TOOLKIT

C S E P - PAT H TO O L S

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 TOOLKIT

Ca na d ia n S oci et y For E xe rc i se P h ysi o l o g y

Phys i cal Ac tivit y Training Fo r He a l t h (CS E P- PAT H ® )

Copyright © 2013, 2019, 2021 Canadian Society for Exercise Physiology.

CSEP-PATH® is a Registered Trademark of the Canadian Society for Exercise Physiology (CSEP). All rights reserved. Except for use
in a review, the reproduction or utilization of this work in any form by any electronic, mechanical, or other means, now known or
hereafter invented, including xerography, photocopying, and recording, and in any information storage and retrieval system, is
forbidden without the written permission of the publisher.

Notice: permission to print out and photocopy the CSEP-PATH® Tools (print and electronic formats) is permitted by users of the
Canadian Society for Exercise Physiology – Physical Activity Training for Health (CSEP-PATH®) Resource Manual.

Canadi an So c iet y fo r Exerc ise Ph ysi ol ogy

101-495 Richmond Rd | Ottawa ON K2A 4B1 | Canada
1.877.651.3755 | info@csep.ca | csep.ca | @CSEPdotCA

ISBN: 978-1-896900-58-2
Previous ISBNs CSEP-PATH® First Edition 978-1-896900-32-2 (2013), First Refreshed Edition: 978-1-896900-40-7 (2018),
Second Edition: 978-1-896900-46-9 (2019)
Printed in Canada

Toolkit 4 Canadian Society for Exercise Physiology

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IN THIS SECTION:
The CSEP-PATH® Toolkit is included as part of the CSEP-PATH®
Resource Manual. To access electronic versions of the CSEP-PATH®
Tools, please consult www.csep.ca/CSEP-PATH.

Ask
1. Welcome Letter
2. Informed Consent - Adult
3. Informed Consent - Youth
4. Get Active Questionnaire
5. Get Active Questionnaire Reference Document
6. Physician Guidance for Physical Activity Form
7. Get Active Questionnaire for Pregnancy
8. Health Care Provider Consultation Form for Prenatal Physical Activity
9. Abilities for Active Living Questionnaire
10. Client Information Sheet
11. SOAP Charting Notes
12. Quick Reference Interview Notes
13. Movement Counselling Tool for Adults 18-64 Years
14. Movement Counselling Tool for Adults 65 Years and Older

CSEP-PATH® Toolkit 5

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 Assess
15. Physical Activity & Sedentary Behaviour Questionnaire (PASB-Q) - Adult
16. Physical Activity & Sedentary Behaviour Questionnaire (PASB-Q) - Youth
17. Healthy Sleep Assessment
18. Stages of Change Questionnaire (SOC-Q)
19. mCAFT Data Collection Sheet
20. Treadmill Walk Data Collection Sheet
21. One Mile Walk Data Collection Sheet
22. Cycle Ergometer Test Data Collection Sheet
23. Predicting 1-RM Data Collection Sheet
24. Y Balance Test Data Collection Sheet
25. Rating of Perceived Exertion (RPE) Chart
26. Quick Reference - Health Benefit Ratings

Advise
27. Evaluation Summary Report Adult
28. Evaluation Summary Report Youth

Agree
29. Inventory of Lifestyle Needs and Activity Preferences
30. Goal Setting Worksheet
31. Physical Activity and Exercise Prescription Card

Assist
32. Barriers to Physical Activity
33. Decision Balance Worksheet
34. First Step Planning Worksheet
35. Alternatives for Action Worksheet

Arrange
36. Weekly Physical Activity Planner and Log
37. Relapse Planning Worksheet

Guidelines
38. Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years)
39. Canadian 24-Hour Movement Guidelines for Children and Youth (ages 5-17 years)
40. Canadian 24-Hour Movement Guidelines for Adults (18-64 years)
41. Canadian 24-Hour Movement Guidelines for Adults (65 years and older)
42. 2019 Canadian Guideline for Physical Activity throughout Pregnancy

Toolkit 6 Canadian Society for Exercise Physiology

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ASK:
TOOL PURPOSE

Welcome Letter Provides the client with an introduction to the CSEP-PATH® appointment. Can
be included in a pre-meeting package with forms such as informed consent, Get
Active Questionnaire, Abilities for Active Living Questionnaire, etc.

Informed Consent - Adult Ensures client is aware of all risks and benefits of fitness assessment/exercise
prescription and that personal information is being collected.

Informed Consent - Youth Ensures adult consenting for youth, as well as the youth, is aware of all risks
and benefits of fitness assessment/exercise prescription and that personal
information is being collected.

Get Active Questionnaire Identifies clients who may need to speak with a qualified exercise professional
or physician before starting/resuming a physical activity program.

Get Active Questionnaire Reference Provides guidance to clients who have one or more yes answer on the Get Active
Document Questionnaire.

Physician Guidance for Physical Used when guidance is needed from a physician about the appropriateness of a
Activity Form client starting/resuming a physical activity program.

Get Active Questionnaire for Identifies prenatal clients who may need to speak with their health care provider
Pregnancy before starting/resuming a physical activity program.

Health Care Provider Consultation Used to facilitate the conversation between a pregnant client and their obstetric
Form for Prenatal Physical Activity health care provider about contraindications to prenatal exercise.

Abilities for Active Living Allows persons who live with a disability to identify accommodations that may
Questionnaire (AAL-Q) be needed for a fitness assessment or supervised exercise session.

Client Information Sheet Allows majority of data obtained during Step 1 – Ask and Step 2 – Assess to be
compiled on one form.

SOAP Charting Notes Basic record keeping method employed by many qualified exercise
professionals to help clarify the thinking process and the rationale for a course
of evaluation, action, or both.

Quick Reference - Client Interview Example of how an interview may be conducted with a new client.
Notes

Movement Counselling Tool for Guides the qualified exercise professional through the six-step process
Adults Aged 18-64 Years (Ask, Assess, Advise, Agree, Assist, Arrange) as it relates to implementing the
Canadian 24-Hour Movement Guidelines with their client.

Movement Counselling Tool for Guides the qualified exercise professional through the six-step process
Adults Aged 65 Years and Older (Ask, Assess, Advise, Agree, Assist, Arrange) as it relates to implementing the
Canadian 24-Hour Movement Guidelines with their client.

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CSEP-PATH: WELCOME LETTER
Welcome to ________________________________________________________________________________________________________

Thank you for booking an appointment for the CSEP Physical Activity Training for Health (CSEP-PATH® )

Assessment with: ________________________________________at________________________________________________________

Several forms have been included in this package. Please review the materials provided and complete any
forms in advance of your appointment.

£ Get Active Questionnaire: While physical activity has many benefits, and is very safe for most people, it is
important to identify individuals who require further screening before becoming much more physically
active. If you answer ‘yes’ to one or more questions on page 1 of the Get Active Questionnaire, please
contact us at your earliest convenience. Physical activity may still be appropriate, but we may need to
obtain some further information first.

£ Informed Consent: This must be signed and witnessed prior to your appointment. Those under 19 years
of age require a signature of a parent or guardian.

£ Abilities for Active Living Questionnaire (AAL-Q): If you have a disability that may require some
accommodation on our part to make your first meeting with us a success, please complete this form.

£ Physical Activity and Sedentary Behaviour Questionnaire (PASB-Q): This tool helps us to understand your
types and levels of physical activity and sedentary behaviour. Consider a typical week as you complete
the PASB-Q. If you have a wearable device or smartphone that tracks the time you spend being
physically active or sedentary, use it to help with recall.

£ Fitness Assessment (optional): If you wish to participate in a fitness assessment (e.g., anthropometry,
aerobic and musculoskeletal fitness tests), please follow the instructions below:
• Wear clothes appropriate for exercise (e.g., shorts, t-shirt and running shoes)
• Do not smoke, eat, or drink caffeinated liquids (e.g., coffee, tea, cola, or chocolate) within
2 hours of your appointment
• Do not drink alcohol (e.g., beer, wine, or liquor) within 6 hours of your appointment
• Do not engage in strenuous exercise within 6 hours of your appointment

£ If you are pregnant or there is a chance you may be pregnant, please let us know. Completion of the Get
Active Questionnaire for Pregnancy form is advised.

We look forward to seeing you and please do not hesitate to contact us if you have any questions
or concerns.

Welcome Letter – Tool #1 page 1/1 Canadian Society for Exercise Physiology

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CSEP-PATH: INFORMED CONSENT – Adult
I, the undersigned, do hereby acknowledge my consent to undergo an assessment of my physical activity,
sedentary behaviour, lifestyle and fitness.

This CSEP-PATH® assessment will be will be administered by a CSEP Certified Personal Trainer® or CSEP
Clinical Exercise Physiologist™ and may include:
• Answering questions concerning my physical activity, sedentary behaviour, medical history (if
applicable), and other lifestyle factors such as sleep and nutrition.
• Measures of my heart rate, blood pressure, height, weight and waist circumference.
• A sub-maximal aerobic fitness test that involves either stepping, walking or cycling for a defined period
of time to measure my heart rate response.
• A series of musculoskeletal fitness tests that may include Grip Strength, Push-ups, Predicted
1-Repetition Maximum (1-RM), Sit and Reach, Vertical Jump, Back Extension, Forearm Plank, Y Balance
Test, One Leg Stance or other appropriate musculoskeletal test not listed.

I understand that the assessment results will be used to determine the type and amount of physical activity
most appropriate for my interests, goals, current physical activity, and fitness level.

I understand that I will be provided with advice about physical activity, sedentary behaviour and other
healthy lifestyle topics.

I understand that I may participate, if desired, in a follow-up supervised training session based on the
findings of the assessment, consisting of a warm-up, aerobic and musculoskeletal training (including a
sub-maximal resistance training load determination), and a cool-down.

I understand that there are small but potential risks during physical activity (e.g., episodes of transient
lightheadedness, loss of consciousness, abnormal heart rate and/or blood pressure, chest discomfort, leg
cramps, nausea), and that I willfully assume those risks.

I understand my obligation to immediately inform the qualified exercise professional of any pain, discomfort,
fatigue, or any other symptoms that I may have during or within 48 hours of the assessment.

I understand that I may stop or delay the fitness assessment or the supervised exercise session at any
time if I so desire, and that the assessment may be terminated by the qualified exercise professional upon
observation of any symptoms of undue distress or abnormal response.

I understand that I may ask any questions or request further explanation or information about the
procedures at any time before, during, and after the assessment.

I have understood and completed a health screening process [e.g., using the Get Active Questionnaire] and
have been deemed ready to participate in the CSEP-PATH® fitness assessment and/or become much more
physically active.

CSEP-PATH® Informed Consent - Adults – Tool #2 page 1 / 2

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This form must be completed, signed and submitted to the assessor, along with the completed Get Active
Questionnaire, at the time of the assessment. The form must also be witnessed at the time of signing. The witness
must be of the age of majority and be someone other than the qualified exercise professional.

I AGREE THAT I HAVE READ AND UNDERSTAND THIS DOCUMENT

PRINTED NAME OF CLIENT

SIGNATURE OF CLIENT

DATE (YYYY/MM/DD):

PRINTED NAME OF WITNESS

SIGNATURE OF WITNESS

DATE (YYYY/MM/DD):

PRINTED NAME OF QUALIFIED EXERCISE PROFESSIONAL

SIGNATURE OF QUALIFIED EXERCISE PROFESSIONAL

DATE (YYYY/MM/DD):

Informed Consent - Adults – Tool #2 page 2 / 2 Canadian Society for Exercise Physiology

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CSEP-PATH: INFORMED CONSENT – Youth
I, the undersigned, do hereby acknowledge my consent for my dependent to undergo an assessment of
their physical activity, sedentary behaviour, lifestyle and fitness.

This CSEP-PATH® assessment will be administered by a CSEP Certified Personal Trainer® or CSEP Clinical
Exercise Physiologist™ and may include:
• Answering questions concerning my dependent's physical activity, sedentary behaviour, medical history
(if applicable), and other lifestyle factors such as sleep and nutrition.
• Measures of my dependent's heart rate, blood pressure, height, weight and waist circumference.
• A sub-maximal aerobic fitness test that involves either stepping, walking or cycling for a defined period
of time to measure their heart rate response.
• A series of musculoskeletal fitness tests that may include Grip Strength, Push-ups, Predicted
1-Repetition Maximum (1-RM), Sit and Reach, Vertical Jump, Back Extension, Forearm Plank, Y Balance
Test, One Leg Stance or other appropriate musculoskeletal test not listed.

I understand that the assessment results will be used to determine the type and amount of physical activity most
appropriate for my dependent’s interests, goals, current physical activity, and fitness level.

I understand that my dependent will be provided with advice about physical activity, sedentary behaviour
and other healthy lifestyle topics.

I understand that my dependent may participate, if desired, in a follow-up supervised training session based
on the findings of the assessment, consisting of a warm-up, aerobic and musculoskeletal training (including a
sub-maximal resistance training load determination), and a cool-down.

I understand that there are small but potential risks during physical activity (e.g., episodes of transient
lightheadedness, loss of consciousness, abnormal heart rate and/or blood pressure, chest discomfort, leg
cramps, nausea), and that my dependent willfully assumes those risks.

I understand my dependent’s obligation to immediately inform the qualified exercise professional of any
pain, discomfort, fatigue, or any other symptoms that they may have during or within 48 hours of the
assessment.

I understand that my dependent may stop or delay the fitness assessment or the supervised exercise
session at any time if so desired, and that the assessment may be terminated by the qualified exercise
professional upon observation of any symptoms of undue distress or abnormal response.

I understand that I and my dependent may ask any questions or request further explanation or information
about the procedures at any time before, during, and after the assessment.

I have understood and completed a health screening process [e.g., using the Get Active Questionnaire] on behalf of
my dependent and my dependent has been deemed ready to participate in the CSEP-PATH® fitness assessment
and/or become much more physically active.

CSEP-PATH® Informed Consent - Youth – Tool #3 page 1 / 2

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This form must be completed, signed and submitted to the assessor, along with the completed Get Active
Questionnaire, at the time of the assessment. The form must also be witnessed at the time of signing. The witness
must be of the age of majority and be someone other than the qualified exercise professional.

I AGREE THAT I HAVE READ AND UNDERSTAND THIS DOCUMENT

PRINTED NAME OF DEPENDENT

PRINTED NAME OF PARENT/GUARDIAN

SIGNATURE OF PARENT/GUARDIAN

DATE (YYYY/MM/DD):

PRINTED NAME OF WITNESS

SIGNATURE OF WITNESS

DATE (YYYY/MM/DD):

PRINTED NAME OF QUALIFIED EXERCISE PROFESSIONAL

SIGNATURE OF QUALIFIED EXERCISE PROFESSIONAL

DATE (YYYY/MM/DD):

Informed Consent - Youth – Tool #3 page 2 / 2 Canadian Society for Exercise Physiology

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 Get Active Questionnaire
CANADIAN SOCIETY FOR EXERCISE PHYSIOLOGY –
PHYSICAL ACTIVITY TRAINING FOR HEALTH (CSEP-PATH ®)

Physical activity improves your physical and mental health. Even small amounts of physical activity
are good, and more is better.

For almost everyone, the benefits of physical activity far outweigh any risks. For some individuals, specific advice from a
Qualified Exercise Professional (QEP – has post-secondary education in exercise sciences and an advanced certification in the
area – see csep.ca/certifications) or health care provider is advisable. This questionnaire is intended for all ages – to help move
you along the path to becoming more physically active.

I am completing this questionnaire for myself.

I am completing this questionnaire for my child/dependent as parent/guardian.

P R E PA R E T O B E C O M E M O R E A C T I V E

YES NO The following questions will help to ensure that you have a safe physical activity
experience. Please answer YES or NO to each question before you become more
physically active. If you are unsure about any question, answer YES.

1 Have you experienced ANY of the following (A to F) within the past six months?

A A diagnosis of/treatment for heart disease or stroke, or pain/discomfort/pressure

in your chest during activities of daily living or during physical activity?

B A diagnosis of/treatment for high blood pressure (BP), or a resting BP of 160/90 mmHg or higher?

C Dizziness or lightheadedness during physical activity?

D Shortness of breath at rest?

E Loss of consciousness/fainting for any reason?

F Concussion?

2 Do you currently have pain or swelling in any part of your body (such as from an injury,
acute flare-up of arthritis, or back pain) that affects your ability to be physically active?

3 Has a health care provider told you that you should avoid or modify certain types of physical activity?

4 Do you have any other medical or physical condition (such as diabetes, cancer, osteoporosis,
asthma, spinal cord injury) that may affect your ability to be physically active?

NO to all questions: go to Page 2 – ASSESS YOUR CURRENT PHYSICAL ACTIVITY

YES to any question: go to Reference Document – ADVICE ON WHAT TO DO IF YOU HAVE A YES RESPONSE

© Canadian Society for Exercise Physiology, 2017. All rights reserved. PAGE 1 OF 2

CSEP-PATH® Get Active Questionnaire – Tool #4 page 1 / 2

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 Get Active Questionnaire
ASSESS YOUR CURRENT PHYSICAL ACTIVITY
Answer the following questions to assess how active you are now.
1 During a typical week, on how many days do you do moderate- to vigorous-intensity aerobic physical DAYS/
WEEK
activity (such as brisk walking, cycling or jogging)?
2 On days that you do at least moderate-intensity aerobic physical activity (e.g., brisk walking), MINUTES/
DAY
for how many minutes do you do this activity?
MINUTES/
For adults, please multiply your average number of days/week by the average number of minutes/day: WEEK

Canadian 24-Hour Movement Guidelines recommend that adults accumulate at least 150 minutes of moderate- to vigorous-
intensity physical activity per week. For children and youth, at least 60 minutes daily is recommended. Strengthening muscles
and bones at least two times per week for adults, and three times per week for children and youth, is also recommended
(see csep.ca/guidelines).

GENERAL ADVICE FOR BECOMING MORE ACTIVE

Increase your physical activity gradually so that you have a positive experience. Build physical activities that you enjoy
into your day (e.g., take a walk with a friend, ride your bike to school or work) and reduce your sedentary behaviour
(e.g., prolonged sitting).
If you want to do vigorous-intensity physical activity (i.e., physical activity at an intensity that makes it hard to carry on a
conversation), and you do not meet minimum physical activity recommendations noted above, consult a Qualified Exercise
Professional (QEP) beforehand. This can help ensure that your physical activity is safe and suitable for your circumstances.
Physical activity is also an important part of a healthy pregnancy.
Delay becoming more active if you are not feeling well because of a temporary illness.

