Exercise and Safety: Start with the Get Active Questionnaire
For you and I, physical activity matters. Repeated sessions of physical activity will improve health, fitness, and performance. To the individual reading this, first off, Hi! thank you for your time and attention, and second, odds are, hearing that physical activity matters is not new to you. Instead, what may be new to you, and where your attention can turn if you have committed yourself to preparing for physical activity, specifically exercise, is how to go about physical activity and safety. For those of you who are reading this and are already experienced in structured physical activity, in that of exercise, the value in this article lies in your learnings to then teach this to someone you love. Each one teach one.
For almost everyone, participating in physical activity is safe, as the benefits of physical activity outweigh the risks. However, it is important to consider how a chronic condition, medication or treatment, as well as a complex medical history, can affect and individuals response to exercise. For example, specific medications might impact an individual’s reaction to physical activity, or functional limitations from prior injuries can limit the amount of weight-bearing an individual can place on their joints.
Emphasizing this importance of physical activity and safety is the commonality in which three in five Canadians over the age of 20 live with at least one chronic condition, such as cancer, cardiovascular disease, diabetes, or arthritis, and four in five are at risk of developing such conditions.
Further, for inactive individuals, who may have a decline in physiological measures, such as aerobic capacity (VO2 max), muscle strength, balance and flexibility, or also individuals with low physical literacy, choosing the appropriate physical activity prescription with realistic goal setting, frequency, and intensity, calls for the type of decision-making to not take lightly.
Therefore, knowing if and where to start with physical activity, can be a safety concern.
This is why a pre-participation screening (pre-screening) process for physical activity can identify risk factors and determine who should first seek medical clearance from a qualified exercise professional (QEP) or health care provider in order to make an informed decision about the appropriateness and prescription for physical activity. All to say, physical activity may still be appropriate for an individual, but gathering some further information, coupled with insight from a QEP or health care provider, can be advisable.
As a recommended first step for physical activity and safety, this article highlights the Get Active Questionnaire (GAQ).
Introducing the Get Active Questionnaire
The Get Active Questionnaire is the current the Canadian Society for Exercise Physiology (CSEP) evidence-based pre-screening tool for physical activity.
The Get Active Questionnaire helps an individual to determine whether it is necessary to seek further advice from a QEP or health care provider, before engaging with physical activity. The Get Active Questionnaire is appropriate for all ages, with the overall purpose of the Get Active Questionnaire to screen-in the majority of apparently healthy Canadians to physical activity. Ease of access and user experience is certainly friendly with the Get Active Questionnaire, as it takes approximately just a few minutes to complete, consisting of a series of four yes/no questions, based on the past six months.
In terms of application of the Get Active Questionnaire, it can be used through a number ways and settings. To share first, the Get Active Questionnaire can be used by individuals on their own initiative as a self-administered tool. Similarly, an individual may also complete the questionnaire for a child or dependent. Recreation centres or health clubs (gyms), along with trainers and QEP’s, may have attendees or clients complete the questionnaire before to joining an exercise class or program. In addition, health care providers may have patients complete the questionnaire as a gesture to begin exercising, i.e. giving an exercise prescription. Check out Prescription to Get Active to learn more about inserting physical activity into the repertoire of prescription choices by health care providers.
Completing and Scoring the Get Active Questionnaire
If an individual, or the individual who the Get Active Questionnaire is intended for, answers ‘yes’ to any of the questions on page one of the Get Active Questionnaire, and has not yet consulted with a QEP or health care provider about becoming more physically active, are to take a look at the Get Active Questionnaire Reference Document. The Get Active Questionnaire Reference Document accompanies the Get Active Questionnaire, and is designed to advise on next steps for each ‘yes’ response from page one of the Get Active Questionnaire. The advice and discussion for each question shown in the Get Active Questionnaire Reference Document allows an individual to make an informed decision of the relative risk for physical activity, and whether they should seek further advice from a QEP or health care provider before becoming more physically active. If an individual is completing the Get Active Questionnaire with a QEP, the QEP can discuss the individual’s answers with them, right then and there, to help decide if clearance is required or not. Only a QEP with an advanced certification, as well as specific knowledge and expertise of the medical condition or individual safety concern in question, can provide clearance on their own, if they have established that the individual, or client, has a stable or lower-risk medical condition. QEP’s should probe individuals for a detailed medical history, to determine if factors such as medications, high blood sugar/glucose, joint pain, poor upper body strength, a temporary illness or if other suspected chronic conditions, are present.
Regardless of the answers provided through the Get active Questionnaire, or QEP or health care provider may ask an individual is there is a suspected or diagnosed medical condition, and if so, if there are any symptoms associated with the medical condition, along with if an individual currently takes any medications?
If a client cannot remember specific details about their personal health history, the client should follow up with their physician. Then, the Get Active Questionnaire can be re-visited. Overall. if extra guidance is needed from a physician, there is the Physician Physical Activity Readiness Clearance Form, from CSEP.
Conversely, if an individual answers ‘no’ to all the questions on page 1 of the Get Active Questionnaire, AND, their resting heart rate and blood pressure are below the appropriate cut-offs (less than 100 bpm for resting heart rate, as well as less than 160 mmHg for systolic blood pressure, and less than 90 mmHg for diastolic blood pressure), it is reasonable to assume that the individual is able to participate in physical activity and can proceed to page two of the Get Active Questionnaire to complete the rest of the questions on their current physical activity levels, and review general advice, especially for increasing physical activity levels gradually.
Picture the following as statement for an individual who has been screened-in for physical activity by the Get Active Questionnaire:
“I have read, understood, and completed the Get Active Questionnaire, and the answers to all the questions were negative, or for any positive answers, I have been cleared by a QEP or if needed, received clearance by my physician.”
All in all, individuals with a chronic condition or complex medical history can safely perform physical activity, but their risks of an adverse event may be elevated compared to healthy individuals during certain modalities/types and intensities of physical activity. Going through the Get Active Questionnaire, and depending on the answers to the questions, obtaining guidance and clearance from a QEP or health care provider such as a physician, is a recommended first step for physical activity and safety.
For further reading:
https://www.csep.ca/
https://store.csep.ca/pages/get-active-questionnaire-resources
https://pubmed.ncbi.nlm.nih.gov/29342366/
https://pubmed.ncbi.nlm.nih.gov/30500268/
The content of this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.
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Nathan Kolar
linkedin.com/in/nathankolar
