COMMENTARY

Just 10 Minutes! Getting Older Patients to Exercise

David Brown, PhD

Disclosures

February 24, 2014

Editorial Collaboration

Medscape &

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Hi. I am David Brown, from the Division of Nutrition, Physical Activity, and Obesity at the Centers for Disease Control and Prevention (CDC). I am pleased to speak with you today, as part of the CDC Expert Commentary Series on Medscape, and I am here to talk to you about the 2008 Physical Activity Guidelines for Older Adults.

The guidelines say that older adults need to do 2 types of physical activity each week to improve health: aerobic and muscle-strengthening.

For aerobic physical activity, the guidelines recommend that adults 65 years and older do:

2.5 hours of moderate-intensity aerobic physical activity per week; or

1 hour and 15 minutes of vigorous intensity aerobic physical activity; or

An equivalent combination of moderate and vigorous intensity physical activity weekly.

There are even greater health benefits from doing more than 2.5 hours of moderate-intensity aerobic physical activity every week. Activities should last at least 10 minutes at a time. Doing 10-minute sessions of physical activity 3 times a day counts as much as doing a single 30-minute session.

The guidelines also recommend:

Muscle strengthening on 2 or more days a week, preferably not on consecutive days, for all major muscle groups; and

Balance exercises at least 3 days per week for those at risk for falling.

It is important to let your older adult patients know that adults who participate in any amount of regular physical activity according to their abilities gain some health benefits. Anyone with a chronic condition or symptoms (such as heart disease, for example) should be under the care of their healthcare provider.

Here are some steps to take in discussing physical activity with patients, which can be found on ExerciseisMedicine.org:

Assess their willingness to be physically active, and assess safety issues using the Physical Activity Readiness Questionnaire (PAR-Q) to determine whether they can safely increase physical activity

Assist them by writing an exercise prescription (such as "walk 30 minutes every day to reach 2.5 or more hours of walking each week); or

Refer patients to a hospital health education and wellness program or other community physical activity program using the exercise prescription form.

Also, encourage your older patients to:

Get at least 10 minutes of daily physical activity (1-3 times per day) and commit to doing so for at least 6-8 weeks;

Plan and schedule activity into the next day's routine;

Develop a "buddy system" for support;

Encourage patients to keep a physical activity diary or log to share during follow-up; and

Watch and follow along with videos on muscle strengthening

Walking is a good place to start for those who can walk safely. Those who walk are more likely to meet the aerobic physical activity guidelines. After assessing their health status, you may offer some suggestions for walking locations -- such as walking at a mall (or manual wheeling in a wheelchair); joining a walking group; walking in the neighborhood with family, friends, or dog; walking or hiking in a park; walking at work; or walking while shopping or running errands.

Often, older patients mention barriers to being active. Their reasons may include:

"I don't have the time." A possible response is, "Start with a 10-minute session of physical activity 3 days a week. It all adds up over the course of a week. Do more as time allows."

"I am too tired." You can say, "It may be hard to get out the door, but doing just 10 or 15 minutes of physical activity that you enjoy may help you feel better and have more vigor after you finish."

"It costs too much." A response is, "You don't have to join a health club or buy fancy equipment to be active. Play with your grandchildren. Walk briskly with your friends, family member, or dog."

"I am too old." You can say, "It is never too late to start. Do some moderate-intensity physical activity; being active is better than being inactive."

Web Resources

CDC: How Much Physical Activity Do Older Adults Need?

CDC: Healthy Aging

US Department of Health and Human Services: 2008 Physical Activity Guidelines for Americans

Exercise Is Medicine

David Brown, PhD, is a Senior Behavioral Scientist at the Centers for Disease Control and Prevention (CDC), Division of Nutrition, Physical Activity, and Obesity (DNPAO), Physical Activity and Health Branch. His public health focus is on mental health outcomes associated with physical activity, and promoting physical activity among older adults, persons with disabilities, and different racial/ethnic groups. He served on the review and writing teams to develop the 2008 Physical Activity Guidelines for Americans, and recently as a coeditor on Promoting Physical Activity: A Guide for Community Action. Dr. Brown is currently promoting physical activity as part of worksite wellness programs. He is a Fellow of the American College of Sports Medicine and currently serves as Co-chair of DNPAO's Health Equity Work Group.

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