Role of the exercise professional in metabolic and bariatric surgery.

BACKGROUND: Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined. OBJECTIVES: To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform? SETTING: Clinical and academic exercise settings worldwide. METHODS: This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model. RESULTS: The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and postoperative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care". CONCLUSIONS: The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare.

Role of the exercise professional in metabolic and bariatric surgery.

Background: Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined. Objectives: To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform? Setting: Clinical and academic exercise settings worldwide. Methods: This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model. Results: The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being: supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and post-operative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care". Conclusions: The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare.

How is Physical Activity Measured in Spinal Muscular Atrophy and Duchenne Muscular Dystrophy?

BACKGROUND: Physical activity (PA) provides many substantial benefits to help reduce risk for cardiometabolic disease, improve cognitive function, and improve quality of life. Individuals with neuromuscular disorders (NMDs), such as spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD) are characterized by muscular weakness and fatigue, which limits the capacity to reach the recommended guidelines of PA. Measuring PA in these populations can provide insight to participation in daily activities, track disease progression, and monitor efficacy of drug treatments. OBJECTIVE: The objective of this study was to identify how PA is measured in SMA and DMD using instrumented and self-report methods, and how these methods are employed in ambulatory and non-ambulatory groups. METHODS: A scoping review was performed to identify studies that reported PA in these neuromuscular disorders. Inclusion was determined after a multi-stage review process by several reviewers, followed by an in-depth analysis of metrics reported by each tool that was used. RESULTS: A total of nineteen studies were identified and included in this review. Sixteen studies included instrumented measures and four studies utilized self-reported measures, with eleven studies also reporting PA information from a non-ambulatory group. A variety of metrics have been reported using both classes of measurement tools. CONCLUSION: Although a wide variety of research exists that details both instrumented and self-reported measurement tools, feasibility, cost, and study aims are important factors to consider in addition to testing methodology when selecting which type of tool to use. We recommend using a combination of instrumented and self-report measures to provide context to the PA measured in these populations. Improvements in both instrumented and self-report methodologies will add valuable knowledge about the disease burden and efficacy of treatment and disease management methods in SMA and DMD.

Exercise and cardiovascular health: A state-of-the-art review.

Cardiovascular (CV) disease (CVD) is the leading cause of global morbidity and mortality, and low levels of physical activity (PA) is a leading independent predictor of poor CV health and associated with an increased prevalence of risk factors that predispose to CVD development. In this review, we evaluate the benefits of exercise on CV health. We discuss the CV adaptations to exercise, focusing on the physiological changes in the heart and vasculature. We review the impact and benefits of exercise on specific CV prevention, including type II diabetes, hypertension, hyperlipidemia, coronary artery disease, and heart failure, in addition to CVD-related and all-cause mortality. Lastly, we evaluate the current PA guidelines and various modes of exercise, assessing the current literature for the effective regimens of PA that improve CVD outcomes.

Exploring a Dance/Movement Program on Mental Health and Well-Being in Survivors of Intimate Partner Violence During a Pandemic.

Aims: The aim of this study was to explore the feasibility and benefits of a 12-session dance/movement program for intimate partner violence survivors' mental health and PTSD symptoms during the COVID-19 Pandemic. The specific purposes were fourfold: (1) To determine the feasibility of delivering a virtual dance/movement workshop program; (2) to examine the effects of the program on symptoms of PTSD and psychological distress; (3) to determine whether heart rate variability improves; and (4) to describe the individual and shared experiences of a subgroup of participants of the program. Methods: Forty-five women ages 23-48 years were randomized to a 12-session virtual creative dance/movement program or a usual care control group, and completed questionnaires about PTSD and mental health symptoms, general health, physical activity, and underwent a brief measurement of heart rate variability. A subset of the intervention group participated in a semi-structured focus group. Results: The results of the study showed that the female survivors of intimate partner violence who participated in the virtual workshops felt better, and they experienced improved affect and reduced tension. They found new ways to express themselves, attune to their bodies, learn new self-care habits, and build community as they engaged in the workshops. Over the course of the study, the participants' symptoms of PTSD and psychological distress lessened. There were no changes in heart rate variability. Conclusions: This complex study was successfully completed during a global pandemic and resulted in improvements in some mental health symptoms and overall well-being. Given the importance of this work with intimate partner violence survivors, further work exploring dance/movement workshops for participants virtually and in-person is needed.

