Make Exercise a New Vital Sign in Your Practice

Physical inactivity has been established to be an independent risk factor for many chronic diseases and conditions that threaten the health of the nation. Additionally, older adults are at particular risk for leading sedentary lifestyles.

June is good time to add exercise as a new vital sign in your practice, now that the weather is nice to walk, go fishing, plant a garden and enjoy the sunshine. According to the Centers for Disease Control and Prevention (CDC), regular physical activity is one of the most important things that people can do for their health.

Exercise helps with weight control; reduces the risk of disease (including heart disease, Type 2 diabetes, and some cancers); strengthens bones and muscles; improves mental health and mood; prevents falls in older adults, and can increase life expectancy.

Physician advice to increase physical activity can motivate older adults to become more active, and there are some simple steps to incorporate activity assessment into your practice workflow. The Guide to Promoting Physical Activity in Primary Care, by Health Scotland, recommends what you should ask your patient if you have less than 30 seconds.

The following are key messages (as appropriate for your patient) to open the discussion and “plant the seed” for changing behavior.

To benefit your health, make you feel better and maintain your body weight, you should do regular physical activity and try not to sit for long periods of time.
You should do at least 30 minutes of moderate-intensity physical activity, above usual activity at work or home, on at least five days of the week.
Walking is an easy way to get started. This should be at a brisk pace; enough to make you feel warmer and breathe more deeply but without any discomfort. Slowly increase the length of each session and then think about trying other activities; include some stretching and resistance exercises (these can be performed at home and need not involve any special clothing or equipment).
You are more likely to remain physically active if you find an activity that you enjoy and that can be fitted into your everyday life.

Another approach to engaging your patients is one taken by Kaiser Permanente. Exercise is now a vital sign for all of their members. When a patient has their weight, height and blood pressure measured before a doctor visit, the patient’s exercise habits are assessed so doctors can follow-up. The questions asked and documented in the medical record, along with all other vital signs, are the following