3.2 Get Active Questionnaire (GAQ) & Reference Document Protocols
Key Takeaways
The Get Active Questionnaire (CSEP, 2017) replaces all earlier CSEP-endorsed pre-screening tools, including the PAR-Q+.
GAQ Question 1 asks about six items within the past six months: heart disease or chest symptoms, high blood pressure or resting BP of 160/90 mmHg or higher, dizziness during activity, shortness of breath at rest, fainting, and concussion.
A YES answer sends the client to the GAQ Reference Document, which gives advice for each item rather than automatically requiring a physician visit.
The GAQ declaration asks clients to complete the questionnaire again whenever their health changes.
CSEP-CPTs add resting HR and BP checks and three medical-history questions; more than one condition, or an unstable condition, means referral to a CSEP-CEP.
Get Active Questionnaire (GAQ) & Reference Document Protocols
CSEP released the Get Active Questionnaire (GAQ) in 2017 after two years of development. It replaces all previously CSEP-endorsed pre-screening tools, including the PAR-Q+ that CSEP-PATH used before. The GAQ is designed to "screen in" most Canadians for safe physical activity. It identifies the small number of people who should get more advice first, without sending everyone to a physician. It is self-administered and suitable for all ages. A parent or guardian completes it for a child or dependent.
The GAQ is a two-page questionnaire. A separate two-page GAQ Reference Document gives advice for each possible YES answer. For pregnant clients, CSEP publishes a separate Get Active Questionnaire for Pregnancy (see Section 3.5).
Page 1: "Prepare to Become More Active"
The client answers YES or NO to four questions. The form instructs: if you are unsure about any question, answer YES.
| Question | What it asks |
|---|---|
| 1 | Within the past six months, have you experienced any of the following? |
| 1A | A diagnosis of or treatment for heart disease or stroke, or pain/discomfort/pressure in the chest during activities of daily living or physical activity |
| 1B | A diagnosis of or treatment for high blood pressure, or a resting BP of 160/90 mmHg or higher |
| 1C | Dizziness or lightheadedness during physical activity |
| 1D | Shortness of breath at rest |
| 1E | Loss of consciousness or fainting for any reason |
| 1F | Concussion |
| 2 | Do you currently have pain or swelling in any part of your body (from an injury, acute arthritis flare-up 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 or spinal cord injury) that may affect your ability to be physically active? |
NO to all questions sends the client to Page 2. YES to any question sends the client to the Reference Document first.
Page 2: "Assess Your Current Physical Activity" and Declaration
Page 2 asks how many days per week the client does moderate- to vigorous-intensity aerobic activity, and for how many minutes on those days. Adults multiply the two numbers to get minutes per week. The page compares the result with the Canadian 24-Hour Movement Guidelines: at least 150 minutes per week for adults, at least 60 minutes daily for children and youth, and muscle- and bone-strengthening at least twice per week for adults (three times for children and youth). Its general advice:
- Increase activity gradually and reduce prolonged sitting.
- Consult a QEP before vigorous activity if you do not already meet the minimum recommendations.
- Delay becoming more active during a temporary illness.
In the Declaration, the client confirms the information is correct and promises to complete the questionnaire again if their health changes. A client who answered YES ticks one of two boxes:
- "I have consulted a health care provider or QEP who has recommended that I become more physically active", or
- "I am comfortable with becoming more physically active on my own without consulting a health care provider or QEP."
Note
The GAQ itself does not set an expiry date. It does require the client to complete it again whenever their health changes. Treat any new symptom, diagnosis or medication change as a reason to re-screen.
The GAQ Reference Document: Advice for Each YES
| YES to | Reference Document advice (summary) |
|---|---|
| 1A Heart disease, stroke or chest symptoms | Activity is likely beneficial. If treated for heart disease but you have not completed a cardiac rehabilitation program in the past 6 months, consult a doctor; supervised cardiac rehab is strongly recommended. New chest pain/pressure: talk to a doctor. |
| 1B High blood pressure | Activity is likely beneficial if BP is diagnosed and treated. If unsure of resting BP, have it measured by a health care provider or QEP. If BP is 160/90 or higher, get medical clearance and consult a QEP. |
| 1C Dizziness during activity | Consult a health care provider before becoming more active; until then, do not increase intensity. |
| 1D Shortness of breath at rest | If it is asthma relieved by medication, light to moderate activity is safe; if not relieved by medication, consult a doctor. |
| 1E Fainting or loss of consciousness | Consult a doctor first; once cleared, consult a QEP about suitable activity. |
| 1F Concussion | Increasing activity while symptomatic can worsen symptoms and prolong recovery; a health care provider decides when activity can start, and a QEP can help. |
| 2 Pain or swelling | New pain or swelling: consult a health care provider. Otherwise move joints gently through the pain-free range, choose low-impact activities, and resume gradually below the pre-flare level. |
| 3 Told to avoid or modify activity | Follow the health care provider's advice; a QEP builds a plan around it. |
| 4 Other condition | Regular activity helps manage many conditions; a QEP can tailor safe activity. |
What the CSEP-CPT Does With the GAQ
The GAQ is a self-screening tool, but a CSEP-CPT does not stop there. CSEP's CSEP-CPT Pre-Participation Screening Procedures add professional steps within Step 1 – Ask:
- Review the GAQ. Some answers mean the client should first get clearance from a health care provider, for example chest pain or pressure during daily activities or exercise, dizziness during activity, or a recent concussion.