[Formula: see text]Is there an effective dose of aerobic exercise associated with better executive function in youth with attention deficit hyperactivity disorder?

Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder in children, and it's linked to a higher risk of academic failure, interpersonal issues, mental illness, and criminality. Despite several of the comparative and detailed reviews on the effects of ADHD interventions on core symptoms, there is no data summarizing the effects of aerobic exercise (AE) on executive functions (EFs). Therefore, this study aimed to systematically review and determine the relationship between AE (acute and chronic) dosage and EFs (attention, inhibition, set-shifting, and working memory) in youth with ADHD. The consideration of how AE dosage impacts aspects of EFs has not been investigated in detail previously. The study adhered to PRISMA guideline. Sixdatabases were searched without any date restrictions, up to February 2021, for articles relating to AE interventions to influence EFs in youth with ADHD≤18 years old. Quality assessment of the reviewed papers was addressed. Thirteen studies met the inclusion criteria. Improvements in all aspects of EFs were reported after children with ADHD engaged in acute AE lasting 20-30 minutes with at least moderate intensity (65% ≤ 80% HRmax).Furthermore, chronic exercise that lasts at least 45 minutes and in the range of moderate tohigh intensity (i.e., 60% ≤ 75% HRmax), 3 days/week for 6-12, elicits additional benefits in inhibition and set-shifting.Different dosage of AE might differently influence aspects of EFs; however, this finding rests on preliminary evidence at this stage and thus should be treated with caution.It is necessary to establish suitable interventions with regard to the dosage of AE types to improve EFs in young people with ADHD.

Effectiveness of the POWER Program in Improving Physical Activity and Executive Function in Fifth Grade Students.

BACKGROUND: High volumes of school-based sedentary time may impact academic achievement and executive function negatively. This study evaluated a multimodal classroom program's (POWER) effect on fifth graders' physical activity (PA) and executive function. METHODS: Six 5th grade classes (3 = intervention [POW]; 3 = waitlist control [CONT]) in 2 diverse New Jersey schools participated. Data were collected before, during, and post-intervention. PA was assessed via accelerometer, executive function by NIH Toolbox, and academic achievement via standardized math tests. The POW principal, teachers, and select students participated in follow-up interviews. Group comparisons were made by multivariate repeated-measures ANOVA and linear regression. RESULTS: PA decreased in both groups over time, but POW's post-intervention class-time PA was significantly higher than CONT's. POW's NIH Toolbox score increased 3 percentiles more than CONT's. Intervention fidelity was associated with significantly higher scores for one NIH Toolbox test. Student math test scores increased significantly for both schools, but there was no significant main effect for group. POW's feedback was positive, with the principal reporting fewer disciplinary referrals and teachers and students conveying positive growth. CONCLUSIONS: Overall, POW's positive changes and the favorable reception of POWER support POWER'S ability to improve children's socioemotional and physical health.

Who Uses Wearable Activity Trackers and Why? A Comparison of Former and Current Users in the United States.

