Making patients move requires the right exercise advice

It is common knowledge that regular exercise supports physical and mental well-being. Despite this and recommendations from health care providers, the majority of patients with chronic illnesses remain inactive.

In a new study, University of Missouri researchers found that adults with chronic illness who received interventions focused on behavior-changing strategies significantly increased their physical activity levels. In contrast, interventions based on cognitive approaches, which attempt to change knowledge, beliefs and attitudes, and are most commonly used by health care providers, did not improve physical activity.

"The information that physicians are giving patients isn't working. Patients are not motivated when they hear 'exercise is good; it will improve your health.' What works is providing patients with simple, action-orientated strategies to increase their activity levels," said Vicki Conn, professor and associate dean of research in the MU Sinclair School of Nursing.

Behavior strategies include feedback, goal setting, self-monitoring, and stimulus or cues. Self-monitoring, any method where participants record and track their activity over time, significantly increased awareness and provided motivation for improvement, Conn said.

"It is important for care providers to set very specific, manageable goals with patients," Conn said. "For example, ask them to exercise for 20 minutes, three times a week and track their progress by writing it down. Have them schedule exercise on their calendars, or prompt them by setting their walking shoes by their doors. Ask how they can reward themselves if they accomplish the goal. This will help incorporate activity into their daily routines and provide them with a sense of accomplishment."

Conn completed a meta-analysis incorporating data from 22,527 participants in 163 research reports. No previous analysis has examined physical activity levels following interventions among adults with diverse chronic illnesses. Conn found that interventions were similarly effective regardless of gender, age, ethnicity and socioeconomic status.

"Behavior interventions increased participants' activity by an average of 48 minutes per week, which is enough to provide them with health benefits," Conn said. "People may feel overwhelmed by the thought of exercise, or think they have to work out 60 minutes, five days a week, but doing just 12 minutes per day may get them started toward better health."

The study "Meta-Analysis of Patient Education Interventions to Increase Physical Activity Among Chronically Ill Adults," was published in Patient and Education Counseling. Conn's research is funded by a more than $1 million grant from the National Institutes of Health.