From acute care to chronic disease management: integrating physical exercise into hospital settings

PURPOSE: The growing burden of chronic disease, population ageing, and declining physical activity levels are increasing pressure on healthcare systems oriented towards acute care, while exercise remains underused in hospital practice despite its recognised effectiveness and cost-efficiency. This study explored the perspectives of healthcare professionals and exercise specialists on the role of physical activity and exercise in chronic disease care. METHOD: A qualitative focus group study was conducted with eight professionals working in a public hospital in Spain, data were examined using inductive thematic analysis. RESULTS: Participants described patients' physical activity levels as low. The increasing presence of chronic patients was identified as a challenge for healthcare systems designed to manage acute conditions. Barriers to exercise promotion included limited resources, lack of institutional support and weak regulatory frameworks. Participants highlighted the importance of increasing awareness among patients and healthcare professionals, improving visibility of programmes and fostering collaboration with external institutions. Integrating exercise professionals and developing hospital-based exercise programmes were viewed as important components of a comprehensive approach to chronic disease management. CONCLUSION: These findings support a shift toward preventive, long-term, and multidisciplinary care, with stronger collaboration, the integration of exercise professionals and clearer organisational pathways as steps towards more sustainable and patient-centred health systems.