Promoting physical activity among patients is a top concern for many physicians; however, the lack of accessible areas for patients continues to be a public health issue around the world.  Given the limited patient/provider consultation, it can be helpful for providers to provide their patients with some quick tips to promote walking.  It may also be beneficial to identify potential resources for patients who may need additional accommodations as they embark on their journey of health.  Common approaches include the following:

• Providing patients with a list of accessible locations nearby that they can use as resources to exercise.
• Discuss the health benefits of walking.
• Discuss the physical activity guidelines.
• Provide patients with a list of alternatives to walking that also serve as physical activity, specifically for individuals with disabilities or anyone who needs additional accommodations.

List of Accessible Locations

There may be multiple locations in the community that are accessible for patients, but oftentimes patients and/or physicians may not be aware of these locations.  Here are some strategies to help:

• The National Public Radio (NPR) has created a resource to identify accessible playgrounds throughout the United States: http://www.playgroundsforeveryone.com/search.html
• Try the AXS Map app.  This app provides users with the ability to rate and review wheelchair accessibility of a variety of locations: https://www.axsmap.com/
• Link patients to their local YMCA.  These centers provide multiple resources for individuals with disabilities to be and/or remain active: http://www.ymca.net/

Health Benefits of Walking

There are a number of benefits to walking for individuals of all age, race, gender, and ethnicity including the following:

• Reduces arthritis-related pain (Harvard Medical School, 2018)
• Reduces chocolate cravings (Harvard Medical School, 2018)
• Reduces the risk of developing breast cancer (Harvard Medical School, 2018)
• Boosts immune function (Harvard Medical School, 2018)
• Reduces the effects of weight-promoting genes (Harvard Medical School, 2018)

Guidelines and Exercises

The United States Department of Health and Human Services (USDHH) created the 2008 physical activity guidelines for Americans as a guide to promoting physical activity among adults and children.  See below for more information.

Physical activity guidelines for adults:

• Adults should participate in some form of moderately-intensive physical activity for at least 150 minutes a week (USDHH, 2008).
• Alternatively, adults can also participate in vigorous-intensive aerobic physical activity for 75 minutes a week (USDHH, 2008).
• Lastly, adults can participate in a combination of the two (USDHH, 2008).

Physical activity guidelines for children and adolescents:

• Children and adolescents should participate in at least 60 minutes of physical activity a day (USDHH, 2008).
• Children and adolescents should participate in aerobic exercise at least three days a week (USDHH, 2008).
• Children and adolescents should participate in muscle-strength activities at least three days a week (USDHH, 2008).
• Children and adolescents should participate in bone-strengthening activities at least three days a week (USDHH, 2008).

Additional guidelines can be found for individuals who may have a disability.

For some patients, it may be necessary to identify their barriers to exercise and offer suggestions on potential modifications.  For patients who benefit from modifications, you can provide the following suggestions:

• Rowing
• Seated volleyball
• Swimming laps
• Pushing in a wheelchair
• Wheelchair basketball
• Wheelchair tennis

1.    5 Surprising Benefits of Walking. Boston, MA: Harvard Health Publishing. Available at https://www.health.harvard.edu/staying-healthy/5-surprising-benefits-of-walking
2.    2008 Physical Activity Guidelines for Americans. Washington, DC: US Department of Health and Human Services; 2008. Available at http://www.health.gov/paguidelines/guidelines/default.aspx
3.    Rimmer JH, Riley B, Wang E, Rauworth A, Jurkowski J. Physical activity participation among persons with disabilities: barriers and facilitators. Am J Prev Med 2004;26:419–25.