This document summarizes a seminar on promoting physiotherapy leadership to reduce sedentary behavior in clinical populations. The seminar objectives are to review the state of research on sedentary behavior and physical activity among key clinical groups, present findings from physiotherapy-delivered interventions, and provide practical advice for implementing interventions. The structure includes an overview of sedentary behavior recommendations and research, followed by four presentations of physiotherapist-led multi-modal interventions, and a question and answer session with panelists. The goal is to communicate relevant messages to delegates on how physiotherapists can help break cycles of prolonged sitting and inactivity in clinical settings.

1. Sedentary behaviour
Promoting physiotherapy leadership to reduce
sedentary behaviour in clinical populations
SEMINAR-09
Room E, Monday 13 May, 15:45 – 17:15

2. 2
Professor Antonio Cuesta-Vargas
Universidad de Málaga, Spain
@aicuesta

3. 3

4. Objectives
◉ State of the art sedentary behaviour and physical activity
among key clinical populations
◉ Latest findings from physiotherapy delivered interventions
evaluated in clinical trial
◉ Provide an overview of practical advice and
implementation of interventions in clinical settings by
physiotherapists
4

5. Structure
◉ 1) Review sedentary behaviour and physical activity
recommendations, key research (10 min)
◉ 2) 4 presentations (15 min. each) on physiotherapist-
led multi-modal interventions
◉ 3) Q & A session with the panel (15 min)
◉ 4) Summary of relevant messages for the delegates to
take away from the session (5 min).
5

6. 6
EVIDENCE, BARRIERS & KEY RESEARCH

7. Hallal et al, Lancet 2012
Globally, 1 in 3 adults are inactive physically
@aicuesta

8. Hay et al, Lancet 2017@aicuesta

9. Ding et al, Lancet 2016
Physical inactivity
has been estimated to have
an annual cost of
$54 billion
attributable to direct health care,
of which 57% is incurred by the
public sector
@aicuesta

10. Ekelund et al, Lancet 2016
High levels of moderate PA
(60–75 min per day)
seem to eliminate the
increased risk of death
associated with high sitting time
“Sitting is NOT new smoking”
@aicuesta

11. Ekelund et al, Lancet 2016@aicuesta

12. Tremblay et al. IJBNPA 2017
Sedentary behaviour is
any waking behaviour characterized by
an energy expenditure≤1.5 METs,
while in a sitting, reclining or lying posture
Sedentary
<1,5 METs
Light PA
1,5-3 METs
ModeratePA
3-6 METS
Vigorous PA
>6 METs
The Energy Expenditure Continuum
@aicuesta

13. Conceptual model of movement-based
terminology arranged around 24h period,
focused in postures & energy expenditure.
@aicuesta Tremblay et al. IJBNPA 2017

14. Buck et al, PLOS One 2019
33
Factors
6
Dimensions
@aicuesta

15. Peake et al Front Physiol 2018
Wearable technologies
Remote monitoring of activities are possible at home and in clinical settings
Only 5% of these technologies have been formally validated
@aicuesta

16. “
Physiotherapistsare ideally placed to deliver
evidence-informed interventions to break the cycle of
prolonged sitting that could contribute to, or worsen,
musculoskeletal impairments and chronic disease
@aicuesta

17. Zusman et al, JGPT 2019 Growdon et al, JAMA internal Medicine 2017
Physiotherapy patients
may be at elevated risk of inactivity due challenges associated
with their acute and chronic conditions.
The best available evidence suggests healthcare
professionals err too conservatively on the side of rest

18. McPhail & Waite, JOMT 2014@aicuesta

19. Prof. Cuesta-Vargas
PhD Past (Physio)
Dra. Casuso-Holgado
Dr. Galán-Mercant
Dra. Martin-Valero
Dr. Castillo-Lozano
Dra. Cantero-Téllez
Dr. González-Sánchez
Dra. Romero-Godoy
Dra. Osuna-Pérez
Dr. Rodriguez-Exposito
Dr. Belón-Pérez
Dr. Muro-Culebras
Dr. Cano-Herrera
Dra. Conejo-Tirado
Dr. Roldán-Jiménez
PhD Past (Podiatrist)
Dra. Jiménez-Cebrian
Dra. Ortega-Avila
Dr. Paez-Moguer
Dr. Ruiz-Muñoz
PhD past (Occ T)
Dr. Rodriguez-Martínez,
Dr. Martin-Martin
Dr. Pérez-Cruzado
Dr. Merchán-Baeza
Dr. Gutiérrez-Sánchez (Nursing)
International
Prof. Lee, UK
Prof. Adams, UK
A/Prof. Jon Williams, UK
Dra. Kuisma, UK
A/ Prof. Farasyn, Be
Prof. Peter Vaes, Be
Prof. Nijs, Be
Prof. Daly, Be
A/ Prof. Benelli, Italy
Prof. Burkett, Australia
Prof. Kerr, Australia
Prof. McPhail
Dr. Gabel, Australia
Prof. Osborne, USA
Prof Gatchel, USA
Dr. Nebblet, USA
National
Prof. Gine-Garriga, Barcelona
Prof Martinez-Vizcaino, Cuenca
Dr. Luciano, Barcelona
Dr. Grandes, Bilbao
Dr. Arroyo-Morales, UGR
Dr. Ortega, UGR
Local
Prof. Alba
Dr. Mayoral
Dr. Garcia-Romero
Dr. Barón-Lopez
Current PhD Students
Garrido-Cervera
Vera-García
Mateo-Angulo
Barreda-Pitarch
Rodriguez-González
Trinidad-Fernández
Carrasco E
Escríche-Escuder
Giraldo-Ortega
Pérez-Panero
Pareja-Cano
Fuentes-Aboláfio
Barni L

20. Any questions ?
Q & A session with the panel
You can find me at
● @aicuesta
● acuesta@uma.es
Thanks!
20

21. Howto change #SedBeh across Clinical Populations?
Which
outcome
What is
need to change
Who
to target
21
@aicuesta

22. What is need to change in Physios IN & OUTPATIENTS?
first lastsecond
22
BREAK
PROLONGED
Sitting
Lying
Reclining
>(4h/day)
MOD-VIGOR
THERAPEUTIC
EXERCISES
(60 min/day
>3 Corrected
METs intensity
PLUS
MINUTES/DAY
>1,5 A 3
Corrected
METs intensity
@aicuesta

23. first last
Which outcome?
POLYPILLS
MULTI-SYSTEMS
@aicuesta

24. Whoto target?
first lastsecond
24
INFANT &
ADOLESCENT
YOUNG & OLDER
ADULTS ELDERLY
INPATIENTS
OUTPATIENTS
ACROSSALLDISEASES
POLYPILLS
ACROSS LIFESPAN@aicuesta

25. #iGAME
Multi-dimensional Intervention Support Architecture for
Gamified eHealth and mHealth Products:
H2020 MSCA RISE 2018
Nº 823871

26. You can find me at
● Twitter @aicuesta
● email; acuesta@uma.es
Thanks!
26
Please Evaluate this session in the App
Conf2GO WCPT2019