Physical Activity Implementation Guide
Boosting physical activity among adults with arthritis

Health Care


Strategies and Tools

Strategy 1

Incorporate into every visit of your patients with arthritis an assessment of their physical activity levels and specific barriers.

A decade or two ago, physicians did not routinely ask their patients about tobacco habits, alcohol intake, or seat belt use. Today, questions about these health risks and behaviors are expected and serve to raise awareness among patients of the link between certain behaviors and disease, injury, and quality of life. This holds true for arthritis patients and physical activity. Health care providers can change patients’ attitudes and behavior about physical activity simply by asking the right questions, sharing information about the benefits of being more active, and bringing to light the critical barriers they may face. Medical assessments can help patients set appropriate, individualized goals. They can also be used as a “trigger” to indicate when to recommend attending a community physical activity program or seeing a physical therapist.

Tools

Exercise is Medicine® was designed by the American College of Sports Medicine (ACSM) and the American Medical Association (AMA) to help improve health and well-being through a regular physical activity prescription from doctors and other health care providers. A toolkit helps you plan for May, Exercise is Medicine Month.

Questions for Assessing Physical Activity
Two sets of questions are offered to get you started. The first is from the BRFSS, modified to include physical activity. The second came from Physical Activity Recommendations For People with Type 2 Diabetes From Diabetes Coalition of California.

Physical Activity Calculators
http://www.ehow.com/how_7264020_calculate-physical-activity-level.html
https://www.supertracker.usda.gov/physicalactivitytracker.aspx

Strategy 2

Record physical activity as a vital sign in medical records.

Just as assessment of patients’ physical activity raises awareness of its importance, documenting activity levels in their medical records could help facilitate counseling and monitoring of levels over time.

To learn more

Kaiser Permanente Study Finds Efforts to Establish Exercise as a Vital Sign Prove Valid: Kaiser Permanente is one of the first health care organizations to establish a systematic method for recording patients’ physical activity into their electronic health records.

Strategy 3

Design electronic systems to record and monitor physical activity levels of your patients with arthritis and their receipt of physical activity information and recommendations.

Efforts are underway at a national level to get physical activity included in electronic medical records.

To learn more

Kaiser Permanente Study Finds Efforts to Establish Exercise as a Vital Sign Prove Valid: Kaiser Permanente is one of the first health care organizations to establish a systematic method for recording patients’ physical activity into their electronic health records. http://xnet.kp.org/newscenter/pressreleases/nat/2012/101712_exercise_vital_sign.html

A Physical Activity Toolkit for Registered Dietitians: Utilizing Resources of Exercise is Medicine®

Strategy 4

Recommend that your patients with arthritis participate in community-based physical activity interventions, other physical activity appropriate for adults with arthritis, or rehabilitation therapies as needed.

Advice from providers about being more physically active should be very specific, or patients are likely not to listen. Just saying “go to gym more often” will not produce desired behavior change. Instead, recommendations about the type and frequency of activity must be as precise as possible.

In addition, giving the patient a list of locally available sites for recommended activity (e.g., local Y’s, community centers, fitness centers, physical therapists) could increase the odds that the patient will actually follow through. Perhaps your medical office or practice could even become a host site for physical activity interventions.

Samples

Prescription Print Pad from California

Patient Information Sheet

Tools

To locate Walk with Ease programs in your community sponsored by the Arthritis Foundation

To locate other AF programs in your community

Brochures and newsletter articles from the Arthritis Foundation

American Heart Association’s Start Walking Now

Track and React, sponsored by Arthritis Today

American Physical Therapy Association’s Move Forward program

American Physical Therapy Association’s Health and Prevention Tips

Strategy 5

Empower your patients with arthritis with skills to perform their own self-assessment, or refer them to a trained professional to develop a personalized plan for physical activity.

With support and encouragement, patients can take charge of their health and how it is impacted by physical activity. The more engaged they are, the more likely they will be able to sustain recommended activity levels over time.

Tools

Self-management interventions

Track and React, sponsored by Arthritis Today

The National Council on Aging leads a Falls Free® Initiative, with tools and resources for addressing the growing public health issue of falls and fall-related injuries and deaths in older adults

Strategy 6

In health care insurance packages, include reimbursement and financial incentives to support screening and participation in evidence-based physical activity among adults with arthritis.

Six physical activity programs have been proven to enhance the symptoms, function, and quality of life of adults with arthritis. In addition, CDC has developed a guidance document to help select the appropriate interventions for your situation.

Tools

Arthritis Appropriate Physical Activity and Self-Management Education Interventions, A Compendium of Implementation Information

Six physical activity programs

Active Living Everyday

Arthritis Foundation Aquatic Program

Arthritis Foundation Exercise Program

Arthritis Foundation Walk With Ease Program (group led)

EnhanceFitness

Fit and Strong!

Nebo Content Management System Tracking