S10-3: Updating the German Recommendations for Physical Activity. Moving Beyond Quantitative Recommendations?

Abstract

Background: Physical activity (PA) guidelines have traditionally focused on quantitative targets, such as recommending at least 150 minutes of PA per week. However, qualitative aspects (like exercising in green spaces or being active with meaningful others) may also contribute to the health benefits of PA but are rarely addressed in existing guidelines. The German Recommendations for Physical Activity and Physical Activity Promotion (Rütten & Pfeifer, 2016) are currently being updated. In this context, the study explores how the predominantly quantitative focus can be expanded to include qualitative dimensions of PA. Methods: The guideline update follows the GRADE-ADOLOPMENT approach (Klugar et al., 2024). To incorporate qualitative aspects of PA, we first define the scope (Step 1) and prioritise relevant key questions, especially regarding PA quality – based on Vella et al. (2023) and expert consultation (Step 2). In Step 3, recent national PA guidelines are identified and assessed using the AGREE II instrument (with scores of ≥60% in domains 1–3 and an accompanying evidence update). Recommendations from these sources are then matched to the prioritised questions (Step 4) to identify existing relevant recommendations (Step 5). Where necessary, evidence updates are performed (Step 6). Results: New German PA recommendations will be developed for several target groups, including children, adults, older adults, the oldest old, individuals with disabilities, and adults with non-communicable diseases (Step 1). Key questions regarding the quality aspects of PA (Step 2) include whether health-related outcomes differ by PA domain, individual preferences, or the social and physical environment. Of 66 guidelines reviewed, 11 were included (Step 3). An initial content analysis revealed that the only quality aspect addressed was the comparison between workplace PA and PA in other domains (Steps 4 and 5). The next step (Step 6) is to determine which evidence updates on PA quality aspects will be conducted. Conclusion: This study analyses the evidence base for a potential shift of the German PA Recommendations from a purely quantitative approach towards a broader, more holistic perspective. While integrating qualitative aspects of PA presents challenges, it also offers significant potential to enhance future PA guidelines. Funding Source: German Ministry of Health. Keywords: Physical activity guidelines, quality, context