arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2016-22-2-153-159arthyper-421Research ArticleОБЗОРREVIEWФизическая активность — полувековая история формирования рекомендаций и поиска методов оценкиPhysical activity — history and development of methodology and guidelinesОрловА. В.OrlovA. V.

аспирант, научный сотрудник лаборатории эпидемиологии неинфекционных заболеваний ФГБУ «СЗФМИЦ им. В. А. Алмазова» Минздрава России

MD, Researcher, Department of Epidemiology of Noncommunicable Diseases, V. A. Almazov Federal North-West Medical Research Centre

orlov_av@almazovcentre.ruРотарьО. П.RotarO. P.

кандидат медицинских наук, заведующая научно-исследовательской лабораторией эпидемиологии неинфекционных заболеваний ФГБУ «СЗФМИЦ им. В. А. Алмазова» Минздрава России, инженер международной лаборатории биоинформатики и геномики, Университет ИТМО

MD, PhD, Head, Department of Epidemiology of Noncommunicable Diseases, V. A. Almazov Federal North-West Medical Research Centre, engineer, ITMO University

rotar@almazovcentre.ruБояриноваМ. А.BoyarinovaM. A.

аспирант, младший научный сотрудник научно-исследовательской лаборатории эпидемиологии неинфекционных заболеваний ФГБУ «СЗФМИЦ им. В. А. Алмазова» Минздрава России

MD, Researcher, Department of Epidemiology of Noncommunicable Diseases, V. A. Almazov Federal North-West Medical Research Centre

boyarinova@almazovcentre.ruДемченкоЕ. А.DemchenkoE. A.

доктор медицинских наук, заведующая научно-исследовательской лабораторией реабилитации, руководитель научно-клинического объединения реабилитации ФГБУ «СЗФМИЦ им. В. А. Алмазова» Минздрава России

MD, PhD, Professor, Head, Research Laboratory for Rehabilitation, V. A. Almazov Federal North-West Medical Research Centre

demchenko@almazovcentre.ruКонрадиА. О.KonradiA. O.

доктор медицинских наук, профессор, заместитель генерального директора по научной работе ФГБУ «СЗФМИЦ им. В. А. Алмазова» Минздрава России, директор Института трансляционной медицины, Университет ИТМО

MD, PhD, Professor, the Deputy Director on Science, Head, Research Department for Hypertension, V. A. Almazov Federal North-West Medical Research Centre, Professor, ITMO University

konradi@almazovcentre.ruФГБУ «Северо-Западный федеральный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации, Санкт-Петербург, Россия ул. Аккуратова, д. 2, Санкт-Петербург, Россия, 197341РоссияV. A. Almazov Federal North-West Medical Research Centre, St Petersburg, Russia 2 Akkuratov street, St Petersburg, 197341 RussiaRussian FederationФГБУ «Северо-Западный федеральный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации, Санкт-Петербург, Россия Университет ИТМО, Санкт-Петербург, РоссияРоссияV. A. Almazov Federal North-West Medical Research Centre, St Petersburg, Russia ITMO University, St Petersburg, RussiaRussian FederationФГБУ «Северо-Западный федеральный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации, Санкт-Петербург, РоссияРоссияV. A. Almazov Federal North-West Medical Research Centre, St Petersburg, RussiaRussian Federation201622082016222153159Copyright © Орлов А.В., Ротарь О.П., Бояринова М.А., Демченко Е.А., Конради А.О., 20162016Орлов А.В., Ротарь О.П., Бояринова М.А., Демченко Е.А., Конради А.О.Orlov A.V., Rotar O.P., Boyarinova M.A., Demchenko E.A., Konradi A.O.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/421

Уже более 50 лет проводятся исследования в области физической активности и ее профилактической значимости в развитии хронических неинфекционных заболеваний. Изначально задачей данных исследований была оценка риска сердечно-сосудистых событий на высоте нагрузки, а в дальнейшем ведущей целью стало исследование феномена адаптации к физическим упражнениям как превентивной меры и определение оптимальных характеристик нагрузки. С течением времени менялись методические подходы к оценке интенсивности и длительности физических упражнений — от субъективных методов на основе дневников и опросников до современных мобильных устройств — шагомеров и акселерометров, что находило свое отражение в изменении рекомендаций по физической активности. На сегодняшний день всемирно признанными считаются рекомендации Всемирной организации здравоохранения 2010 года, однако в данной области остаются нерешенными еще многие вопросы ввиду отсутствия идеального для эпидемиологических исследований метода оценки физической нагрузки.

