Table 1 Research recommendations for children & adolescents, adults, older adults, people with disabilities, and pregnant women

General Research Recommendations

(all age groups and sub-populations)

Conduct RCTs, Mendelian randomization studies, and prospective cohort studies that use device-based measures to address a range of physical activity exposures (volume and/or intensity) and sedentary time, in order to determine the dose-response relationship between these behaviors and a broad range of health outcomes in this age group.

Conduct adequately-powered experimental studies to examine the health benefits of light-intensity physical activity and of breaking up sedentary time with light-intensity activity.

Conduct adequately-powered prospective observational studies using device-based measures and self-report to examine differences in the health effects of various types and domains of physical activity (leisure-time; occupational; transportation; household; education) and of sedentary behavior (occupational; class or study time; screen time; television viewing).

Conduct adequately-powered observational studies to examine the joint association between physical activity and sedentary time with health outcomes across the life course.

Conduct longitudinal studies of various domains of sedentary behavior (e.g., total sitting time, TV time, video-games, computer/phone screen time) and health, using both self-report and device-based measures that can distinguish between different postures (reclining, sitting, standing, and moving).

Conduct adequately-powered experimental studies on the effects of interruptions or breaks in sedentary behavior with physical activity of various intensities and durations on health biomarkers, such as blood pressure or blood concentrations of glucose, insulin and lipids.

Conduct adequately-powered observational studies to examine the independent and joint effects of physical activity and sedentary behavior on health outcomes in children and adolescents.

Develop standardized (harmonized) methods of measuring and processing device-based estimates of physical activity in this age group.

Specific Research Recommendations for Adults (≥18 years)

Conduct adequately-powered population-based studies of adults that include both self-report and device-based measures of physical activity to improve the quantification of domain-specific and type-specific physical activity and to examine their dose-response relationships with various health and disease outcomes.

Conduct high quality studies examining specific characteristics of occupational physical activity and their effects on worker health.

Conduct experimental studies to determine if the benefits of physical activity for health differ with regard to muscular strength training vs. aerobic exercise training.

Conduct adequately-powered population-based studies using pooled analyses, as well as prospectively- or retrospectively-harmonized meta-analyses to examine the role of physical activity in health and function.

Conduct adequately-powered population-based studies in high-, middle- and low-income countries to compare and contrast the relationships among different types and domains of physical activity and health outcomes.

Conduct adequately-powered population-based studies to examine the role of physical activity and sport in increasing community cohesion and social capital.

Specific Research Recommendations for Older Adults (> 64 years)

Conduct adequately-powered observational and experimental studies to investigate further the dose-response relationships between different intensities, volumes, and types of physical activity (aerobic, muscle strengthening, balance, and multicomponent) and multiple health outcomes. The reporting of adverse events in these studies is especially important for establishing safety thresholds.

Conduct adequately-powered RCTs of older adults at high risk of falls designed with fall-related injuries and bone fractures as the primary outcomes of interest.

Conduct adequately-powered RCTs to determine the effects of specific alternative or complementary forms of exercise on the reduced risk of falls and on physical function in healthy older adults, as well as those with different chronic conditions.

Conduct more experimental research on dual-task training that clearly describe the dual-task training procedures and the parameters of the outcome task. In addition, these studies should provide evidence of whether dual-task benefits were increased by training and whether dual-task training transfers to untrained tasks.

Conduct adequately-powered RCTs with 6- and 12-month post-intervention follow-up assessments to determine the effects of physical activity on activities of daily living (ADL) mobility, instrumental ADLs, free-living physical/ ambulatory activity and social participation for older individuals with existing chronic disease, who may be at accelerated risk of physical and cognitive decline, disability, and social isolation.

Conduct adequately-poweredcohort or experimental studies on the effects of specific types of physical activity on perceived social isolation and loneliness.

Conduct adequately-poweredcohort and experimental studies to determine the dose-intensity and timing of physical activity necessary to prevent functional decline or to improve physical function across the spectrum of cognitive dysfunction and dementia.

Specific Research Recommendations for People with Disabilities

Conduct adequately-powered observational and experimental studies that examine the relationship between physical activity, sedentary behavior, and health and wellbeing in people living with intellectual, mental, physical, and/or sensory impairments.

Conduct adequately-powered RCTs that are targeted toward different types of impairment (e.g. physical, sensory, or cognitive) and different degrees of impairments (from mild to complete), rather than only on specific health conditions such as multiple sclerosis, spinal cord injury, intellectual disability, Parkinson’s disease, or stroke. Include people with disabilities into large “mainstream” studies (from which they are typically excluded) in order to increase the generalizability of findings.

Conduct mixed-methods studies to examine the physical, social and attitudinal barriers and facilitators to physical activity for people living with disabilities, as well as appropriate policies and strategies to encourage and support participation.

Specific Research Recommendations during Pregnancy

Conduct adequately-powered RCTs on the health benefits of breaking up sedentary time with bouts of light-intensity activity.

Conduct adequately-powered observational research on the joint association of physical activity and sedentary time with maternal health and fetal outcomes.

Conduct observational and experimental studies of the effects of vigorous-intensity physical activity before and during pregnancy on maternal and fetal outcomes.

Conduct experimental and observational studies to investigate the effects of various types, intensities, and volumes of regular physical activity on quality of life, sleep, and symptoms of anxiety and depression during pregnancy and the postpartum period.

Conduct adequately-powered observational studies to determine whether the timing (before, during, or following pregnancy) or specific domains/settings of physical activity affect maternal and fetal outcomes, such as preterm birth, low birth weight, and preeclampsia differentially. These studies should have ample statistical power within the different domains to be able to adjust for the influence of several confounding variables.

Conduct observational and/or experimental research that has adequate statistical power to determine whether the associations between physical activity and maternal or fetal outcomes vary by age, race/ethnicity, socioeconomic status, or by weight status.