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  • Heart Association Calls for Physical Activity Assessments to be Considered a Vital Health Measure

    An American Heart Association (AHA) scientific statement released in October 2013 urges clinicians and researchers to include physical activity assessments as a vital patient health measure equal to other cardiovascular risk factors like obesity, smoking, diabetes, and hypertension.

    The statement, released online this month and scheduled for print publication in November, points out the well-established connection between physical activity and overall health. Despite this connection, most adults in the United States fail to achieve the recommended 150 minutes per week of moderate physical activity or 75 minutes per week of vigorous activity, though the degree to which these adults are falling short tends to vary among studies.

    According to the AHA statement, this variation is part of what begs the need for "consistent assessment of physical activity in research and clinical settings to improve risk factor identification, minimize physical inactivity, and further advance our understanding of health-related impact." But the heart of the matter, so to speak, is the fact that a clear risk factor and "vital health measure" are often overlooked.

    The statement provides an overview of assessment approaches that range from questionnaires and logs to more objective techniques such as indirect calorimetry, heart rate monitoring, and accelerometer use. The authors also include a "decision matrix guide" to the selection of a physical activity monitoring instrument that offers options related to what needs to be described, burden on the patient, personnel available, and other factors. The idea behind the matrix and other information in the statement is "to provide a guide to allow professionals to make a goal-specific selection of a meaningful physical activity method."

    The importance of physical activity has been a central focus of APTA and is the foundation of the APTA "Fit After 50" campaign. The campaign recently reached millions of Americans through APTA's publication of the "Top 10 Fittest Baby Boomer Cities in America," in partnership with the Huffington Post. APTA has long supported the promotion of physical activity and the value of physical fitness, and currently has representatives on the practice committee of Exercise is Medicine and the board of the National Physical Activity Plan Alliance.

    Weight Loss Apps Light on Behavioral Content

    Though extremely popular, weight loss apps may not really deliver the kinds of help proven to be most effective in shedding pounds and keeping them off. This was the conclusion of a study published in the October, 2013 issues of the American Journal of Preventive Medicine.

    The study evaluated 30 weight loss apps listed in the top 100 downloaded apps in both iPhone and Android platforms by rating each app in terms of the number of behavioral weight-loss strategies offered. The behavioral strategies were drawn from the Diabetes Prevention Program (DPP), which the study's authors describe as "evidence-based lifestyle interventions." These interventions include behavioral strategies ranging from the establishment of a weight loss goal to stress reduction, overcoming negative thinking, identification of problem social cues, and time management.

    The results? No app made the cut in terms of including a wide range of behavioral strategies. Although most apps included weight and dietary goal-setting, self-monitoring, and calorie balance, authors found that all of the apps were completely lacking in 7 strategies: stress reduction, relapse prevention, social cues, negative thinking, regulating eating patterns, time management, and instruction on reading nutritional labels. The study also concluded that paid apps were no more likely to include behavioral strategies than free ones.

    The conclusions reached in the study are consistent with approaches to weight loss taken by physical therapists (PTs), which emphasize focusing on building a healthy lifestyle over a fixation on pounds lost. APTA's Move Forward website offers tips for families on how to encourage changes that will contribute to long-term health.

    ED Visits for Falls Will Rise as Population Ages

    Injuries—particularly injuries suffered in falls—will become an increasingly prevalent reason for emergency department (ED) visits as the US population continues to age, according to the Centers for Disease Control and Prevention (CDC).

    A recently released data brief from the CDC reports that between 2009 and 2010, 19 million ED visits were made by people 65 and older, a number that represents about 1 out of every 20 older Americans. The rates increased with age.

    Particularly significant for physical therapists (PTs) and physical therapist assistants (PTAs), the CDC brief states that of the 19 million ED visits in this age group, nearly 30% were injury-related, with falls accounting for 13.5% of the visits. The likelihood of fall-related visits increased markedly with age.

    Older Americans can recover from falls and other injuries with the help of a physical therapist (PT) both in EDs and as part of the recovery process. APTA offers resources for physical therapy practice in EDs as well as information related to balance and falls. Research on risk factors for community dwelling elders is also available on the PTNow website.

    The CDC brief predicts that by 2030, 20% of the US population will be 65 or over with a proportionate rise in ED visits, many of which will be for falls.