5 key lessons from our ‘Engaging Every Body’ webinar

EMD UK’s Chief Executive, Gill Cummings-Bell BA (Hon’s), M.Sc. PGCE. MBA shares key advice for creating inclusive group exercise environments for people who have long-term health conditions.

Physical inactivity is a primary cause of many long-term health conditions. The group exercise community is invaluable in creating an inclusive exercise environment to encourage people to move more and to engage everybody. But what about those who already have long-term conditions?

Most group exercise instructors are qualified to teach ‘normal healthy adults’, but many class members may have some form of long-term condition. In fact, around half of all adults in the UK are living with a long-term condition, and approximately 24% of people with a long-term condition are living with three or more health conditions.

At our recent Engaging Every Body webinar, Gill Cummings-Bell shared her insights on how to best support participants with long-term health conditions, so that as a group exercise instructor, you can have more confidence in the class.

The first step, is understanding what a long-term condition is. There are four key types…

The survey indicates that 63.7% of adults (30 million) are now classified as active, engaging in at least 150 minutes of physical activity per week. This marks a notable increase from previous years, reflecting a broader societal shift towards more active lifestyles. The proportion of inactive adults has decreased by 0.5%, equating to 121,000 fewer inactive individuals compared to the previous year. 

One of the standout trends is the rise in participation in fitness activities and exercise classes. The number of adults engaging in fitness activities has increased by 904,000 (+1.6%) over the past 12 months. This growth is part of a longer-term trend, with over one million more adults participating in fitness activities compared to seven years ago. Exercise classes in particular have seen a significant uptake, with a 1.6% increase in participation. 

Including people with long-term conditions in group exercise

Participants in your class may be affected by any of these types of long-term condition. So, how can you help them to practice group exercise safely, and to feel included? Here are some of the top tips that Gill shared…

1. Many people with long-term conditions CAN exercise

The first thing to know is that you can work with people with long-term conditions…if their condition is stable and not in decline. In fact, when they take part in the right type of exercise, it can be extremely beneficial. 

However, knowing when to adapt and when to refer to a specialist is critical – if a condition is unstable, acute, or rapidly deteriorating, referral is necessary. This doesn’t mean they won’t be able to participate to their fullest in your classes in the future – conditions can fluctuate – but it’s important to put the core health of your participant first. 

It’s key to manage conversations around referral sensitively. Always hold these conversations privately and gently highlight your concerns and the reasons behind them. Reassure the participant that you are referring in order to get them the support they need to feel their best.   

2. Risk stratification and screening are essential

Quick and ongoing informal screening for each class is important, because full PAR-Q forms, which are used to assess your ability to exercise, aren’t always collected.

You can keep risk assessment simple by categorising participants into low, medium, or high-risk based on symptoms, conditions, and stability.

Maintain your observations in the short and long-term. As you develop trust and gather information over time through observation, questions, and participant feedback, you can better assess the risks. 

3. Adapt exercises for long-term conditions

Adaptations are a great way to include people with long-term conditions. Share adaptations as standard so that people of all abilities can feel included and know that they don’t have to push themselves past safe levels of activity. 

Here are some adaptations you can include for warm-ups, workouts, and cool-downs:

• Longer, gradual warm-ups.
• Lower intensity, simpler movements.
• More focus on mobility, posture, and stability.
• Progressive overload is important, but must be gentle and adjusted for conditions.
• Avoid complex or high-impact exercises unless you’re sure the participant can manage them.

4. Mental health and confidence really matter

Around 40% of people with a physical long-term condition also have a mental health condition such as anxiety or depression. Lack of confidence, fear of pain, and perceived lack of control (known as a low “locus of control”) are major barriers to participation.

As a group exercise instructor, you are uniquely placed to rebuild participants’ confidence, to educate on the benefits of exercise, and to encourage positive movement behaviours outside of class. This will come from every interaction that you have in the class, from making newcomers feel welcome, to keeping an eye on your regulars and encouraging anyone who feels like they are losing the will. 

For newcomers, consider pairing them up with someone who is more confident in your class to help cheer them on. 

Notice when some of your participants are dropping in enthusiasm, sometimes just a little encouragement can go a long way. 

5. Build inclusive, non-discriminatory classes

It’s important to recognise that turning people away purely because they have a long-term condition can be seen as discriminatory under equality laws. However, it’s acceptable to turn someone away if the exercise could cause them harm. This must be clearly explained and based on evidence. The aim should be to widen access safely by making adaptations, growing your confidence, and working within your qualifications and knowledge.

To build your confidence in implementing the steps above, look out for the free training released by EMD in early June. Taking this training should ensure that your classes are inclusive and safe for everyone, so that all of your participants can benefit from the value of group exercise. Ensure you sign up to be notified of the release of the training.  

You can learn more about the astonishing benefits of group exercise in our Social Value of Group Exercise report, which shows that the social value of our sector to the wider public is worth at least £5.3bn.