Interpretation of the World Health Organization 2020 guidelines on physical activity and sedentary behaviour_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Dongze ^1,2 , LI Fanghui ^1,2 , LIU Yi ^1,2 , JIA Yu ^1,2 , LI Wentao ³ , YAO Yi ⁴ , YANG Rong ⁴ , ZENG Rui ³ , LIAO Xiaoyang ⁴ ,  WAN Zhi ^1,2

1. Emergency Department/Emergency Medicine Laboratory, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. Disaster Medicine Center, Sichuan University, Chengdu, 610041, P.R.China;
3. Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
4. Department of General Practice and National Clinical Research Center for Geriatrics, International Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

WAN Zhi, Email: 303680215@qq.com

Keywords：

World Health Organization (WHO); physical activity; sedentary behaviour; guidelines interpretation

DOI：

10.7507/1007-4848.202012101

Video：

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The World Health Organization (WHO) released the WHO 2020 guidelines on physical activity and sedentary behaviour in November 2020. Compared with the 2010 WHO guidelines, this guideline has incorporated more extensive medical evidence and made targeted recommendations for special populations. The main content includes physical activity and sedentary behaviour advice for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic conditions, and disability. This review will interpret the 2020 WHO guidelines in detail.

Citation： LI Dongze, LI Fanghui, LIU Yi, JIA Yu, LI Wentao, YAO Yi, YANG Rong, ZENG Rui, LIAO Xiaoyang, WAN Zhi. Interpretation of the World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(4): 376-383. doi: 10.7507/1007-4848.202012101 Copy

