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Physical activity benefits outweigh risks for people with long-term health conditions

A new consensus statement from health experts has determined that physical activity is safe – even for people living with symptoms of multiple conditions.

5th November 2021

The benefits of taking part in physical activity “outweigh the risks” for people with long-term health conditions. 

A major review of scientific evidence and expert clinical consensus has found physical activity is safe – even for people living with symptoms of multiple conditions. 

The findings will offer guidance for healthcare professionals that physical activity can be used to manage the majority of long-term health conditions and lead to more people with long-term health conditions being encouraged to take part in sport and physical activity.  

A man performs exercises at home using a resistance band.

One in four people in England live with a long-term health condition, and those in this group are twice as likely to be inactive, despite evidence that being active can help manage many conditions and reduce the impact and severity of some symptoms. 

However, there are many barriers to getting active for those living with a long-term health condition – including fears that physical activity may worsen their symptoms, and requirements to gain medical clearance prior to increasing activity levels.  

The new consensus statement aims to break down these barriers by clarifying fundamental safety considerations and bridging the gap between evidence, clinical and public health guidelines and people’s lived experience. 

Tim Hollingsworth, our chief executive, said the research would give more people the confidence to promote and take part in sport and physical activity, and prove crucial in our long-term strategy’s goal of helping people with long-term health conditions enjoy the benefits of being active.  

“Breaking down the barriers that make it harder for the 15 million people living with long-term health conditions in England to get active is critical to tackling health inequalities: a key aim of our Uniting the Movement strategy,” he said.  

“This new consensus statement is a really positive step – it will play a vital role in supporting healthcare professionals to empower their patients to get active in a way that is right for them.  

“In future, our ambition is for this work to be embedded into the sport and physical activity sector too, ensuring a joined-up approach between the different sectors that support people’s health.” 

There are five impact statements that make up the consensus: 

  • For people living with long-term conditions, the benefits of physical activity far outweigh the risks and physical activity is safe, even for people living with symptoms of multiple long-term conditions 

  • Despite the risks of serious events being very low, perceived risk is high 

  • It's not as easy as just telling someone to move more; person-centred conversations are essential for addressing perceived risk 

  • Everybody has their own starting point 

  • People should stop and seek medical attention if they experience a dramatic increase in symptoms. 

There are eight symptom specific statements, to support healthcare professionals to have well informed personalised conversations with patients to effectively address concerns about the impact of increasing activity on their symptoms. These include; Musculoskeletal pain, Fatigue (NB), Shortness of breath, Cardiac chest pain, Palpitations, Dysglycaemia, (high or low blood sugar), Cognitive impairment, Falls and frailty to support conversations with patients. 

We worked with the Faculty of Sport and Exercise Medicine UK, the Office for Health Improvement and Disparities and the Royal College of General Practitioners to develop these statements, through expert consensus, about the medical risks of physical activity for all adults, irrespective of age, or living with one or more long-term conditions. 

What isn’t covered by the statements 

The list of medical conditions covered by this consensus statement is not exhaustive. For instance, chronic fatigue syndromes/ME and long Covid-19 were excluded from this study as evidence regarding the risks of physical activity in these conditions is evolving. Existing guidance should be followed for those conditions. For more information about included conditions, please see the British Journal of Sports Medicine’s website.

This new consensus statement is a really positive step – it will play a vital role in supporting healthcare professionals to empower their patients to get active in a way that is right for them. 

Tim Hollingsworth

Chief executive, Sport England

Why it matters 

Strengthening the connections between sport, physical activity, health and wellbeing, so more people can feel the benefits of, and advocate for, an active life, is one of the five big issues in our long-term strategy, Uniting the Movement.  

Despite evidence showing that one in four people would be more active if advised by a GP or nurse, nearly three-quarters of GPs don't speak about the benefits of physical activity to their patients because of either a lack of knowledge, skills or confidence, with 80% reporting being unfamiliar with the national physical activity guidelines. 

Almost 50% of GPs, in a recent survey of 830 GPs in England, indicated that a barrier to effectively advising patients about physical activity were concerns by the patient about perceived risks of taking up physical activity (46%), but this is a recognised barrier across healthcare professions and not just those in primary care. 

Through the work of the Moving Healthcare Professionals Programme, the new consensus statements will give confidence to the 650,000 healthcare professionals to promote physical activity and lead to more people with long-term health conditions enjoying sport and physical activity – having fun, making friends, being healthy and building stronger community connections.  

As well as the physical benefits, the mental health and wellbeing of people is boosted, communities become more cohesive, and individual employment prospects are supported. 

Also, if just one in four of the inactive population received and acted on advice from their healthcare professional, there'd be 2.9 million less inactive adults in England who'd gain the benefits of moving more. 

The timing of the statements is also crucial, as our most recent Active Lives Adult Survey report found the coronavirus (Covid-19) pandemic led to a decline in the number of people with long-term health conditions taking part in sport and physical activity.  

Even since restrictions started to ease, those with a condition have seen no recovery in activity levels.  

We’re working hard to help people with long-term health conditions build activity into their lives. 

We Are Undefeatable, a national campaign led by a collaboration of 16 leading health and social care charities that benefits from our expertise and insight, along with National Lottery funding, aims to help those with conditions such as diabetes, cancer, arthritis and Parkinson’s to build physical activity into their lives. 

For more information on the campaign, and to become a supporter, visit the campaign's website

What next?

This research provides us with the foundation and evidence for future collaboration across health, sport and physical activity partners, including insurers to review the need for medical clearance and explore and determine what appropriate pre-participation screening protocols should look like.  

Insights from the recent #EasierToBeActive consultation, led by the National Centre for Sport and Exercise Medicine at Sheffield Hallam, which saw over 600 people take part, many with lived experience of health conditions, provides further evidence to support the development of these reviews.

Further reaction

  • Dr Jeanelle de Gruchy 

    Deputy Chief Medical Officer 

    “There has previously been some concern that long-term conditions could be made worse by physical activity. However, the evidence is that physical activity has an important role to play in preventing and treating many conditions and that, for most people with long-term conditions, the benefits outweigh the risks. This expert consensus, supported by the Office for Health Improvement and Disparities, will help healthcare professionals to have informed, personal conversations with their patients living with long-term conditions.” 

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  • Dr Natasha Jones

    President-elect of the Faculty of Sport and Exercise medicine

    "We need to build our patients’ confidence and motivation to move more, because moving more makes nearly everybody feel better. The medical professions and the fitness industry will work together to create and support a new generation of empowered people, living with long term conditions, confident in their own ability to be more active.”

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  • Dr Andrew Boyd

    Physical activity and lifestyle lead, Royal College of General Practitioners 

    “This guidance will help healthcare colleagues, in primary care and beyond, share the best available evidence when supporting people with long-term conditions to move more, every day. I commend all patient facing clinical staff to read the statement, share with their colleagues, and build the principles into their consultations, with the aim of making every contact count.” 

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