D E C L A R AT I O N
To the best of my knowledge, all of the information I have supplied on this questionnaire is correct.
If my health changes, I will complete this questionnaire again.

I answered NO to all questions on Page 1 I answered YES to any question on Page 1

Check the box below that applies to you:

I have consulted a health care provider or Qualified Exercise Professional

(QEP) who has recommended that I become more physically active.
Sign and date the Declaration below
I am comfortable with becoming more physically active on my own
without consulting a health care provider or QEP.

Name (+ Name of Parent/Guardian if applicable) [Please print] Signature (or Signature of Parent/Guardian if applicable) Date of Birth

Date Email (optional) Telephone (optional)

With planning and support you can enjoy the benefits of becoming more physically active. A QEP can help.

Check this box if you would like to consult a QEP about becoming more physically active.
(This completed questionnaire will help the QEP get to know you and understand your needs.)

© Canadian Society for Exercise Physiology, 2017. All rights reserved. PAGE 2 OF 2

Get Active Questionnaire – Tool #4 page 2 / 2 Canadian Society for Exercise Physiology

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 Get Active Questionnaire – Reference Document
ADVICE ON WHAT TO DO IF YOU HAVE A YES RESPONSE

Use this reference document if you answered YES to any question and you have not consulted a
health care provider or Qualified Exercise Professional (QEP) about becoming more physically active.

1 Have you experienced ANY of the following (A to F) within the past six months?

A A diagnosis of/treatment for Physical activity is likely to be beneficial. If you have been treated for heart
heart disease or stroke, or pain/ disease but have not completed a cardiac rehabilitation program within the
discomfort/pressure in your past 6 months, consult a doctor – a supervised cardiac rehabilitation program
chest during activities of daily is strongly recommended. If you are resuming physical activity after more than
living or during physical activity? 6 months of inactivity, begin slowly with light- to moderate-intensity physical
activity. If you have pain/discomfort/pressure in your chest and it is new for you,
YES talk to a doctor. Describe the symptom and what activities bring it on.

B A diagnosis of/treatment Physical activity is likely to be beneficial if you have been diagnosed and treated for
for high blood pressure high blood pressure (BP). If you are unsure of your resting BP, consult a health care
(BP), or a resting BP of provider or a Qualified Exercise Professional (QEP) to have it measured. If you are
160/90 mmHg or higher? taking BP medication and your BP is under good control, regular physical activity
is recommended as it may help to lower your BP. Your doctor should be aware of
YES your physical activity level so your medication needs can be monitored. If your BP
is 160/90 or higher, you should receive medical clearance and consult a QEP about
safe and appropriate physical activity.

C Dizziness or lightheadedness There are several possible reasons for feeling this way and many are not
during physical activity worrisome. Before becoming more active, consult a health care provider to
identify reasons and minimize risk. Until then, refrain from increasing the intensity
YES of your physical activity.

D Shortness of breath at rest If you have asthma and this is relieved with medication, light to moderate
physical activity is safe. If your shortness of breath is not relieved with medication,
YES consult a doctor.

E Loss of consciousness/ Before becoming more active, consult a doctor to identify reasons and
fainting for any reason minimize risk. Once you are medically cleared, consult a Qualified Exercise
Professional (QEP) about types of physical activity suitable for your condition.
YES

F Concussion A concussion is an injury to the brain that requires time to recover. Increasing
physical activity while still experiencing symptoms may worsen your symptoms,
YES lengthen your recovery, and increase your risk for another concussion. A health
care provider will let you know when you can start becoming more physically
active, and a Qualified Exercise Professional (QEP) can help get you started.

After reading the ADVICE for your YES response, go to Page 2 of the
Get Active Questionnaire – ASSESS YOUR CURRENT PHYSICAL ACTIVITY

© Canadian Society for Exercise Physiology, 2017. All rights reserved. PAGE 1 OF 2

CSEP-PATH® Get Active Questionnaire Reference Document – Tool #5 page 1 / 2

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 Get Active Questionnaire – Reference Document
ADVICE ON WHAT TO DO IF YOU HAVE A YES RESPONSE

Use this reference document if you answered YES to any question and you have not consulted a
health care provider or Qualified Exercise Professional (QEP) about becoming more physically active.

2 Do you currently have pain or swelling in any part of your body (such as YES
from an injury, acute flare-up of arthritis, or back pain) that affects your
ability to be physically active?

If this swelling or pain is new, consult a health care provider. Otherwise, keep joints healthy and reduce pain by moving
your joints slowly and gently through the entire pain-free range of motion. If you have hip, knee or ankle pain, choose
low-impact activities such as swimming or cycling. As the pain subsides, gradually resume your normal physical activities
starting at a level lower than before the flare-up. Consult a Qualified Exercise Professional (QEP) in follow-up to help you
become more active and prevent or minimize future pain.

3 Has a health care provider told you that you should avoid or modify certain YES
types of physical activity?

Listen to the advice of your health care provider. A Qualified Exercise Professional (QEP) will ask you about any
considerations and provide specific advice for physical activity that is safe and that takes your lifestyle and health
care provider’s advice into account.

4 Do you have any other medical or physical condition YES

(such as diabetes, cancer, osteoporosis, asthma, spinal cord injury)
that may affect your ability to be physically active?

Some people may worry if they have a medical or physical condition that physical activity might be unsafe. In fact,
regular physical activity can help to manage and improve many conditions. Physical activity can also reduce the risk
of complications. A Qualified Exercise Professional (QEP) can help with specific advice for physical activity that is safe
and that takes your medical history and lifestyle into account.

After reading the ADVICE for your YES response, go to Page 2 of the
Get Active Questionnaire – ASSESS YOUR CURRENT PHYSICAL ACTIVITY

W A N T A D D I T I O N A L I N F O R M AT I O N O N
B E C O M I N G M O R E P H Y S I C A L LY A C T I V E ?

csep.ca/certifications csep.ca/guidelines
CSEP Certified members can help you Canadian 24-Hour Movement Guidelines
with your physical activity goals. for all ages.

© Canadian Society for Exercise Physiology, 2017. All rights reserved. PAGE 2 OF 2

Get Active Questionnaire Reference Document – Tool #5 page 2 / 2 Canadian Society for Exercise Physiology

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CSEP-PATH: PHYSICIAN GUIDANCE FOR
PHYSICAL ACTIVITY FORM
Dear Physician, ____________________________________________________________________________________________________

Patient Name: _____________________________________________________________________________________________________

Date: ________________________________________________________________________________________________________________

Your patient has consulted a Canadian Society for Exercise Physiology (CSEP) Certified Personal Trainer®
(CSEP-CPT) for a physical activity, fitness and lifestyle assessment and/or personal training services.

Although evidence demonstrates that becoming more active is very safe for most people and yields many
health benefits, it is important to identify clients who may need a more thorough evaluation before doing a
fitness assessment or becoming much more physically active.

During our standardized screening procedures we became aware that your patient:

£ Answered “Yes” to one or more questions on the Get Active Questionnaire – see copy attached. Specific
concern: _______________________________________________________________________________________________________

£ Had a Resting Heart Rate of ____________________ (above the safety cut-off of ≥100 bpm)

£ Had a Resting Blood Pressure of _________/_________ (above the safety cut-off of ≥160/90 mmHg)

To ensure that your patient proceeds in the safest way possible, they were advised to consult with you
about becoming more physically active. Please complete and sign this form, indicating any necessary
physical activity restrictions, and have your patient return the form to their CSEP-CPT.

Based upon my review of the health status of ____________________________________________________ , I recommend:

£ Unrestricted physical activity based on the Canadian 24-Hour Movement Guidelines – start slowly and
build up gradually

£ Progressive physical activity:

£ With avoidance of:________________________________________________________________________________________

£ With inclusion of:_________________________________________________________________________________________

£ Only a medically-supervised exercise program at this time

£ No physical activity

CSEP-PATH® Physician Guidance for Physical Activity Form – Tool #6 page 1 / 3

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 PHYSICIAN NAME (PLEASE PRINT)

SIGNED

DATE (YYYY/MM/DD)

PHYSICIAN/CLINIC STAMP

If you have any questions regarding the CSEP-PATH® assessment, the Get Active Questionnaire, or the services
provided by the CSEP-CPT, please contact:

CSEP-CPT

EMAIL

PHONE

NOTE: This Physician Guidance for Physical Activity Form is valid for a maximum of one year from the date it
is completed or until the patient's medical condition changes.

Physician Guidance for Physical Activity Form – Tool #6 page 2 / 3 Canadian Society for Exercise Physiology

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CSEP Certifications
The Canadian Society for Exercise Physiology (CSEP) is the Gold Standard for physical activity, health and fitness
research, and personal training in Canada. Our qualified exercise professionals strive to help Canadians achieve the well-
documented health benefits of being physically active each day, minimizing sedentary behaviour, and achieving sufficient
sleep as recommended in the Canadian 24-Hour Movement Guidelines.

The CSEP Certified Personal Trainer® (CSEP-CPT) is sanctioned to administer the assessment, including appropriate
submaximal fitness assessment protocols, to apparently healthy individuals, interpret results, develop a client-centred
physical activity action program, and act as a personal trainer. The CSEP Clinical Exercise Physiologist™ (CSEP-CEP) is an
advanced certification. Those with the CSEP-CEP conduct fitness assessments and prescribe safe and individualized
physical activity programs to individuals living with chronic diseases or conditions.

All CSEP Certified professionals are required to carry a minimum of $3,000,000 Professional Liability insurance
and $2,000,000 Commercial General Liability insurance. A CSEP-CPT has a minimum of 2 years of University/
College coursework in the Exercise Sciences while a CSEP-CEP has a Bachelor degree in the Exercise Sciences.
Both certifications require candidates to successfully complete a national theory and practical exam.
See www.csep.ca/csep-cpt or www.csep.ca/csep-cep for more information.

CSEP-PATH® Assessment
The physical activity, fitness and lifestyle assessment administered is outlined in the CSEP Physical Activity Training for
Health (CSEP-PATH®) Resource Manual. The assessment provides information to help clients safely and effectively build
regular physical activity into their daily lives to improve their health and well-being.

The CSEP-PATH® evaluates physical activity, sedentary behaviour and other lifestyle factors (e.g., sleep, healthy eating,
etc.) using simple questionnaires. The fitness assessment involves a series of physical tests and measurements. Some
of these (e.g., height, body weight, waist circumference) require no physical exertion. Those that evaluate aerobic and
musculoskeletal fitness require physical exertion but are of a submaximal nature (except for grip strength and vertical
jump, if selected). In order to ensure clients have a safe physical activity assessment, heart rate is measured throughout
the aerobic fitness assessment and both heart rate and blood pressure are measured post-exercise to ensure each
have a normal response. All clients sign an Informed Consent Form prior to proceeding.

Canadian 24-Hour Movement Guidelines – The Whole Day Matters!

For health benefits, Canadians of all ages should be physically active each day, minimize time spent being sedentary, and
achieve sufficient sleep. See the Canadian 24-Hour Movement Guidelines for all ages at www.csep.ca/guidelines.

CSEP-PATH® Physician Guidance for Physical Activity Form – Tool #6 page 3 / 3

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 GET ACTIVE QUESTIONNAIRE
FOR PREGNANCY
NAME (+ NAME OF PARENT/GUARDIAN IF APPLICABLE) [PLEASE PRINT]:

TODAY'S DATE (DD/MM/YYYY): YOUR DUE DATE (DD/MM/YYYY): NO. OF WEEKS PREGNANT: AGE:

Physical activity during pregnancy has many health benefits

and is generally not risky for you and your baby. But for Please answer YES or NO to each
some conditions, physical activity is not recommended. This question to the best of your ability.
If your health changes as your
questionnaire is to help decide whether you should speak to
pregnancy progresses you should
your Obstetric Health Care Provider (e.g., your physician or fill in this questionnaire again.
midwife) before you begin or continue to be physically active.

1. In this pregnancy, do you have:

a. Mild, moderate or severe respiratory or cardiovascular diseases (e.g., chronic bronchitis)? Y N

b. Epilepsy that is not stable? Y N

c. Type 1 diabetes that is not stable or your blood sugar is outside of target ranges? Y N

d. Thyroid disease that is not stable or your thyroid function is outside of target ranges? Y N

e. An eating disorder(s) or malnutrition? Y N

f. Twins (28 weeks pregnant or later)? Or are you expecting triplets or higher multiple births? Y N

g. Low red blood cell number (anemia) with high levels of fatigue and/or light-headedness? Y N

h. High blood pressure (preeclampsia, gestational hypertension, or chronic hypertension that is not stable)? Y N

i. A baby that is growing slowly (intrauterine growth restriction)? Y N

j. Unexplained bleeding, ruptured membranes or labour before 37 weeks? Y N

k. A placenta that is partially or completely covering the cervix (placenta previa)? Y N

l. Weak cervical tissue (incompetent cervix)? Y N

m. A stitch or tape to reinforce your cervix (cerclage)? Y N

2. In previous pregnancies, have you had:

a. Recurrent miscarriages (loss of your baby before 20 weeks gestation two or more times)? Y N

b. Early delivery (before 37 weeks gestation)? Y N

3. Do you have any other medical condition that may affect your ability to be physically active during pregnancy? Y N
What is the condition? Specify:

4. Is there any other reason you are concerned about physical activity during pregnancy?

Go to Page 2 Describe Your Physical Activity Level

© Canadian Society for Exercise Physiology (CSEP) Page 1

Get Active Questionnaire for Pregnancy – Tool #7 page 1 / 2 Canadian Society for Exercise Physiology

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 Describe Your Physical Activity Level
During a typical week, what types of physical activities do you take part in (e.g., swimming, walking, resistance training, yoga)?

During the same week, please describe ON AVERAGE how often and for how long you engage in physical activity of a light,
moderate or vigorous intensity. See definitions for intensity below the box.

ON AVERAGE FREQUENCY INTENSITY DURATION

(times per week) (see below for definitions) (minutes per session)

How physically active were you in the six months 0 3-4 light <20 31-60
before pregnancy? 1-2 5-7 moderate 20-30 >60
vigorous
How physically active have you been during this 0 3-4 light <20 31-60
pregnancy? 1-2 5-7 moderate 20-30 >60
vigorous
What are your physical activity goals for the rest 0 3-4 light <20 31-60
of your pregnancy? 1-2 5-7 moderate 20-30 >60
vigorous

Light intensity physical activity: You are Moderate intensity physical activity: Your Vigorous intensity physical activity: Your heart
moving, but you do not sweat or breathe heart rate goes up and you may sweat or rate goes up substantially, you feel hot and
hard, such as walking to get the mail or breathe hard. You can talk, but could not sweaty, and you cannot say more than a few
light gardening. sing. Examples include brisk walking. words without pausing to breathe. Examples
include fast stationary cycling and running.

Declaration
General Advice for Being Physically To the best of my knowledge, all of the
Active During Pregnancy information I have supplied on this questionnaire
is correct. If my health changes, I will complete
Follow the advice in the 2019 Canadian Guidelines for Physical
this questionnaire again.
Activity throughout Pregnancy: csepguidelines.ca/pregnancy
I answered NO to all questions on Page 1.
It recommends that pregnant women get at least 150 minutes Sign and date the declaration below.
of moderate-intensity physical activity (resistance training, Physical activity is recommended.
brisk walking, swimming, gardening), spread over three or
I answered YES to one or more questions on Page 1
more days of the week. If you are planning to take part in
and I will speak with my health care provider
vigorous-intensity physical activity, or be physically active
before beginning or continuing physical activity.
at elevations above 2500 m (8200 feet), then consult with The Health Care Provider Consultation Form for Prenatal
your health care provider. If you have any questions about Physical Activity can be used to start the conversation
physical activity during pregnancy, consult a Qualified Exercise (www.csep.ca/getactivequestionnaire-pregnancy).
Professional or your health care provider beforehand.
I have spoken with my health care provider who
This can help ensure that your physical activity is safe and
has recommended that I take part in physical
suitable for you.
activity during my pregnancy.
Sign and date the declaration below.

NAME (+ NAME OF PARENT/GUARDIAN IF APPLICABLE) [PLEASE PRINT]: SIGNATURE (OR SIGNATURE OF PARENT/GUARDIAN IF APPLICABLE):

TODAY'S DATE (DD/MM/YYYY): TELEPHONE (OPTIONAL): EMAIL (OPTIONAL):

© Canadian Society for Exercise Physiology (CSEP) Page 2

CSEP-PATH® Get Active Questionnaire for Pregnancy – Tool #7 page 2 / 2

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 HEALTH CARE PROVIDER
CONSULTATION FORM FOR
PRENATAL PHYSICAL ACTIVITY
PATIENT NAME: DUE DATE (DD/MM/YYYY): TODAY'S DATE (DD/MM/YYYY):

Your patient wishes to begin or continue to be physically active during

pregnancy. Your patient answered "Yes" to one or more questions on the Get
Active Questionnaire for Pregnancy and has been asked to seek your advice
Absolute contraindications
(www.csep.ca/getactivequestionnaire-pregnancy). Pregnant women with these conditions
should continue activities of daily living,
Physical activity is safe for most pregnant individuals and has many health but not take part in moderate or vigorous
benefits. However, a small number of patients may need a thorough physical activity:
evaluation before taking part in physical activity during pregnancy.
ruptured membranes,
The Society of Obstetricians and Gynaecologists of Canada/Canadian premature labour,
Society for Exercise Physiology 2019 Canadian Guideline for Physical Activity unexplained persistent vaginal bleeding,
throughout Pregnancy recommends that pregnant women get at least 150 placenta previa after 28 weeks gestation,
minutes of moderate intensity physical activity each week (see next page or preeclampsia,
csepguidelines.ca/pregnancy). But there are contraindications to this goal for incompetent cervix,
some conditions (see right). intrauterine growth restriction,
high-order multiple pregnancy
Specific concern from your patient and/or from a Qualified Exercise (e.g. triplets),
Professional: uncontrolled Type I diabetes,
uncontrolled hypertension,
uncontrolled thyroid disease,
other serious cardiovascular,
respiratory or systemic disorder.
To ensure that your patient proceeds in the safest way possible, they were
advised to consult with you about becoming or continuing to be physically
active during pregnancy. Please discuss potential concerns you may have Relative contraindications
about physical activity with your patient and indicate in the box below any
Pregnant women with these conditions
modifications you might recommend:
should discuss advantages and
disadvantages of physical activity with
Unrestricted physical activity based on the SOGC/CSEP 2019 Canadian you. They should continue physical
Guidelines for Physical Activity throughout Pregnancy. activity, but modify exercises to reduce
intensity and/or duration.
Progressive physical activity
recurrent pregnancy loss,
Recommend avoiding:
gestational hypertension,
a history of spontaneous preterm birth,
Recommend including: mild/moderate cardiovascular or
respiratory disease,
symptomatic anemia,
Recommend supervision by a Qualified Exercise Professional, if possible.
malnutrition,
Refer to a physiotherapist for pain, impairment and/or a pelvic floor assessment. eating disorder,
twin pregnancy after the 28th week,
Other comments:
other significant medical conditions.

