Physical Activity as a Vital Sign: A Systematic Review

Abstract

Introduction Physical activity (PA) is strongly endorsed for managing chronicconditions, and a vital sign tool (indicator of general physical condition) could alert providers of inadequate PA to prompt counseling or referral. This systematic review examined the use, definitions, psychometric properties, and outcomes of brief PA instruments as vital sign measures, with attention primarily to studiesfocused on arthritis.MethodsElectronic databases were searched for English-language literature from 1985 through 2016 using the terms PA, exercise, vitalsign, exercise referral scheme, and exercise counseling. Of the 838articles identified for title and abstract review, 9 articles qualifiedfor full text review and data extraction.ResultsFive brief PA measures were identified: Exercise Vital Sign(EVS), Physical Activity Vital Sign (PAVS), Speedy Nutritionand Physical Activity Assessment (SNAP), General Practice Physical Activity Questionnaire (GPPAQ), and Stanford Brief ActivitySurvey (SBAS). Studies focusing on arthritis were not found. Over1.5 years of using EVS in a large hospital system, improvementsoccurred in relative weight loss among overweight patients and reduction in glycosylated hemoglobin among diabetic patients. OnPAVS, moderate physical activity of 5 or more days per weekversus fewer than 5 days per week was associated with a lowerbody mass index (−2.90 kg/m2). Compared with accelerometer-defined physical activity, EVS was weakly correlated (r = 0.27),had low sensitivity (27%–59%), and high specificity (74%–89%);SNAP showed weak agreement (κ = 0.12); GPPAQ had moderatesensitivity (46%) and specificity (50%), and SBAS was weaklycorrelated (r = 0.10–0.28), had poor to moderate sensitivity(18%–67%), and had moderate specificity (58%–79%).ConclusionFew studies have examined a brief physical activity tool as a vitalsign measure. Initial investigations suggest the promise of thesesimple and quick assessment tools, and research is needed to testthe effects of their use on chronic disease outcomes.