1.	Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med, 2020, 54(24): 1451-1462.
2.	Meinhardt U, Witassek F, Petrò R, et al. Strength training and physical activity in boys: a randomized trial. Pediatrics, 2013, 132(6): 1105-1111.
3.	Duncan M, BirchS, Woodfield L. Efficacy of an integrated school curriculum pedometer intervention to enhance physical activity and to reduce weight status in children. Eur Phys Ed Rev, 2012, 18(3): 396-407.
4.	Sebire SJ, Jago R, Fox KR, et al. Associations between children's social functioning and physical activity participation are not mediated by social acceptance: a cross-sectional study. Int J Behav Nutr Phys Act, 2011, 8(6): 106.
5.	Standage M, Gillison FB, Ntoumanis N, et al. Predicting students' physical activity and health-related well-being: A prospective cross-domain investigation of motivation across school physical education and exercise settings. J Sport Exerc Psychol, 2012, 34(1): 37-60.
6.	Eddolls WTB, McNarry MA, Stratton G, et al. High-intensity interval training interventions in children and adolescents: A systematic review. Sports Med, 2017, 47(11): 2363-2374.
7.	Hjorth MF, Chaput JP, Ritz C, et al. Fatness predicts decreased physical activity and increased sedentary time, but not vice versa: Support from a longitudinal study in 8- to 11-year-old children. Int J Obes (Lond), 2014, 38(7): 959-965.
8.	Martinez-Gomez D, Ruiz JR, Ortega FB, et al. Recommended levels and intensities of physical activity to avoid low-cardiorespiratory fitness in European adolescents: The HELENA study. Am J Hum Biol, Nov-Dec 2010, 22(6): 750-756.
9.	Cieśla E, Mleczko E, Bergier J, et al. Health-related physical fitness, BMI, physical activity and time spent at a computer screen in 6 and 7-year-old children from rural areas in Poland. Ann Agric Environ Med, 2014, 21(3): 617-621.
10.	Parkes A, Sweeting H, Wight D, et al. Do television and electronic games predict children's psychosocial adjustment? Longitudinal research using the UK Millennium Cohort Study. Arch Dis Child, 2013, 98(5): 341-348.
11.	Chastin SF, Palarea-Albaladejo J, Dontje ML, et al. Combined effects of time spent in physical activity, sedentary behaviors and sleep on obesity and cardio-metabolic health markers: A novel compositional data analysis approach. PLoS One, 2015, 10(10): e0139984.
12.	Cao M, Quan M, Zhuang J. Effect of high-intensity interval training versus moderate-intensity continuous training on cardiorespiratory fitness in children and adolescents: A meta-analysis. Int J Environ Res Public Health, 2019, 5(6): 209.
13.	Carson V, Hunter S, Kuzik N, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: An update. Appl Physiol Nutr Metab, 2016, 41(6 Suppl 3): S240-S265.
14.	Ekelund U, Tarp J, Steene-Johannessen J, et al. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: Systematic review and harmonised meta-analysis. BMJ, 2019, 336(10): l4570.
15.	Patterson R, McNamara E, Tainio M, et al. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: A systematic review and dose response meta-analysis. Eur J Epidemiol, 2018, 33(9): 811-829.
16.	Ekelund U, Brown WJ, Steene-Johannessen J, et al. Do the associations of sedentary behaviour with cardiovascular disease mortality and cancer mortality differ by physical activity level? A systematic review and harmonised meta-analysis of data from 850 060 participants. Br J Sports Med, 2019, 53(14): 886-894.
17.	Jakicic JM, Kraus WE, Powell KE, et al. Association between bout duration of physical activity and health: Systematic review. Med Sci Sports Exerc, 2019, 51(6): 1213-1219.
