{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:00:10Z","timestamp":1790586010265,"version":"4.1.0"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gesundheitswesen"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In numerous chronic conditions, the positive effects of physical activity and\n                        exercise on health and health-related quality of life are beyond discussion.\n                        Thereby, a clear distinction must be made between physical activity,\n                        exercise therapy, and training. Clinical practice guidelines (CPGs) aim to\n                        provide evidence- and\/or consensus-based decision-making frameworks within\n                        the context of healthcare. To date, however, it remains unclear how\n                        exercise, physical training, and movement-based health care services are\n                        addressed in German CPGs.<\/jats:p>\n                  <jats:p>A systematic document analysis was conducted of all available German CPGs on\n                        chronic conditions for which positive or at least inconclusive evidence\n                        regarding the effectiveness of physical activity was available. The present\n                        study examined the presentation of indication-specific evidence regarding\n                        physical activity, general recommendations on physical activity,\n                        recommendations on specific healthcare services, the involvement of\n                        professional associations with physical activity expertise, and information\n                        on indication-specific training recommendations (FITT principle: frequency,\n                        intensity, time, and type of exercise).<\/jats:p>\n                  <jats:p>A total of 79 CPGs on chronic conditions with positive evidence for physical\n                        activity and 15 CPGs with unclear evidence were included in the analysis.\n                        Indication-specific evidence regarding physical activity was reported in 65\n                        CPGs (82%) referring to indications with positive evidence for physical\n                        activity and exercise and 12 (80%) on CPGs that referred to indications with\n                        unclear evidence. Recommendations on specific movement-based healthcare\n                        services were reported in 40 (51%) and 4 (27%) of CPGs, respectively.\n                        Complete training-specific recommendations in accordance with the FITT\n                        criteria were reported in 18 (23%) and 2 (13%) CPGs. Professional\n                        associations with physical activity expertise were involved in the\n                        development of 36 (46%) CPGs with positive evidence and 2 (13%) CPGs with\n                        unclear evidence for physical activity.<\/jats:p>\n                  <jats:p>Despite the well-documented health benefits of physical activity and exercise\n                        for chronic conditions, they have not yet been sufficiently integrated into\n                        relevant CPGs. This results in a relevant gap in healthcare provision and a\n                        reduction in the quality of care within the healthcare system. Consequently,\n                        expertise in physical activity and exercise should always be systematically\n                        integrated into the development of CPGs and physical activity-related\n                        healthcare services should be specifically promoted and expanded.<\/jats:p>","DOI":"10.1055\/a-2925-4082","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T20:16:30Z","timestamp":1787688990000},"source":"Crossref","is-referenced-by-count":0,"title":["Physical activity and exercise in clinical practice guidelines in\n                    Germany: systematic document analysis"],"prefix":"10.1055","author":[{"given":"Lars","family":"Gabrys","sequence":"additional","affiliation":[{"name":"University of Applied Sciences for Sport and Management Potsdam\n                    (FHSMP), Sport and Health, Potsdam, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Peters","sequence":"additional","affiliation":[{"name":"University of the Bundeswehr Munich, Faculty of Human Sciences,\n                    Institute of Sport Science, Neubiberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Thiel","sequence":"additional","affiliation":[{"name":"Bochum University of Applied Sciences, Faculty of Nursing, Midwifery\n                    and Therapeutic Sciences, Gesundheitscampus, Bochum, Germany"},{"name":"Ruhr-University Bochum, Faculty of Sports Science, Gesundheitscampus,\n                    Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Schaller","sequence":"additional","affiliation":[{"name":"University of the Bundeswehr Munich, Faculty of Human Sciences,\n                    Institute of Sport Science, Neubiberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref2","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1152\/physiol.00019.2013","article-title":"Exercise is the real polypill","volume":"28","author":"C Fiuza-Luces","year":"2013","journal-title":"Physiology (Bethesda, Md)"},{"key":"ref3","first-page":"655","article-title":"DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health\n                    Services Research","volume":"86","author":"L Gabrys","year":"2024","journal-title":"Gesundheitswesen"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s12966-025-01772-1","article-title":"Physical activity promotion in physical therapy, exercise therapy and other\n                    movement-based therapies: a scoping review and content analysis of intervention\n                    studies and theoretical works","volume":"22","author":"L Matting","year":"2025","journal-title":"International