Written by guest blogger, Jake Lynch, from Rails-to-Trails Conservancy.

In recent years Rails-to-Trails Conservancy (RTC) has seen trails evolve from being considered purely as recreational facilities to occupying a key role in the relationship between built environments and public health. But building the trails themselves is only half the battle. Longer-term work involves encouraging their use, investing residents and users with a sense of ownership, and making trails a natural, integral part of the community.

To facilitate this relationship, RTC staff must be creative, running programs that, at first glance, seem far removed from their trails mission. For example, RTC staff recently helped students at a D.C. school paint a colorful mural on a trailside wall, next to a vegetable garden. We brought along a fitness instructor who specialized in children’s activities, so the young artists took breaks from painting by running, stretching and racing along the trail. The event began a gradual process of familiarization that the trail is for them, that it connects to their school, and that it offers physical and personal freedom in an environment that can be restrictive. 

In Pittsburgh, RTC sponsors students from low-income neighborhoods to join the annual Sojourn bicycle tour. As training, volunteers from Bike Pittsburgh lead rides along local trails. To warm up, they do yoga. It’s a wonderful sight: A group of young black students in the Lion’s Pose as cyclists and joggers cruise by. Bike Pittsburgh also operates a Free Ride Recycled Bike Shop. In areas where being able to afford a bike is a major obstacle, creative initiatives like these have a real impact on the number of people riding for regular trips.

In Spartanburg, S.C., an educational scavenger hunt on the Mary Black Trail is increasing trail usage among students and seniors. Small train sculptures are hidden along the trail; kiosks, signage and iPods transmit historical facts and scavenger hunt clues. Organizers hope to bring regular educational trails trips into the school syllabus.

Across America, rail-trail organizations stage fun runs and races. An underlying purpose of these events is to establish the local trail in the collective mind of the community as a free fitness and recreation facility open to all. Staging events for people who are already active runners does little to address broader health goals, so trail organizers are innovating and expanding their reach. An annual fitness day on the Hurley Trail in New York includes a cycle-spin workshop and Zumba sessions. ‘Trail Mix’ on the W&OD Trail combines biking, walking and the area's Civil War history, plus live entertainment and sports clinics. The Morgana Run hosts "Walk a Hound, Lose a Pound."

Trails are the backbone of programs that provide incentives for students to ride or walk to school, ostensibly to reduce vehicle congestion at drop-off and pick-up times. RTC hosts Compton BikeFest, encouraging riding among children in inner-city communities, a focus of anti-obesity efforts. For trails advocates, the key to increasing physical activity is often to make it about anything but the exercise, promoting the financial savings, convenience, accessibility, freedom, social interaction and environmental aspects of riding and biking.  

Featured Post

When debate causes a rift between Americans and our elected leaders, it can be reassuring to note areas of broad consensus. For example, most everyone agrees that obesity threatens individual health and quality of life. Despite a range of opinions on the particulars, we see this collectively as a public health priority with profound implications for health care costs and a myriad of other effects.

We know that obesity and physical inactivity fuel a wide array of chronic conditions, from diabetes and hypertension to coronary heart disease and cancer. The science is clear and the conclusion is unmistakable: preventable diseases impact the health and livelihood of far too many Americans, and we as a society have to pay for it.

Enter the National Prevention Strategy, a comprehensive plan that will help increase the number of Americans who are healthy at every stage of life. Thoroughly researched and carefully considered, the strategy was guided by a distinguished panel headed by U.S. Surgeon General Regina Benjamin, MD, MBA, and informed by listening sessions, town hall meetings and guidance from experts and stakeholders from a variety of backgrounds. As announced in June, the plan is built on four strategic pillars:

• Building Healthy and Safe Community Environments: Prevention of disease starts in our communities and at home; not just in the doctor's office.
• Expanding Quality Preventive Services in Both Clinical and Community Settings: When people receive preventive care, such as immunizations and cancer screenings, they have better health and lower health care costs.
• Empowering People to Make Healthy Choices: When people have access to actionable and easy-to-understand information and resources, they are empowered to make healthier choices.
• Eliminating Health Disparities: By eliminating disparities in achieving and maintaining health, we can help improve quality of life for all Americans.

