The ACES Framework of Physical Activity Prescription.
Tools and Resources
We've compiled the tools and resources below to help health professionals open a dialogue with their patients about their physical activity levels.
Calculate Your Physical Activity Vital Sign
Use this tool to quantify and visualize weekly physical activity. After imputing exercise and sedentary behaviour the report compares the individual's physical activity levels to the Canadian Physical Activity Guidelines. The 2-page report can then be downloaded and saved, printed, or emailed.

Start by breaking up sedentary time. Encourage individuals to pick an activity they like, set a goal and be consistent in working toward it.
This graphic helps introduce increasing physical activity to a sedentary patient in a step-wise manner. First break-up sedentary time with standing, short walks and encouraging individuals to make the day more physically challenging (e.g. taking the stairs, parking farther away). Add enjoyable activities like hiking, gardening, golf, etc. Encourage patients to set an activity goal and while working towards this, increase the frequency and intensity of the exercise performed.

Many individuals only do aerobic activity but would benefit from adding strengthening, balance and flexibility to their routine. This handout lists common activities and what aspect of fitness they primarily target.
Use this table to initiate a discussion about enjoyable or preferred physical activity. While doing some aerobic activity is better than none, motivated individuals may not realize they would also benefit from strengthening their muscles and bones, improving their balance and maintaining flexibility (range of motion). This handout or office poster could also serve as a starting point for a discussion of strengths and weaknesses and provide further motivation for individuals to seek out the expertise of a qualified exercise professional.
Use this form to evaluate exercise safety. For almost everyone, the benefits outweigh the risks, especially when starting light intensity exercise. This questionnaire is intended for all ages to move individuals along the path to becoming more physically active. See the Reference Document for "Yes" answer explanations.

This form serves as a bridge between health and exercise professionals. Use it to close your discussion and encourage follow-up with an exercise professional.
Use the QEP Referral Form for medically complex patients or for individuals needing to follow a specific exercise program.
Space is provided to include the reason for referral, pertinent comorbidities and medications and whether you wish to receive communication from the exercise professional about the patient.

If you prefer giving individuals a written prescription for Physical Activity, we've included the Exercise Medicine Canada Prescription Pad. Use it in combination with any of the ExRxMed Resources.
Individuals with training in exercise prescriptions include:

Exercise physiologistsAthletic therapists

Certified personal trainersSports medicine physicians

Physical Activity Guidelines
These patient handouts provide examples of moderate and vigorous activities and practical suggestions for adding more physical activity to each day.
Exercise Safety
While it is safe for most people to begin light intensity exercise some people with complex medical histories may need medical clearance before beginning an exercise program. These links will help health professionals identify individuals at risk for an adverse event. We've also included a link to the recommendations from the American College of Sports Medicine for Exercise Participation and Screening (2015 Update).
1. Sallis R, Franklin B, Joy L, Ross R, Sabgir D, Stone J. Strategies for promoting physical activity in clinical practice. Prog Cardiovasc Dis. 2015;57(4):375-386. doi:10.1016/j.pcad.2014.10.003
2. Coleman KJ, Ngor E, Reynolds K, et al. Initial validation of an exercise "vital sign" in electronic medical records. Med Sci Sports Exerc. 2012;44(11):2071-2076. doi:10.1249/MSS.0b013e3182630ec1
3. RIEBE D, FRANKLIN BA, THOMPSON PD, GARBER CE, WHITFIELD GP, MAGAL M, et al. Updating ACSM’s Recommendations for Exercise Preparticipation Health Screening. Med Sci Sport Exerc. 2015;47:2473–9

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The project is funded by St. Paul's Foundation with support of the UBC Faculty of Medicine.

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The ACES Framework of Physical Activity Prescription
Ask every patient every time about physical activity