Jason Fanning, associate professor of Health & Exercise Science at Wake Forest University, is leading a new research study focused on promoting movement in older adults. With $5.7 million in funding from the National Institutes of Health, the five-year project—A Mobile Health Intervention to Reduce Pain and Improve Health (MORPH) in Older Adults With Obesity—aims to demonstrate how daily movement affects pain levels related to osteoarthritis.
Fanning explained that the language used to encourage physical activity can influence participation. “From a health promotion perspective, I have a few issues with focusing solely on ‘exercise’ because we’ve been trying to promote it for about a hundred years and haven’t seen a lot of progress. If you say ‘cardio’ or ‘workout,’ these are people in tight clothing, lifting heavy weights in a specific gym context. Many people find those things intimidating, and these are behaviors they just don’t happen to enjoy.”
He noted that structured exercise routines might lead some individuals to reduce other forms of movement during the day. According to Fanning, “We have compared people doing treadmill-based exercise versus something like moving across the day, and what we see is that, on average, people who exercise actually drop the non-exercise behaviors they do across the day—they actually sit more.” He suggested shifting conversations toward broader concepts of movement, including activities like dancing or playing with grandchildren.
Fanning also discussed the concept of the “active couch potato,” describing it as someone who exercises briefly but remains sedentary for most of the day. He said, “If you have chronic pain, sitting all day can make you feel stiff and make your pain feel much worse, greatly impacting your quality of life.” He added that frequent movement helps regulate blood sugar and may reduce unhealthy snacking.
The MORPH study uses remote technology so participants never need to visit campus; instead, they join weekly video calls for six months and use custom apps paired with wearable sensors. The program aims to help participants understand how their activity patterns relate to pain management while building social connections through group counseling sessions.
Describing his approach to fitness trends such as Zone Zero—which emphasizes low-intensity activity throughout the day—Fanning stated: “Something like Zone Zero is good in some ways because it encourages people to think more about that lower end of the intensity continuum: How am I spending most of my day, and how can I move in ways that feel good and are restorative? But like a lot of trends, it feels a little bit like a quick fix… We need to move across that full intensity continuum.”
For those struggling with physical activity habits, Fanning emphasized intrinsic motivation: “The broader psychological literature says that the strongest predictor of a person sticking around in a behavior for a long time is if they find that behavior intrinsically motivating… If you can keep a focus on, ‘Am I enjoying it or do I find it satisfying,’ you’re going to continue to come back to that behavior in the long term.”
He concluded by comparing physical activity promotion strategies with prescribing medicine: “When dispensing medicine, we need to know the active ingredient… In the context of physical activity, this means determining the parameters of movement that will meet the needs of a very specific person… We need to help people break out of their preconceived notions about what movement and exercise look like and be creative and curious about building an active lifestyle.”
The MORPH study is currently recruiting participants aged 65 or older who have osteoarthritis. Participation is free and all study visits take place online.