18.	Blond K, Brinkløv CF, Ried-Larsen M, et al. Association of high amounts of physical activity with mortality risk: A systematic review and meta-analysis. Br J Sports Med, 2020, 54(20): 1195-1201.
19.	Stamatakis E, Lee IM, Bennie J, et al. Does strength-promoting exercise confer unique health benefits? A pooled analysis of data on 11 population cohorts with all-cause, cancer, and cardiovascular mortality endpoints. Am J Epidemiol, 2018, 187(5): 1102-1112.
20.	Mahmood S, Macinnis RJ, English DR, et al. Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: A systematic review and meta-analysis. Int J Epidemiol, 2017, 46(6): 1797-813.
21.	Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee scientific report. Washington, DC: US Department of Health and Human Services; 2018.
22.	Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev, 2019, 1: CD012424.
23.	Bueno de Souza RO, Marcon LF, Arruda ASF, et al. Effects of mat pilates on physical functional performance of older adults: A meta-analysis of randomized controlled trials. Am J Phys Med Rehabil, 2018, 97(6): 414-425.
24.	Sherrington C, Fairhall N, Kwok W, et al. Evidence on physical activity and falls prevention for people 1 aged 65+ years: Systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. J Phys Act Health, In press.
25.	Ekelund U, Steene-Johannessen J, Brown WJ, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet, 2016, 388(10051): 1302-1310.
26.	Di Mascio D, Magro-Malosso ER, Saccone G, et al. Exercise during pregnancy in normal-weight women and risk of preterm birth: A systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol, 2016, 215(5): 561-571.
27.	Barakat, R. Exercise during pregnancy protects against hypertension and macrosomia: Randomized clinical trial. Am J Obstet Gynecol, 2016, 214(5): p.649.e1-8.
28.	Perales M, Artal R, Lucia A. Exercise during pregnancy. JAMA, 2017, 317(11): 1113-1114.
29.	Choi J, Fukuoka Y, Lee JH. The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: A systematic review and meta-analysis of randomized controlled trials. Prev Med, 2013, 56(6): 351-364.
30.	Dipietro L, Evenson KR, Bloodgood B, et al. Benefits of physical activity during pregnancy and postpartum: An umbrella review. Med Sci Sports Exerc, 2019, 51(6): 1292-1302.
31.	Wang C, Wei Y, Zhang X, et al. A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women. Am J Obstet Gynecol, 2017, 216(4): 340-351.
32.	Jukic AM, Evenson KR, Daniels JL, et al. A prospective study of the association between vigorous physical activity during pregnancy and length of gestation and birthweight. Matern Child Health J, 2012, 16(5): 1031-1044.
33.	Tomić V, Sporiš G, Tomić J, et al. The effect of maternal exercise during pregnancy on abnormal fetal growth. Croat Med J, 2013, 54(4): 362-368.
34.	ACOG Committee Opinion No. 650: Physical Activity and exercise during pregnancy and the postpartum period. Obstet Gynecol, 2015, 126(6): p.e135-42.
35.	Fazzi C. Sedentary behaviours during pregnancy: A systematic review. Int J Behav Nutr Phys Act, 2017, 14(1): 32.
36.	Friedenreich CM, Stone CR, Cheung WY, et al. Physical activity and mortality in cancer survivors: A systematic review and meta-analysis. JNCI Cancer Spectrum, 2019: 3.
37.	Costa EC, Hay JL, Kehler DS, et al. Effects of high-intensity interval training versus moderate-intensity continuous training on blood pressure in adults with pre- to established hypertension: a systematic review and meta-analysis of randomized trials. Sports Med, 2018, 48(9): 2127-2142.