© Canadian Society for Exercise Physiology (CSEP) Page 1

Health Care Provider Consultation Form for Prenatal

Physical Activity – Tool #8 page 1 / 2 Canadian Society for Exercise Physiology

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 SOGC/CSEP 2019
CANADIAN GUIDELINE
FOR PHYSICAL ACTIVITY
THROUGHOUT PREGNANCY
The evidence-based guideline outlines the right amount of physical activity women
should get throughout pregnancy to promote maternal, fetal, and neonatal health.

Research shows the health benefits and safety of being active throughout pregnancy
for both mother and baby. Physical activity is now seen as a critical part of a healthy
pregnancy. Following the guideline can reduce the risk of pregnancy-related illnesses
such as depression, by at least 25%, and of developing gestational diabetes, high blood
pressure and preeclampsia by 40%.

Pregnant women should get at least 150 minutes of moderate-intensity physical

activity each week over at least three days per week. But even if they do not meet
that goal, they are encouraged to be active in a variety of ways every day. Please
visit csepguidelines.ca/pregnancy for more information. The guideline makes six
recommendations:

1 2 3
All women without contraindication Pregnant women should Physical activity should be
should be physically active accumulate at least 150 minutes accumulated over a minimum of
throughout pregnancy. Specific of moderate-intensity physical three days per week; however, being
subgroups were examined: activity each week to achieve active every day is encouraged.
clinically meaningful health benefits
• Women who were previously inactive. and reductions in pregnancy
• Women diagnosed with gestational
complications.
diabetes mellitus.
• Women categorized as overweight or
obese (pre-pregnancy body mass index
≥25kg/m2).

4 5 6
Pregnant women should Pelvic floor muscle training (e.g., Pregnant women who experience
incorporate a variety of aerobic Kegel exercises) may be performed light-headedness, nausea or feel
and resistance training activities to on a daily basis to reduce the risk of unwell when they exercise flat
achieve greater benefits. Adding urinary incontinence. Instruction in on their back should modify their
yoga and/or gentle stretching may proper technique is recommended exercise position to avoid the supine
also be beneficial. to obtain optimal benefits. position.

No. 367-2019 Canadian Guideline for Physical Activity throughout Pregnancy

JOINT SOGC/CSEP CLINICAL PRACTICE GUIDELINE | Volume 40, ISSUE 11, P1528-1537, November 01, 2018

© Canadian Society for Exercise Physiology (CSEP) Page 2

CSEP-PATH® Health Care Provider Consultation Form for Prenatal Physical Activity – Tool #8 page 2 / 2

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CSEP-PATH: ABILITIES FOR ACTIVE LIVING
QUESTIONNAIRE (AAL-Q)
Virtually anyone can participate in a physical activity, fitness and lifestyle assessment, and achieve health
and fitness benefits with coaching support from a qualified exercise professional. Individuals with disabilities
(i.e., physical or mental differences in function that affect their abilities to perform specific tasks and actions)
are more likely to encounter environmental barriers in their pursuit of a physically active lifestyle. Please
help us to help you achieve your health and fitness goals by reviewing and completing this form. Contact us
in advance if you feel there are specific accommodations we can make so that your initial meeting with us
can be a complete success.

Do you have a physical limitation or disability that may affect how you engage in physical activity or exercise?

£ Yes £ No

If you answered ‘Yes’, please expand on the nature of the disability by checking the items below that
best describe your situation.This information will help the qualified exercise professional consider
specific accommodations that may be appropriate to ensure you can successfully undertake a physical
activity, fitness and lifestyle assessment and explore physical activity and exercise options that are most
appropriate for you.

£ I have trouble moving from place to place (e.g., walking or running) or moving my legs

£ I have trouble picking up objects or moving my hands or arms

£ I am not strong enough to do physical activity

£ I cannot move for long periods of time

£ I cannot move or stretch my joints

£ I have trouble cooperating, talking or being active with others

£ I have trouble controlling my emotions and reactions to others

£ I have trouble performing physical activity the way others do

£ I have a vision impairment. I may require printed information in alternative format

£ I have a hearing impairment. I read lips or use sign language

£ I have a verbal impairment

£ I have another sensory input impairment. Please specify:_____________________________________________________

£ I have trouble understanding or remembering instructions

£ Other issues not covered here. Please specify:________________________________________________________________

Abilities for Active Living Questionnaire (AAL-Q) – Tool #9 page 1 / 2 Canadian Society for Exercise Physiology

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We invite you to consider and describe how you currently manage activities of daily living, so the qualified
exercise professional can consider how these strategies and techniques may be used in the context of
helping you pursue a more active lifestyle. You can write your thoughts here and/or discuss them at the first
consultation meeting.

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

CSEP-PATH® Abilities for Active Living Questionnaire (AAL-Q) – Tool #9 page 2 / 2

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CSEP-PATH: CLIENT INFORMATION SHEET
DATE (YYYY/MM/DD): QUALIFIED EXERCISE PROFESSIONAL:

CLIENT INFORMATION

NAME: EMAIL ADDRESS:

AGE (YEARS): GENDER: TELEPHONE:

REFERRAL: £ CSEP-CEP £ Physician £ Other

EMERGENCY CONTACTS

PHYSICIAN: TELEPHONE:

EMERGENCY CONTACT: TELEPHONE:

CONSENT AND PRE-PARTICIPATION

£ Informed Consent completed, signed, witnessed

£ AAL-Q completed £ NA £ Accommodations requested:

£ Get Active Questionnaire £ All NO £ Get Active Questionnaire Reference

Declaration, signed £ YES page 1 #_____ Document discussed

If Physican Guidance for Physical Activity Form or Get Active Questionnaire for Pregnancy issued, append completed and signed form to this sheet.

£ Observations £ Pregnant £ Illness or fever

£ Difficulty breathing at rest £ Lower extremity swelling
£ Did not follow preliminary instructions £ Persistant cough

£ Resting Heart Rate (RHR) £ 1st RHR ≥ 100 bpm

Wait 5 min, re-measure
RHR (15 sec): RHR (bpm):
£ 2nd RHR ≥ 100 bpm
RHR (15 sec): RHR (bpm): Refer to physician

£ Resting Blood Pressure £ 1st SBP ≥ 160 or DBP ≥ 90 mmHg

Wait 5 min, re-measure
SBP (mmHg): DBP (mmHg):
£ 2nd SBP ≥ 160 or DBP ≥ 90 mmHg
SBP (mmHg): DBP (mmHg): Refer to physician

Tools and Handouts provided:

£ Stages of Change Questionnaire £ Goal Setting Worksheet £ Canadian 24-Hour Movement

£ Inventory of Lifestyle Needs and £ Weekly Activity Planner & Log Guidelines
Activity Preferences £ Relapse Planning Worksheet £ 2019 Canadian Guideline for Physical
£ Barriers to Physical Activity Activity during Pregnancy
£ Healthy Sleep Assessment
£ Decision Balance Worksheet £ Canada’s Food Guide
£ CSEP-PATH® Evaluation
£ First Step Planning Worksheet Summary Report £ Other, specify:
£ Alternatives for Action Worksheet £ Exercise Prescription Card

Client Information Sheet – Tool #10 page 1 / 2 Canadian Society for Exercise Physiology

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 PHYSICAL ACTIVITY AND SEDENTARY BEHAVIOUR QUESTIONNAIRE

£ PASB-Q completed

Aerobic Activity Min-Wk-1 HBR:

Muscle Strengthening Sessions per week HBR:

Perceived Aerobic Fitness: HBR:

Sedentary Behaviour Hrs-Day-1 HBR:

ANTHROPOMETRY ASSESSMENT

Weight (kg): BMI (kg•m2): BMI or Combined BMI-WC

[BMI = weight (kg) / height2 (m)] Health Risk Category:

Height (cm): Waist Circumference (cm):

AEROBIC FITNESS ASSESSMENT

Aerobic Submaximal Protocol (see relevant data sheet for workload, HR, RPE, and recovery data):

£ mCAFT £ One Mile Walk Predicted VO2max: HBR:

£ Treadmill Walk £ Cycle Ergometer VO2max (ml · kg-1 · min-1)

MUSCULOSKELETAL FITNESS ASSESSMENT*

MSK Tests Used: Final Score HBR/Normative Score

£ Grip Strength Right 1: Left 1:

________________ kg HBR:
Right 2: Left 2:

£ Push-ups ________________ reps HBR:

£ Sit and Reach Trial 1: Trial 2: ________________ cm HBR:

£ Vertical Jump Reach Height:

Trial 1: Trial 2:
Trial 3:

Jump Height:
Leg power (watts) = [(60.7 x jump height, cm) + ________________ watts HBR:
(45.3 x body mass, kg)] - 2055

£ Back Extension ________________ (sec) HBR:

£ Forearm Plank ________________ (sec) Percentile:

£ One Leg Stance

Above mean
Eyes Open Left: Right: ________________ (sec)
Below mean

Above mean
Eyes Closed Left: Right: ________________ (sec)
Below mean

*see predicted 1-RM and Y Balance Test data sheets for final scores and interpretation of respective results

CSEP-PATH® Client Information Sheet – Tool #10 page 2 / 2

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CSEP-PATH: SOAP CHARTING NOTES
SOAP notes (Subjective, Objective, Assessment, and Plan) is a basic record keeping method employed by many qualified exercise
professionals to help clarify the thinking process and the rationale for a course of evaluation, action or both. Unique needs and concerns
are identified and the intervention is documented, largely so that follow-up evaluations can be compared to earlier visits. It can be kept on
file with the Client Information Sheet, Exercise Prescription Card, and other relevant paperwork appended.

DATE (YYYY/MM/DD): CLIENT NAME:

SUBJECTIVE NOTES:

Purpose of Appointment
(e.g., reason for appointment, general
physical activity goals, etc.)

Physical Activity & Lifestyle

Behaviour History
(e.g., present/past physical activity,
time spent being sedentary, activity
preferences, sleep levels, etc.)

External Factors
(e.g., time availability, equipment/facility
access, barriers, motivation, etc.)

Medical History
(e.g., diagnosed medical conditions,
medications, surgeries, etc.)

OBJECTIVE DATA:

Results of Assessment
(e.g., pertinent results from pre-
participation health screen and fitness
assessment; append client information
sheet, aerobic recording sheets, etc.)

ASSESSMENT:

Analysis
(e.g., interpretation of subjective and
objective notes as it relates to client’s
goal)

PLAN:

Physical Activity or Lifestyle

Intervention
(e.g., specific FITT or other action steps
agreed to by client)

SOAP Charting Notes – Tool #11 page 1 / 1 Canadian Society for Exercise Physiology

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CSEP-PATH: QUICK REFERENCE – CLIENT
INTERVIEW NOTES
With time and practice, many qualified exercise professionals will find the Client Information Sheet (CIS) to be a sufficient memory aid
for gathering and recording essential information in the initial stages of a client interview. For those new to the art of interviewing, the
following can help establish the kind of conversational flow that can help put clients at ease. Use the form on the back of this sheet for
capturing key notes of relevance that you can use later to complete the CIS and as a memory aid in future meetings with the client.

TASK SAMPLE SCRIPT

Welcome the client and put Hi [use the client’s name from the booking], my name is [your name]. I am so pleased you have
them at ease come to visit us today.

Have you ever been to our facility before? Have you had a chance to look around a little? [If it is a
client’s first time, take a few minutes to show them around, highlighting locations of washrooms/
change facilities, etc.]

Ask the client a few ‘ice How is today going for you? Have you been outside to enjoy the weather? Did this time fit into
breaking’ questions about your schedule or did you have to juggle things a little to fit it in? Is our facility close to where you
themselves live or work? What do you do for a living? Where do you work? Where do you go to school?

Inquire about the client’s So, what brings you here to see us today? Have you ever worked with a personal trainer before?
reasons for booking the
appointment What kinds of physical activity do you currently do?

Did you used to be more active? What did you like to do then?

What do you think you might enjoy now?

Have you ever had a fitness assessment before?

Confirm completion of Let’s take a seat here and take care of some paperwork to get started.
the preliminary screening
devices Did you have a chance to review the materials provided in the Welcome Package when you made
your appointment? Was there anything in there that you have questions about?

Let’s take a look at what we have.

The AAL-Q is designed to identify clients who may have a disability I should be aware of as a
trainer/appraiser. Have you noted anything on it?

The Get Active Questionnaire is designed to help identify anyone who may have a health issue that
I need to be aware of before we start to work together. Let’s take a look at your form. [Review
the form to ensure it has been completed, signed and witnessed. Confirm the client is within
your scope of practice and whether their answers affect the scope of the assessment you can
undertake.]

The Informed Consent is another item I have to have on file. It confirms that you understand
the nature of the risks involved in undertaking a fitness assessment or becoming much more
physically active. Do you have any questions about it? Have you signed it and had it witnessed?

There is a questionnaire in the package – the PASB-Q. Did you have a chance to review and
complete? We’ll go over this together a bit later.

Establish the client’s Let’s talk about what you want to accomplish today. [Broadly outline the purpose and three
preferences for the fitness major components of the assessment and the client’s options in that regard e.g., receive
assessment information and advice only, full or partial fitness assessment.]

In your Welcome Package were a few pre-assessment instructions about not eating, drinking or
exercising in the hours leading up to your appointment. That’s so we can get accurate results in
the tests. Did you follow those instructions?

Great. Let’s get started by first taking your Resting Heart Rate and Blood Pressure
measurements (Remember to ask permission to touch the client’s arm/wrist).

CSEP-PATH® Quick Reference - Client Interview Notes – Tool #12 page 1 / 1

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 18-64 years

CSEP-PATH:
MOVEMENT COUNSELLING TOOL
FOR ADULTS AGED 18-64 YEARS

The Canadian 24-Hour Movement Guidelines for adults integrate three core movement behaviour
recommendations for optimal health benefits:

REDUCE
MOVE MORE SLEEP WELL
SEDENTARY TIME
Use this tool to guide your conversation with clients that express an interest in
changing a movement behaviour.

STEP 1: ASK client for permission to discuss their movement behaviours (i.e., physical
activity, sedentary time, sleep).
• “May I discuss Canada’s daily movement recommendations with you?”
• Discuss the Canadian 24-Hour Movement Guidelines with your client.

STEP 2: ASSESS client’s physical activity, sedentary time, and sleep.

• Ask open-ended questions such as “Tell me about your current physical activity levels?” or “How
would you describe your sleep schedule?”
• Use the information gathered and the movement recommendations below to help guide goal
setting and action planning (STEP 4).

A HEALTHY 24 HOURS INCLUDES:

PHYSICAL ACTIVITY SEDENTARY TIME SLEEP

150 minutes per week Limit sedentary time to 8 Get 7 to 9 hours of good-
of moderate to vigorous hours or less quality sleep on a regular
aerobic physical activities basis
No more than 3 hours of
Muscle strengthening recreational screen time Consistent bed and wake-up
activities at least twice a times
week Break up long periods of
sitting as often as possible
Several hours of light
physical activities including Replacing sedentary behaviour with additional physical activity and trading light
standing physical activity for more moderate to vigorous physical activity, while preserving
sufficient sleep, can provide greater health benefits.

24-Hour Movement Guideline Conversation Tool for Adults

Aged 18-64 Years – Tool #13 page 1 / 2 Canadian Society for Exercise Physiology

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CANADIAN 24-HOUR MOVEMENT GUIDELINES FOR ADULTS (AGED 18-64 YEARS)

18-64 years

STEP 3: ADVISE client on their current movement behaviours.

• Discuss the health benefits and/or risks of their current status if necessary.

STEP 4: AGREE on a realistic goal with your client.

• Ask client which movement behaviour(s) they would like to focus on. Create a SMART goal with
your client that helps them move towards the guideline recommendations (see Goal Setting Work-
sheet). Offer practical strategies when needed. (examples of strategies for each target are below)

• Remind client that progressing towards any of the movement behaviour targets will result in
some health benefits.

PHYSICAL ACTIVITY SEDENTARY TIME SLEEP

Discuss ways to increase Identify periods of the day Have them develop relaxing
the types and intensities where they are sedentary bedtime routine, avoid
of aerobic activity they and discuss how to replace caffeine consumption in
perform each day. them with other movement afternoon, no screens 30-60
behaviours (e.g., standing). mins before bedtime.
Develop an appropriate
resistance training program Encourage them to Encourage them to go bed
for your client. keep screens away from at the same time every day.
bedrooms and eating areas.
Discuss how they could
replace sedentary periods Encourage them to get up
of their day with light and get a glass water during
activities such as standing. the day, or use technology
to remind them to take
breaks.

SMART Goal:

STEP 5: ASSIST client to increase self-confidence and overcome barriers.

• Consider using tools such as the Decision Balance Worksheet or the Barriers to Physical
Activity Tool, to help facilitate the discussion.

STEP 6: ARRANGE a follow-up with your client (e.g., 2 weeks).

Follow-up date and time:

© Canadian Society for Exercise Physiology, 2021. All rights reserved.

24-Hour Movement Guideline Conversation Tool for Adults

CSEP-PATH ®
Aged 18-64 Years – Tool #13 page 2 / 2

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 65 years or older

CSEP-PATH:
MOVEMENT COUNSELLING TOOL
FOR ADULTS AGED 65 YEARS OR OLDER

Canada’s 24-Hour Movement Guidelines for adults integrate three core movement behaviour
recommendations for optimal health benefits:

REDUCE
MOVE MORE SLEEP WELL
SEDENTARY TIME
Use this tool to guide your conversation with clients that express an interest in
changing a movement behaviour.

