Exercise Pros Action Guide: Step 3

Work with Referred Patients/Clients

Patient/client safety is your first area of concern. 
  • When you accept a new client or receive a referral from a health care provider, use the Exercise Preparticipation Health Screening Questionnaire for Exercise Professionals form, guided by the updated screening algorithm found in the 10th edition of ACSM’s Guidelines for Exercise Testing and Prescription. Check out this handy infographic of the algorithm. If you have any questions about the individual’s ability to safely engage in exercise, utilize the Medical Clearance form and obtain the referring provider’s approval and/or patient-specific guidelines. You may also use the Health History Questionnaire, Fitness Assessment, Informed Consent, Cancellation Policy and PAR-Q+ physical activity readiness questionnaire
  • Utilize the latest edition of ACSM’s Guidelines for Exercise Testing and Prescription to ensure that you are applying the most up-to-date recommendations regarding exercise for sedentary individuals and those with common chronic diseases or medical conditions.
  • Thoughtfully apply the principles of progression, intensity and volume (frequency and time) to engage your patients in safe and enjoyable exercise. Begin with light-to-moderate intensity exercise (that the client enjoys or agrees to do). Move your client through a progressive transitional period to allow them to acclimate to the program, minimize the risk of musculoskeletal injuries, and have a pleasant experience to facilitate adherence.
  • If your client is apparently healthy, provide ACSM’s Being Active for Better Health patient handout (print or e-mail). If your client has a chronic health condition, look at ACSM’s Your Prescription for Health series to see if your patient’s condition is included. Provide a copy–if not already given to them by their health care provider–and review the disease-specific guidelines. This series has been reviewed by experts from the American College of Sports Medicine and includes information for health care providers and exercise professionals as well as a separate version designed for patients/clients.
  • Be aware of any disease-specific risks associated with exercise when your client has a health concern. If your client experiences significant changes in their health or mobility status that may affect their ability to exercise safely, encourage them to contact their health care provider. If you have concerns or questions about the client’s safety during a workout, discontinue exercise and seek advice from the referring provider and/or the appropriate medical expert.
  • Monitor your clients for signs or symptoms of cardiovascular disease/distress. Know the closest location of an AED in your facility. Maintain your CPR/AED certification and periodically review the key steps and emergency procedures in your facility.
Build a safe and effective program.
  • Conduct an individualized assessment of the client/patient. This can be comprehensive or targeted to the individual’s health concerns or primary diagnosis. Establish a baseline so that you can measure your client’s progress. A sample Fitness Assessment Data Sheet is provided, but should be modified based on patient type, health, fitness, access to equipment, and setting.
  • If the results of the Exercise Preparticipation Screening indicate the need for medical clearance prior to the initiation of moderate or vigorous-intensity exercise, request a completed medical clearance from the patient’s primary care provider. Fill out as much information as you can so that it’s easy for the provider or medical staff to complete it and send it back to you (with the patient or by mail). Your client/patient will need to sign a release of medical information form at their doctor’s office, allowing you to receive any protected health information.
Provide behavioral support to engage your client.
  • Your ultimate goal is to build your client’s self-efficacy, so they continue to integrate physical activity into their lives long after their contact with you has ended. You want them to feel so good about their experience with exercise that they can say “I’m the kind of person who is physically active because it’s part of who I am now – and I actually enjoy it!”
  • Utilize motivational interviewing to tap into the patient’s own reasons for being there and what lifestyle changes THEY would like to make, how THEY believe that they could be successful.
  • Acquire new skills as a lifestyle or health/wellness coach to make you more effective in supporting and guiding your patients toward a physically active lifestyle. Wellcoaches, an ACSM partner, and the International Consortium for Health and Wellness Coaching (ICHWC) provide respected training and certifications for individuals wanting to move into this profession. Exercise professionals make themselves even more valuable in a health care setting when they can facilitate a spectrum of healthy lifestyle changes in this new role.
  • Establish a schedule of regular appointments that works for your client. Plan to contact them via email, phone or text (their preference) to confirm their participation and reinforce their activity plans. Even brief touchpoints can help to keep your clients engaged and accountable. In this era of technology, a personal touch and genuine concern can be powerful.

Proceed to Step 4: Communicate with Providers
Support for the Exercise is Medicine® Initiative is provided by:

Contact United States EIM Representative | 6510 Telecom Dr., Suite 200, Indianapolis, IN 46278 | 317-637-9200 © 2021 American College of Sports Medicine. All rights reserved worldwide. Exercise is Medicine® is a global health initiative managed by the American College of Sports Medicine.