38.	Liu Y, Ye W, Chen Q, et al. Resistance exercise intensity is correlated with attenuation of HbA1c and insulin in patients with type 2 diabetes: A systematic review and meta-analysis. Int J Environ Res Public Health, 2019, 16(1): 6.
39.	Ibeneme SC, Omeje C, Myezwa H, et al. Effects of physical exercises on inflammatory biomarkers and cardiopulmonary function in patients living with HIV: A systematic review with meta-analysis. BMC infectious diseases. 2019; 19.7.
40.	Poton R, Polito M, Farinatti P. Effects of resistance training in HIV-infected patients: A meta-analysis of randomised controlled trials. J Sports Sci, 2017, 35(24): 2380-2389.
41.	O’Brien KK, Tynan AM, Nixon SA, et al. Effectiveness of aerobic exercise for adults living with HIV: Systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC Infect Dis, 2016, 16(4): 876-879.
42.	Heissel A, Zech P, Rapp MA, et al. Effects of exercise on depression and anxiety in persons living with HIV: A meta-analysis. J Psychosom Res, 2019, 126: 109-123.
43.	Friedenreich CM, Stone CR, Cheung WY, Hayes SC. Physical activity and mortality in cancer survivors: A systematic review and meta-analysiss. JNCI Cancer Spectr. 2019, 4(1): pkz080.
44.	Sadarangani KP, Hamer M, Mindell JS, et al. Physical activity and risk of all-cause and cardiovascular disease mortality in diabetic adults from Great Britain: Pooled analysis of 10 population-based cohorts. Diabetes Care, 2014, 37(4): 1016-1023.
45.	Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC: US Department of Health and Human Services. 2018.
46.	Johnson CC. The benefits of physical activity for youth with developmental disabilities: A systematic review. Am J Health Promot, 2009, 23(3): 157-167.
47.	Chen CJJ, Ringenbach SDR. The effect of acute exercise on the performance of verbal fluency in adolescents and young adults with Down syndrome: a pilot study. J Intellect Disabil Res, 2019, 63(6): 614-623.
48.	Alphonsus KB, Su Y, D'Arcy C. The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis. Complement Ther Med, 2019, 43: 188-195.
49.	Patterson KK, Wong JS, Prout E C, et al. Dance for the rehabilitation of balance and gait in adults with neurological conditions other than Parkinson's disease: A systematic review. Heliyon, 2018, 4(3): e00584.
50.	Firth J, Stubbs B, Rosenbaum S, et al. Aerobic exercise improves cognitive functioning in people with schizophrenia: A systematic review and meta-analysis. Schizophr Bull, 2017, 43(3): 546-556.
51.	Cugusi L, Manca A, Dragone D, et al. Nordic walking for the management of people with parkinson disease: A systematic review. PM R, 2017, 9(11): 1157-1166.
52.	Law CK, Lam FM, Chung RC, et al. Physical exercise attenuates cognitive decline and reduces behavioural problems in people with mild cognitive impairment and dementia: A systematic review. J Physiother, 2020, 66(1): 9-18.
53.	Barajas-galindo DE, González ArnáiZ E, Ferrero Vicente P, et al. Effects of physical exercise in sarcopenia. A systematic review. Endocrinol Diabetes Nutr, 2020: S2530-0164(20)30114-2.
54.	Christie J. Progressive resistance strength training for improving physical function in older adults. Int J Older People Nurs, 2011, 6(3): 244-246.
55.	Tu RH, Zeng ZY, Zhong GQ, et al. Effects of exercise training on depression in patients with heart failure: A systematic review and meta-analysis of randomized controlled trials. Eur J Heart Fail, 2014, 16(7): 749-757.

1. Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med, 2020, 54(24): 1451-1462.
2. Meinhardt U, Witassek F, Petrò R, et al. Strength training and physical activity in boys: a randomized trial. Pediatrics, 2013, 132(6): 1105-1111.
3. Duncan M, BirchS, Woodfield L. Efficacy of an integrated school curriculum pedometer intervention to enhance physical activity and to reduce weight status in children. Eur Phys Ed Rev, 2012, 18(3): 396-407.
4. Sebire SJ, Jago R, Fox KR, et al. Associations between children's social functioning and physical activity participation are not mediated by social acceptance: a cross-sectional study. Int J Behav Nutr Phys Act, 2011, 8(6): 106.
5. Standage M, Gillison FB, Ntoumanis N, et al. Predicting students' physical activity and health-related well-being: A prospective cross-domain investigation of motivation across school physical education and exercise settings. J Sport Exerc Psychol, 2012, 34(1): 37-60.
6. Eddolls WTB, McNarry MA, Stratton G, et al. High-intensity interval training interventions in children and adolescents: A systematic review. Sports Med, 2017, 47(11): 2363-2374.
7. Hjorth MF, Chaput JP, Ritz C, et al. Fatness predicts decreased physical activity and increased sedentary time, but not vice versa: Support from a longitudinal study in 8- to 11-year-old children. Int J Obes (Lond), 2014, 38(7): 959-965.
8. Martinez-Gomez D, Ruiz JR, Ortega FB, et al. Recommended levels and intensities of physical activity to avoid low-cardiorespiratory fitness in European adolescents: The HELENA study. Am J Hum Biol, Nov-Dec 2010, 22(6): 750-756.
9. Cieśla E, Mleczko E, Bergier J, et al. Health-related physical fitness, BMI, physical activity and time spent at a computer screen in 6 and 7-year-old children from rural areas in Poland. Ann Agric Environ Med, 2014, 21(3): 617-621.
10. Parkes A, Sweeting H, Wight D, et al. Do television and electronic games predict children's psychosocial adjustment? Longitudinal research using the UK Millennium Cohort Study. Arch Dis Child, 2013, 98(5): 341-348.
11. Chastin SF, Palarea-Albaladejo J, Dontje ML, et al. Combined effects of time spent in physical activity, sedentary behaviors and sleep on obesity and cardio-metabolic health markers: A novel compositional data analysis approach. PLoS One, 2015, 10(10): e0139984.
12. Cao M, Quan M, Zhuang J. Effect of high-intensity interval training versus moderate-intensity continuous training on cardiorespiratory fitness in children and adolescents: A meta-analysis. Int J Environ Res Public Health, 2019, 5(6): 209.
13. Carson V, Hunter S, Kuzik N, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: An update. Appl Physiol Nutr Metab, 2016, 41(6 Suppl 3): S240-S265.
14. Ekelund U, Tarp J, Steene-Johannessen J, et al. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: Systematic review and harmonised meta-analysis. BMJ, 2019, 336(10): l4570.
15. Patterson R, McNamara E, Tainio M, et al. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: A systematic review and dose response meta-analysis. Eur J Epidemiol, 2018, 33(9): 811-829.
16. Ekelund U, Brown WJ, Steene-Johannessen J, et al. Do the associations of sedentary behaviour with cardiovascular disease mortality and cancer mortality differ by physical activity level? A systematic review and harmonised meta-analysis of data from 850 060 participants. Br J Sports Med, 2019, 53(14): 886-894.
17. Jakicic JM, Kraus WE, Powell KE, et al. Association between bout duration of physical activity and health: Systematic review. Med Sci Sports Exerc, 2019, 51(6): 1213-1219.
18. Blond K, Brinkløv CF, Ried-Larsen M, et al. Association of high amounts of physical activity with mortality risk: A systematic review and meta-analysis. Br J Sports Med, 2020, 54(20): 1195-1201.
19. Stamatakis E, Lee IM, Bennie J, et al. Does strength-promoting exercise confer unique health benefits? A pooled analysis of data on 11 population cohorts with all-cause, cancer, and cardiovascular mortality endpoints. Am J Epidemiol, 2018, 187(5): 1102-1112.
20. Mahmood S, Macinnis RJ, English DR, et al. Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: A systematic review and meta-analysis. Int J Epidemiol, 2017, 46(6): 1797-813.
21. Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee scientific report. Washington, DC: US Department of Health and Human Services; 2018.
22. Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev, 2019, 1: CD012424.
23. Bueno de Souza RO, Marcon LF, Arruda ASF, et al. Effects of mat pilates on physical functional performance of older adults: A meta-analysis of randomized controlled trials. Am J Phys Med Rehabil, 2018, 97(6): 414-425.
24. Sherrington C, Fairhall N, Kwok W, et al. Evidence on physical activity and falls prevention for people 1 aged 65+ years: Systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. J Phys Act Health, In press.
25. Ekelund U, Steene-Johannessen J, Brown WJ, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet, 2016, 388(10051): 1302-1310.
26. Di Mascio D, Magro-Malosso ER, Saccone G, et al. Exercise during pregnancy in normal-weight women and risk of preterm birth: A systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol, 2016, 215(5): 561-571.
27. Barakat, R. Exercise during pregnancy protects against hypertension and macrosomia: Randomized clinical trial. Am J Obstet Gynecol, 2016, 214(5): p.649.e1-8.