First studies in the field of physical activity and its role in chronic non-communicable diseases prevention were published more than 50 years ago. Initially, the goal of these investigations was to assess the risk of cardiovascular events during exercises. However, later the assessment of optimal intensity and duration of physical activity within preventive measures became the leading issue of research. Evolution of methodological approaches in physical activity assessment — from subjective methods based on the diaries and questionnaires to modern mobile devices — pedometers and accelerometers, required the changes in physical activity guidelines. Global recommendations on physical activity for health, published by WHO in 2010, leave many open questions due to the lack of an ideal method for physical activity evaluation.

физическая активностьрекомендацииметоды оценкиphysical activityrecommendationsevaluation methodsReferencesLee IM. Epidemiologic methods in physical activity studies. New York: Oxford University Press; 2008. p. 284–302.Lee IM. Epidemiologic methods in physical activity studies. New York: Oxford University Press; 2008. p. 284–302.American Heart Association. Committee on Exercise. Exercise testing and training of apparently healthy individuals: a handbook for physicians. Dallas, Tex.: American Heart Assoc; 1972. p. 15–27.American Heart Association. Committee on Exercise. Exercise testing and training of apparently healthy individuals: a handbook for physicians. Dallas, Tex.: American Heart Assoc; 1972. p. 15–27.Пшенникова М. Г. Адаптация к физическим нагрузкам. Физиология адаптационных процессов. Руководство по физиологии. М.: Наука, 1986. 221 с. [Pshennikova MG. Adaptation to physical exercise. Physiology of adaptation processes. Textbook on physiology. Moscow: Science, 1986. 221 p. In Russian].Pshennikova MG. Adaptation to physical exercise. Physiology of adaptation processes. Textbook on physiology. Moscow: Science, 1986. 221 p.Pollock ML. The quantification of endurance training programs. Exerc Sport Sci Rev. 1973;1:155–188.Pollock ML. The quantification of endurance training programs. Exerc Sport Sci Rev. 1973;1:155–188.Leon AS, Connett J, Jacobs DR, Rauramaa R. Leisure-time physical activity levels and risk of coronary heart disease and death. The Multiple Risk Factor Intervention Trial. J Am Med Assoc. 1987;258(17):2388–2395.Leon AS, Connett J, Jacobs DR, Rauramaa R. Leisuretime physical activity levels and risk of coronary heart disease and death. The Multiple Risk Factor Intervention Trial. J Am Med Assoc. 1987;258(17):2388–2395.Shaper AG, Wannamethee G, Weatherall R. Physical activity and ischemic heart disease in middle-aged British men. Br Heart J. 1991;66(5):384–394.Shaper AG, Wannamethee G, Weatherall R. Physical activity and ischemic heart disease in middle-aged British men. Br Heart J. 1991;66(5):384–394.Fletcher GF, Blair SN, Blumenthal J, Caspersen C, Chaitman B, Epstein S et al. Statement on exercise. Benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart association. Circulation. 1992;86(1):340–344.Fletcher GF, Blair SN, Blumenthal J, Caspersen C, Chaitman B, Epstein S et al. Statement on exercise. Benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart association. Circulation. 1992;86(1):340–344.Physical Activity Guidelines Advisory Committee (PAGAC). Physical Activity Guidelines Advisory Committee Report, 2008. Washington, DC, US Department of Health and Human Services; 2008. p. 668.Physical Activity Guidelines Advisory Committee (PAGAC). Physical Activity Guidelines Advisory Committee Report, 2008. Washington, DC, US Department of Health and Human Services; 2008. p. 668.Warburton DE, Katzmarzyk PT, Rhodes RE, Shephard RJ. Evidence-informed physical activity guidelines for Canadian adults.Can J Public Health. 2007;98(2): S16–68.Warburton DE, Katzmarzyk PT, Rhodes RE, Shephard RJ. Evidence-informed physical activity guidelines for Canadian adults. Can J Public Health. 2007;98(2):S16–68.Sofi F, Capalbo A, Cesari F, Abbate R, Gensini GF. Physical activity during leisure time and primary prevention of coronary heart disease: an updated meta-analysis of cohort studies. Eur J Cardiovasc Prev Rehabil. 2008;15(3):247–257.Sofi F, Capalbo A, Cesari F, Abbate R, Gensini GF. Physical activity during leisure time and primary prevention of coronary heart disease: an updated meta-analysis of cohort studies. Eur J Cardiovasc Prev Rehabil. 