Exercise is Health: Normalising Exercise for Elderly Primary Care Patients

Year Submitted: 2025
Published Date: 26 November 2025

Tags: Applied/Translational Research, Mixed-Methods, Care Continuum, Preventive Care, Community Health, Patient Education, Rehabilitative Care

About this Content

Aims

To safely increase the intensity, duration, and type of exercise in older and frail SLCC patients to meet national physical activity guidelines.
1. Increase in number of patients participating in SLH exercise programmes
2. Increase in number of patients empowered for self-directed exercise
3. Increase in total Moderate to Vigorous Physical Activity (MVPA)

Background

Regular exercise is vital for the elderly, especially those who are frail or pre-frail, as it improves physical and mental well-being while preventing, managing, and even reversing chronic conditions like hypertension, hyperlipidemia, and diabetes. However, many of our elderly patients who often present with complex health and social needs, face barriers to exercise due to medical, psychological, and environmental factors], limiting their participation in existing community exercise programmes.

Methods

A mixed methods study was conducted to assess the improvement of subjective patient-reported outcomes as well as objective physical and functional testing.
Retrospective extraction of de-identified pre-post physical assessment data was extracted for a 1-year period between May 2023 to May 2024.

A problem analysis was conducted which highlighted the following findings about SLCC patients:
1. Less Active: Fewer SLCC patients meet exercise recommendations: 25.1% (SLCC needs analysis study) vs 74.2% (NPHS 2023 respondents aged 60-74).
2. Less Motivated: Majority of patients are not thinking about starting or increasing the intensity and duration of exercise.
3. Cultural Barriers: Age-related stereotypes reduced perceived capability and to exercise.
4. Poor Health Literacy: Patients lack knowledge regarding exercise recommendation resulting in an underestimation of what is enough.
5. Fear of Injury: Older age and poorer function (Clinical Frailty Scale, Activities of Daily Living, Ambulation) are associated with less exercise.

Recognising the complex factors affecting exercise participation, the team developed a multi-pronged approach with 3 key components, grounded in behavioral health theories:
1. Preparing Infrastructure
2. Optimising Processes
3. Establishing Programme

Results

All dependent variables showed statistically significant improvement pre- and post-programme except for weight. The absence of significant weight loss could be due to the increase in muscle mass, which was expected due to the inclusion of muscle strengthening exercises as part of the programme.

Additionally, GymUp has fostered a vibrant community where clients exercise and build connections.
Graduates of GymUp are also invited back as ambassadors to guide newcomers, boosting capacity while staying meaningfully engaged and giving back to the community.

Conclusion

Exercise is Health can be scaled across other institutions, enhancing accessibility for Singapore's aging population.

As a proof of concept, the team hopes that Exercise is Health can be scaled across other institutions, enhancing accessibility for Singapore's aging population.

Lessons Learnt

Recognizing the complex factors affecting exercise participation, a multi-pronged approach was developed, grounded in behavioral health theories, addressing motivation, capability, and opportunity through process redesign and environmental modifications.

Additional Information

This project has won National Healthcare Innovation and Productivity Awards 2025 under Best Adopter category.

Keywords

Preventive Care, Elderly, Exercise

Innovators' Details

Connect with this contributor!

Wong Wei Mon - weimonwong@stluke.org.sg

Project Attachment

220_SLH_NHIP_2025_Exercise_is_Health_Normalising_Exercise_for_Elderly_Primary_Care_Patients.pdf