BACKGROUND: There has been an explosion in the use of wearable activity trackers (WATs), but we do not fully understand who wears them and why. This study's purpose was to describe the characteristics of WAT users and to compare current and former users. MATERIALS AND METHODS: A variety of internet-based resources (eg, Craigslist, Facebook) were used to recruit current and former WAT users. Respondents completed a web-based survey, where they provided information on sociodemographic characteristics, health, physical activity behavior, and about their WAT use. RESULTS: Of the 2826 respondents who gave informed consent, 70.8% (n = 2002) met inclusion criteria for this analysis. Respondents ranged from 18 to 81 years old (mean 32.9 ± 12.2 standard deviation) with 73.8% women. Most were current WAT users (68.7%), and the average length of WAT use overall was 9.3 ± 9.7 months. On average, current users wore the device for 3.7 months longer than former users. Compared to current users, former users had a lower body mass index (1.2 kg/m2 less), reported fewer medical conditions, shared data from their device less often, and received the device as a gift more frequently. CONCLUSIONS: Current and former users varied in their reasons for using a WAT and how they used their device. Differences identified between these groups support further exploration of associations between WAT users' profiles and their physical activity behavior.

An Examination of the Relationship Between Motivation, Physical Activity, and Wearable Activity Monitor Use.

Wearable physical activity (PA) monitors are widely promoted as a means to motivate people to be more active, but the motivational profile of users has never been assessed. This study's purpose was to classify adult users by their motivational regulation scores and examine how these profiles were associated with moderate to vigorous PA (MVPA). Current users (N = 320) recruited across the United States completed a Web-based survey. Motivational regulations were measured using the Behavioral Regulation in Exercise Questionnaire, and associations with MVPA were explored using bivariate correlations. MVPA was more highly correlated with autonomous rather than controlling regulations. A cluster analysis was conducted using the respondents' motivational regulation scores. Five motivational profiles emerged from this analysis, and they differed significantly across motivation and MVPA scores. PA monitor users characterized by more autonomous motives presented with higher MVPA. As technology use increases, assessing the multidimensionality of PA monitor users' motivation may add value when researching PA behaviors.

Quantifying Physical Activity in Young Children Using a Three-Dimensional Camera.

The purpose of this study was to determine the feasibility and validity of using three-dimensional (3D) video data and computer vision to estimate physical activity intensities in young children. Families with children (2-5-years-old) were invited to participate in semi-structured 20-minute play sessions that included a range of indoor play activities. During the play session, children's physical activity (PA) was recorded using a 3D camera. PA video data were analyzed via direct observation, and 3D PA video data were processed and converted into triaxial PA accelerations using computer vision. PA video data from children (n = 10) were analyzed using direct observation as the ground truth, and the Receiver Operating Characteristic Area Under the Curve (AUC) was calculated in order to determine the classification accuracy of a Classification and Regression Tree (CART) algorithm for estimating PA intensity from video data. A CART algorithm accurately estimated the proportion of time that children spent sedentary (AUC = 0.89) in light PA (AUC = 0.87) and moderate-vigorous PA (AUC = 0.92) during the play session, and there were no significant differences (p > 0.05) between the directly observed and CART-determined proportions of time spent in each activity intensity. A computer vision algorithm and 3D camera can be used to estimate the proportion of time that children spend in all activity intensities indoors.

Establishing a Global Standard for Wearable Devices in Sport and Fitness: Perspectives from the New England Chapter of the American College of Sports Medicine Members.

The recent explosion of wearable technology and the associated concerns prompted the International Federation of Sports Medicine (FIMS) to create a quality assurance standard for wearable devices, which provides commissioned testing of marketing claims and endorsement of commercial wearables that test favorably. An open forum as announced in the conference advertising was held at the Annual Meeting of the New England Regional Chapter of the American College of Sports Medicine (NEACSM) November 7 to 8, 2019, in Providence, Rhode Island, USA for attending NEACSM members to voice their input on the process. Herein, we report the proceedings. The round table participants perceived the quality assurance standard to be important, but identified some practical process challenges that included the broad scope and complexity of the device universe, the need for a multiphase testing pathway, and the associated fees for product evaluation. The participants also supported the evaluation of device data analysis, behavioral influences, and user experience in the overall evaluation. Looking forward, the FIMS quality assurance standard faces the challenge of balancing these broader perspectives with practical constraints of budget, facilities, time, and human resources.

Associations Between Habitual Sedentary Behavior and Endothelial Cell Health.