2008;15 (3):247–257.Nocon M, Hiemann T, Müller-Riemenschneider F, Thalau F, Roll S, Willich SN. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil. 2008;15(3):239–246.Nocon M, Hiemann T, Müller-Riemenschneider F, Thalau F, Roll S, Willich SN. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil. 2008;15(3):239–246.Глобальная стратегия по питанию, физической активности и здоровью. Женева, Всемирная организация здравоохранения. 2010. URL: http://who.int/publications/list/9241592222/ru [Global strategy on nutrition, physical activity and health. Geneva, WHO. 2010. URL: http://who.int/publications/list/9241592222/ru. In Russian].Global strategy on nutrition, physical activity and health. Geneva, WHO. 2010. URL: http://who.int/publications/list/9241592222/ruПотемкин Р. А. Физическая активность и питание. Руководство для врачей. Москва, 2011. 144 с. [Potemkin RA. Physical activity and nutrition. Textbook for physicians. Moscow, 2011. 144 p. In Russian].Potemkin RA. Physical activity and nutrition. Textbook for physicians. Moscow, 2011. 144 p.Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk. Circulation. 2014;129(25 Suppl 2): S76–99. doi: 10.1161/01.cir.0000437740.48606.d1Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk. Circulation. 2014;129(25 Suppl 2): S76–99. doi: 10.1161/01.cir.0000437740.48606.d1.de Souto Barreto P. Global health agenda on noncommunicable diseases: has WHO set a smart goal for physical activity? Br Med J. 2015;350:23. doi: 10.1136/bmj.h23.de Souto Barreto P. Global health agenda on noncommunicable diseases: has WHO set a smart goal for physical activity? Br Med J. 2015;350:23. doi: 10.1136/bmj.h23.Dahabreh IJ, Paulus JK. Association of episodic physical and sexual activity with triggering of acute cardiac events. Systematic review and meta-analysis. J Am Med Assoc. 2011;305 (12):1225–1233.Dahabreh IJ, Paulus JK. Association of episodic physical and sexual activity with triggering of acute cardiac events. Systematic review and meta-analysis. J Am Med Assoc. 2011;305(12):1225–1233.Healy GN, Winkler EA, Owen N, Anuradha S, Dunstan DW. Replacing sitting time with standing or stepping: associations with cardio-metabolic risk biomarkers. Eur Heart J. 2015;36 (39):2643–2649.Healy GN, Winkler EA, Owen N, Anuradha S, Dunstan DW. Replacing sitting time with standing or stepping: associations with cardio-metabolic risk biomarkers. Eur Heart J. 2015;36(39):2643–2649.Barreto P. Why are we failing to promote physical activity globally? Bulletin of the World Health Organization. 2013;91 (6):390–390A.Barreto P. Why are we failing to promote physical activity globally? Bulletin of the World Health Organization. 2013;91(6):390–390A.Kriska AM, Caspersen CJ. A collection of physical activity questionnaires for health- related research. Med Sci Sports Exerc. 1997;29: S1‑S205.Kriska AM, Caspersen CJ. A collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc. 1997;29: S1-S205.Montoye HJ, Kemper HG, Saris WHM, Washburg RA. Measuring physical activity and energy expenditure. Human Kinetics. Champaign, IL. 1996;42–71.Montoye HJ, Kemper HG, Saris WHM, Washburg RA. Measuring physical activity and energy expenditure. Human Kinetics. Champaign, IL. 1996;42–71.International physical activity questionnare. URL: www.ipaq.ki.se.International physical activity questionnare. URL: www.ipaq.ki.se.Prevalence of regular physical activity among adults. United States, 2001 and 2005. MMWR. 2007;56(46):1209–1212.Prevalence of regular physical activity among adults. United States, 2001 and 2005. MMWR. 2007;56(46): 1209–1212.Cooper KH, Aerobics. Bantam, New York; 1968. p. 201– 213.Cooper KH, Aerobics. Bantam, New York; 1968. p. 201–213.Zabina E, Muravov O. Experience in validation and use of CINDI physical activity questionnaire. Copenhagen: World Health Organization, Regional Office for Europe, 1995. p. 25.Zabina E, Muravov O. Experience in validation and use of CINDI physical activity questionnaire. Copenhagen: World Health Organization, Regional Office for Europe, 1995. p. 25.Duncan GE, Sydeman SJ, Perri MG, Limacher MC, Martin AD. Can sedentary adults accurately recall the intensity of their physical activity? Prev Med. 2001;33(1):18–26.Duncan GE, Sydeman SJ, Perri MG, Limacher MC, Martin AD. Can sedentary adults accurately recall the intensity of their physical activity? Prev Med. 2001;33(1):18–26.Troiano RP, Berrigan D, Dodd KW, Mâsse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–188.Troiano RP, Berrigan D, Dodd KW, Mâsse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40 (1):181–188.Ewald B., McEvoy M, Attia J. Step counts superior to physical activity scale for identifying health markers in older adults. British Journal of Sports Medicine. 