- Measure resting HR and BP. Above 100 bpm, or above 160 mmHg systolic or 90 mmHg diastolic, the client sees a health care provider or is referred to a CSEP-CEP.
- Ask the three medical-history questions (diagnosed or suspected condition, related symptoms, medications) whatever the GAQ answers were.
- Consider current activity level from the GAQ or the PASB-Q. Regular activity lowers exercise-related cardiovascular risk.
- Judge the risk of an adverse event. A CSEP-CPT may work with one diagnosed condition that is stable. CSEP defines stable as medically managed with no symptoms, no change in medication or treatment plan in the past 6 months, and prescribed medication taken as directed. The CSEP-CPT Health Screening Tool checks the common conditions (Section 3.4).
Clearance for clients who need it comes from a physician, using the CSEP-PATH Physician Guidance for Physical Activity Form, which earlier toolkits called the Physician Physical Activity Readiness Clearance. It can also come from a CSEP-CEP, whose scope allows them to clear clients with one chronic condition to work with a CSEP-CPT.
| Screening finding | CSEP-CPT action |
|---|---|
| NO to all GAQ questions; resting HR and BP within limits; no condition or medication | Proceed to Step 2 – Assess |
| One stable, managed condition; no check marks on the Health Screening Tool | Proceed, starting at the client's current activity level |
| Chest pain or pressure, dizziness during activity, fainting or recent concussion | Medical clearance first |
| Resting BP above 160/90 mmHg or HR above 100 bpm | Health care provider clearance or CSEP-CEP |
| More than one medical condition, an unstable condition, or unclear health information | Refer to a CSEP-CEP (or a health care provider for clearance) |
Tip
CSEP adds a prudence rule. A client without diagnosed hypertension whose resting systolic pressure is above 140 mmHg should be encouraged to discuss it with a physician, even though it is below the 160/90 screening limit.
A client checks YES to Question 1B on the Get Active Questionnaire because their resting blood pressure was 162/94 mmHg at a pharmacy kiosk last week. They have never been diagnosed with hypertension. What does the GAQ Reference Document advise?
Physical activity is likely beneficial, so the client may begin vigorous training immediately without further steps.
The client should receive medical clearance and consult a qualified exercise professional about safe, appropriate activity.
The client should repeat the GAQ in 12 months, because only two readings above 160/90 mmHg count as a YES.
The client should complete the PAR-Q+ instead, because the GAQ does not screen for blood pressure.
While completing Page 1 of the GAQ, a 55-year-old client checks 'YES' to having high blood pressure. They explain that they take a daily ACE inhibitor prescribed by their family physician, their blood pressure has been well-controlled for three years, and they have no other symptoms or medical conditions. Using the GAQ Reference Document and the CSEP-CPT screening procedures, what is the appropriate determination?
Proceed with activity and submaximal testing once resting BP is confirmed within the screening limits, emphasizing aerobic and dynamic resistance work.
Defer the client and send them for medical clearance, because any YES answer on the GAQ requires a signed physician clearance form first.
Allow maximal aerobic testing and heavy isometric strength testing without checking resting blood pressure, because the condition is controlled.
Transfer the client to a registered physiotherapist for clinical rehabilitation before any personal training can begin.
A new client answers YES to GAQ Question 1A, reporting heavy chest tightness spreading down the left arm while climbing stairs twice in the past month, with lightheadedness. What is the correct CSEP-CPT response?
Proceed with modified low-intensity exercise, keeping heart rate below 50% of heart rate reserve.
Administer the mCAFT to see whether the chest tightness recurs during the stepping stages.
Do not assess or exercise the client; they need medical evaluation and physician clearance first.
Have the client rest for 5 minutes, drink water, and continue if resting heart rate is below 100 bpm.
Sections you finish are checked off in the contents.