28. Perales M, Artal R, Lucia A. Exercise during pregnancy. JAMA, 2017, 317(11): 1113-1114.
29. Choi J, Fukuoka Y, Lee JH. The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: A systematic review and meta-analysis of randomized controlled trials. Prev Med, 2013, 56(6): 351-364.
30. Dipietro L, Evenson KR, Bloodgood B, et al. Benefits of physical activity during pregnancy and postpartum: An umbrella review. Med Sci Sports Exerc, 2019, 51(6): 1292-1302.
31. Wang C, Wei Y, Zhang X, et al. A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women. Am J Obstet Gynecol, 2017, 216(4): 340-351.
32. Jukic AM, Evenson KR, Daniels JL, et al. A prospective study of the association between vigorous physical activity during pregnancy and length of gestation and birthweight. Matern Child Health J, 2012, 16(5): 1031-1044.
33. Tomić V, Sporiš G, Tomić J, et al. The effect of maternal exercise during pregnancy on abnormal fetal growth. Croat Med J, 2013, 54(4): 362-368.
34. ACOG Committee Opinion No. 650: Physical Activity and exercise during pregnancy and the postpartum period. Obstet Gynecol, 2015, 126(6): p.e135-42.
35. Fazzi C. Sedentary behaviours during pregnancy: A systematic review. Int J Behav Nutr Phys Act, 2017, 14(1): 32.
36. Friedenreich CM, Stone CR, Cheung WY, et al. Physical activity and mortality in cancer survivors: A systematic review and meta-analysis. JNCI Cancer Spectrum, 2019: 3.
37. Costa EC, Hay JL, Kehler DS, et al. Effects of high-intensity interval training versus moderate-intensity continuous training on blood pressure in adults with pre- to established hypertension: a systematic review and meta-analysis of randomized trials. Sports Med, 2018, 48(9): 2127-2142.
38. Liu Y, Ye W, Chen Q, et al. Resistance exercise intensity is correlated with attenuation of HbA1c and insulin in patients with type 2 diabetes: A systematic review and meta-analysis. Int J Environ Res Public Health, 2019, 16(1): 6.
39. Ibeneme SC, Omeje C, Myezwa H, et al. Effects of physical exercises on inflammatory biomarkers and cardiopulmonary function in patients living with HIV: A systematic review with meta-analysis. BMC infectious diseases. 2019; 19.7.
40. Poton R, Polito M, Farinatti P. Effects of resistance training in HIV-infected patients: A meta-analysis of randomised controlled trials. J Sports Sci, 2017, 35(24): 2380-2389.
41. O’Brien KK, Tynan AM, Nixon SA, et al. Effectiveness of aerobic exercise for adults living with HIV: Systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC Infect Dis, 2016, 16(4): 876-879.
42. Heissel A, Zech P, Rapp MA, et al. Effects of exercise on depression and anxiety in persons living with HIV: A meta-analysis. J Psychosom Res, 2019, 126: 109-123.
43. Friedenreich CM, Stone CR, Cheung WY, Hayes SC. Physical activity and mortality in cancer survivors: A systematic review and meta-analysiss. JNCI Cancer Spectr. 2019, 4(1): pkz080.
44. Sadarangani KP, Hamer M, Mindell JS, et al. Physical activity and risk of all-cause and cardiovascular disease mortality in diabetic adults from Great Britain: Pooled analysis of 10 population-based cohorts. Diabetes Care, 2014, 37(4): 1016-1023.
45. Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC: US Department of Health and Human Services. 2018.
46. Johnson CC. The benefits of physical activity for youth with developmental disabilities: A systematic review. Am J Health Promot, 2009, 23(3): 157-167.
47. Chen CJJ, Ringenbach SDR. The effect of acute exercise on the performance of verbal fluency in adolescents and young adults with Down syndrome: a pilot study. J Intellect Disabil Res, 2019, 63(6): 614-623.
48. Alphonsus KB, Su Y, D'Arcy C. The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis. Complement Ther Med, 2019, 43: 188-195.
49. Patterson KK, Wong JS, Prout E C, et al. Dance for the rehabilitation of balance and gait in adults with neurological conditions other than Parkinson's disease: A systematic review. Heliyon, 2018, 4(3): e00584.
50. Firth J, Stubbs B, Rosenbaum S, et al. Aerobic exercise improves cognitive functioning in people with schizophrenia: A systematic review and meta-analysis. Schizophr Bull, 2017, 43(3): 546-556.
51. Cugusi L, Manca A, Dragone D, et al. Nordic walking for the management of people with parkinson disease: A systematic review. PM R, 2017, 9(11): 1157-1166.
52. Law CK, Lam FM, Chung RC, et al. Physical exercise attenuates cognitive decline and reduces behavioural problems in people with mild cognitive impairment and dementia: A systematic review. J Physiother, 2020, 66(1): 9-18.
53. Barajas-galindo DE, González ArnáiZ E, Ferrero Vicente P, et al. Effects of physical exercise in sarcopenia. A systematic review. Endocrinol Diabetes Nutr, 2020: S2530-0164(20)30114-2.
54. Christie J. Progressive resistance strength training for improving physical function in older adults. Int J Older People Nurs, 2011, 6(3): 244-246.
55. Tu RH, Zeng ZY, Zhong GQ, et al. Effects of exercise training on depression in patients with heart failure: A systematic review and meta-analysis of randomized controlled trials. Eur J Heart Fail, 2014, 16(7): 749-757.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Interpretation of the World Health Organization 2020 guidelines on physical activity and sedentary behaviour

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