Physical Activity Implementation Guide
Boosting physical activity among adults with arthritis

Parks, Recreation, Fitness
and Sport

Strategies and Tools

Strategy 1

Include at least one evidence-based arthritis-appropriate physical activity intervention in your schedule of exercise programs.

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


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)


Fit and Strong!

Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Increase Physical Activity in the Community

AF Community Programs for Better Living

CDC Community Transformation Grants


Miami-Dade Parks & the Health Foundation of South Florida’s Free ''Walk with Ease'' Walking Program for Seniors

Strategy 2

Provide literature on arthritis and physical activity in all park, recreation, fitness, and sport facilities.

Good brochures and pamphlets can help spread the word about the importance of physical activity for adults with arthritis, the benefits of that activity, and available resources in the community for services and support. Such material should be positioned strategically, in locations that are highly trafficked by regular patrons—near the front check-in desk, in locker rooms, or beside a main exit.


American Heart Association’s Find a Walking Path


Arthritis Foundation Store, Fitness and Nutrition Publications

CDC Arthritis Communication Campaigns

CDC Arthritis Localizable Campaign Materials

Strategy 3

In fitness and sports facilities, offer more low-impact and low-intensity exercise equipment for older adults and individuals with arthritis and disabilities.

When purchasing equipment and designing exercise space, health clubs and other recreational facilities should take into account the accessibility needs for persons with arthritis, limited mobility, and/or disabilities. The built environment (facility layout and structure, as well as interior design), supplemented with supportive internal policies and professional behavior (attitudes and knowledge), can make a major difference in facilitating use.


NCPAD Before and After a Fitness Makeover

U.S. Access Board’s Guide to Accessible Sports Facilities

American College of Sports Medicine’s Health and Fitness Facility Standards and Guidelines

Guidelines for equipment, space, and classes from The National Center on Physical Activity and Disability

Current 2010 Standards for Accessible Design as they apply to sports facilities, as provided by Access Board

Recreation, Park and Health Promotion Grant and Program Resources

Strategy 4

Promote the development of sidewalks to create safe pathways to parks and recreation facilities.

Adults must be able to get to parks and recreation facilities easily and safely. Installation and maintenance of solid sidewalks can remove one of the main access barriers for all adults, not just those with arthritis.


NRPA’s Parks Build Healthy Communities: Success Stories

NRPA ACHIEVE Case Studies: Successful Practices for Building Healthier Communities

CDC’s Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Increase Physical Activity in the Community

America Walks

Creating Safe Park Environments to Enhance Community Wellness

Strategy 5

Install benches or rest areas in parks, trails, and recreation facilities to support greater use by adults with arthritis.

Before visiting a nearby park or walking path, adults with arthritis need to know that there are frequent, safe, and comfortable places for them to rest. Due to pain and/or limitations in endurance and stamina, adults with arthritis may need to take frequent breaks from walking to protect their health. Signs can also help adults with arthritis select walking paths that are level or have gradual slopes, and avoid those that are hilly or steep.


NRPA’s Parks Build Healthy Communities: Success Stories

NRPA’s Issue Brief on Creating Safe Park Environments to Enhance Community Wellness

Convergence Partnership’s efforts to strengthen the built environment through transportation and joint use

CDC’s Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Increase Physical Activity in the Community

America Walks

Creating Safe Park Environments to Enhance Community Wellness

Strategy 6

Use tools such as audits or walk-ability checklists to assess whether trails or paths are accessible to people with arthritis.

A walking audit (also referred to as a walking assessment) can help examine the walking conditions along specified streets, trails, and paths. It is designed to assess availability, safety, and attractiveness of walking routes in a community. It can help you map out the most commonly used walking routes, and identify the most common safety hazards and inconveniences that can keep people from walking.


NRPA article, Walk This Way

NRPA’s Parks Build Healthy Communities: Success Stories

Pedestrian and Bicycle Information Center Walk-ability Checklist

America Walks

Pedestrian and Bicycle Center

American Heart Association’s Find a Walking Path

Walkable and Livable Institute

Walkable Communities, Inc.

Active Living Research

Products of Washington University Prevention Research Center:

Healthy PAGE (Policies and Actions Guided by Evidence) Project

Physical Activity Policy Research Network


Strategy 7

Enhance arthritis and exercise expertise of park, recreation, fitness, and sport professionals by:

  • Supporting professional development programs or training
  • Including arthritis-specific information in all exercise certification programs and undergraduate exercise professional training curricula
  • Providing more sources of appropriate arthritis-friendly physical activity training for fitness professionals, peer leaders, etc.

In addition to offering classes and equipment that can be adapted for adults with arthritis, facilities should have staff skilled in modifying exercises and equipment for different ability levels. To the extent possible, modifications should be tailored to the individual, and the type, frequency, intensity, and duration of recommended exercise should depend on the severity, type, and location of the arthritis. Training should develop skills in tailoring exercise programs to individual needs and helping adults who have developed arthritis modify their approach to exercise (e.g., by changing intensity, frequency, or type) in order to prevent pain or other negative outcomes.


The Fitness Professional’s Guide to Training Clients with Osteoarthritis

American College of Sports Medicine specialty fitness certifications

Nebo Content Management System Tracking