In 2020–21, 3 in 10 adults aged 18–64 years did not perform at least 150 minutes of physical activity per week, and 1 in 2 of those aged ≥65 years (47% of men and 52% of women) were insufficiently active, with little change over the previous decade.¹ In 2011–12, 83% of children aged 2–5 years, 88% of children aged 5–12 years were insufficiently active for their age.¹ In 2017–18, just over 1 in 10 (11%) of those aged 5–17 years were sufficiently active for their age, whereas just over 1 in 6 (16%) met the recommended muscle strengthening activity guidelines.² Insufficient physical activity contributes 2.5% of the total burden of disease due to death or disability.¹

The message that any physical activity is better than none is important.³ If a patient does not already engage in regular physical activity, they can be encouraged to start by doing some, and then gradually building up to the recommended amount.³ Advice, written physical activity materials and referral should be tailored to age, disability and level of risk.

Engaging in regular physical activity and avoiding long periods of sedentary behaviour can help maintain a healthy weight and avoid a range of chronic illnesses. 

Where possible, people should incorporate a variety of intensities of physical activity, as defined below:^3,8

• Light: Movement where people do not think about it (light gardening, getting dressed, stretching). The World Health Organization (WHO) defines light-intensity physical activity as between 1.5 and 3 metabolic equivalents of task (METs); that is, activities with an energy cost less than three times the energy expenditure at rest for that person. These activities can include slow walking, bathing or other incidental activities that do not result in a substantial increase in heart rate or breathing rate.³
• Moderate: Putting in effort, but not strenuous activity (gentle bike riding, brisk walk). According to the WHO definition, on an absolute scale, ‘moderate intensity’ refers to physical activity that is performed at an intensity between three and less than six times the intensity of rest. On a scale of 0–10 relative to an individual’s personal capacity, moderate-intensity physical activity is usually rated a 5 or 6.³
• Vigorous: out of breath and sweating (jogging, star jumps, sit-ups). On an absolute scale, the WHO definition of vigorous-intensity activity as physical activity that is performed at ≥6.0 METS. On a scale of 0–10 relative to an individual’s personal capacity, vigorous-intensity physical activity is usually rated a 7 or 8.³ 

Assessment of physical activity involves questions about minutes of activity and being sedentary each day, and on how many days per week. Brief advice about increasing physical activity can be given in the consultation with the support of:

• written materials (including an exercise prescription)
• tools such as the RACGP Healthy Habits conversation guide and app and an activity tracker. The RACGP’s Handbook of non-drug interventions (HANDI) provides further information on the use of pedometers for increasing physical activity.

Assessment of physical activity should be supplemented by referral, especially for patients with risk factors or physical or social barriers to physical activity. This may include:

• telephone counselling
• local community-based programs
• individual exercise physiology.

The choice of referral should be based on individualised shared decision making with the patient.

For specific recommendations for Aboriginal and Torres Strait Islander people, please refer to Physical activity in the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander peoples.

Make sure to ask people with disability about their levels of physical activity.

For recommendations about physical activity during pregnancy, please refer to the First antenatal visit and During pregnancy chapters.

For recommendations about physical activity for falls prevention, please refer to the Falls chapter.

To assist GPs and practice staff work with patients on the modifiable risk factors of smoking, nutrition, alcohol and physical activity:
Smoking, nutrition, alcohol, physical activity (SNAP) | RACGP 

A free digital tool to discuss physical activity and nutrition with patients and monitor their progress:
RACGP Healthy Habits app 

For exercise interventions to use with patients:
Handbook of non-drug interventions (HANDI)