How to Start Moving Again When It Feels Impossible, With Reema Dbouk, M.D.

When it comes to physical activity, many people with mobility challenges or chronic health conditions feel overwhelmed or left out of the conversation. Reema Dbouk, M.D., a physician and assistant professor at Emory Healthcare, believes that the key to helping these patients thrive isn’t pushing them toward fitness goals they’re not ready for — it’s meeting them exactly where they are.

“We build from the baseline — whatever that looks like,” Dbouk explains. Whether it’s difficulty walking, leg weakness, or fatigue from medication or chronic illness, her approach is to first understand the patient’s current ability and collaborate on small, realistic goals they feel confident about.

Instead of immediately discussing public health benchmarks like 150 minutes of moderate exercise per week, she often recommends starting with simple movements:

• Parking farther from the store
• Walking to the mailbox twice a day
• Chair-based leg lifts or gentle arm raises
• Practicing sit-to-stand movements to build real-world strength

These functional exercises — such as standing up from a chair or lifting light items — aren’t just placeholders for fitness. They directly support daily independence, which Dbouk sees as one of the most important health outcomes for patients with physical limitations.

She also stresses that body weight movements and resistance to gravity can be highly effective, even without formal gym equipment. The focus is on building tolerance, confidence and momentum over time — not perfection.

Dbouk acknowledges that many patients feel stigmatized by limited mobility or weight, and may feel intimidated even talking about exercise with their provider. Her advice to fellow health care professionals: Approach the topic with compassion, flexibility and partnership.

“We want patients to know we’re on their team,” she says. “And progress doesn’t have to start big — it just has to start.”

This transcript was edited for clarity.