Endothelial dysfunction is a mechanism that may explain the link between prolonged sedentary time and cardiovascular disease. However, the relation between habitual sedentary behavior (SED) and endothelial function has yet to be explored. PURPOSE-: The purpose of this study was to examine the association of accelerometer-measured SED with markers of endothelial cell health. METHODS-: Healthy adult participants (n=83; 43.4% male; 25.5 ± 5.8 years old) were examined. SED was measured for 7-days by accelerometer. Endothelial function measures included endothelium-dependent vasodilation (EDV); endothelial microparticles (EMPs) [CD62E+ and CD31+/CD42- EMPs]; and endothelial progenitor cells (EPCs) [CD34+/CD133+/KDR+ and CD34+/KDR+EPCs]. Participants were classified as having low or high SED based on a median split. RESULTS-: Participants in the low and high SED group spent a mean ± SD of 8.6 ± 1.1 and 11.1 ± 1.0 h/day in SED, respectively. No significant differences between the low and high SED groups were detected in mean [95% confidence interval (CI)] EDV (2.51 [2.21-2.81] vs. 2.36 [2.07-2.64], p=0.50), EMPs (CD62E+: 6.70 [6.55-6.84] vs. 6.56 [6.42-6.69], p=0.20; CD31+/CD42‒: 6.26 [6.10-6.42] vs. 6.18 [6.03-6.33], p=0.50), or EPCs (CD34+/KDR+: 11.91 [9.23-14.48]×10-2 vs. 14.87 [12.41-17.32]×10-2, p=0.13); CD34+/CD133+/KDR+: 1.84 [1.28-2.39]×10-2 vs. 2.17 [1.64-2.70]×10-2, p=0.43). CONCLUSIONS-: Among healthy adults, habitual SED was not associated with markers of endothelial cell health.

Limitations of 6-minute walk test reference values for spinal muscular atrophy.

INTRODUCTION: The 6-minute walk test (6MWT) is a well-established clinical assessment of functional endurance, validated as a measure of walking ability in spinal muscular atrophy (SMA). The current availability of disease-modifying therapies for SMA indicates a growing need for normative reference data to compare SMA patients with healthy controls. METHODS: The literature was searched in two scientific databases. Studies were evaluated and selected based on adherence to American Thoracic Society guidelines for administering the 6MWT. Reference equations from the selected studies were applied to 6MWT data collected from SMA patients to calculate and compare % predicted values. RESULTS: Three pediatric and six adult studies were selected for comparison. The % predicted values using the pediatric and adult equations ranged from 47.7 ± 18.2% to 67.6 ± 26.2% and 43.0 ± 17.9% to 59.5 ± 26.2%, respectively, and were significantly different (P < 0.001). DISCUSSION: Results suggest significant variability between % predicted values derived from published reference equations in children and adults, despite adherence to 6MWT standardization.

BRICS nations and the opportunities for community physical activity interventions.

•Rapid urbanization and its environmental impact have led to challenges to health and well-being of residents in BRICS nations.•Physical activity should be a priority public health target for primary and secondary prevention because of the high prevalence of chronic diseases and cardiometabolic risk factors in BRICS nations.•BRICS nations can harness scientific evidence prospectively to promote environmental and policy supports for physical activity.•Physical activity interventions engaging the members of the community and that are culturally relevant are more likely to be effective.

The Health Benefits of Exercise in Overweight and Obese Patients.

More than 30% of U.S. adults are obese or overweight. A program of regular physical activity is recommended as part of an effective lifestyle intervention for weight loss and weight management. However, more than 40% of adults do not engage in sufficient physical activity to realize these beneficial effects on body weight. Physicians may encounter many barriers to counseling physical activity, such as lack of knowledge or self-efficacy for counseling patients about physical activity. Obese individuals may be reluctant to exercise because of weight stigma, physique anxiety, and other factors; therefore, referral to a weight management specialist or clinical exercise physiologist can be helpful in facilitating exercise and assisting in achieving a clinically meaningful weight loss. Exercise has many benefits on physical and mental health and well-being that go well beyond weight loss, and it is for these reasons that exercise is particularly important for overweight and obese individuals.

