Exercise plays a critical role in promoting healthy aging and in the management of chronic illness. In this paper, we provide an overview of the leading research regarding exercise and chronic illness, and the variables influencing exercise participation among persons with a chronic illness. We then examine the Empoli Adaptive Physical Activity (APA) program as a model program that has overcome many of the obstacles to exercise adherence. Piloted by Local Health Authority 11 in Tuscany, Italy, APA has over 2,000 participants, and it provides tailored exercise opportunities for persons with stroke, back pain, Parkinson's disease or multiple sclerosis, among others illnesses. The Empoli APA program serves as a model community exercise program and is now being replicated throughout Tuscany and in the United States.

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