New Perspectives on Activity/Disease Relationships Yielded by Objective Monitoring

Abstract

The Hockley Valley Consensus Symposium based most of its conclusions on dose/response relationships between physical activity and disease on subjective questionnaire reports. In this chapter, we summarize the findings from the Hockley Valley meeting, and we examine how far these conclusions have been amplified and/or modified by the use of objective physical activity monitors. Among a wide range of topics, we have included data on objective activity monitoring in relation to all-cause mortality, cardiac death, cardiovascular disease, stroke, peripheral vascular disease, hypertension, cardiac and metabolic risk factors, diabetes mellitus, obesity, low back pain. osteoarthritis, osteoporosis, chronic chest disease, cancer, depression, quality of life and the capacity for independent living. The introduction of objective monitoring has clarified dose/response relationships in a number of areas, allowing us to define relationships in terms of objective metrics (the number of steps taken per day). However, much of the information that is currently available remains cross-sectional in type. In many areas of rehabilitation, the pedometer/accelerometer seems a useful motivating device, providing well-documented increments of weekly activity. However, there remains a need for well-designed longitudinal trials, using objective monitors to follow changes in habitual activity and thus to demonstrate causality in the association between physical activity and good health.