Physical Activity and Cardiovascular Risk among Kidney Transplant Patients.

PURPOSE: Research examining the relationship between physical activity (PA) and cardiovascular disease (CVD) risk factors among kidney transplant recipients (KTR) is limited. Accordingly, we sought to 1) describe the levels of PA in KTR and 2) analyze the associations between PA levels and CVD risk factors in KTR. METHODS: Baseline data from KTR participants in a large multiethnic, multicenter trial (the Folic Acid for Vascular Outcome Reduction in Transplantation) were examined. PA was categorized in tertiles (low, moderate, and high) derived from a modified PA summary score from the Yale Physical Activity Survey. CVD risk factors were examined across levels of PA by ANOVA, Kruskal-Wallis rank test, and hierarchical multiple regression. RESULTS: The 4034 participants were 37% female (mean ± SD = 51.9 ± 9.4 yr of age, 75% White, 97% with stage 2T-4T chronic kidney disease, and 20% with prevalent CVD. Participants in the "high" PA tertile reported more vigorous PA and walking, compared with participants in moderate and low tertiles (both P < 0.001). No differences were observed in daily household, occupational, or sedentary activities across PA tertiles. More participants in the "low" PA tertile were overweight/obese, had a history of prevalent diabetes, and/or had CVD compared with more active participants (all P < 0.001). Hierarchical modeling revealed that younger age (P = 0.002), cadaveric donor source (P = 0.006), shorter transplant vintage (P = 0.025), lower pulse pressure (P < 0.001), and no history of diabetes (P < 0.001) were associated with higher PA scores. CONCLUSION: The most active KTR engaged in more intentional exercise. Lower levels of PA were positively associated with more CVD risk factors. Higher PA levels were associated with younger age and with more positive KTR outcomes.

Factors associated with objectively measured exercise participation after hospitalization for acute coronary syndrome.

BACKGROUND: Guidelines recommend exercise for secondary prevention of acute coronary syndrome (ACS), however adherence to guidelines is low. A paucity of data examining factors associated with objectively-measured exercise post-discharge in ACS survivors exists. The purpose of this study was to identify factors associated with exercise during the 5 weeks after ACS discharge. METHODS: A sample of 151 ACS patients treated at a university hospital were enrolled into an observational cohort study and wore an accelerometer for 35 days post-discharge. Days on which participants accumulated ≥30 min of moderate-to-vigorous physical activity in bouts ≥10 min were considered exercise days. Participants were categorized as non-exercisers (0 exercise days) or exercisers (≥1 exercise day). A multi-variable logistic regression model was used to examine the association between exercise and socio-demographics, depression, SF-12 physical and mental health scores, disease severity, length of hospitalization, and percutaneous coronary intervention. RESULTS: 39.7% of participants were non-exercisers. Factors associated with non-exercise were age (OR: 1.11; 95% CI: 1.06-1.17, p < 0.001), female sex (OR: 2.76; 95% CI: 1.10-6.95, p = 0.031), and lower SF-12 physical health score (OR: 0.94; 95% CI: 0.90-0.98, p = 0.005). CONCLUSION: In ACS patients in whom exercise participation was objectively measured for 5 weeks post-discharge, demographic and poor physical health factors were associated with non-exercise. These findings identify populations (e.g. older adults, women) at especially high risk for being physically inactive in whom more intense intervention may be warranted.

How Do Physical Activity and Health Vary Among Younger, Middle-Aged, and Older Adults With and Without Disability?

