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Physical Activity Interactive Decision Tool

Healthcare Provider Tool

Complete this tool to help assess your patient's physical ability and level of motivation to start and/or progress through a physical activity program.

When your patient is succeeding at being physically active you can encourage progression through an increase in the duration of physical activity followed by a progression in intensity, provided they are not limited by angina or other medical issues. The recommendations and programs from the use of this tool should be reassessed at regular intervals - every 6 - 12 months.

Reset

▼ STEP 1: Pre-Activity Screening ► STEP 1: Pre-Activity Screening

Does your patient currently have symptoms of angina that would limit participation in physical activity (such as chest pain or severe pressure on physical exertion)?

Yes No

Caution

Patient should be referred for further medical evaluation as soon as possible

Continue

Continue to Part 2 to assess your patient's physical activity level and participation

▼ STEP 2: Physical Activity Level and Participation ► STEP 2: Physical Activity Level and Participation

Please complete step 1

In a typical week, how many days per week and minutes per day does your patient consistently do moderate intensity aerobic physical activity (such as a brisk walk) to vigorous intensity (such as jogging)?

days per week (range 0-7)
minutes per day Submit

How many days in a week does your patient complete resistance training?

days per week (range 0-7) Submit

Would your patient like to become more active or try a new activity?

Yes No

MVPA < 50 min/week

Advise patient of benefits of reducing sedentary behaviour for diabetes management

Resistance training needed

Advise patient of benefits of resistance activities for diabetes management

Consult with patient

Acknowledge barriers, identify potential sources of motivation and recommend the brochure: Benefits of Physical Activity

▼ STEP 3: Physical Activity Program Recommendation ► STEP 3: Physical Activity Program Recommendation

Please complete step 2

Moving forward, what level (intensity) and type (aerobic and/or resistance) of physical activity or exercise would your patient like to do?

Low aerobic activity? (such as easy walking, gardening, golf, fishing)
Low aerobic activity and Resistance exercise?
Resistance exercise alone?

Moderate aerobic activity? (such as brisk walking, easy bicycling, easy swimming, alpine skiing)
Moderate aerobic physical activity and Resistance exercise?

Vigorous aerobic activity? (such as running, jogging, hockey, soccer, cross-country skiing)
Vigorous aerobic activity and Resistance exercise?

*IMPORTANT* Does your patient have any musculo-skeletal injuries or medical limitations that limits their ability to do physical activity (aerobic) and / or exercise (resistance)?

Yes No

Has your patient had a previous coronary event, MI or stroke? Or, do they have complications from diabetes such as severe retinopathy, nephropathy or, advanced neuropathy? Is your patient at high risk for cardiovascular event? I.e. have they had a previous coronary event, MI, stroke? Or do they have severe diabetic complications such as severe retinopathy, nephropathy or advanced neuropathy?

Yes No

*CAUTION*: Patients with pre-proliferative or proliferative retinopathy should be treated and stabilized prior to starting vigorous exercise. Patients with severe peripheral neuropathy should wear appropriate footwear and inspect their feet daily, especially on days they are physically active.

Does your patient have availability (location) and resources (monetary) to access a program or facility for resistance exercise or are there resources to seek out the advice of a Qualified Exercise Professional (QEP)?

Yes No

Which type of resistance exercise is more appealing to your patient?

Resistance bands Dumbbells / body exercises

MVPA Calculation

Add MVPA score to the patient care flow sheet or medical record

Key Counselling Tips

Brochure

Step 3 recommendation

CAUTION:

If anyone experiences severe pressure in the chest, severe shortness of breath, or severe leg pain that stops physical activity or, gets worse with the progression of activity, a referral for medical evaluation is strongly recommended.
Signs and symptoms of peripheral artery disease: Pain in either leg on walking, typically in calf (or calves) that causes you stop or slow down, and typically disappears in 10 minutes or less.

** For those with mild to moderate arthritis, increasing physical activity may benefit symptoms. Options for physical activity that may be more comfortable are water based activities, pool walking, recumbent cycling or stepping and mild resistance training (such as resistance bands). Referral to a qualified exercise professional is recommended to help create or modify a suitable exercise routine.

Acronyms:

METS	METabolic equivalentS
Max HR	Maximum Heart Rate
RPE	Rate of Perceived Exertion
MVPA	Moderate to Vigorous Physical Activity

Definitions:

Physical activity: Any body movement that results in caloric energy expenditure above resting levels.
Exercise: A specific type of physical activity that is typically structured, planned and, of a threshold level of intensity duration plus type that is focused to increase fitness.
Aerobic exercise: continuous, rhythmic movements of large muscle groups lasting for at least 10 minutes at a time. Examples are walking, bicycling, jogging or swimming.
Resistance exercise: movements involving brief repetitive exercises with weights, weight machines, resistance bands or one's own body weight (e.g. push-ups) to increase muscle strength or endurance. Examples are power lifting or Olympic lifting.
Low intensity exercise: physical activity that only mildly increases heart rate or breathing rate or energy expenditure above resting levels (i.e. < 3 METS; or < 50% of Max HR or RPE < 3/10). Examples are casual walking, walking the dog, most house work, mild gardening, resistance band training.
Moderate intensity exercise: Physical activity that increases heart rate or breathing rate above resting levels, and may cause an adult to sweat. (i.e. 3 to < 6 METS or 50-70% of Max HR, or RPE 3-6 / 10). Examples are brisk walking, biking > 15 kph, continuous swimming, dancing, water aerobics, raking leaves, pickleball, dumbbell resistance exercise.
Vigorous Intensity exercise: physical activity that dramatically increases breathing rate and heart rate and typically causes an adult to sweat. (i.e. > 6 METS, or > 70% of Max HR, or RPE > 6/10). Examples are: brisk walking up an incline, jogging, aerobics, hockey, basketball, fast swimming, fast dancing, high intensity circuit training.

Additional Resources:

Guidelines Chapter: Physical Activity and Diabetes

Patient Resources:

Physical Activity and Diabetes
Benefits of Physical Activity
Planning for Regular Physical Activity
Introductory Resistance Program
Maintaining Aerobic Exercise
Resistance Exercise Guidelines

This is only to be used as a decision support tool and is subject to these terms.
For more information, please see terms of use.

*The Canadian Diabetes Association is the registered owner of the name Diabetes Canada. All content on guidelines.diabetes.ca, CPG Apps and in our online store remains exactly the same. For questions, contact communications@diabetes.ca.