Chapman Cole G, Schroeder Mary C, Marcussen Britt, Carr Lucas J
Department of Pharmacy Practice and Science, University of Iowa, Iowa City.
Department of Family Medicine, University of Iowa Health Care, Iowa City.
Prev Chronic Dis. 2025 Jan 2;22:E02. doi: 10.5888/pcd22.240149.
Physical inactivity is a major health risk factor for multiple chronic diseases and early death. Despite evidence supporting diet and physical activity behavioral counseling interventions, physical inactivity is rarely measured or managed in primary care. A need exists to fully explore and demonstrate the value of screening patients for physical inactivity. This study aimed to 1) compare health profiles of patients screened for inactivity versus patients not screened for inactivity, and 2) compare health profiles of inactive, insufficiently active, and active patients as measured by the Exercise Vital Sign screener.
The study sample comprised adult patients attending a well visit from November 1, 2017, through December 1, 2022, at a large midwestern university hospital. We extracted data from electronic medical records on exercise behavior reported by patients using the Exercise Vital Sign (EVS) questionnaire. We extracted data on demographics characteristics, resting pulse, encounters, and disease diagnoses from PCORnet Common Data Model (version 6.1). We used the Elixhauser Comorbidity Index to determine disease burden. We compared patients with complete and valid EVS values (n =7,261) with patients not screened for inactivity (n = 33,445). We conducted further comparisons between screened patients reporting 0 minutes (inactive), 1 to 149 minutes (insufficiently active), or ≥150 minutes (active) minutes per week of moderate-vigorous physical activity.
Patients screened for inactivity had significantly lower rates of several comorbid conditions, including obesity (P < .001), diabetes (P < .001), and hypertension (P < .001) when compared with unscreened patients. Compared with insufficiently active and inactive patients, active patients had a lower risk of 19 inactivity-related comorbid conditions including obesity (P < .001), depression (P < .001), hypertension (P < .001), diabetes (P < .001), and valvular disease (P < .001).
These findings suggest inactive and insufficiently active patients are at increased risk for multiple inactivity-related chronic conditions. These findings further support existing recommendations that inactive patients receive or be referred to evidence-based lifestyle behavioral counseling programs.
缺乏身体活动是多种慢性疾病和过早死亡的主要健康风险因素。尽管有证据支持饮食和身体活动行为咨询干预措施，但在初级保健中，很少对缺乏身体活动进行测量或管理。有必要充分探索和证明对患者进行身体活动不足筛查的价值。本研究旨在：1）比较接受身体活动不足筛查的患者与未接受筛查的患者的健康状况；2）比较通过运动生命体征筛查器测量的身体活动不足、活动不足和活动充足患者的健康状况。
研究样本包括2017年11月1日至2022年12月1日在中西部一所大型大学医院进行健康体检的成年患者。我们从电子病历中提取了患者使用运动生命体征（EVS）问卷报告的运动行为数据。我们从PCORnet通用数据模型（版本6.1）中提取了人口统计学特征、静息脉搏、就诊次数和疾病诊断数据。我们使用埃利克斯豪泽共病指数来确定疾病负担。我们将具有完整且有效EVS值的患者（n = 7261）与未接受身体活动不足筛查的患者（n = 33445）进行了比较。我们对报告每周中等强度至剧烈身体活动时间为0分钟（身体活动不足）、1至149分钟（活动不足）或≥150分钟（活动充足）的筛查患者进行了进一步比较。
与未筛查的患者相比，接受身体活动不足筛查的患者几种共病的发生率显著较低，包括肥胖（P <.001）、糖尿病（P <.001）和高血压（P <.001）。与活动不足和身体活动不足的患者相比，活动充足的患者患19种与身体活动不足相关共病的风险较低，包括肥胖（P <.001）、抑郁症（P <.001）、高血压（P <.001）、糖尿病（P <.001）和瓣膜病（P <.001）。
这些发现表明，身体活动不足和活动不足的患者患多种与身体活动不足相关慢性病的风险增加。这些发现进一步支持了现有建议，即身体活动不足的患者应接受或被转介到基于证据的生活方式行为咨询项目。
