WHO Recommendations for Addressing Muscle Loss and Disability
The WHO recommends that people with disabilities should strive to meet the same physical activity guidelines as the general population whenever possible, with adaptations based on individual abilities, to prevent muscle loss and maintain functional independence. 1
WHO Guidelines for Physical Activity in People with Disabilities
The 2020 WHO guidelines on physical activity and sedentary behavior specifically address people with disabilities for the first time, recognizing the importance of physical activity for this population 1. These recommendations include:
For Adults with Disabilities:
- 150-300 minutes of moderate-intensity aerobic physical activity per week
- OR 75-150 minutes of vigorous-intensity aerobic physical activity per week
- OR an equivalent combination of both intensities
- Muscle-strengthening activities involving all major muscle groups on at least 2 days per week
- Reduction in sedentary behaviors
Key Principles for Implementation:
- Some physical activity is better than none
- Start with small amounts and gradually increase frequency, intensity, and duration
- Adapt recommendations to fit individual abilities and health conditions
- Avoid inactivity whenever possible
Global Implementation Status
A 2025 scoping review in the British Journal of Sports Medicine found that while many countries have developed physical activity guidelines for older adults, a significant proportion (46%) lack specific guidelines for people with chronic conditions or disabilities 1. This represents a failure to meet WHO recommendations and address the unique barriers faced by these populations.
Country-Specific Approaches:
- Singapore (2022): Encourages those able to meet general guidelines to do so; others should avoid inactivity and engage in regular physical activity according to ability 1
- Spain (2022): Recommends that people with specific disabilities (including spinal cord injury, intellectual disability, Parkinson's disease, stroke, depression, and schizophrenia) follow general population guidelines when possible 1
- Switzerland (2023): Provides the most comprehensive approach, encouraging people with disabilities to strive for basic recommendations with appropriate adaptations, and offering alternatives for those with mobility limitations 1
Benefits of Physical Activity for Preventing Muscle Loss
Regular physical activity and exercise are the primary interventions recommended by WHO to address sarcopenia (age-related loss of muscle mass and function) and prevent disability 2, 3. Benefits include:
- Prevention of 3-8% muscle mass loss per decade that typically occurs with inactivity 4
- Potential increase in lean weight and resting metabolic rate 4
- Improved physical performance, movement control, and walking speed 4
- Enhanced functional independence and cognitive abilities 4
- Reduced risk of falls and related injuries 3
Implementation Challenges
The WHO acknowledges several barriers to implementing these recommendations:
- Lack of country-specific guidelines tailored to people with disabilities 1
- Limited evidence from low and middle-income countries 1
- Insufficient research on dose-response relationships between physical activity and health outcomes in people with disabilities 1
- Socioeconomic factors affecting access to information and resources 1
Call to Action
The WHO emphasizes the urgent need for:
- Development of contemporary, context-specific national guidelines for populations with chronic conditions and disabilities 1
- Greater research focus on physical activity interventions for people with disabilities 1
- Integration of these guidelines into national health policies aligned with the WHO Global Action Plan on Physical Activity 2018-2030 1
By following these WHO recommendations, individuals with disabilities can significantly reduce the risk of muscle loss and associated disability, maintaining better quality of life and functional independence.