2010;44(10):756–61.Ewald B, McEvoy M, Attia J. Step counts superior to physical activity scale for identifying health markers in older adults. British Journal of Sports Medicine. 2010;44 (10):756–61.Strycker LA, Duncan SC, Chaumeton NR, Duncan TE, Toobert DJ. Reliability of pedometer data in samples of youth and older women. International J Behav Nutr Phys Act. 2007;4:4.Strycker LA, Duncan SC, Chaumeton NR, Duncan TE, Toobert DJ. Reliability of pedometer data in samples of youth and older women. International J Behav Nutr Phys Act. 2007;4:4.Melanson EL, Knoll JR, Bell ML, Donahoo WT, Hill JO, Nysse LJ et al. Commercially available pedometers: considerations for accurate step counting. Prevent Med. 2004;39(2):361–368.Melanson EL, Knoll JR, Bell ML, Donahoo WT,Hill JO, Nysse LJ et al. Commercially available pedometers: considerations for accurate step counting. Prevent Med. 2004;39(2):361–368.Storti KL, Pettee KK, Brach JS, Talkowski JB, Richardson CR, Kriska AM. Gait speed and step-count monitor accuracy in community-dwelling older adults. Med Sci Sports Exerc. 2008;40(1):59–64.Storti KL, Pettee KK, Brach JS, Talkowski JB, Richardson CR, Kriska AM. Gait speed and step-count monitor accuracy in community-dwelling older adults. Med Sci Sports Exerc. 2008;40(1):59–64.Mathie MJ, Coster AC, Lovell NH, Celler BG. Accelerometry: providing an integrated, practical method for long-term, ambulatory monitoring of human movement. Physiol Meas. 2004;25(2):R1–20.Mathie MJ, Coster AC, Lovell NH, Celler BG. Accelerometry: providing an integrated, practical method for long-term, ambulatory monitoring of human movement. Physiol Meas. 2004;25(2): R1–20.Hatano Y. Use of the pedometer for promoting daily walking exercise. ICHPER. 1993;29:4–8.Hatano Y. Use of the pedometer for promoting daily walking exercise. ICHPER. 1993;29:4–8.Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR et al. Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol. 2008;167(7):875–881.Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR et al. Amount of time spent in sedentary behaviorsin the United States, 2003–2004. Am J Epidemiol. 2008;167(7):875–881.Hagstromer M, Oja P, Sjostrom M. Physical activity and inactivity in an adult population assessed by accelerometry. Med Sci Sports Exerc. 2007;39(9):1502–1508.Hagstromer M, Oja P, Sjostrom M. Physical activity and inactivity in an adult population assessed by accelerometry. Med Sci Sports Exerc. 2007;39(9):1502–1508.Troiano RP, Berrigan D, Dodd KW, Mâsse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–188.Troiano RP, Berrigan D, Dodd KW, Mâsse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40 (1):181–188.Bouten CV, Westerterp KR, Verduin M, Janssen JD. Assessment of energy expenditure for physical activity using a triaxial accelerometer. Med Sci Sports Exerc. 1994;26(12):1516.Bouten CV, Westerterp KR, Verduin M, Janssen JD. Assessment of energy expenditure for physical activity using a triaxial accelerometer. Med Sci Sports Exerc. 1994;26(12):1516.Plasqui G, Joosen AM, Kester AD, Goris AH, Westerterp KR. Measuring free-living energy expenditure and physical activity with triaxial accelerometry. Obes Res. 2005;13(8):1363–1369.Plasqui G, Joosen AM, Kester AD, Goris AH, Westerterp KR. Measuring free-living energy expenditure and physical activity with triaxial accelerometry. Obes Res. 2005;13(8):1363–1369.Whitney A, Welch DR, Bassett DL, Thompson PS, Freedson JW, Staudenmayer DJ et al. Classification accuracy of the wrist-worn GENEA accelerometer. Med Sci Sports Exerc. 2013;45 (10):2012–2019.Whitney A, Welch DR, Bassett DL, Thompson PS, Freedson JW, Staudenmayer DJ et al. Classification accuracy of the wrist-worn GENEA accelerometer. Med Sci Sports Exerc. 2013;45(10):2012–2019.Rosenberger ME, Buman MP, Haskell WL, McConnell MV, Carstensen LL. 24 hours of sleep, sedentary behavior, and physical activity with nine wearable devices. Med Sci Sports Exerc.2016;48(3):457–465.Rosenberger ME, Buman MP, Haskell WL, McConnell MV, Carstensen LL. 24 hours of sleep, sedentary behavior, and physical activity with nine wearable devices. Med Sci Sports Exerc. 2016;48(3):457–465.

The authors declare that there are no conflicts of interest present.