STEP 1: ASK client for permission to discuss their movement behaviours (i.e., physical
activity, sedentary time, sleep).
• “May I discuss Canada’s daily movement recommendations with you?”
• Discuss the Canadian 24-Hour Movement Guidelines with your client.

STEP 2: ASSESS client’s physical activity, sedentary time, and sleep.

• Ask open-ended questions such as “Tell me about your current physical activity levels?” or “How
would you describe your sleep schedule?”
• Use the information gathered and the movement recommendations below to help guide goal
setting and action planning (STEP 4).

A HEALTHY 24 HOURS INCLUDES:

PHYSICAL ACTIVITY SEDENTARY TIME SLEEP

150 minutes per week Limit sedentary time to 8 Get 7 to 8 hours of good-
of moderate to vigorous hours or less quality sleep on a regular
aerobic physical activities basis
No more than 3 hours of
Muscle strengthening recreational screen time Consistent bed and wake-up
activities at least twice a times
week Break up long periods of
sitting as often as possible
Several hours of light
physical activities including Replacing sedentary behaviour with additional physical activity and trading light
standing physical activity for more moderate to vigorous physical activity, while preserving
sufficient sleep, can provide greater health benefits.
Physical activities that
challenge balance

24-Hour Movement Guideline Conversation Tool for Adults

Aged 65 Years and Older – Tool #14 page 1 / 2 Canadian Society for Exercise Physiology

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CANADIAN 24-HOUR MOVEMENT GUIDELINES FOR ADULTS (AGED 18-64 YEARS)

65 years or older

STEP 3: ADVISE client on their current movement behaviours.

• Discuss the health benefits and/or risks of their current status if necessary.

STEP 4: AGREE on a realistic goal with your client.

• Ask client which movement behaviour(s) they would like to focus on. Create a SMART goal with
your client that helps them move towards the guideline recommendations (see Goal Setting Work-
sheet). Offer practical strategies when needed. (examples of strategies for each target are below)

• Remind client that progressing towards any of the movement behaviour targets will result in
some health benefits.

PHYSICAL ACTIVITY SEDENTARY TIME SLEEP

Discuss ways to increase Identify periods of the day Have them develop relaxing
the types and intensities where they are sedentary bedtime routine, avoid
of aerobic activity they and discuss how to replace caffeine consumption in
perform each day. them with other movement afternoon, no screens 30-60
behaviours (e.g., standing). mins before bedtime.
Develop an appropriate
resistance training program Encourage them to Encourage them to go bed
for your client. keep screens away from at the same time every day.
bedrooms and eating areas.
Discuss how they could
replace sedentary periods Encourage them to get up
of their day with light and get a glass water during
activities such as standing. the day, or use technology
to remind them to take
Develop an appropriate breaks.
balance training program
for your client.
SMART Goal:

STEP 5: ASSIST client to increase self-confidence and overcome barriers.

• Consider using tools such as the Decision Balance Worksheet, or Barriers to Physical Activity
Tool, to help facilitate the discussion.

STEP 6: ARRANGE a follow-up with your client (e.g., 2 weeks).

Follow-up date and time:

© Canadian Society for Exercise Physiology, 2021. All rights reserved.

24-Hour Movement Guideline Conversation Tool for Adults

CSEP-PATH ®
Aged 65 Years and Older – Tool #14 page 2 / 2

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ASSESS:
TOOL PURPOSE

Physical Activity & Sedentary Provides information about client’s levels of physical activity and sedentary
Behaviour Questionnaire (PASB-Q) – behaviour.
Adult

Physical Activity & Sedentary Provides information about client’s levels of physical activity and sedentary
Behaviour Questionnaire (PASB-Q) – behaviour.
Youth

Healthy Sleep Assessment Collects information about client's sleep patterns and provides prompts for
discussion about healthy sleep habits.

Stages of Change Questionnaire Identifies client’s current stage of change.

(SOC-Q)

mCAFT Data Collection Sheet

Treadmill Walk Data Collection Sheet

Allows raw data obtained during these specific fitness assessments to
One Mile Walk Data Collection Sheet be charted.

Cycle Ergometer Test Data Collection Remember that many of the results from the fitness assessments are
Sheet recorded directly on the Client Information Sheet (BP, HR, height, weight, waist
circumference, grip strength, push-ups, sit and reach, back extension, forearm
Predicting 1-RM Data Collection plank, one-leg stance, and vertical jump).
Sheet

Y Balance Test Data Collection Sheet

Rating of Perceived Exertion (RPE) Reliable indicator to monitor exercise intensity during the fitness assessment
Chart and/or the supervised exercise session.

Quick Reference – Health Benefit Snapshot of Health Benefit Ratings and Normative Ratings associated with each
Ratings fitness test provided in the CSEP-PATH®

Canadian Society for Exercise Physiology

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CSEP-PATH: PHYSICAL ACTIVITY AND
SEDENTARY BEHAVIOUR QUESTIONNAIRE
(PASB-Q) for Adults
Please answer the following questions based on what you do in a typical week. To increase accuracy, you may wish
to log your physical activity and sedentary behaviour for one week prior to answering the questions.

Aerobic Physical Activity

1. Frequency: In a typical week, how many days do you do moderate- ______________days/week
intensity (like brisk walking) to vigorous-intensity (like running)
aerobic physical activity ?

2. Time or Duration: On average for days that you do at least ______________minutes/day

moderate-intensity aerobic physical activity (as specified above),
how many minutes do you do?

Total: Multiply your average number of days per week by the ______________minutes/week
average number of minutes per day.

Muscle Strengthening Physical Activity

3. In a typical week, how many times do you do muscle strengthening ______________times/week
activities (such as resistance training or very heavy gardening)?

Perceived Aerobic Fitness

4. In general, would you say that your aerobic fitness (ability to walk/run distances) is:
£ Excellent £ Very Good £ Good £ Fair £ Poor

CSEP-PATH® PASB-Q Adults – Tool #15 page 1 / 2

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Sedentary Behaviour
5. O
 n a typical day, how many hours do you spend in continuous sitting: at work, in meetings, volunteer
commitments and commuting (i.e., by motorized transport)?
£ None £ < 1 hour £ 1 to < 2 £ 2 to < 3

£ 3 to < 4 £ 4 to < 5 £ 5 to < 6 £ >6

6. On a typical day, how many hours do you watch television, use a computer, read, and spend sitting
quietly during your leisure time?
£ None £ < 1 hour £ 1 to < 2 £ 2 to < 3

£ 3 to < 4 £ 4 to < 5 £ 5 to < 6 £ >6

Total Sedentary Behaviour (add responses to questions 5 and 6) ______________hours/day

7. When sitting for prolonged periods (one hour or more), at what interval would you typically take a break
to stand and move around for two minutes?
£ < 10 minutes £ 30 to < 45 minutes £ 1.5 to < 2 hours

£ 10 to < 20 minutes £ 45 to < 1 hour £ > 2 hours

£ 20 to < 30 minutes £ 1 to < 1.5 hours

PASB-Q Adults – Tool #15 page 2 / 2 Canadian Society for Exercise Physiology

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CSEP-PATH: PHYSICAL ACTIVITY AND
SEDENTARY BEHAVIOUR QUESTIONNAIRE
(PASB-Q) for Youth (12–17 Years)
Please answer the following questions based on what you do in a typical week. To increase accuracy, you may wish
to log your physical activity and sedentary behaviour for one week prior to answering the questions.

Aerobic Physical Activity

1. Frequency: In a typical week, how many days do you do moderate- ______________days/week
intensity (like brisk walking) to vigorous-intensity (like running)
aerobic physical activity ?

2. Time or Duration: On average for days that you do at least ______________minutes/day

moderate-intensity aerobic physical activity (as specified above),
how many minutes do you do?

3. In a typical week, how many days do you do vigorous-intensity ______________days/week

aerobic physical activity?

Muscle Strengthening Physical Activity

4. Frequency: In a typical week, how many times do you do muscle ______________times/week
strengthening activities (such as resistance training, wall climbing, or
competitive sport)?

5. Time or Duration: On average, for days that you do muscle ______________minutes/week

strengthening activities (as specified above), how many minutes
do you do?

Total Physical Activity (add responses to questions 2 and 5) ______________minutes/day

Perceived Aerobic Fitness

6. In general, would you say that your aerobic fitness (ability to walk/run distances) is:
£ Excellent £ Very Good £ Good £ Fair £ Poor

CSEP-PATH® PASB-Q Youth – Tool #16 page 1 / 2

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Sedentary Behaviour
7. On a typical day, how many hours do you spend in continuous sitting: at school, work, volunteer
commitments and commuting (i.e., by motorized transport)?
£ None £ < 1 hour £ 1 to < 2 £ 2 to < 3

£ 3 to < 4 £ 4 to < 5 £ 5 to < 6 £ >6

8. On a typical day, how many hours do you watch television, use a computer, play video games, read, and
spend sitting quietly during your leisure time?
£ None £ < 1 hour £ 1 to < 2 £ 2 to < 3

£ 3 to < 4 £ 4 to < 5 £ 5 to < 6 £ >6

Total Sedentary Behaviour (add responses to questions 7 and 8) ______________hours/day

9. When sitting for prolonged periods (one hour or more), at what interval would you typically take a break
to stand and move around for two minutes?
£ < 10 minutes £ 30 to < 45 minutes £ 1.5 to < 2 hours

£ 10 to < 20 minutes £ 45 to < 1 hour £ > 2 hours

£ 20 to < 30 minutes £ 1 to < 1.5 hours

PASB-Q Youth – Tool #16 page 2 / 2 Canadian Society for Exercise Physiology

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CSEP-PATH: HEALTHY SLEEP ASSESSMENT
The Healthy Sleep Assessment is an evidence-informed module for assessing the sleep health of Canadians.
These questions can provide an indication of whether the client has “good” or “poor” sleeping habits in
general. There are three short question banks, for Toddlers (ages 3-4), Children and Youth (ages 5-17 years)
and Adults (18 years and older). Utilize the question bank that corresponds to your client’s age.

Children of the Early Years (Toddlers 3–4 years)

1. How many hours of sleep does your child get in a typical 24-hour day (including naps)?
hours and minutes

2. How many naps does your child get in a typical 24-hour day?

£0 £1 £2 £3 £ 4 or more

3. Does your child have consistent bedtimes and wake-up times?

£ Yes, they don’t vary by more than 30 minutes each day
£ No, they vary by more than 30 minutes each day

4. Do you establish a calming bedtime routine for your child (e.g., bath time, saying goodnight, giving a kiss/
hug, storytelling)?

£ Every night £ Some nights £ Almost never

5. Does your child use electronics (e.g., TV, video game, computer, tablet or smartphone) before bedtime?

£ Yes £ No

6. Does your child have electronics in the bedroom (e.g., TV, video game, computer, tablet or smartphone)?

£ Yes £ No

Children and Youth (5–17 years)

1. During the past week, what time have you usually turned out the light and gone to sleep on school days?

2. During the past week, at what time have you usually woken up in the morning on school days?

CSEP-PATH® Healthy Sleep Assessment – Tool #17 page 1 / 3

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3. During the past week, what time have you usually turned out the light and gone to sleep on
weekend days?

4. During the past week, at what time have you usually woken up in the morning on weekend days?

5. During the past week, how would you rate your sleep quality overall (how well you sleep)?
£ Very good £ Fairly good £ Fairly bad £ Very bad

6. Do you have electronics in your bedroom (e.g., TV, video games, computer, tablet or smartphone)?

£ Yes £ No

7. Do you use your electronics (e.g., TV, video games, computer, tablet or smartphone) right
before bedtime?
£ Yes £ No

Adults (≥18 years)

1. At what time do you usually fall asleep on weekdays or your work days?

2. At what time do you usually wake up on weekdays or your work days?

3. At what time do you usually fall asleep on weekends or your non-work days?

4. At what time do you usually wake up on weekends or your non-work days?

5. During the past month, how would you rate your sleep quality overall?
£ Very good £ Fairly good £ Fairly bad £ Very bad

6. Do you have electronics in your bedroom (e.g., TV, video games, computer, tablet or smartphone)?

£ Yes £ No

7. Do you use your electronics (e.g., TV, video games, computer, tablet or smartphone) right
before bedtime?
£ Yes £ No

Healthy Sleep Assessment – Tool #17 page 2 / 3 Canadian Society for Exercise Physiology

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Desired Answers
Children of the early years Children and youth Adults (≥18 years)
(3–4 years) (5–17 years) 1. At what time do you usually fall
1. How many hours of sleep does your 1. During the past week, what time asleep on weekdays or your work
child get in a typical 24-hour day have you usually turned out the light days?
(including naps)? and gone to sleep on school days? Desired answer: Bedtime that allows
Desired answer: 10 to 13 hours Desired answer: Bedtime that client to obtain age-appropriate
allows to obtain age-appropriate amounts of sleep as per the Canadian
2. How many naps does your child get amounts of sleep as per the 24-Hour 24-Hour Movement Guidelines.
in a typical 24-hour day? Movement Guidelines.
Desired answer: no more than 2. At what time do you usually wake up
1 nap a day 2. During the past week, at what time on weekdays or your work days?
have you usually woken up in the Desired answer: Wake-up time that
3. Does your child have consistent morning on school days? allows client to obtain age-appropriate
bedtimes and wake-up times? Desired answer: Wake-up time that amounts of sleep as per the Canadian
Desired answer: yes allows client to obtain age-appropriate 24-Hour Movement Guidelines.
amounts of sleep as per the Canadian
4. Do you establish a calming bedtime 24-Hour Movement Guidelines. 3. At what time do you usually fall
routine for your child (e.g., bath asleep on weekends or your
time, saying goodnight, giving a kiss/ 3. During the past week, what time non-work days?
hug, storytelling)? have you usually turned out the light Desired answer: Bedtime that allows
Desired answer: every night and gone to sleep on weekend days? client to obtain age-appropriate
Desired answer: Bedtime that allows amounts of sleep as per the Canadian
5. Does your child use electronics (e.g., client to obtain age-appropriate 24-Hour Movement Guidelines.
TV, video game, computer, tablet amounts of sleep as per the Canadian
or smartphone) before bedtime? 24-Hour Movement Guidelines. 4. At what time do you usually wake
Desired answer: No up on weekends or your non-work
4. During the past week, at what time days?
6. Does your child have electronics in have you usually woken up in the Desired answer: Wake-up time that
the bedroom (e.g., TV, video game, morning on weekend days? allows client to obtain age-appropriate
computer, tablet or smartphone)? Desired answer: Wake-up time that amounts of sleep as per the Canadian
Desired answer: No allows client to obtain age-appropriate 24-Hour Movement Guidelines.
amounts of sleep as per the Canadian
24-Hour Movement Guidelines. Weekday-to-weekend consistency
in sleep schedules can be obtained
Weekday-to-weekend consistency with the first 4 questions.
in sleep schedules can be obtained
with the first 4 questions. 5. During the past month, how would
you rate your sleep quality overall?
5. During the past week, how would Desired answer: Very good
you rate your sleep quality overall
(how well you sleep)? 6. Do you have electronics in your
Desired answer: very good bedroom (e.g., TV, video games,
computer, tablet or smartphone)?
6. Do you have electronics in your Desired answer: No
bedroom (e.g., TV, video games,
computer, tablet or smartphone)? 7. Do you use your electronics (e.g.,
Desired answer: No TV, video games, computer, tablet or
smartphone) right before bedtime?
7. Do you use your electronics (e.g., Desired answer: No
TV, video games, computer, tablet or
smartphone) right before bedtime?
Desired answer: No

CSEP-PATH® Healthy Sleep Assessment – Tool #17 page 3 / 3

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CSEP-PATH: STAGES OF CHANGE
QUESTIONNAIRE (SOC-Q)
Physical activity can include activities such as walking, cycling, swimming, climbing the stairs, dancing, active
gardening, walking to work, aerobics or sports. For health benefits, Canadians of all ages should be physically
active each day, minimize time spent being sedentary, and achieve sufficient sleep. See the Canadian 24-
Hour Movement Guidelines for all ages at www.csep.ca/guidelines.

1. Here are a number of statements describing various levels of physical activity. Please check the box that
corresponds to the statement that most closely describes your current level of physical activity.

£ I am not physically active and I do not plan on becoming so in the next six months.

£ I am not physically active, but I have been thinking about becoming so in the next six months.

£ I am physically active once in a while, but not regularly.

£ I am currently physically active, but have only begun doing so within the last six months.

£ I participate in regular physical activity and have done so for more than six months.

2. If you are not currently physically active, were you physically active in the past?
£ Yes £ No

Stages of Change Questionnaire – Tool #18 page 1 / 1 Canadian Society for Exercise Physiology

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CSEP-PATH: mCAFT DATA COLLECTION
WORKSHEET
NAME:

DATE (YYYY/MM/DD): AGE (YEARS): WEIGHT (KG): GENDER:

PREDICTED HRMAX (BPM): 85% PREDICTED HRMAX: B/10 SECONDS

MEASURED BY:
HR (BPM): AUSCULTATION PALPATION ELECTRONIC HR MONITOR

EXERCISE STARTING STAGE* HR (bpm) RPE

1st stage

2nd stage

3rd stage

4th stage

5th stage

6th stage

7th stage

8th stage

*Use Table 2 of page 2 of this tool to determine starting stage.

Please Note: A standardized recovery protocol applies to each aerobic fitness assessment. At test
completion, use the table to record the client’s Heart Rate and Blood Pressure at the designated intervals.

POST-EXERCISE TIME (min) HR (bpm) BP (mmHg)

Active Recovery 1
2

4*
5*

Passive Recovery 1
2

4**
5**

* If client does not feel sufficiently recovered by 3 min, then complete another 2 min of very light recovery, before sitting.
** If at 3 min of passive recovery, HR and BP is above prescreening cutoffs (SBP ≥ 160, DBP ≥ 90, and HR ≥ 100), wait another 2 minutes, and then measure
HR and BP. Clients with HR or BP values that remain above the cutoffs at this time should postpone the remainder of the assessment to a later date.

CSEP-PATH® mCAFT Data Collection Worksheet – Tool #19 page 1 / 2

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mCAFT Equations to Predict VO2max

VO2max (ml·kg-1·min-1) = 17.2 + (1.29 × O2 cost of the last

VO2max (ml·kg-1·min-1) = 17.2 + (1.29 × O2cost) −
completed stage) − (0.09 × mass in kg) − (0.18 × age in years)
(0.09 × kg) − (0.18 × yrs)
Note: O2 cost is provided in Table 2 below.

