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Barriers to Physical Activity and Exercise
Although the benefits of exercise are clear, clinicians must also
recognize potential risks and barriers.
• Clinicians must assess a patient's f itness for exercise and refer to
specialist care when appropriate.
▶ Ambulatory testing tools for cardiorespiratory f itness, functional
status, and mobility include the six-minute walk test, chair rise test,
and grip dynamometry.
▶ The PAR-Q+ is often used as a pre-participation screening tool to
assess exercise readiness.
• Beyond physical limitations, other barriers to exercise should be
investigated during the patient evaluation, including:
▶ Lack of time, energy, or motivation
▶ Lack of knowledge or skills
▶ Lack of social support
▶ Lack of access (cost, unsafe environment, or adverse weather, etc.)
Risks
• Risks include adverse cardiovascular events and falls.
▶ The most common risk is musculoskeletal injury, such as sprains or
repetitive strain injuries.
▶ Sudden cardiac arrest is uncommon, but risk can be assessed with
pre-exercise screening. For individuals with signif icant cardiovascular
risk, an exercise stress test may be indicated.
▶ In rare cases, excessive exertion may contribute to rhabdomyolysis or
heatstroke.
