility (1.89), unstructured play (2.4), or activities of unspecified modality (1.94). While guidelines improved according to both AGREE II and NAM standards over time, their FITT scores did not improve. Guidelines produced by governmental or other non-profit agencies or using the GRADE approach were of higher quality.
Conclusions:Organizations producing guidelines about physical activity should improve processes for public representation, external review, and conflict of interest management. Future recommendations about physical activity should also be more specific and include strategies for implementation.
Patient or healthcare consumer involvement:No