Predicted VO2max______________________ (ml·kg-1min-1) HBR:_________________________________________________________

Table 1: mCAFT Starting Stage Table 3: Estimated VO2max - HBR

AGE FEMALES MALES AGE ZONE MALE FEMALE

15–19 Excellent 57.4 + 49.0 +

15–19 3 4
Very Good 52.4–57.3 43.7–48.9
20–29 3 4 Good 48.8–52.3 39.5–43.6
Fair 43.6–48.7 36.8–39.4
30–39 3 3 Poor < 43.6 < 36.8

40–49 2 3 20–29 Excellent 55.6 + 47.2 +

Very Good 50.6–55.5 42.0–47.1
50–59 1 2 Good 47.2–50.5 37.8–41.9
Fair 41.6–47.1 35.0–37.7
60–69 1 1 Poor < 41.6 < 35.0

30–39 Excellent 48.8 + 45.4 +

Very Good 45.4–48.7 40.1–45.3
Table 2: O2 cost table for the various Good 40.1–45.3 36.0–40.0
mCAFT stepping stages Fair 33.7–40.0 33.0–35.9
O2COST VO2 (ml·kg ·min )
-1 -1 Poor < 33.7 < 33.0

STAGE FEMALES MALES 40–49 Excellent 47.0 + 40.0 +

Very Good 42.7–46.9 35.1–39.9
1 15.9 15.9 Good 35.5–42.6 31.9–35.0
Fair 31.9–35.4 27.1–31.8
2 18.0 18.0
Poor < 31.9 < 27.1
3 22.0 22.0
50–59 Excellent 41.8 + 36.6 +
4 24.5 24.5 Very Good 36.5–41.7 34.0–36.5
Good 30.1–36.4 31.0–33.9
5 26.3 29.5 Fair 26.0–30.0 24.6–30.9
Poor < 26.0 < 24.6
6 29.5 33.6
60–69 Excellent 38.4 + 35.8 +
7 33.6 36.2 Very Good 32.8–38.3 32.8–35.7
Good 28.7–32.7 29.6–32.7
8 36.2 40.1
Fair 23.5–28.6 23.5–29.5
Poor < 23.5 < 23.5

mCAFT Data Collection Worksheet – Tool #19 page 2 / 2 Canadian Society for Exercise Physiology

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CSEP-PATH: TREADMILL WALK DATA
COLLECTION WORKSHEET
NAME:

DATE (YYYY/MM/DD): AGE (YEARS): WEIGHT (KG): GENDER:

WARM-UP HR 50% PREDICTED 70% PREDICTED 85% PREDICTED

TRAINING ZONE: HRMAX (BPM) = HRMAX (BPM) = HRMAX (BPM) =

MEASURED BY:
HR (BPM) AUSCULTATION PALPATION ELECTRONIC HR MONITOR

TIME (min) SPEED (mph) GRADE (%) HR (bpm) RPE

Warm-up 1 0
2 0
3 0
4 0

Workload 1 5
2 5
3 5
4 5
5* 5

* If HR is not at steady state (differs by >5 bpm) between 3rd and 4th minute, extend workload to 5th minute.

Please Note: A standardized recovery protocol applies to each aerobic fitness assessment. At test
completion, use the table to record the client’s Heart Rate and Blood Pressure at the designated intervals.

POST-EXERCISE TIME (min) HR (bpm) BP (mmHg)

Active Recovery 1
2
3
4*
5*

Passive Recovery 1
2
3
4**
5**

* If client does not feel sufficiently recovered by 3 min, then complete another 2 min of very light recovery, before sitting.
** If at 3 min of passive recovery, HR and BP is above prescreening cutoffs (SBP ≥ 160, DBP ≥ 90, and HR ≥ 100), wait another 2 minutes, and then measure
HR and BP. Clients with HR or BP values that remain above the cutoffs at this time should postpone the remainder of the assessment to a later date.

CSEP-PATH® Treadmill Walk Data Collection Worksheet – Tool #20 page 1 / 2

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Equation to Predict VO2max for Treadmill Walk

VO2max (ml·kg-1·min-1) = 15.1 + (21.8 × walking

speed in mph) − (0.327 × SS HR in bpm averaged VO2max (ml·kg-1·min-1) = 15.1 + (21.8 × mph) −
from last two workloads) − (0.263 × walking speed in (0.327 × bpm) − (0.263 × mph × years) +
mph × age in years) + (0.00504 × SS HR in bpm × age in (0.00504 × bpm × in years) + (5.98 × )
years) + (5.98 × gender)
Gender = 1 for males or 0 for females

Predicted VO2max______________________ (ml·kg-1min-1) HBR:_________________________________________________________

Estimated VO2max - HBR

AGE ZONE MALE FEMALE AGE ZONE MALE FEMALE

15–19 Excellent 57.4 + 49.0 + 40–49 Excellent 47.0 + 40.0 +

Very Good 52.4–57.3 43.7–48.9 Very Good 42.7–46.9 35.1–39.9
Good 48.8–52.3 39.5–43.6 Good 35.5–42.6 31.9–35.0
Fair 43.6–48.7 36.8–39.4 Fair 31.9–35.4 27.1–31.8
Poor < 43.6 < 36.8 Poor < 31.9 < 27.1

20–29 Excellent 55.6 + 47.2 + 50–59 Excellent 41.8 + 36.6 +

Very Good 50.6–55.5 42.0–47.1 Very Good 36.5–41.7 34.0–36.5
Good 47.2–50.5 37.8–41.9 Good 30.1–36.4 31.0–33.9
Fair 41.6–47.1 35.0–37.7 Fair 26.0–30.0 24.6–30.9
Poor < 41.6 < 35.0 Poor < 26.0 < 24.6

30–39 Excellent 48.8 + 45.4 + 60–69 Excellent 38.4 + 35.8 +

Very Good 45.4–48.7 40.1–45.3 Very Good 32.8–38.3 32.8–35.7
Good 40.1–45.3 36.0–40.0 Good 28.7–32.7 29.6–32.7
Fair 33.7–40.0 33.0–35.9 Fair 23.5–28.6 23.5–29.5
Poor < 33.7 < 33.0 Poor < 23.5 < 23.5

Treadmill Walk Data Collection Worksheet – Tool #20 page 2 / 2 Canadian Society for Exercise Physiology

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CSEP-PATH: ONE MILE WALK DATA
COLLECTION WORKSHEET
NAME:

DATE (YYYY/MM/DD): AGE (YEARS): WEIGHT (KG): GENDER:

TIME TO COMPLETE ONE MILE (1600M): (MINUTES:SECONDS) (=MINUTES)

MEASURED BY:
HR (BPM) AUSCULTATION PALPATION ELECTRONIC HR MONITOR

Please Note: A standardized recovery protocol applies to each aerobic fitness assessment. At test
completion, use the table to record the client’s Heart Rate and Blood Pressure at the designated intervals.

POST-EXERCISE TIME (min) HR (bpm) BP (mmHg)

Active Recovery 1

4*

5*

Passive Recovery 1

4**

5**

* If client does not feel sufficiently recovered by 3 min, then complete another 2 min of very light recovery, before sitting.
** If at 3 min of passive recovery, HR and BP is above prescreening cutoffs (SBP ≥ 160, DBP ≥ 90, and HR ≥ 100), wait another 2 minutes, and then measure
HR and BP. Clients with HR or BP values that remain above the cutoffs at this time should postpone the remainder of the assessment to a later date.

CSEP-PATH® One Mile Walk Data Collection Worksheet – Tool #21 page 1 / 2

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Equation to Predict VO2max for One Mile Walk Test
VO2max (ml·kg-1·min-1) = 132.853 − (0.16918 x body mass
VO2max (ml·kg-1·min-1) = 132.853 − (0.16918 × kg) –
in kg) − (0.3877 × age in years) + (6.315 × gender)
(0.3877 × yrs) + (6.315 × )
− (3.2649 × time in minutes) − (0.1565 × HR in bpm)
– (3.2649 × min) – (0.1565 × bpm)
Gender = 1 for males or 0 for females

Predicted VO2max______________________ (ml·kg-1min-1) HBR:_________________________________________________________

Estimated VO2max - HBR

AGE ZONE MALE FEMALE AGE ZONE MALE FEMALE

15–19 Excellent 57.4+ 49.0+ 40–49 Excellent 47.0+ 40.0+

Very Good 52.4–57.3 43.7–48.9 Very Good 42.7–46.9 35.1–39.9
Good 48.8–52.3 39.5–43.6 Good 35.5–42.6 31.9–35.0
Fair 43.6–48.7 36.8–39.4 Fair 31.9–35.4 27.1–31.8
Poor <43.6 <36.8 Poor <31.9 <27.1

20–29 Excellent 55.6+ 47.2+ 50–59 Excellent 41.8+ 36.6+

Very Good 50.6–55.5 42.0–47.1 Very Good 36.5–41.7 34.0–36.5
Good 47.2–50.5 37.8–41.9 Good 30.1–36.4 31.0–33.9
Fair 41.6–47.1 35.0–37.7 Fair 26.0–30.0 24.6–30.9
Poor <41.6 <35.0 Poor <26.0 <24.6

30–39 Excellent 48.8+ 45.4+ 60–69 Excellent 38.4+ 35.8+

Very Good 45.4–48.7 40.1–45.3 Very Good 32.8–38.3 32.8–35.7
Good 40.1–45.3 36.0–40.0 Good 28.7–32.7 29.6–32.7
Fair 33.7–40.0 33.0–35.9 Fair 23.5–28.6 23.5–29.5
Poor <33.7 <33.0 Poor <23.5 <23.5

One Mile Walk Data Collection Worksheet – Tool #21 page 2 / 2 Canadian Society for Exercise Physiology

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CSEP-PATH: CYCLE ERGOMETER DATA
COLLECTION WORKSHEET
NAME:

DATE (YYYY/MM/DD): AGE (YEARS): WEIGHT (KG): GENDER:

85% PREDICTED HR MAX: BPM SEAT HEIGHT:

HR (BPM) MEASURED BY: AUSCULTATION PALPATION ELECTRONIC HR MONITOR

Determine the loading sequence using the table on page 3 of this tool.

RESISTANCE
TIME (min) (kg or watts) CADENCE (rpm) HR (bpm) RPE

Workload 1
One
2

4*

Workload 1
Two
2

4*

Workload 1
Three
2

4*

Workload 1
Four
2

4*

* if HR is not at steady state (differs by > 5 bpm) between 2nd and 3rd minute, extend workload to 4th minute

CSEP-PATH® Cycle Ergometer Data Collection Worksheet – Tool #22 page 1 / 3

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Please Note: A standardized recovery protocol applies to each aerobic fitness assessment. At test completion, use the
table to record the client’s Heart Rate and Blood Pressure at the designated intervals.

POST-EXERCISE TIME (min) HR (bpm) BP (mmHg)

Active Recovery 1
2
3
4*
5*

Passive Recovery 1
2
3
4**
5**

* If client does not feel sufficiently recovered by 3 min, then complete another 2 min of very light recovery, before sitting.
** If at 3 min of passive recovery, HR and BP is above prescreening cutoffs (SBP ≥ 160, DBP ≥ 90, and HR ≥ 100), wait another 2 minutes, and then
measure HR and BP. Clients with HR or BP values that remain above the cutoffs at this time should postpone the remainder of the assessment to a
later date.

Equation to Predict VO2max for Cycle Ergometer Test

Note the use of the following acronyms:
• SM1 is the submaximal oxygen cost (VO2) for the second to last workload
• SM2 is the submaximal VO2 for the last workload
• HR1 is the average steady state HR for the second to last workload
• HR2 is the average steady state HR for the last workload.

1. Determine power output for each workload

SM1 (ml·kg-1·min-1) = [( watts / kg) × 10.8] + 7 =

VO2max (ml·kg-1·min-1) = [(Workload in watts / body
mass in kg) × 10.8] + 7
SM2 (ml·kg-1·min-1) = [( watts / kg) × 10.8] + 7 =

2. Determine multi-stage slope of the line

b=( ml·kg-1·min-1) − ( ml·kg-1·min-1) /

Slope (b) = (SM2 − SM1) / (HR2 − HR1) ( bpm) − ( bpm)

3. Determine VO2max
Estimated VO2max (ml·kg-1·min-1) =
Estimated VO2max (ml·kg-1·min-1) = SM2 + [b
+[ ×( − )]
(HRmax − HR2)]

Predicted VO2max (ml·kg-1min-1) HBR:

Cycle Ergometer Data Collection Worksheet – Tool #22 page 2 / 3 Canadian Society for Exercise Physiology

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Heart Rate and Loading Sequence for the Cycle Ergometer Test
1st WORKLOAD 150 KPM MINUTE-1 (0.5 KP or 25W)
(3 minutes) Heart Rate for the last minute of the 1st workload determines the resistance applied in the 2nd workload

HR < 80 BP HR = 80–89 BPM HR = 90–100 BPM HR >100 BPM

750 kpm·min-1 600 kpm·min-1 450 kpm·min-1 300 kpm·min-1

2nd workload*
(2.5 kp or 125W) (2.0 kp or 100W) (1.5 kp or 75W) (1.0 kp or 50W)

900 kpm·min-1 750 kpm·min-1 600 kpm·min-1 450 kpm·min-1

3rd workload
(3.0 kp or 150W) (2.5 kp or 125W) (2.0 kp or 100W) (1.5 kp or 75W)

1050 kpm·min-1 900 kpm·min-1 750 kpm·min-1 600 kpm·min-1

4th workload
(3.5 kp or 175W) (3.0 kp or 150W) (2.5 kp or 125W) (2.0 kp or 100W)

Additional If additional workloads are required so that HR increases to between 110 bpm and 85%HRmax
workloads for 2 consecutive workloads, add 150 kpm·min-1 (0.5 kp or 25W) to the previous workload

*Once you select the 2nd workload add 150 kpm•min-1 (0.5 kp or 25W) for every subsequent workload (i.e., stay in the same column for the rest of the test).

Estimated VO2max - HBR

AGE ZONE MALE FEMALE AGE ZONE MALE FEMALE

15–19 Excellent 57.4+ 49.0+ 40–49 Excellent 47.0+ 40.0+

Very Good 52.4–57.3 43.7–48.9 Very Good 42.7–46.9 35.1–39.9
Good 48.8–52.3 39.5–43.6 Good 35.5–42.6 31.9–35.0
Fair 43.6–48.7 36.8–39.4 Fair 31.9–35.4 27.1–31.8
Poor <43.6 <36.8 Poor <31.9 <27.1

20–29 Excellent 55.6+ 47.2+ 50–59 Excellent 41.8+ 36.6+

Very Good 50.6–55.5 42.0–47.1 Very Good 36.5–41.7 34.0–36.5
Good 47.2–50.5 37.8–41.9 Good 30.1–36.4 31.0–33.9
Fair 41.6–47.1 35.0–37.7 Fair 26.0–30.0 24.6–30.9
Poor <41.6 <35.0 Poor <26.0 <24.6

30–39 Excellent 48.8+ 45.4+ 60–69 Excellent 38.4+ 35.8+

Very Good 45.4–48.7 40.1–45.3 Very Good 32.8–38.3 32.8–35.7
Good 40.1–45.3 36.0–40.0 Good 28.7–32.7 29.6–32.7
Fair 33.7–40.0 33.0–35.9 Fair 23.5–28.6 23.5–29.5
Poor <33.7 <33.0 Poor <23.5 <23.5

CSEP-PATH® Cycle Ergometer Data Collection Worksheet – Tool #22 page 3 / 3

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CSEP-PATH: PREDICTING 1-RM DATA
COLLECTION WORKSHEET
NAME:

DATE (YYYY/MM/DD): AGE (YEARS): WEIGHT (KG): GENDER:

EQUIPMENT USED:

SET 1: SET 2: SET 3: LOWER UPPER

BODY WEIGHT REPS WEIGHT REPS WEIGHT REPS PREDICTED % 1-RM % 1-RM
SEGMENT EXERCISE (kg or lbs) COMPLETE (kg or lbs) COMPLETE (kg or lbs) COMPLETE 1-RM (_____) (_____)

Legs

Chest

Back

Shoulders

Upper
arms

Formula to Predict 1-RM

1-RM = Weight (kg or lbs) ÷ (% 1-RM value from the table

1-RM = (kg or lbs) ÷ ( ÷ 100)
below ÷ 100)

REPS
1 2 3 4 5 6 7 8 9 10
COMPLETED

% 1-RM 100 95 93 90 87 85 83 80 77 75

Predicting 1-RM Data Collection Worksheet – Tool #23 page 1 / 1 Canadian Society for Exercise Physiology

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CSEP-PATH: Y BALANCE TEST DATA
COLLECTION WORKSHEET
NAME:

DATE (YYYY/MM/DD): AGE (YEARS): WEIGHT (KG): GENDER:

EQUIPMENT USED:

REACH DIRECTION RIGHT LEG STANCE LEFT LEG STANCE

Anterior direction (A) Forward Forward

Posterolateral direction (PL) Reach left leg to the back and to the right Reach right leg to the back and to the left
(behind the right leg) (behind the left leg)

Posteromedial direction (PM) Reach left leg back and to the left Reach right leg back and to the right

Limb Length (cm):

(anterior superior iliac spine to the centre of the medial malleolus)

NORMALIZED SCORE
TRIAL 1 (cm) TRIAL 2 (cm) TRIAL 3 (cm) AVERAGE (cm) TO LIMB RELATIVE TO
LENGTH (%)* MEAN

Right Leg Stance

Anterior (A)

Posterolateral
(PL)

Posteromedial
(PM)

Left Leg Stance

Anterior (A)

Posterolateral
(PL)

Posteromedial
(PM)

*to normalize to limb length: take final mean score and divide by limb length and multiply x 100

CSEP-PATH® Y Balance Test Data Collection Worksheet – Tool #24 page 1 / 1

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CSEP-PATH: RATING OF PERCEIVED EXERTION
(RPE) (Scale of 6–20 or Scale of 0–10)

6 0 Nothing at all

Very, very light 0.3

7 0.5 Extremely weak Just noticeable

0.7

Very light 1 Very weak

9

1.5

10

Fairly light 2 Weak Light

11

2.5

12

Somewhat hard 3 Moderate

13

14

Hard 5 Strong Heavy

15

6
16

Very hard 7 Very Strong

17

18

Very, very hard 9

19

10 Extremely strong “Maximal”

20

(BORG, 1982)

Rating of Perceived Exertion (RPE) – Tool #25 page 1 / 1 Canadian Society for Exercise Physiology

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CSEP–PATH: QUICK REFERENCE – HEALTH
BENEFITS RATINGS (HBR) FOR ADULTS
Physical Activity and Sedentary Behaviour Questionnaire (PASB–Q)
AEROBIC PHYSICAL STRENGTH SEDENTARY
HEALTH BENEFIT ACTIVITY PHYSICAL ACTIVITY PERCEIVED BEHAVIOUR
RATINGS (min/week) (times/week) AEROBIC FITNESS (hours/day)

Excellent 300+ 4+ Excellent <2

Very Good 225–299 3 Very Good 2–4

Good 150–224 2 Good 4–6

Fair 75–149 1 Fair 6–8

Poor 0–74 0 Poor >8

Health Risk for BMI and for Combined BMI – Waist Circumference (WC)
BMI (kg/m2) BMI RISK WC FOR MEN (cm) WC FOR WOMEN (cm) BMI–WC RISK

< 18.5 Increased – – –

18.5–24.9 Least ≥ 90 ≥ 80 High

25–29.9 Increased ≥ 100 ≥ 90 Very High

30–34.9 High ≥ 110 ≥ 105 Extremely High

35–39.9 Very High ≥ 125 ≥ 115 Extremely High

≥ 40 Extremely High ≥ 125 ≥ 125 Extremely High

These values apply to adults aged 20–65 years and are based on the North American population (85% Caucasian).