Journal of Behavioral Nutrition and Physical\n                    Activity"},{"key":"ref5","first-page":"126","article-title":"Physical activity, exercise, and physical fitness: definitions and distinctions\n                    for health-related research","volume":"100","author":"C J Caspersen","year":"1985","journal-title":"Public health reports"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1007\/s40279-016-0488-y","article-title":"Embedding physical activity in the heart of the NHS: the need for a whole-system\n                    approach","volume":"46","author":"H Speake","year":"2016","journal-title":"Sports Medicine"},{"key":"ref10","first-page":"69","article-title":"Physical Activity-Related Health Services in Germany: Relevance and Necessary\n                    Framework Conditions\u2013a Position Paper of the DNVF Working Group Physical\n                    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Sport"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"11","DOI":"10.5507\/euj.2024.008","article-title":"Physical activity barriers among adults with physical disabilities or chronic\n                    diseases during and after rehabilitation","volume":"17","author":"M Wildekamp","year":"2024","journal-title":"European Journal of Adapted Physical Activity"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1123\/kr.2020-0036","article-title":"Why is exercise underutilized in clinical practice despite evidence it is\n                    effective? Lessons in pragmatism from the inclusion of exercise in guidelines\n                    for the treatment of depression in the British National Health Service","volume":"10","author":"P Ekkekakis","year":"2020","journal-title":"Kinesiology Review"},{"key":"ref15","volume-title":"ACSM's Guidelines for Exercise Testing and Prescription","author":"American College of Sports Medicine\n                        (ACSM)","year":"2021"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s10195-025-00885-4","article-title":"Active and passive physical therapy in patients with chronic low-back pain: a\n                    level I Bayesian network meta-analysis","volume":"26","author":"A Baroncini","year":"2025","journal-title":"Journal of Orthopaedics and Traumatology"},{"key":"ref17","first-page":"130","article-title":"Suggestions of the German Society for Rehabilitation Sciences Aimed at the\n                    Advancement of the\" Framework Agreement on Rehabilitation Sports and\n                    Functional Training\", Issued Jan. 1, 2011 by the Federal Rehabilitation\n                    Council (BAR)","volume":"55","author":"K Pfeifer","year":"2016","journal-title":"Rehabilitation"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"CPG1","DOI":"10.2519\/jospt.2023.0301","article-title":"Exercise-based knee and anterior cruciate ligament injury prevention: clinical\n                    practice guidelines linked to the international classification of functioning,\n                    disability and health from the academy of orthopaedic physical therapy and the\n                    American academy of sports physical therapy","volume":"53","author":"A J Arundale","year":"2023","journal-title":"Journal of Orthopaedic & Sports Physical Therapy"},{"key":"ref21","first-page":"S54","article-title":"Clinical practice guidelines physical activity and diabetes diabetes Canada\n                    clinical practice guidelines expert committee","volume":"42","author":"R Sigal","year":"2018","journal-title":"Can J Diabetes"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"e29953","DOI":"10.1002\/pbc.29953","article-title":"Multidisciplinary Network ActiveOncoKids guidelines for providing movement and\n                    exercise in pediatric oncology: Consensus-based recommendations","volume":"69","author":"M G\u00f6tte","year":"2022","journal-title":"Pediatric blood & cancer"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1123\/japa.2023-0283","article-title":"A practice guide for physical therapists prescribing physical exercise for older\n                    adults","volume":"32","author":"F M Baptista","year":"2024","journal-title":"Journal of aging and physical activity"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"2679","DOI":"10.1007\/s00421-025-05858-3","article-title":"Beyond FITT: addressing density in understanding the dose\u2013response relationships\n                    of physical activity with health\u2014an example based on brain health","volume":"125","author":"F Herold","year":"2025","journal-title":"European Journal of Applied Physiology"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary\n                    behaviour","volume":"54","author":"F C Bull","year":"2020","journal-title":"British Journal of Sports Medicine"},{"key":"ref28","first-page":"449","volume-title":"Update: S3-Leitline Bewegungstherapie bei onkologischen Erkrankungen","author":"J Wiskemann","year":"2022"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1136\/bjsports-2025-110301","article-title":"Effect of exercise on depression and anxiety symptoms: systematic umbrella\n                    review with meta-meta-analysis","volume":"60","author":"N R Munro","year":"2026","journal-title":"British journal of sports medicine"}],"container-title":["Das Gesundheitswesen"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2925-4082.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:41:49Z","timestamp":1790584909000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2925-4082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":21,"URL":"https:\/\/doi.org\/10.1055\/a-2925-4082","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0941-3790","1439-4421"],"issn-type":[{"value":"0941-3790","type":"print"},{"value":"1439-4421","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8,3]]},"published":{"date-parts":[[2026,8,3]]}}}