How Much Exercise is Enough? Ask a Physiotherapist!

As Ontario slowly starts to creep out of the 3rd wave of COVID-19, and as the world begins to re-open, you may be wondering how you’ll return back to life as we knew it pre-pandemic. All of us have likely become less active in the past year, due to the lockdown and closures of outdoor activities, sports, and gyms – and in general, not having to rush around for work or other commitments. Returning back to our previous routines should also include regular physical activity.

You may be familiar with the various health benefits of physical activity. However, regularly engaging in physical activity, and reducing sedentary behaviour (physical inactivity), are needed in order to obtain these benefits. But, how much exercise is enough? The World Health Organization (WHO) has created evidence-based physical activity guidelines for different age groups, with the latest update just released in 2020. This blog post will help break down these guidelines for you.
First, let’s cover some basic definitions:

  • Light intensity physical activity: On a scale relative to an individual’s personal capacity, this is usually a 2–4 on a rating scale of perceived exertion scale of 0–10. Examples include slow walking, bathing or other activities that do not result in a substantial increase in heart rate or breathing rate.
  • Moderate intensity physical activity: On an individual scale, this refers to a 5-6 rating on a perceived exertion scale from 0-10.
  • Vigorous intensity physical activity: this refers to a rating of 7-8 on a perceived exertion scale of 0-10.
  • Aerobic exercise: Activity in which the body’s large muscles move in a rhythmic manner for a sustained period of time. Aerobic activity—also called endurance activity—improves cardiorespiratory fitness. Examples include walking, running, swimming and bicycling.
  • Balance training: exercises that are designed to improve an individual’s ability to withstand challenges to their balance


Children and adolescents (aged 5–17 years), including those living with disability

  • The benefits of physical activity in this age group include: physical fitness (cardiorespiratory and muscular fitness), cardiometabolic health (blood pressure, cholesterol levels, glucose and insulin resistance), bone health, cognitive outcomes (academic performance, executive function) and mental health (reduced symptoms of depression) and reduced adiposity (body fat)
  • Sedentary behaviour (physical inactivity) can have negative effects in this age group, particularly relating to fitness and cardiometabolic health, adiposity, behavioural conduct/pro-social behaviour and sleep duration.
  • Recommendations for physical activity
    • Children and adolescents should do at least an average of 60min/day of moderate to vigorous intensity, mostly aerobic physical activity across the week
    • Vigorous-intensity aerobic activities, as well as those that strengthen muscle and bone should be incorporated at least 3 days a week
  • Recommendations for sedentary behaviour
    • Children and adolescents should limit the amount of time spent being sedentary, particularly the amount of recreational screen time


Adults (aged 18–64 years) including those with chronic conditions and those living with disability

  • The benefits of physical activity for adults includes: reducing all-cause mortality (any cause of death), reducing cardiovascular disease mortality (death due to cardiovascular disease), reducing hypertension, type 2 diabetes, site-specific cancers, mental health improvements (reduced symptoms of anxiety and depression), cognitive health and sleep ; measures of adiposity (body fat) may also improve.
  • In adults, higher amounts of sedentary behaviour are associated with negative effects relating to all-cause mortality, cardiovascular disease mortality and cancer mortality, and incidence of cardiovascular disease, type 2 diabetes and cancer.
  • Recommendations for physical activity
    • All adults should undertake regular physical activity
    • Adults should do at least 150–300 min of moderate-intensity aerobic physical activity, or at least 75–150min of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate-intensity and vigorous-intensity activity throughout the week for substantial health benefits. Increasing exercise time beyond these recommendations can result in additional health benefits (when it is not contraindicated for those with chronic conditions).
    • Adults should also do muscle-strengthening activities at moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these provide additional health benefits.
  • Recommendations for sedentary behaviour
    • Adults should limit the amount of time spent being sedentary. Replacing sedentary time with physical activity of any intensity (including light intensity) provides health benefits.
    • To help reduce the detrimental effects of high levels of sedentary behaviour on health, adults should aim to do more than the recommended levels of moderate to vigorous physical activity.


Older adults (aged 65 years and older) including those with chronic conditions and those living with disability

  • In older adults, physical activity also helps prevent falls and falls-related injuries and declines in bone health and functional ability.
  • Recommendations for physical activity
    • Same as for adults, as well as;
    • As part of their weekly physical activity, older adults should do varied multicomponent physical activity that emphasises functional balance and strength training at moderate or greater intensity on 3 or more days a week, to enhance functional capacity and to prevent falls
  • Recommendations for sedentary behaviour
    • Same as for adults

Pregnant and postpartum women

  • Physical activity in this group has benefits for both mother and fetus including: reduced risk of preeclampsia, gestational hypertension, gestational diabetes, excessive gestational weight gain, delivery complications and postpartum depression and no increase in risk of stillbirth, newborn complications or adverse effects on birth weight.
  • Recommendations for physical activity (in those without contraindications)
    • undertake regular physical activity throughout pregnancy and post partum
    • do at least 150min of moderate-intensity aerobic physical activity throughout the week for substantial health benefits
    • incorporate a variety of aerobic and muscle-strengthening activities. Adding gentle stretching may also be beneficial
  • Recommendations for sedentary behaviour
    • Pregnant and postpartum women should limit the amount of time spent being sedentary. Replacing sedentary time with physical activity of any intensity (including light intensity) provides health benefits.


What’s different in this update?

  • The biggest change in the 2020 update is the addition of recommendations for sedentary behaviour. Limiting sedentary behaviour is important across all age groups, and reducing sedentary time even by a little bit can make a big difference. Replacing sedentary time with even light intensity physical activity has health benefits. In other words, SOME physical activity is better than NONE!
  • Another key difference is that there is no longer a recommendation to exercise in a minimum of 10 minute bouts. This is because studies have shown that engaging in physical activity of ANY bout duration is associated with health benefits.
  • It was previously recommended that only older adults with poor mobility should participate in balance training to reduce falls. However, now it is recommended that ALL older adults should engage in multicomponent exercise that targets balance and strength in order to improve falls.
  • The development of recommendations on physical activity and sedentary behaviours specifically for people living with disability and chronic conditions, as well as for pregnant and postpartum women, addressed important gaps in global health policy. These new recommendations affirm that physical activity is feasible for these groups.

As the weather begins to warm up (and as Ontario begins to reopen outdoor activities!) be sure to try doing some physical activity outdoors. Check out our past blog posts for some tips if you aren’t sure how to incorporate these guidelines into your daily routine. Physiotherapists are also a great resource for providing guidance on different exercises!
By Rebecca Chow
Physiotherapy Graduate
Headshot of Alpha Health Services Physiotherapist Rebecca Chow

Feel Better. Move Better. Be Better.
Our goal is simple —  to provide the best physiotherapy we can!

Bull FC, AlAnsari SS, Biddle S, et al. Br J Sports Med 2020;54:1451–1462.

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