Professional perspectives on physical activity screening practices: Shifting the paradigm

Contexts: This was a qualitative study with focus groups that included researchers and health care providers with expertise in exercise and physical activities with adults. Objective: The purpose of this study was to explore professional perspectives on current practices and beliefs about screening of older adults prior to having them initiate a structured or independent physical activity program appropriate for their physical ability and interests. Design and setting: This qualitative study included five different focus groups held at four national professional meetings based on a standard interview guide. Participants: Forty-two practitioners and researchers participated in these focus groups. These individuals were selected for participation based on their expertise in aging, primary care, exercise science, or behavioral science. Results: The focus groups revealed professional perspectives articulating advantages and disadvantages of pre-exercise screening. Four major themes were identified: (1) rationale for physical activity screening; (2) rationale for no screening prior to physical activity; (3) knowledge gaps and research needs; and (4) recommendations for new screening guidelines. Conclusions: Results suggested there was a need for a paradigm shift in screening from an 'exclusions' focus to an emphasis on individualized physical activity programs that would result in optimal benefits while preventing rare but possible activity-induced adverse events. Future research needs were delineated and focused on gaining a better understanding of the effectiveness and use of screening measures in identifying cardiovascular and musculoskeletal problems associated with specific physical activities and exercise.