Aerobic Fitness (ml•kg-1•min-1)

AGE ZONE MALE FEMALE AGE ZONE MALE FEMALE

15–19 Excellent 57.4 + 49.0 + 40–49 Excellent 47.0 + 40.0 +

Very Good 52.4–57.3 43.7–48.9 Very Good 42.7–46.9 35.1–39.9

Good 48.8–52.3 39.5–43.6 Good 35.5–42.6 31.9–35.0

Fair 43.6–48.7 36.8–39.4 Fair 31.9–35.4 27.1–31.8

Poor < 43.6 < 36.8 Poor < 31.9 < 27.1

20–29 Excellent 55.6 + 47.2 + 50–59 Excellent 41.8 + 36.6 +

Very Good 50.6–55.5 42.0–47.1 Very Good 36.5–41.7 34.0–36.5

Good 47.2–50.5 37.8–41.9 Good 30.1–36.4 31.0–33.9

Fair 41.6–47.1 35.0–37.7 Fair 26.0–30.0 24.6–30.9

Poor < 41.6 < 35.0 Poor < 26.0 < 24.6

30–39 Excellent 48.8 + 45.4 + 60–69 Excellent 38.4 + 35.8 +

Very Good 45.4–48.7 40.1–45.3 Very Good 32.8–38.3 32.8–35.7

Good 40.1–45.3 36.0–40.0 Good 28.7–32.7 29.6–32.7

Fair 33.7–40.0 33.0–35.9 Fair 23.5–28.6 23.5–29.5

Poor < 33.7 < 33.0 Poor < 23.5 < 23.5

CSEP-PATH® Quick Reference - Health Benefit Ratings – Tool #26 page 1 / 3

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Musculoskeletal Fitness
GRIP STRENGTH PUSH–UPS SIT AND REACH VERTICAL JUMP BACK EXTENSION
(KG) (#) (CM) (WATTS) (S)

AGE (years) MALE FEMALE MALE FEMALE MALE FEMALE MALE FEMALE MALE FEMALE

15–19

Excellent ≥ 108 ≥ 68 ≥ 39 ≥ 33 ≥ 39 ≥ 43 ≥ 4644 ≥ 3167 158–180 169–180

Very Good 98–107 60–67 29–38 25–32 34–38 38–42 4185–4643 2795–3166 135–157 141–168

Good 90–97 53–59 23–28 18–24 29–33 34–37 3858–4184 2399–2794 119–134 122–140

Fair 79–89 48–52 18–22 12–17 24–28 29–33 3323–3857 2156–2398 91–118 91–121

Poor ≤ 78 ≤ 47 ≤ 17 ≤11 ≤ 23 ≤ 28 ≤ 3322 ≤ 2155 ≤ 90 ≤90

20–29

Excellent ≥ 115 ≥ 70 ≥ 36 ≥ 30 ≥ 40 ≥ 41 ≥5094 ≥ 3250 176–180 180

Very Good 104–114 63–69 29–35 21–29 34–39 37–40 4640–5093 2804–3249 133–175 136–179

Good 95–103 58–62 22–28 15–20 30–33 33–36 4297–4639 2478–2803 99–132 102–135

Fair 84–94 52–57 17–21 10–14 25–29 28–32 3775–4296 2271–2477 86–98 66–101

Poor ≤ 83 ≤ 51 ≤ 16 ≤9 ≤ 24 ≤ 27 ≤ 3774 ≤ 2270 ≤ 85 ≤ 65

30–39

Excellent ≥ 115 ≥ 71 ≥ 30 ≥ 27 ≥ 38 ≥ 41 ≥ 4860 ≥ 3193 147–180 180

Very Good 104–114 63–70 22–29 20–26 33–37 36–40 4389–4859 2550–3192 109–146 141–179

Good 95–103 58–62 17–21 13–19 28–32 32–35 3967–4388 2335–2549 91–108 112–140

Fair 84–94 51–57 12–16 8–12 23–27 27–31 3485–3966 2147–2334 56–90 61–111

Poor ≤ 83 ≤ 50 ≤ 11 ≤7 ≤ 22 ≤ 26 ≤ 3484 ≤ 2146 ≤ 55 ≤ 60

40–49

Excellent ≥ 108 ≥ 69 ≥ 25 ≥ 24 ≥ 35 ≥ 38 ≥ 4320 ≥ 2675 130–180 180

Very Good 97–107 61–68 17–24 15–23 29–34 34–37 3700–4319 2288–2674 84–129 115–179

Good 88–96 54–60 13–16 11–14 24–28 30–33 3242–3699 2101–2287 71–83 80–114

Fair 80–87 49–53 10–12 5–10 18–23 25–29 2708–3241 1688–2100 32–70 42–79

Poor ≤ 79 ≤ 48 ≤9 ≤4 ≤ 17 ≤ 24 ≤ 2707 ≤ 1687 ≤ 31 ≤ 41

50–59

Excellent ≥ 101 ≥ 61 ≥ 21 ≥ 21 ≥ 35 ≥ 39 ≥ 4019 ≥ 2559 120–180 110–180

Very Good 92–100 54–60 13–20 11–20 28–34 33–38 3567–4018 2161–2558 88–119 75–109

Good 84–91 49–53 10–12 7–10 24–27 30–32 2937–3566 1701–2160 54–87 47–74

Fair 76–83 45–48 7–9 2–6 16–23 25–29 2512–2936 1386–1700 20–53 15–46

Poor ≤ 75 ≤ 44 ≤6 ≤1 ≤ 15 ≤ 24 ≤ 2511 ≤ 1385 ≤ 19 ≤ 14

60–69

Excellent ≥ 100 ≥ 54 ≥ 18 ≥ 17 ≥ 33 ≥ 35 ≥ 3764 ≥ 2475 ≥ 117 91–180

Very Good 91–99 48–53 11–17 12–16 25–32 31–34 3291–3763 1718–2474 78–116 40–90

Good 84–90 45–47 8–10 5–11 20–24 27–30 2843–3290 1317–1717 52–77 19–39

Fair 73–83 41–44 5–7 2–4 15–19 23–26 2383–2842 1198–1316 20–51 6–18

Poor ≤ 72 ≤ 40 ≤4 ≤1 ≤ 14 ≤ 22 ≤ 2382 ≤ 1197 ≤ 19 ≤5

Quick Reference - Health Benefit Ratings – Tool #26 page 2 / 3 Canadian Society for Exercise Physiology

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One Leg Stance
The following values represent mean times based on the best of two trials conducted. Interpretation will simply categorize clients as above or below the mean
values (i.e., given the lack of evidence upon which to base a more detailed Health Benefit Rating)

AGE GROUP EYES OPEN (sec) EYES CLOSED (sec)

MALE FEMALE MALE FEMALE

18–39 44.4 45.0 16.9 13.1

40–49 41.6 42.1 12.0 13.5

50–59 41.5 40.9 8.6 7.9

60–69 33.8 30.4 5.1 3.6

Y Balance Test
REACH DIRECTION MEAN REACH DISTANCE AS % OF LEG LENGTH

MALE FEMALE

Anterior 79.2 76.9

Posterolateral 90.4 85.5

Posteromedial 95.6 89.1

Forearm Plank
TIME TO FATIGUE IN THE PLANK TEST (ALL VALUES IN SECONDS)

PERCENTILE 10TH 20TH 30TH 40TH 50TH 60TH 70TH 80TH 90TH

Female Non-varsity (n=227) 34 47 56 62 70 79 91 103 130

Female Varsity (n=50) 45 59 63 74 87 97 110 162 194

Male Non-varsity (n=134) 49 72 83 95 103 115 125 142 189

Male Varsity (n=59) 74 84 94 117 125 140 157 183 228

CSEP-PATH® Quick Reference - Health Benefit Ratings – Tool #26 page 3 / 3

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ADVISE:
TOOL PURPOSE

Evaluation Summary Report Adult

Provides clients with a summary of the results of their physical activity, fitness
and lifestyle assessment in terms of the Health Benefit Ratings.
Evaluation Summary Report Youth

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CSEP-PATH:
EVALUATION SUMMARY REPORT – Adult

CLIENT NAME: EXERCISE PROFESSIONAL:

DATE (YYYY/MM/DD): LOCATION:

Physical Activity & Sedentary Behaviour Questionnaire (PASB-Q)

HEALTH BENEFIT RATINGS EXCELLENT VERY GOOD GOOD FAIR POOR

Aerobic Activity: £ 300+ £ 225–299 £ 150–224 £ 75–149 £ 0–74

(minutes/week)

Strength Activity: £ 4+ £ 3 £ 2 £ 1 £ 0
(times/week)

Perceived
£ Excellent £ Very Good £ Good £ Fair £ Poor
Aerobic Fitness:

Sedentary Behaviour: £ <2 £ 2–4 £ 4–6 £ 6–8 £ >8

(hours/day)

Anthropometry Assessment
EXTREMELY
HEALTH RISK RATINGS LEAST INCREASED HIGH VERY HIGH
HIGH

BMI or BMI-Waist £ ____ kg•m2 £ ____ kg•m2 £ ____ kg•m2 £ ____ kg•m2 £ ____ kg•m2
Circumference ____ cm ____ cm ____ cm ____ cm ____ cm
Combined Results:

Aerobic Fitness Assessment

HEALTH BENEFIT RATINGS EXCELLENT VERY GOOD GOOD FAIR POOR

Estimated VO2max:
(ml.kg–1.min–1)

Musculoskeletal Fitness Assessment

HEALTH BENEFIT RATINGS EXCELLENT VERY GOOD GOOD FAIR POOR

Grip Strength (kg):

Push-ups (#):

Sit & Reach (cm):

Vertical Jump (watts):

Back Extension (sec):

CSEP-PATH® Evaluation Summary Report - Adult – Tool #27 page 1 / 2

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Musculoskeletal Fitness Assessment (continued)
PREDICTED 1-RM TEST(S) SCORE

Exercise:

Exercise:

Exercise:

Exercise:
MUSCULAR ENDURANCE TEST SCORE PERCENTILE

Forearm Plank (seconds):

BALANCE TESTS ABOVE MEAN BELOW MEAN

One-Leg Stance – Eyes open (sec)

One-Leg Stance – Eyes closed (sec)

Y Balance Test – Anterior (%)

Y Balance Test – Posterolateral (%)

Y Balance Test – Posteromedial (%)

Health Benefits Rating Summary

The majority of the CSEP-PATH® assessment results are presented in terms of the Health Benefit Ratings
calculated for each of the physical activity, sedentary behaviour, lifestyle and fitness assessments.

HEALTH BENEFIT ASSOCIATED HEALTH BENEFITS

RATINGS AND RISKS GENERAL RECOMMENDATION

Excellent Optimal health benefits Keep up the good work! What are your long-term physical activity goals?
What do you plan to do to keep yourself on-track to achieve them?

Very Good Considerable health benefits Keep up the good work! What are your specific short- and long-term
physical activity goals? What are you planning to do to achieve your
goals to help you stay active for life?

Good Many health benefits What are your specific short- and long-term physical activity goals?
What are you planning to do to achieve your goals and become more
physically active?

Fair Some health benefits, but What are your short-term physical activity goals? What are you planning
also some risks to do to achieve those goals, and then progress further from there?

Poor Considerable health risks What are your short-term goals to begin building physical activity
into your daily life? (Evidence shows that starting with small changes
and building on your successes is the best way to go.) What are you
planning to do to achieve your goals?

Canadian 24-Hour Movement Guidelines

For health benefits, Canadians of all ages should be physically active each day, minimize time spent being sedentary, and
achieve sufficient sleep. See the Canadian 24-Hour Movement Guidelines for all ages at www.csep.ca/guidelines.

Evaluation Summary Report - Adult – Tool #27 page 2 / 2 Canadian Society for Exercise Physiology

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CSEP-PATH:
EVALUATION SUMMARY REPORT – Youth

CLIENT NAME: EXERCISE PROFESSIONAL:

DATE (YYYY/MM/DD): LOCATION:

Physical Activity & Sedentary Behaviour Questionnaire (PASB-Q): 12–17 years

HEALTH BENEFIT RATINGS EXCELLENT VERY GOOD GOOD FAIR POOR

Total Physical Activity: £ 120 + £ 90–119 £ 60–89 £ 30–59 £ 0–29

(minutes/day)

Vigorous Aerobic
Activity: £ 6+ £ 4–5 £ 3 £ 1–2 £ 0
(times/week)

Strength Activity: £ 6+ £ 4–5 £ 3 £ 1–2 £ 0

(times/week)

Perceived Aerobic
£ Excellent £ Very Good £ Good £ Fair £ Poor
Fitness:

Sedentary Behaviour: £ <2 £ 2–4 £ 4–6 £ 6–8 £ >8

(hours/day)

Anthropometry Assessment: Under 20 years

EXTREMELY
HEALTH RISK RATINGS LEAST INCREASED HIGH VERY HIGH
HIGH

BMI or BMI-Waist £ ____ kg•m2 £ ____ kg•m2 £ ____ kg•m2 £ ____ kg•m2 £ ____ kg•m2
Circumference ____ cm ____ cm ____ cm ____ cm ____ cm
Combined Results:

Aerobic Fitness Assessment

HEALTH BENEFIT RATINGS EXCELLENT VERY GOOD GOOD FAIR POOR

Estimated VO2max:
(ml.kg–1.min–1)

Musculoskeletal Fitness Assessment

HEALTH BENEFIT RATINGS EXCELLENT VERY GOOD GOOD FAIR POOR

Grip Strength (kg):

Push-ups (#):

Sit & Reach (cm):

Vertical Jump (watts):

Back Extension (sec):

CSEP-PATH® Evaluation Summary Report - Youth – Tool #28 page 1 / 2

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Musculoskeletal Fitness Assessment (continued)
PREDICTED 1-RM TEST(S) SCORE

Exercise:

Exercise:

Exercise:

Exercise:
MUSCULAR ENDURANCE TEST SCORE PERCENTILE

Forearm Plank (seconds):

BALANCE TESTS ABOVE MEAN BELOW MEAN

One-Leg Stance – Eyes open (sec)

One-Leg Stance – Eyes closed (sec)

Y Balance Test – Anterior (%)

Y Balance Test – Posterolateral (%)

Y Balance Test – Posteromedial (%)

Health Benefits Rating Summary

The CSEP-PATH® assessment results are presented in terms of the Health Benefit Ratings calculated for
each of the physical activity, sedentary behaviour, lifestyle and fitness assessments.

HEALTH BENEFIT ASSOCIATED HEALTH BENEFITS

RATINGS AND RISKS GENERAL RECOMMENDATION

Excellent Optimal health benefits Keep up the good work! What are your long-term physical activity goals?
What do you plan to do to keep yourself on-track to achieve them?

Very Good Considerable health benefits Keep up the good work! What are your specific short- and long-term
physical activity goals? What are you planning to do to achieve your
goals to help you stay active for life?

Good Many health benefits What are your specific short- and long-term physical activity goals?
What are you planning to do to achieve your goals and become more
physically active?

Fair Some health benefits, but also What are your short-term physical activity goals? What are you planning
some risks to do to achieve those goals, and then progress further from there?

Poor Considerable health risks What are your short-term goals to begin building physical activity into
your daily life? (Evidence shows that starting with small changes and
building on your successes is the best way to go.) What are you planning
to do to achieve your goals?

Canadian 24-Hour Movement Guidelines

For health benefits, Canadians of all ages should be physically active each day, minimize time spent being sedentary, and
achieve sufficient sleep. See the Canadian 24-Hour Movement Guidelines for all ages at www.csep.ca/guidelines.

Evaluation Summary Report - Youth – Tool #28 page 2 / 2 Canadian Society for Exercise Physiology

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AGREE:
TOOL PURPOSE

Inventory of Lifestyle Needs and Identifies lifestyle needs that are important to the client and then has them
Activity Preferences choose physical activities that will help meet these needs.

Goal Setting Worksheet Helps clients identify practical, short-term and longer-term goals, and specific
actions for achieving them.

Physical Activity and Exercise Summarizes the physical activity/exercise program.

Prescription Card

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CSEP-PATH: INVENTORY OF LIFESTYLE NEEDS
AND PHYSICAL ACTIVITY PREFERENCES
Please review and consider which of the lifestyle needs listed below are important to you. Once you have
done so, list the three that are most important to you and the kinds of physical activities that would most
likely satisfy those needs. Use the physical activity list below to guide you or add your own ideas.

