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Physical Activity is one of the most popular self-care topics people will choose to focus on as they create their Personal Health Plans (PHPs). This overview focuses on the benefits of physical activity and ways to support people who want to increase their activity levels. It highlights the latest research related to exercise and other forms of activity, and it specifically discusses the potential roles of yoga (and yoga therapy), tai chi, Pilates, walking, and running. Physical Activity can improve flexibility, balance, and coordination, as well as strength and endurance. Even a few extra minutes of activity each day has potential benefits. This overview elaborates on what is covered in Chapter 5, “Moving the Body” in the Passport to Whole Health.

Key Points

• Physical activity is beneficial for a multitude of health issues, and it is one of the most powerful approaches to prevention we have as well.
• When starting an activity program, a person should take their current level of fitness into account. If a person is at risk or has not been active recently, they should see a provider before they begin a new activity plan.
• Mindful awareness can be helpful when it comes to physical activity. Tuning into the body is a common way to cultivate mindful awareness, and this helps people to both tune into any symptoms they might have as well as to focus on what feels most helpful when it comes to various forms of activity.
• There are many different forms of yoga. Hatha yoga, which involves various body positions, is one of the most familiar in the West. This approach has the benefits seen with other forms of physical activity and may have others as well, particularly in terms of cultivating mindful awareness. It seems to be helpful to people with nonspecific low back pain, cardiovascular disease, mental health, type 2 diabetes, and perhaps PTSD.
• Tai chi and qi gong involve (among other aspects) gentle movements that are performed in a very specific way. They also show a number of potential health benefits, especially in terms of fall prevention and improved balances.
• It is helpful to become familiar with various resources you can share with patients on this topic, including various apps and websites.

Meet the Patient

People say that losing weight is no walk in the park. When I hear that I think, yeah, that’s the problem.

—Chris Adams

Javier is a 50 year-old arborist and former football player who has experienced multiple injuries to his joints, muscles, and bones. While he cannot remember how all these injuries happened, he does recall many “hard hits” to his body, especially when he played high school football. After some of these impacts, he was not able to get up without assistance.

Javier’s health has been steadily deteriorating. He now has chronic, debilitating bilateral knee and low back pain. He underwent arthroscopic knee surgery, which was complicated by both a post-operative wound infection and an allergic reaction to antibiotics. Soon after, he gained massive amounts of weight, and he eventually developed severe sleep apnea requiring continuous positive airway pressure (CPAP) with supplemental oxygen. He began binge eating and rationalized his behavior by telling himself that it did not interfere with his normal functioning, and it was better than using any drugs or alcohol. He does not take his prescribed extended-release oxycodone.

Things began to change after Javier “hit rock bottom” a few months ago, feeling like he simply could not do his job anymore, because climbing trees was just too taxing. His weight reached a lifetime maximum at 260 pounds. He was diagnosed with type 2 diabetes. Around this time, he remembered how a yoga class had previously made his back feel great. However, when he went looking for local yoga classes, he felt intimidated by the intensity of the classes and the fact that he would have been the oldest person in the class. Luckily, Javier heard that his local YMCA was offering yoga classes. He also began thinking it might be good for him to join a gym.

Javier’s PHI

Vitality Signs. Javier’s primary care team asked him to complete a Brief Personal Health Inventory (PHI) prior to his visit. A few things stood out. First, his vitality signs were fairly low:

He denies being suicidal, but his provider felt compelled to check. His answer to the next question is reassuring along those lines.

What do you live for? What matters to you? Why do you want to be healthy?

Javier wrote:

“I love my kids. I have to be around for my family. I want to not hurt, mostly because I want to be the dad and husband they deserve.”

Javier’s answers on the “Where You Are and Where You Would Like to Be” section of the PHI were variable, ranging from 1 out of 5 (Food and Drink, Physical Activity) to 5 out of 5 (Professional Care and Spirit and Soul). Javier is clear that he wants to work on Physical Activity as his top priority right now. He rates himself a 1 in terms of “Where I am Now” and 4 on “Where I Want to be.” When asked why he chose a 4 as “Where I Want to Be,” he says, “I doubt I even have it in me to get back up to a 5 like I was in college. My body is broken.”

Next Steps. Finally, he helps write the Personal Health Plan (PHP) with his answer to the last PHI question:

“I want to get my body back. I weigh 260 pounds, and when I played football, I was 195. I want to get back there, or as close as I can. If I exercise, I’ll eat less at night, because exercise decreases my appetite. A buddy told me about yoga. I don’t know, but I guess I am willing to try just about anything.”

How can Physical Activity serve Javier? This overview answers questions about how to realistically – and safely - bring physical activity into a person’s health plan. It discusses different ways to move the body, including some that tend to be classed as complementary approaches. Benefits, harms, and suggestions for making referrals for these practices will be highlighted. The diagram in Figure 1 is used to guide patients as they consider which topics related to Physical Activity they could add to their PHPs.

Figure 1. Subtopics Within the Physical Activity Self-Care Circle

What we know about integrative health care has come to us thanks to the efforts, experiences, and collective wisdom of people from many cultures and backgrounds. We wish to acknowledge all the healers, researchers, patients, and peoples who have informed the content of this tool.

Author(s)

This overview was adapted for the Osher Center for Integrative Health at the University of Wisconsin-Madison by J. Adam Rindfleisch, MPhil, MD, building on the original written by Surya Pierce, MD, and updated by Sagar Shah, MD.

Originally Created: 2014, Updated: 2018

Modified for UW Integrative Health: 2020