Exercise for patients with chronic disease: physician responsibility.

Patients with chronic disease typically become severely deconditioned, which often leads to physical disability. Every effort should be made to recommend and encourage patients to adopt and maintain a program of physical activity. Although there are no specific exercise guidelines for many chronic conditions, patients should be instructed to start a routine of physical activity that is gradual for most (if not all) days of the week, working up to 30 minutes per session at an exertion level that is easily tolerated. It is critical that assessment of physical functioning and recommendations for physical activity be included as a part of routine medical care. In doing so, we change the expectations of patients and family members, and work toward optimizing physical functioning and quality of life.