Physical activity is a priority tool in the prevention of functional worsening. In current health services scenarios, a lot of persons deals with chronic conditions and they need training programs with structured exercise to promote healthy lifestyle, even when slight disability is present, due to aging, arthrosis, surgical intervention for hip/knee prosthesis, stroke or chronical neurological diseases such as Parkinson. Emilia-Romagna Region strongly supported the development of Adapted Physical Activity (APA) programs in the last years.

In Reggio Emilia, a multidisciplinary group started a project to implement APA in 2010–2011, involving Rehabilitation Department, Local Health Care Services, General Practitioners (GPs) and sport societies. According to regional guidelines, several exercise protocols were set up and pilot APA groups started, to offer training programs to people with chronic pain for osteoarthrosis/arthritis. APA groups were supervised by instructors graduated in Physical Education. The pilot groups experience was very encouraging and a broader network was implemented between 2011–2017.

The local network now involves 22 community gyms (throughout the all district) and the number of persons attending regular APA programs grew from 226 in 2011 to 1223 in 2017. No significant adverse event occurred. The participants level of satisfaction and compliance are very high. The number of GPs supporting APA grew from 106 in 2011 to 578 in 2017. Every year an update event is organized, to implement education for professionists leading APA groups and to verify exercise protocols.

The development of APA network in Reggio Emilia was a strategy to create opportunities for healthy life style. The key elements of the projects were: 1. interaction between Rehabilitation Department, Local Health Care Services, sport societies and community gyms 2. Structured training for APA group leaders (at least once a year) 3. Involvement of GPs to promote regular physical activity for people dealing with chronic conditions.