Physical activity (PA) and health were compared in younger (YA; 18-44 years), middle-aged (MA; 45-64 years), and older (OA; ≥65 years) adults with disability (PWD), functional limitation (PFL), or without disability (PWoD). Disability occurred in YA (PWD: 2.3%; PFL: 14.3%), MA (PWD: 8.5%; PFL: 23.8%), and OA (PWD: 14.9%; PFL: 26.6%). Not meeting aerobic/muscle-strengthening PA recommendations was frequent in YA (PWD: 50.7%; PFL: 42.5%; PWoD: 35.8%), MA (PWD: 56.7%; PFL: 44.0%; PWoD: 35.6%), and OA (PWD: 57.8%; PFL: 44.1%; PWoD: 33.1%). Among PWD, YA and MA met muscle, strengthening recommendations more frequently than did OA; PFL did more aerobic PA than PWD. The presence of chronic diseases, female gender, White race, lower education, and less income were associated with being PWD or PFL. Those with greater PA were less likely to be PWD or PFL. Results suggest increasing public health efforts to promote healthy lifestyles in MA and OA.

Interactive Dyadic Physical Activity and Spatial Proximity Patterns in 2-Year-Olds and Their Parents.

This study aimed to characterize daily physical activity (PA) behaviors in 2-year-old girls and boys and their parents, with and without an objective measure of dyadic spatial proximity. Urban-dwelling parent⁻toddler dyads (N = 110) wore accelerometers for 7 days, and parents completed a sociodemographic questionnaire. Accelerometers were initialized to collect PA and Bluetooth-based proximity data. After applying wear-time algorithms, n = 65 dyads were further analyzed using a dyadic analysis statistical methodology. Toddler⁻parent sedentary and light PA time were respectively interdependent, conditional on child sex and child-parent proximity, but moderate⁻vigorous physical activity (MVPA) time was not. Toddlers were significantly more active on weekdays and weekends than their parents, and no differences were found in daily PA volumes between girls and boys. In dyads with proximity data (n = 34), analyses of joint (i.e., proximal and mutual) PA time showed that girls participated in significantly more joint PA with their mothers than boys. Children who engaged in ≥60 min of MVPA/day participated in ~2 h of joint PA/day, on average, while children with <60 min of MVPA/day engaged in ~30 min less joint-PA time with their mothers. Boys and girls who participated in higher daily MVPA volumes engaged in joint PA with their mothers across greater relative distances, as compared to less active boys who engaged in joint PA at closer relative distances to their mothers. Toddlers who engaged in ≥60 min of daily MVPA participated in joint PA with their mothers at greater relative distances and for longer durations than less active children. Further research on the dyadic activity⁻proximity relationship is needed across early childhood development.

A Review of Current Literature on Vital Sign Assessment of Physical Activity in Primary Care.

PURPOSE: To conduct an integrated review of the performance and implementation of two physical activity (PA) assessment tools, the exercise vital sign (EVS) and the physical activity vital sign (PAVS), in U.S. primary care practice. DESIGN: An integrative review following Whittemore and Knafl's methodology. METHODS: Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched. Search terms were "exercise vital sign" OR "physical activity vital sign" AND "primary care". Additional inclusion criteria were studies conducted in the United States, published in English, in primary care, between 2010 and 2016. RESULTS: Nine studies met inclusion criteria. Five studies reported validity data of the EVS tool, while four studies reported data from the PAVS tool. Compared with the accelerometer, the EVS tool overestimated moderate-vigorous PA, while the PAVS tool demonstrated moderate agreement in identifying those not meeting national PA guidelines. The EVS tool was successfully implemented in large, integrated practices utilizing electronic health record systems. PA documentation increased compared to non-EVS practices. The predictive ability of the PAVS tool for clinical outcomes was shown. Studies of PA assessment tool use in children were not found. CONCLUSIONS: Preliminary evidence on the validity of both the EVS and PAVS tools support cautious use of each as a screening tool in primary care. There were no data on reliability, with limited data on tool use in diverse populations or settings. Data in children, older adults, and diverse population subgroups were lacking. CLINICAL RELEVANCE: Two brief exercise vital signs tools have each shown some initial validity for use by primary care clinicians as measures to identify patients not meeting PA guidelines.