I feel it is important to me to …

£ like the people I’m with £ release energy

£ be in a group £ improve my health

£ be independent £ have common interests with other people

£ get to know other people well £ be able to contribute something to a group

£ meet many new people £ have other people like me

£ be a leader £ be physically active

£ feel confident £ use my imagination

£ learn something £ create something

£ be in pleasant, attractive surroundings £ find the activity challenging

£ be alone £ feel safe and secure

£ have a structured activity £ try something new and different

£ be able to do things at the last minute £ be myself

£ follow rules £ use my talents

£ be praised £ improve myself and my skills

£ have fun and enjoy myself £ accomplish something

£ release frustration £ relax

£ take a risk £ spend time with my family

£ enjoy the outdoors

Inventory of Lifestyle Needs and Activity Preferences –

Tool #29 page 1 / 2 Canadian Society for Exercise Physiology

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For me, the three most important lifestyle needs are:

1. ___________________________________________________________________________________________________________________

2. ___________________________________________________________________________________________________________________

3. ___________________________________________________________________________________________________________________

I think the following activity would satisfy those needs:

1. ___________________________________________________________________________________________________________________

2. ___________________________________________________________________________________________________________________

3. ___________________________________________________________________________________________________________________

Inventory of Potential Physical Activities:

• Aerobics/Exercise- • Curling • Martial Arts • Snowshoeing

to-music • Dancing • Orienteering • Soccer
• Aquafit • Fencing • Paddleboarding • Squash
• Archery • Floor Hockey • Pickleball • Stair Climbing
• Badminton • Football • Racquetball • Swimming
• Baseball/Softball • Gardening, Yard • Ringette • T’ai chi
• Basketball work • Rollerblading • Table Tennis
• Bicycling (utility or • Golf • Roller Skating • Tennis
pleasure) • Handball • Rowing • Volleyball
• Bowling • Hiking • Running • Walking
• Broomball • Hockey • Sailing • Water Skiing /
• Calisthenics • Horseback Riding Wakeboarding
• Skateboarding
• Camping • Household Chores • Weight Training
• Skiing (X-country)
• Canoeing/Kayaking • Ice Skating • Wind Surfing
• Skiing (downhill)
• Climbing • Inline Skating • Yoga
• Sledge Hockey
• Coaching • Jogging

For more ideas visit the ParticipACTION 150Playlist www.participaction.com

CSEP-PATH® Inventory of Lifestyle Needs and Activity Preferences – Tool #29 page 2 / 2

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CSEP-PATH: GOAL SETTING WORKSHEET
Complete the following exercise to make a formal record of your overall physical activity goals and obstacles.
Its OK to dream a little and make these long-term goals something you’d like to achieve over a year or so –
just be sure to keep them realistic for you. Once you have completed part 1, proceed to breaking down the
overall goals into a more specific set of short-term goals and actions for the next 1–4 weeks. This may also
serve as a tool to help practice SMART goals:

Specific: Well-defined clear actions. “I will be more active each week, during my lunch hour at work”.
Measurable: Objective and quantifiable so both you know when they’ve been achieved. “I will aim for 3 times
a week for 4 weeks in a row”.
Actionable: Based on things you will do. “I will walk twice a week and join a class once a week”.
Relevant: They must be important and meaningful to you. “It is important to me to be more active on a
consistent basis, during the day.”
Timed: Without a set deadline, there is no sense of urgency. “I will begin on Monday and track my progress”.

My long-term physical activity goal is:_______________________________________________________________________________

To achieve this, I need to focus on:_________________________________________________________________________________
I am willing to do the following to make it happen:_________________________________________________________________
Others will know about the change I am making when:____________________________________________________________
I might sabotage my plan by:_______________________________________________________________________________________
Therefore, my promise to myself is:________________________________________________________________________________

Goals and Actions

Goal #1:_____________________________________________________________________________________________________________
Actions:______________________________________________________________________________________________________________

Goal #2:_____________________________________________________________________________________________________________
Actions:______________________________________________________________________________________________________________

Goal #3:_____________________________________________________________________________________________________________
Actions:______________________________________________________________________________________________________________

Success Indicators
1._____________________________________________________________________________________________________________________
2._____________________________________________________________________________________________________________________
3._____________________________________________________________________________________________________________________
Date for next assessment:__________________________________________________________________________________________

Goal Setting Worksheet – Tool #30 page 1 / 1 Canadian Society for Exercise Physiology

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CSEP-PATH: PHYSICAL ACTIVITY AND
EXERCISE PRESCRIPTION CARD

CLIENT NAME:

DATE (YYYY/MM/DD): QUALIFIED EXERCISE PROFESSIONAL:

AEROBIC TRAINING

Goals: Special Considerations:

Warm-up: Cool-down (including stretching):

FREQUENCY & DURATION INTENSITY

ACTIVITY (# sessions & minutes/week) (HRR Range & RPE) PROGRESSION

Additional Notes:

CSEP-PATH® Physical Activity and Exercise Prescription Card – Tool #31 page 1 / 2

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 RESISTANCE TRAINING

Goals: Special Considerations:

Warm-up: Cool-down (including stretching):

SETS X
EXERCISE & EQUIPMENT WEIGHT REST
REPETITIONS

BALANCE TRAINING

Additional Notes:

Physical Activity and Exercise Prescription Card – Tool #31 page 2 / 2 Canadian Society for Exercise Physiology

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ASSIST:
TOOL PURPOSE

Barriers to Physical Activity Allows clients (pre-contemplative and contemplative stage of change) to identify
obstacles or barriers that may be preventing them from becoming more
physically active.

Decision Balance Worksheet Provides clients (contemplative or preparation stage) an opportunity to explore
the possible benefits and drawbacks of increasing levels of physical activity.

First Step Planning Worksheet Helps clients (contemplation phase) discover what their best option is for getting
started on the road increasing physical activity, minimizing sedentary behaviour,
or getting sufficient sleep.

Alternatives for Action Worksheet Helps clients (pre-contemplative and contemplative stage) to consider the
potential benefits and downsides of increasing their physical activity and identify
specific coping strategies.

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CSEP-PATH: BARRIERS TO PHYSICAL ACTIVITY
Anyone considering integrating regular physical activity into their lives may face certain obstacles or barriers.
From the following list of commonly cited barriers to physical activity, indicate the level of importance to your
situation on a scale of 1 to 10 by circling the relevant number.

NOT IMPORTANT VERY IMPORTANT

Previous negative experiences with

1 2 3 4 5 6 7 8 9 10
physical activity

Lack of time 1 2 3 4 5 6 7 8 9 10

Have other areas in my life that I feel

1 2 3 4 5 6 7 8 9 10
must take priority in my day

Costs 1 2 3 4 5 6 7 8 9 10

Lack of energy 1 2 3 4 5 6 7 8 9 10

Lack of knowledge 1 2 3 4 5 6 7 8 9 10

Lack of motivation 1 2 3 4 5 6 7 8 9 10

Lack of skill 1 2 3 4 5 6 7 8 9 10

Feeling uncomfortable or intimidated

1 2 3 4 5 6 7 8 9 10
in a gym

Fear of injury or re-injury 1 2 3 4 5 6 7 8 9 10

Fear of making an existing condition

1 2 3 4 5 6 7 8 9 10
worse

How I see my body 1 2 3 4 5 6 7 8 9 10

Failure to reach goals in past attempts 1 2 3 4 5 6 7 8 9 10

Know that I cannot achieve the goals

1 2 3 4 5 6 7 8 9 10
I want so why bother

Barriers to Physical Activity – Tool #32 page 1 / 2 Canadian Society for Exercise Physiology

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 NOT IMPORTANT VERY IMPORTANT

Lack of access to opportunities such

1 2 3 4 5 6 7 8 9 10
as nearby facilities

Keep talking myself out of it 1 2 3 4 5 6 7 8 9 10

Lack of safe places 1 2 3 4 5 6 7 8 9 10

Lack of child care 1 2 3 4 5 6 7 8 9 10

Lack of partner 1 2 3 4 5 6 7 8 9 10

Lack of available and suitable exercise

1 2 3 4 5 6 7 8 9 10
programs at my level

Lack of support from others 1 2 3 4 5 6 7 8 9 10

Lack of transportation 1 2 3 4 5 6 7 8 9 10

Lack of ability to work at a level for it

1 2 3 4 5 6 7 8 9 10
to be worthwhile

Find that other people pressure me

1 2 3 4 5 6 7 8 9 10
and that bothers me

Other 1 2 3 4 5 6 7 8 9 10

CSEP-PATH® Barriers to Physical Activity – Tool #32 page 2 / 2

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CSEP-PATH: DECISION BALANCE WORKSHEET
Think about the gains and losses/drawbacks you might face by increasing your level of physical activity.
List all of the gains and losses you anticipate (e.g., “I will have more energy” would be a gain for you, while
“My spouse will have to manage the kids dinner and after school sports on their own.” might be a loss to
others). After you have completed your list, score each item by assigning a number from 1 to 3 to indicate
the level of impact that item has on your behaviour (3 = it has a very significant impact; 1 = it has less of an
impact). Add up the scores for each column to determine whether the gains outweigh the losses for you
and for others in your life.

GAINS LOSSES
IMPACT IMPACT
FOR ME (1–3)
FOR ME (1–3)

Score: Score:

IMPACT IMPACT
FOR OTHERS IN MY LIFE (1–3)
FOR OTHERS IN MY LIFE (1–3)

Score: Score:

Decision Balance Worksheet – Tool #33 page 1 / 2 Canadian Society for Exercise Physiology

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Decision Balance
Do your total scores for the gains outweigh the losses?

£ Yes £ No

Strategies for Success

Write down strategies for tipping the balance further in your favour (i.e., ways to increase the gains or
reduce the losses to yourself and others).

1. ___________________________________________________________________________________________________________________

2. ___________________________________________________________________________________________________________________

3. ___________________________________________________________________________________________________________________

CSEP-PATH® Decision Balance Worksheet – Tool #33 page 2 / 2

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CSEP-PATH: FIRST STEP PLANNING WORKSHEET

For health benefits, the Canadian 24-Hour Movement Guidelines recommend that people should be physically
active each day, minimize sedentary behaviour, and achieve sufficient sleep. Choose a first step you would like to
take to move toward the guideline recommendations:

increase physical activity reduce sedentary time sleep well

Write down two benefits you hope to achieve by taking this first step:

1. ___________________________________________________________________________________________________________________

2. ____________________________________________________________________________________________________________________

Choose a strategy that will help you reach your goal or think of your own strategy.

Increase Physical Activity Reduce Sedentary Time Sleep Well

Go for a walk after dinner even if Replace long periods of being Develop a relaxing bedtime routine
it is just 10 minutes. All types and sedentary with light activity (e.g., Avoid caffeine consumption
intensities of physical activity count! standing). in afternoon
Try active commuting (e.g., walking Reduce recreational screen time Turn off screens 30-60 mins
or cycling) even for just part of by keeping screens away from before bedtime.
the journey. bedrooms and eating areas.
Have consistent bed and
 ake it a habit to stand and stretch
M  reak up long periods of sitting
B wake-up times.
while talking on the phone, at work using technology to remind you to
or at home. take breaks.

Your own strategy: _________________________________________________________________________________________________

Try to implement your strategy on just one day. Write down the day you are going to try this strategy.

Day: ___________________________________________________

Think about how you did. Answer the questions below by circling the rating that applies. Add up the numbers
to get a score. If you score 6 or above, that option may be a good one for you to start with. If you scored less
than 6, consider modifying your strategy or trying a different one.

NOT AT ALL A LITTLE A LOT

Did you enjoy it? 1 2 3

Was it convenient? 1 2 3

Could you fit it into your schedule more regularly? 1 2 3

Total score: _______________________________________________

First Step Planning Worksheet – Tool #34 page 1 / 1 Canadian Society for Exercise Physiology

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CSEP-PATH: ALTERNATIVES FOR ACTION
Generate a list of alternatives for realizing your goal to___________________________________________________________

Then, list the advantages and disadvantages attached to each alternative, making sure to consider the ‘pros’
and ‘cons’ for you personally and for others in your life. Circle the alternative that you feel best suits your
needs and consider what coping strategies you might employ to minimize the disadvantages.

Alternative #1: ____________________________________________________________________________________________________

Advantages _____________________________________________ Disadvantages________________________________________

__________________________________________________________ ________________________________________________________

__________________________________________________________ ________________________________________________________

__________________________________________________________ ________________________________________________________

__________________________________________________________ ________________________________________________________

__________________________________________________________ ________________________________________________________

Alternative #2: ____________________________________________________________________________________________________

Advantages _____________________________________________ Disadvantages________________________________________

__________________________________________________________ ________________________________________________________

__________________________________________________________ ________________________________________________________

__________________________________________________________ ________________________________________________________

__________________________________________________________ ________________________________________________________

__________________________________________________________ ________________________________________________________

Coping Strategies: _________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

CSEP-PATH® Alternatives for Action – Tool #35 page 1 / 2

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Example: Cameron would like to increase their daily physical activity to lose weight and achieve better
health. Cameron identifies two alternatives: a) walking after dinner each night and b) joining a fitness class
during lunch hour at work. Cameron identified the ‘pros’ and ‘cons’ as follows:

ADVANTAGES DISADVANTAGES

TO SELF TO OTHERS TO SELF TO OTHERS

My family will
Walking after Time for myself, need to manage
Interferes with
dinner each little organization I can walk the dog the evening
family time
night required activities without
my help

No time for
Set time for activity
Join a fitness Won’t interfere running errands, Less working
will be easier to
class at work family time having lunch with through lunch
adhere to
co-workers

Based on the review of the ‘pros’ and ‘cons’, Cameron decides to try both options i.e., joining a lunchtime
class on Monday, Wednesday and Friday (so there is time on Tuesday and Thursday for errands) and walking
after dinner on Tuesday and Thursday (so the family will need to manage the evening activities only twice
on their own). Cameron also raises a third option, that of convincing the family to walk together on Saturday
and Sunday.

Alternatives for Action – Tool #35 page 2 / 2 Canadian Society for Exercise Physiology

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ARRANGE:
TOOL PURPOSE

Weekly Physical Activity Planner Helps clients plan and keep track their physical activity, and to facilitate review
and Log with the trainer each week (or as frequently as agreed between the trainer and
client).

Relapse Planning Worksheet Facilitates a discussion of things that might derail the client’s efforts and what
strategies might help keep to them on track.

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CSEP-PATH: WEEKLY PHYSICAL ACTIVITY
PLANNER AND LOG
Planning is an important part of making physical activity a regular part of your day. Use this planner to set
aside times for physical activity in your week and then make note of how you do. Use a to indicate an item
was completed as planned, an to indicate a plan did not work out (and note why). It may also be helpful to
make note of how you felt during/after each session of physical activity.

MORNING AFTERNOON EVENING

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Weekly Physical Activity Planner and Log – Tool #36 page 1 / 1 Canadian Society for Exercise Physiology

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CSEP-PATH: RELAPSE PLANNING
WORKSHEET
Congratulations on your decision to improve your health and quality of life by committing to an action plan
for regular physical activity. Evidence indicates that relapses are likely to occur. How you deal with a relapse
can be an important part of the learning process towards success. It is helpful to anticipate and plan for
relapses to determine what you can do to help keep yourself on track.

How confident are you that you will maintain your physical activity action plan over the next three months?

NOT CONFIDENT VERY CONFIDENT

1 2 3 4 5

If your score is 4 or 5, please outline the reasons for your confidence:

_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________

If your score is 1 to 3, please respond to the following questions:

1. What would you need to change to move you up the confidence scale?
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________

2. Have you experienced difficulty before in maintaining a physical activity action plan? Yes No

_If Yes, please explain the difficulty and reasons behind it:________________________________________________________
_____________________________________________________________________________________________________________________
What helped you get back on track?_______________________________________________________________________________
_____________________________________________________________________________________________________________________

3. What situations do you anticipate might make it difficult to maintain your current physical activity action
plan? How could you handle these situations to increase the likelihood of keeping yourself on-track?
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________

4. If you do experience a relapse, what will help you to minimize it and get started again?
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________

CSEP-PATH® Relapse Planning Worksheet – Tool #37 page 1 / 1

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GUIDELINES:
TOOL

Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years)

Canadian 24-Hour Movement Guidelines for Children and Youth (ages 5-17 years)

Canadian 24-Hour Movement Guidelines for Adults 18-64 years

Canadian 24-Hour Movement Guidelines for Adults 65 years and older

2019 Canadian Guideline for Physical Activity throughout Pregnancy

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 0-4 years

0-4 years

CANADIAN 24-HOUR
MOVEMENT GUIDELINES
CANADIAN 24-HOUR
FOR THE EARLY
MOVEMENT YEARS (0-4 YEARS):
GUIDELINES
An Integration of Physical Activity, Sedentary Behaviour, and Sleep
FOR THE EARLY YEARS (0-4 YEARS):
An Integration of Physical Activity, Sedentary Behaviour, and Sleep
PREAMBLE
These Guidelines are relevant to all apparently healthy infants (less than 1 year), toddlers (1-2 years), and preschoolers
(3-4 years), irrespective of gender, cultural background, or the socio-economic status of the family. These Guidelines
PREAMBLE
may be appropriate for young children with a disability or medical condition; however, a health professional should
be consulted for additional guidance.
These Guidelines are relevant to all apparently healthy infants (less than 1 year), toddlers (1-2 years), and preschoolers
(3-4
To years), irrespective
encourage healthy growthof gender, cultural background,
and development, or the socio-economic
young children status of
should receive support the their
from family. Theseand
parents Guidelines
may be appropriate
caregivers that allowsfor foryoung children
an active withwith
lifestyle a disability or medical
a daily balance condition;
of physical however,
activities, a health
sedentary professional
behaviours, and should
sleep.
be consulted
Young childrenforshould
additional guidance.
participate in a range of developmentally appropriate, enjoyable, and safe play-based and
organized physical activities in a variety of environments (e.g., home/child care/school/community; indoors/outdoors;
To encourage
land/water; healthy growth and
summer/winter), bothdevelopment,
independentlyyoung children
as well shouldwith
as together receive
adultssupport fromchildren.
and other their parents and
For infants,
caregivers that allows for an active lifestyle with a daily balance of physical activities, sedentary
supervised activities could include tummy time, reaching and grasping, pushing and pulling, and crawling. The quality behaviours, and sleep.
Young children should participate in a range of developmentally appropriate, enjoyable, and
of sedentary behaviour matters; for example, interactive non-screen-based behaviours (e.g., reading, storytelling, safe play-based and
organized physical activities in a variety of environments (e.g., home/child care/school/community;
singing, puzzles) are encouraged. Developing healthy sleep hygiene in the early years is important; this includes having indoors/outdoors;
land/water; summer/winter),
a calming bedtime routine withboth independently
consistent bedtimes asand
wellwake-up
as together
times,with adults screen
avoiding and othertimechildren. For infants,
before sleep, and
supervised activities could include
keeping screens out of the bedroom. tummy time, reaching and grasping, pushing and pulling, and crawling. The quality
of sedentary behaviour matters; for example, interactive non-screen-based behaviours (e.g., reading, storytelling,
singing,
Followingpuzzles) are encouraged.
these Guidelines through Developing
the earlyhealthy
years issleep hygiene with
associated in thebetter
early growth,
years is cardiorespiratory
important; this includes
and having
a calming bedtime routine with consistent bedtimes and wake-up times, avoiding screen
musculoskeletal fitness, cognitive development, psychosocial health/emotional regulation, motor development, time before sleep, and
keeping screens out of the bedroom.
body composition, quality of life/well-being, as well as reduced injuries. The benefits of following these Guidelines
exceed potential harms.
Following these Guidelines through the early years is associated with better growth, cardiorespiratory and
musculoskeletal
For fitness,
those not currently cognitive
meeting thesedevelopment, psychosocial
24-Hour Movement health/emotional
Guidelines, a progressive regulation,
adjustment motor development,
toward them is
body composition,
recommended. quality to
Adhering of these
life/well-being,
Guidelinesasmay wellbeaschallenging
reduced injuries.
at times;Theresources
benefits ofarefollowing
availablethese Guidelinesat
for assistance
exceed potential harms.
www.BuildYourBestDay.com/EarlyYears.

