Addressing a Communities Fitness Needs: One Person at a Time


Woman exercising with a physical therapist

Physical inactivity is a leading cause of death in the U.S. due to heart disease, stroke, diabetes, and cancer.  Physical activity is critical in the prevention of the detrimental effects of aging, obesity (33 to 35% of the US adult population), and chronic illnesses.  The Finnish Medical Society Duodecim, has also documented the importance of physical activity in the prevention, treatment and rehabilitation of diseases  .  Despite well‐documented evidence of the benefits of physical activity, we still have not approached the recommendations of the HHS Physical Activity Guidelines .  

What is the problem?  Approximately 70% of US adults are underactive,  40% of American adults do nothing to exercise, and  50% of individuals who start an exercise program drop out after 6 months.  (SportsEconomics:  Battling Attrition – A Study in Improving Member Retention at Health Club Facilities.  SportsEconomics Perspectives, Issue 3.  2001.)

Barriers to implementation  by physicians include limited time, lack of tools and skills, and lack of reimbursement.   Patient barriers to exercise include lack of time and confidence, presence of an injury, and incomplete/improper information regarding exercise relevance, content and dosing.    Research shows that  exercise advice given by a primary care physician may be effective in increasing physical activity in the short‐term [after two months], but not in the long‐term [after four and twelve months], due to insufficient support, accountability, and implementation strategies.

Who is currently in position?  The health and fitness industry is uniquely positioned to meet the growing need for easily accessible, supportive, and guided fitness venues.  They clearly have a role but  health clubs average a loss of 1 to 6 of every 10 members, and experience a mean attrition rate of 40% annually.,  Furthermore, program planning at most health clubs is targeted towards individuals who have already committed  to making physical activity a habit (which may explain why so many new members drop off).

Who else can help?   Successful exercise among those individuals who see more barriers than benefits to exercise depends on four key provider-driven characteristics:  clear, credible data; specific, attainable goals; directed programming; and appropriate reinforcement/support.

What’s Our Solution?  Conduct Annual Physical Therapist‐based Fitness Physicals to establish objective, norm‐referenced baseline measures of strength, flexibility, postural habits, cardio respiratory fitness, risks for injury, and readiness for change.  Develop individual fitness plans to specifically address findings; provide patient education, support, and ongoing feedback; establish multi‐modal fitness strategies including home exercise, private fitness training, and/or group fitness classes to best fit patient’s lifestyle, level of confidence and commitment, and experience; provide structured accountability and positive re‐enforcement systems.

What is your organization doing to engage communities to be more physically active?

Written by: Jennifer M. Gamboa, DPT, OCS, MTC