Action | EIM Japan

The EIM Solution

The EIM Solution refers to an exercise therapy algorithm proposed by EIM that has been developed under the initiative of health care institutions. More specifically, it refers to a sequential process that consists of everything from having a doctor create an exercise prescription for patients with diseases or medical conditions, referring such patients to local fitness facilities, and having professional fitness instructors guide patients in performing such therapeutic exercise at the facilities they have been referred to. Although this process is similar to that used for the Health Promotion Facility Certification System in Japan, it can be said that the proposed solution offers a more standardized and uniformly patterned approach. The exercise therapy algorithm used for the EIM Solution can be divided into 5 steps.

Physical Activity Level Assessments Performed by Doctors

For doctors, it is not an easy task to assess a patient's levels of physical activity in a busy outpatient setting. Here at EIM, we provide you with an easy-to-use method that allows you to assess physical activity levels through just two short questions (EIM Japan Resources > Action Guide for Health Care Providers > Physical Activity Vital Sign).
Providing Exercise Prescriptions

EIM Public presentation 2015
Exercise prescriptions refer to exercise for which such things as the type, intensity, duration, and frequency, etc., of exercise have been prescribed for the purposes of exercise therapy. Although a points-based system for prescribing exercise therapy had already been established in Japan in April of 1996, in practice, this system is rarely utilized due to the complexity of the procedures it involves.
Here at EIM, we recommend that doctors provide their patients with an “Rx for Health Series (leaflet for exercise therapy programs by individual disease or medical condition)” (EIM Japan Action > EIM Japan Resources > Leaflet for Exercise Therapy Programs by Individual Disease or Medical Condition) as an alternative to such conventional exercise prescriptions.
Referring Patients to Professional Fitness Instructors

EIM Public presentation 2015
Doctors and nurses can refer their patients to local fitness facilities (exercise-type health promotion facilities, facilities as given in Article 42 of the Medical Care Act, private/public fitness clubs, comprehensive regional sports clubs, etc.) in order to support them in getting actively engaged in exercise. Although such fitness facilities should ideally be affiliated with a medical institution, even in cases where they are not, doctors and nurses should make an effort to check whether there are fitness facilities in their neighborhood where patients can access professional fitness instructors who are certified as health fitness instructors or physical therapists, and they should reach out and coordinate their efforts with them on a daily basis.
At EIM Japan, we periodically conduct training sessions at our workshops to foster the growth of health fitness instructors “who are able to create exercise programs that meet the needs of patients based on the exercise prescriptions given by their doctors.” For more information, please refer to our directory of workshop participants (EIM Japan Network > Health Fitness Instructors > Directory of EIM-ACSM Standardized Exercise Therapy Program Workshop Participants).
Establishing Local EIM Networks That Can Meet the Expectations of Medical Institutions

EIM Public presentation 2015
In order to allow patients with diseases and medical conditions to reap the benefits of exercise while increasing the number of spaces and opportunities that allow people to safely enjoy exercise, medical institutions must have access to fitness facilities, exercise programs, and professional fitness instructors that they can rely on when referring such patients. At EIM Japan, we have established a system that proactively supports high-quality fitness facilities, exercise programs, and fitness instruction qualifications that are considered to be effective with the aim of helping patients improve their condition/prevent diseases or to improve decreased functioning caused by such diseases. For more information, please refer to the EIM Support System (EIM Japan Action > EIM Support System).
Training EIM Advisors

EIM advisors play the role of intermediary to connect medical institutions to local fitness facilities (EIM Network).
EIM advisors are expected to assess the overall impact of the EIM Solution.
For more information, please refer to the schema shown below that depicts the EIM Solution proof-of-concept experiment that is being carried out in Koto Ward in Tokyo Metropolis (current as of April 2020).

EIM Japan Resources

Action Guide for Health Care Providers

The “EIM Action Guide for Health Care Providers” provides a simplified procedure that health care providers (doctors, nurses, etc.) can use to integrate physical activity/exercise therapy into their daily medical practice. Please use this in combination with the reference materials (“Physical Activity Vital Sign,” and “Being Active for a Better Life”).

Action Guide Items

These individual items are provided as part of the Action Guide. They can be freely customized to meet your needs in the actual field of practice.

Physical Activity Vital Sign
Exercise prescription form
Community resources leaflet template
”Sit Less. Move More.” patient handout leaflet
”Being Active for a Better Life” patient handout leaflet
Provider coding and billing tips
Patient initial assessment form (for fitness instructors)
Patient fitness progress report (for fitness instructors)

Action Guide for Health Care Providers - Reference Materials

Physical Activity/Vital Sign

By using “Physical Activity Vital Sign: PAVS,” it is possible to quickly assess the patient’s current level of physical activity. PAVS itself is designed with only 2 questions. This allows you to obtain a snapshot to determine whether or not the patient is engaging in 150 minutes of moderate to high intensity exercise per week, which acts as the current “Physical Activity Guidelines.”

“Being Active for a Better Life”

The Exercise is Medicine “Sit Less. Move More.” and “Being Active for a Better Life” handout leaflets (and those designed for senior citizens, teenagers, and children) are designed to help patients reduce their amount of sitting with the aim of making it easier for them to take the first step in becoming more active. These resources can prove to be especially useful for patients who are at the stages of developing an interest toward and preparing to engage in exercise.

EIM-ACSM Exercise Therapy Programs by Individual Disease or Condition

In order to provide a basic guideline for exercise for patients who are prone to sitting and those with diseases and medical conditions, EIM has created the “Rx for Health Series (leaflet for exercise therapy programs by individual disease or medical condition).” This leaflet has been developed by the American College of Sports Medicine (ACSM) based on data selected from the vast amount of evidence that they have collected. The “Rx for Health Series” has been designed so that it can be used to aid health care providers and professional fitness instructors when they are recommending physical activity (exercise therapy) for their patients. Please feel free to print out this leaflet and to actively make use of it. With that said, however, please note that EIM Japan assumes absolutely no responsibility in the event that an accident occurs due to any use of these leaflets.
EIM Japan currently provides Japanese translations of 5 types of these leaflets on our website, and we intend on making further resources on other diseases available in the future.

Differences in Guidelines Between Japan and the United States

Although the EIM-ACSM Standardized Program for Exercise Therapy is a highly reliable program that is based on high-quality evidence that has been collected throughout the years by the American College of Sports Medicine (ACSM), a portion of its contents differ with those given in the guidelines for exercise therapy used in Japan. For more details on this, please refer to the comparison chart that we have created that compares these differences between Japan and the United States before using the “Rx for Health Series.”