For those
These not currently
Guidelines were meeting
informedthese 24-Hour
by the Movement
best available Guidelines,
evidence, experta progressive
consensus, adjustment
stakeholdertoward them isand
consultation,
recommended.ofAdhering
consideration to these
values and Guidelines
preferences, may be challenging
applicability, at times;
feasibility, and equity.resources are Guidelines
The specific available for assistance
and at
more details
www.BuildYourBestDay.com/EarlyYears.
on the background research, their interpretation, guidance on how to achieve them, and recommendations for further
research and surveillance are available at www.csep.ca/guidelines.
These Guidelines were informed by the best available evidence, expert consensus, stakeholder consultation, and
consideration of values and preferences, applicability, feasibility, and equity. The specific Guidelines and more details
on the background research, their interpretation, guidance on how to achieve them, and recommendations for further
research and surveillance are available at www.csep.ca/guidelines.

CSEP-PATH® 24-Hour Movement Guidelines: Early Years (0-4) – Tool #38 page 1 / 2

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 Canadian 24-Hour Movement
Guidelines for the Early Years
(0-4 years)
For healthy growth and development,
infants, toddlers, and preschoolers
should achieve the recommended
balance of physical activity, high-quality
sedentary behaviour, and sufficient sleep. MOVE SLEEP SIT

A healthy 24 hours includes:

MOVE SLEEP SIT

INFANTS (LESS THAN 1 YEAR)

Being physically active several times in a variety of ways, 14 to 17 hours (for those aged Not being restrained for more
particularly through interactive floor-based play—more is 0-3 months) or 12 to 16 hours than 1 hour at a time (e.g., in a
better. For those not yet mobile, this includes at least (for those aged 4-11 months) stroller or high chair). Screen
30 minutes of tummy time spread throughout the day of good-quality sleep, time is not recommended.
while awake. including naps. When sedentary, engaging in
pursuits such as reading and
storytelling with a caregiver
is encouraged.

TODDLERS (1–2 YEARS)

At least 180 minutes spent in a variety of physical activities at 11 to 14 hours of good-quality Not being restrained for more
any intensity, including energetic play, spread throughout the sleep, including naps, with than 1 hour at a time (e.g.,
day—more is better. consistent bedtimes and in a stroller or high chair) or
wake-up times. sitting for extended periods.
For those younger than 2
years, sedentary screen time
is not recommended. For
those aged 2 years, sedentary
screen time should be no more
than 1 hour—less is better.
When sedentary, engaging in
pursuits such as reading and
storytelling with a caregiver
is encouraged.
PRESCHOOLERS (3–4 YEARS)

At least 180 minutes spent in a variety of physical activities 10 to 13 hours of good-quality Not being restrained for more
spread throughout the day, of which at least 60 minutes is sleep, which may include a than 1 hour at a time (e.g.,
energetic play—more is better. nap, with consistent bedtimes in a stroller or car seat) or
and wake-up times. sitting for extended periods.
Sedentary screen time should
be no more than 1 hour—less
is better. When sedentary,
engaging in pursuits such as
reading and storytelling with a
caregiver is encouraged.

Replacing time restrained or sedentary screen time with additional energetic play, and trading indoor for outdoor time, while
preserving sufficient sleep, can provide greater health benefits.

24-Hour Movement Guidelines: Early Years (0-4) – Tool #38 page 2 / 2 Canadian Society for Exercise Physiology

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 CANADIAN 24-HOUR
MOVEMENT GUIDELINES
FOR CHILDREN AND YOUTH:
An Integration of Physical Activity, Sedentary Behaviour, and Sleep

PREAMBLE
These guidelines are relevant to apparently healthy children and youth (aged 5–17 years) irrespective of gender, race,
ethnicity, or the socio-economic status of the family. Children and youth are encouraged to live an active lifestyle with
a daily balance of sleep, sedentary behaviours, and physical activities that supports their healthy development.
Children and youth should practice healthy sleep hygiene (habits and practices that are conducive to sleeping well),
limit sedentary behaviours (especially screen time), and participate in a range of physical activities in a variety of
environments (e.g., home/school/community; indoors/outdoors; land/water; summer/winter) and contexts (e.g., play,
recreation, sport, active transportation, hobbies, and chores).
For those not currently meeting these 24-hour movement guidelines, a progressive adjustment toward them
is recommended. Following these guidelines is associated with better body composition, cardiorespiratory
and musculoskeletal fitness, academic achievement and cognition, emotional regulation, pro-social behaviours,
cardiovascular and metabolic health, and overall quality of life. The benefits of following these guidelines far
exceed potential risks.
These guidelines may be appropriate for children and youth with a disability or medical condition; however, a health
professional should be consulted for additional guidance.
The specific guidelines and more details on the background research informing them, their interpretation, guidance
on how to achieve them, and recommendations for research and surveillance are available at www.csep.ca/guidelines.

CSEP-PATH® 24-Hour Movement Guidelines: Children & Youth – Tool #39 page 1 / 2

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 GUIDELINES
For optimal health benefits, children and youth
(aged 5–17 years) should achieve high levels
of physical activity, low levels of sedentary
behaviour, and sufficient sleep each day.

A healthy 24 hours includes:

SWEAT STEP SLEEP SIT

MODERATE TO VIGOROUS LIGHT PHYSICAL ACTIVITY SLEEP SEDENTARY BEHAVIOUR
PHYSICAL ACTIVITY
Several hours of a variety of Uninterrupted 9 to 11 hours No more than 2 hours per day
An accumulation of at least structured and unstructured of sleep per night for those of recreational screen time;
60 minutes per day of moderate light physical activities; aged 5–13 years and 8 to 10 Limited sitting for extended
to vigorous physical activity hours per night for those aged periods.
involving a variety of aerobic 14–17 years, with consistent
activities. Vigorous physical bed and wake-up times;
activities, and muscle and
bone strengthening activities
should each be incorporated
at least 3 days per week;

Preserving sufficient sleep, trading indoor time for outdoor time, and replacing sedentary behaviours and light
physical activity with additional moderate to vigorous physical activity can provide greater health benefits.

24-Hour Movement Guidelines: Children & Youth – Tool #39 page 2 / 2 Canadian Society for Exercise Physiology

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 18-64 years

CANADIAN 24-HOUR
MOVEMENT GUIDELINES
FOR ADULTS AGED 18-64 YEARS:
An Integration of Physical Activity, Sedentary Behaviour, and Sleep

PREAMBLE
This document is intended for use by policy makers, health professionals, and researchers, and it may be
useful to interested members of the public.

These 24-Hour Movement Guidelines are relevant to adults (aged 18-64 years), irrespective of gender, cultural
background, or socio-economic status. These Guidelines may not be appropriate for adults aged 18-64 years who
are pregnant or persons living with a disability or a medical condition; these individuals should consider consulting
the Get Active Questionnaire, disability/condition-specific recommendations, or a health professional for guidance.

Adults aged 18-64 years should participate in a range of physical activities (e.g., weight bearing/non-weight
bearing, sport and recreation) in a variety of environments (e.g., home/work/community; indoors/outdoors;
land/water) and contexts (e.g., leisure, transportation, occupation, household) across all seasons. Adults aged
18-64 years should limit long periods of sedentary behaviours and should practice healthy sleep hygiene
(routines, behaviours, and environments conducive to sleeping well).

Following the 24-Hour Movement Guidelines is associated with these health benefits:

• a lower risk of mortality, cardiovascular disease, hypertension, type 2 diabetes, several cancers, anxiety,
depression, dementia, weight gain, adverse blood lipid profile; and
• improved bone health, cognition, quality of life and physical function.

The benefits of following these Guidelines far exceed potential harms. Following these Guidelines may be
challenging at times; progressing towards any of the Guideline targets will result in some health benefits.

These 24-Hour Movement Guidelines were informed by the best available evidence, expert consensus, stakeholder
consultation, and consideration of values and preferences, applicability, feasibility, and equity. A glossary and more
details on the Guidelines, the background research, their interpretation, guidance on how to achieve them, and
recommendations for further research and surveillance are available at https://csep.ca/guidelines.

CSEP-PATH® Physical Activity Guidelines: Adults (18-64) – Tool #40 page 1 / 2

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 CANADIAN 24-HOUR MOVEMENT GUIDELINES FOR ADULTS (AGED 18-64 YEARS)

For health benefits, adults aged 18-64 years should be physically active each day,
minimize sedentary behaviour, and achieve sufficient sleep.

A healthy 24 hours includes:

PHYSICAL ACTIVITY SLEEP SEDENTARY BEHAVIOUR

Performing a variety of types and Getting 7 to 9 hours of Limiting sedentary

intensities of physical activity, good-quality sleep on time to 8 hours or
which includes: a regular basis, with less, which includes:
consistent bed and
• No more than 3 hours of
wake-up times
• Moderate to vigorous aerobic recreational screen time
physical activities such that

2 H
• Breaking up long periods of
there is an accumulation of at
sitting as often as possible
least 150 minutes per week

• Muscle strengthening
activities using major muscle
groups at least twice a week

• Several hours of light physical

activities, including standing

Replacing sedentary behaviour with additional physical activity and trading light physical activity for
more moderate to vigorous physical activity, while preserving sufficient sleep, can provide greater
health benefits.

Progressing towards any of these targets will result in some health benefits.

Physical Activity Guidelines: Adults (18-64) – Tool #40 page 2 / 2 Canadian Society for Exercise Physiology

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 65 years or older

CANADIAN 24-HOUR
MOVEMENT GUIDELINES
FOR ADULTS 65 YEARS OR OLDER:
An Integration of Physical Activity, Sedentary Behaviour, and Sleep
PREAMBLE

This document is intended for use by policy makers, health professionals, and researchers, and it may be useful
to interested members of the public.

These 24-Hour Movement Guidelines are relevant to adults aged 65 years or older, irrespective of gender, cultural
background, or socio-economic status. These Guidelines may not be appropriate for adults aged 65 years or
older living with a disability or a medical condition; these individuals should consider consulting the Get Active
Questionnaire, disability/condition-specific recommendations, or a health professional for guidance.

Adults aged 65 years or older should participate in a range of physical activities (e.g., weight bearing/non-weight
bearing, sport and recreation) in a variety of environments (e.g., home/work/community; indoors/outdoors; land/
water) and contexts (e.g., leisure, transportation, occupation, household) across all seasons. Adults aged 65 years
or older should limit long periods sedentary behaviours and should practice healthy sleep hygiene (routines,
behaviours, and environments conducive to sleeping well).

Following the 24-Hour Movement Guidelines is associated with these health benefits:

• a lower risk of mortality, cardiovascular disease, hypertension, type 2 diabetes, several cancers, anxiety,
depression, dementia, weight gain, adverse blood lipid profile, falls and fall-related injuries; and
• improved bone health, cognition, quality of life and physical function.

The benefits of following these Guidelines far exceed potential harms. Following these Guidelines may be
challenging at times; progressing towards any of the Guideline targets will result in some health benefits.

These 24-Hour Movement Guidelines were informed by the best available evidence, expert consensus, stakeholder
consultation, and consideration of values and preferences, applicability, feasibility, and equity. A glossary and more
details on the Guidelines, the background research, their interpretation, guidance on how to achieve them, and
recommendations for further research and surveillance are available at https://csep.ca/guidelines.

CSEP-PATH® Physical Activity Guidelines: Older Adults (65+) – Tool #41 page 1 / 2

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 CANADIAN 24-HOUR MOVEMENT GUIDELINES FOR ADULTS (AGED 65 YEARS OR OLDER)

For health benefits, adults aged 65 years or older should be physically active each day,
minimize sedentary behaviour, and achieve sufficient sleep.

A healthy 24 hours includes:

PHYSICAL ACTIVITY SLEEP SEDENTARY BEHAVIOUR

Performing a variety of types and Getting 7 to 8 hours of Limiting sedentary

intensities of physical activity, good-quality sleep on time to 8 hours or
which includes: a regular basis, with less, which includes:
consistent bed and
• No more than 3 hours of
wake-up times
• Moderate to vigorous aerobic recreational screen time
physical activities such that

2 H
• Breaking up long periods of
there is an accumulation of at
sitting as often as possible
least 150 minutes per week

• Muscle strengthening
activities using major muscle
groups at least twice a week

• Physical activities that

challenge balance

• Several hours of light physical

activities, including standing

Replacing sedentary behaviour with additional physical activity and trading light physical activity for
more moderate to vigorous physical activity, while preserving sufficient sleep, can provide greater
health benefits.

Progressing towards any of these targets will result in some health benefits.

Physical Activity Guidelines: Older Adults (65+) – Tool #41 page 2 / 2 Canadian Society for Exercise Physiology

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 Pregnancy

2019 Canadian Guideline

for Physical Activity
throughout Pregnancy

Preamble:
These Guidelines provide evidence-based recommendations regarding physical activity throughout pregnancy in the
promotion of maternal, fetal and neonatal health. In the absence of contraindications (see next page for a detailed
list), following these Guidelines is associated with: 1) fewer newborn complications (i.e., large for gestational age);
and 2) maternal health benefits (i.e., decreased risk of preeclampsia, gestational hypertension, gestational diabetes,
caesarean section, instrumental delivery, urinary incontinence, excessive gestational weight gain, and depression;
improved blood glucose; decreased total gestational weight gain; and decreased severity of depressive symptoms
and lumbopelvic pain).

Physical activity is not associated with miscarriage, stillbirth, neonatal death, preterm birth, preterm/prelabour
rupture of membranes, neonatal hypoglycemia, low birth weight, birth defects, induction of labour, or birth
complications. In general, more physical activity (frequency, duration and/or volume) is associated with greater
benefits. However, evidence was not identified regarding the safety or additional benefit of exercising at levels
significantly above the recommendations. Prenatal physical activity should be considered a front-line therapy
for reducing the risk of pregnancy complications, and enhancing maternal physical and mental health.

For pregnant women not currently meeting these Guidelines, a progressive adjustment toward them is recommended.
Previously active women may continue physical activity throughout pregnancy. Women may need to modify physical
activity as pregnancy progresses. There may be periods when following the guidelines are not possible due to
fatigue and/or discomforts of pregnancy; women are encouraged to do what they can and to return to following the
recommendations when they are able.

These Guidelines were informed by an extensive systematic review of the literature, expert opinion, end-user consultation
and considerations of feasibility, acceptability, costs and equity.

2019 Canadian Guideline for Physical Activity

CSEP-PATH ®
throughout Pregnancy – Tool #42 page 1 / 2

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Recommendations:
The specific recommendations in the 2019 Canadian Guideline for Physical Activity throughout
Pregnancy are provided below.

1
All women without contraindication should be physically active throughout pregnancy.
Specific subgroups were examined:
• Women who were previously inactive.
• Women diagnosed with gestational diabetes mellitus.
• Women categorized as overweight or obese (pre-pregnancy body mass index ≥25 kg/m2).

2 3 4 5 6
Pregnant women Physical activity should Pregnant women Pelvic floor muscle Pregnant women
should accumulate at be accumulated over a should incorporate a training (e.g., Kegel who experience light-
least 150 minutes of minimum of three days variety of aerobic and exercises) may be headedness, nausea or
moderate-intensity per week; however, resistance training performed on a feel unwell when they
physical activity each being active every day activities to achieve daily basis to reduce exercise flat on their
week to achieve is encouraged. greater benefits. the risk of urinary back should modify
clinically meaningful Adding yoga and/or incontinence. their exercise position
health benefits and gentle stretching may Instruction in to avoid the supine
reductions in pregnancy also be beneficial. proper technique position.
complications. is recommended to
obtain optimal benefits.

Contraindications:

All pregnant women can participate in physical activity throughout pregnancy with the exception of those who have contraindications
(listed below). Women with absolute contraindications may continue their usual activities of daily living but should not participate in
more strenuous activities. Women with relative contraindications should discuss the advantages and disadvantages of moderate-to-
vigorous intensity physical activity with their obstetric care provider prior to participation.

Absolute contraindications to exercise Relative contraindications to exercise

are the following: are the following:
• ruptured membranes, • recurrent pregnancy loss,
• premature labour, • gestational hypertension,
• unexplained persistent vaginal bleeding, • a history of spontaneous preterm birth,
• placenta previa after 28 weeks gestation, • mild/moderate cardiovascular or respiratory disease,
• preeclampsia, • symptomatic anemia,
• incompetent cervix, • malnutrition,
• intrauterine growth restriction, • eating disorder,
• high-order multiple pregnancy (e.g., triplets), • twin pregnancy after the 28th week,
• uncontrolled Type I diabetes, • other significant medical conditions.
• uncontrolled hypertension
• uncontrolled thyroid disease,
• other serious cardiovascular, respiratory or
systemic disorder.

2019 Canadian Guideline for Physical Activity

throughout Pregnancy – Tool #42 page 2 / 2 Canadian Society for Exercise Physiology

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Notes

CSEP-PATH® Toolkit 91

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Notes

Toolkit 92 Canadian Society for Exercise Physiology

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Notes

CSEP-PATH® Toolkit 93

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