Agree a plan

Don't be tempted to impose your own plan at this stage - they may agree with you just to end the conversation


“Can I summarise what I think you have said?”

Summarise the main points of the conversation without adding any new information

This may sound something like: ‘so some of the benefits of physical activity for someone like you include A and B and C. The most important reasons for you personally would be P and W’.

Using a summary can be a good way to demonstrate and express empathy, that you can see the world from their perspective. Empathy contributes to outcomes in a range of settings.


‘So, what do you think you will do?’

If they decide that they are NOT ready
Thank them for taking the time to talk with you about physical activity and offer an opportunity to review the conversation. Reassure them that help is available when they feel ready to change.

If they decide to become more active, THEN move on to planning
Continue to keep the focus on them generating their own ideas for change, rather than telling and instructing. People are much more likely to make successful changes if they develop their own plans.

The individual has heard about the benefits of physical activity for someone like them and has had chance to consider the benefits they would most like to experience. They have heard their ideas spoken back to them, which can help to reinforce them. Now it’s decision time.

Asking an open question ‘what do you think you will do?’ rather than a closed question ‘so, are you going to exercise?’ helps remind them that they – not you – are the decision maker.

If they are not ready to change now this can be challenging for you, but they might have good reasons to keep things the same for now. Encouraging further reflection can be an important part of the process of helping people to make successful changes over time. Offer an opportunity to follow up on this conversation to review their thoughts about making changes.

Build activity

Can they think of any easy and/or enjoyable ways of fitting in opportunities to move more during their daily routine?

Build activity into everyday life



Carrying shopping bags

Stand during advert breaks

Housework – doing the hoovering




Public transport


Walking up stairs

Standing desk

Standing to talk on telephone

Active meeting


Pool based activity – swimming or aqua class

Yoga /Pilates

Throwing ball in park

Exercise class

Chair based exercises

Walking the dog


Online exercise videos

Agree a plan

Different options suit different people and can be effective when used alone or with each other.

Explore the options below and print out the relevant PDF for your patient or print the workbook in Information for Patients.


Motivational support

Use this document for people who are keen to review and develop their motivation for behavioural change


Action planning

Action planning is good for those who hope to set structured goals to create a roadmap for behaviour change

Individuals are more likely to change their behaviour if they are following a set of goals they have committed to.

For action planning theory visit:

Gollwitzer P, Social RK-J of P and, 1989 undefined. Effects of deliberative and implemental mind-sets on illusion of control. psycnet.apa.org

Gollwitzer PM, Oettingen G. The emergence and implementation of health goals. Psychol Health 1998;13:687–715. doi:10.1080/08870449808407424

For a comprehensive overview of action planning visit:

Woodcock B. Action Planning. Univ. Kent. 2018.


Step counting

Use this for those keen to use self-monitoring devices such as pedometers, wrist worn accelerometers or even smartphones to monitor their daily step counts.


Kang M, Marshall SJ, Barreira T V, et al. Effect of pedometer-based physical activity interventions: a meta-analysis. Res Q Exerc Sport 2009;80:648–55. doi:10.1080/02701367.2009.10599604
Ogilvie D, Foster CE, Rothnie H, et al. Interventions to promote walking: systematic review. BMJ 2007;334:1204. doi:10.1136/bmj.39198.722720.BE
Jee H. Review of researches on smartphone applications for physical activity promotion in healthy adults. J Exerc Rehabil 2017;13:3–11. doi:10.12965/jer.1732928.464


Make a diary

Creating a personalised monthly schedule helps work out where and when someone can start to fit opportunities to become more active into their own life.

Did you know?

In order to benefit health, research has shown that activities need to be of at least moderate intensity. For most people, this will mean experiencing an increased heart rate and breathing rate during the activity

Department of Health. Start Active, Stay Active: a report on physical activity from the four home countries’ Chief Medical Officers. London, 2011

Those who are currently physically inactive should start gently and build up slowly, enabling their body to gradually adapt to the higher levels of activity

Department of Health. Start Active, Stay Active: a report on physical activity from the four home countries’ Chief Medical Officers. London, 2011


Smith B, Kirby N, Skinner B, et al. Physical activity for general health benefits in disabled adults: summary of a rapid evidence review for the UK Chief Medical Officers’ update of the physical activity guidelines. London: Public Health England, 2018

It is important that measures to increase physical activity in lower limb amputees do not compromise social interaction

Deans SA, McFadyen AK, Rowe PJ. Physical activity and quality of life: A study of a lower-limb amputee population. Prosthetics and Orthotics International 2008;32(2):186-200. doi: 10.1080/03093640802016514

Personalised interventions, access to appropriate equipment/facilities and support from family, professionals and peers can motivate lower limb amputees to be more active

Miller MJ, Jones J, Anderson CB, et al. Factors influencing participation in physical activity after dysvascular amputation: a qualitative meta-synthesis. Disability and rehabilitation 2018:1-10. doi: 10.1080/09638288.2018.1492031

Littman AJ, Bouldin ED, Haselkorn JK. This is your new normal: A qualitative study of barriers and facilitators to physical activity in Veterans with lower extremity loss. Disability and Health Journal 2017;10(4):600-06. doi: 10.1016/j.dhjo.2017.03.004

Littman AJ, Boyko EJ, Thompson ML, et al. Physical activity barriers and enablers in older Veterans with lower-limb amputation. Journal of Rehabilitation Research and Development 2014;51(6):895-906. doi: 10.1682/jrrd.2013.06.0152