Proponents of physical activity know that prevention means more than diagnostic medical tests. The Strategy shines a spotlight on active living, since exercise has been demonstrated to prevent and treat more than 40 chronic diseases. Noting that at least 40 percent of adults and 80 percent of adolescents do not regularly meet the Physical Activity Guidelines for Americans, the Strategy pinpoints five key areas of action:

1. Encourage community design and development that supports physical activity.

2. Promote and strengthen school and early learning policies and programs that increase physical activity.

3. Facilitate access to safe, accessible and affordable places for physical activity.

4. Support workplace policies and programs that increase physical activity.

5. Assess physical activity levels and provide education, counseling and referrals.

If these look familiar, it is because they represent the best, evidence-based recommendations as sifted by the Strategy's comprehensive, inclusive process.

Consensus is Comforting

The recommendations in the Strategy align with those of the National Physical Activity Plan, which is eminently credible and well on its way to implementation. Similarly, they are comparable to Exercise is Medicine, the ACSM American Fitness Index and workplace wellness initiatives. This underscores the validity of our growing understanding that Americans have much to gain from adopting physically active lifestyles, and that we know collectively how to make that happen.

What elements of the National Prevention Strategy, the National Physical Activity Plan and other initiatives can most readily be adopted in your organization? In your community?

The American Physical Therapy Association Section on Geriatrics held a 3-day conference in July 2010 on the campus of the University of Indianapolis to promote the application of research on benefits of exercise for older adults into clinical practice. Both the content format and the unique meeting planning create a model that may be useful to other organizations planning an education offering on the value of physical activity.

The conference, Exercise and Physical Activity in Aging Conference (ExPAAC): Blending Research and Practice, was hosted by the University of Indianapolis Center for Aging & Community and Krannert School of Physical Therapy, and drew 350 participants. Presentation topics included the effects of PA and exercise on health and aging, how to affect behavioral change, and evidence-based prescription for older adults. Our goals for the conference were to: 1) make available current research about PA and exercise from middle through older adulthood; 2) translate research into evidence based practice; 3) identify barriers to translation of research into evidence based practice; 4) promote best practices in physical therapist practice; and 5) evaluate public policies that influence the capacity of physical therapists to provide services. Speakers included national and international researchers Jack Guralnik, MD, PhD, MPH; Pamela Duncan, PT, PhD, FAPTA, FAHA; Alexandre Kalache, MSc, MD, PhD, FRCPH; James Rimmer, PhD; Thomas Prochaska, PhD; Barbara Resnik, PhD, RN, CRNP, FAAN, FAANP; and Luigi Ferrucci, MD, PhD.

Session topics included national and international physical activity initiatives, effects of physical activity and exercise on components of health and aging, determinants of behavior change, and evidence based practice exercise for optimizing function. We also held an evening poster presentation session to highlight case reports, research studies, special interest reports, and theory reports. Some participants wished to attend ExPAAC but felt they needed a review in geriatrics, so we offered a one-day pre-conference course that enabled these participants to maximize their experience. The closing keynote speech was delivered by Dr. James Canton, PhD, renowned author and advisor from the Institute for Global Futures.

Holding the conference at the university allowed us to have many great opportunities for networking and discussion - both formal and informal - at mealtimes in the campus cafeteria, during breaks on the outdoor commons, and at several special social events planned for conference attendees. Attendees stayed in the nearby Holiday Inn or in the dormitories on campus, which had the advantages of lower hotel and meeting site costs. An additional benefit was that conference participants were invited to attend exercise classes and to use campus recreational facilities during their free time.

For those who were unable to attend ExPAAC, we made sure that all of the sessions could be purchased through the APTA Learning Center at (click on "Courses" and search for ExPAAC). The PowerPoint presentations and the commentary of the experts during their ExPAAC presentations were included. Each session features multiple choice question examinations for the purposes of CEU credit.

Because of ExPAAC's overwhelming success, the Section on Geriatrics is considering an "ExPAAC II" in the next 5-10 years. We hope that a model such as ours will be as successful for you as it was for us...

Written by guest bloggers: Ellen Milner, PT, PhD; David M. Morris, PT, PhD