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Table 1 Safety screening for kinesiologists working with people with chronic neurological conditions

From: Advancing motor rehabilitation for adults with chronic neurological conditions through increased involvement of kinesiologists: a perspective review

Health History Safety Screen* (not an exhaustive list)
Questionnaires
CSEP Get Active Questionnaire or equivalent screening tool
Medical Concerns*
Recent surgery Uncontrolled medical conditions
Sudden change in health status Uncontrolled blood pressure or heart rate/rhythm
Not taking prescribed medications Uncontrolled heart condition
 > 1 chronic health condition
Additional screening considerations common in neurological conditions
Pain Pain that limits range of motion may require further assessment
Shoulder subluxation/step deformity Limit to lower extremity if subluxation present
If subluxation corrected, can continue with task-oriented skill practice with caution. Work in pain-free range
Spasticity that limits range of motion Use caution with task-oriented skill practice
Autonomic dysreflexia Use caution. Low risk with task-oriented skill practice
Impaired thermoregulation Use caution as overheating can exacerbate conditions. Low risk with task-oriented skill practice but should be monitored
Altered somatosensation Use caution with task-oriented skill practice as less somatosensory feedback can lead to injury
Altered sensory processing Use caution and adapt for sensitivities to light, noise, touch, etc
Altered cognition May require single step commands during practice
Altered communication May require adaptations or assistance to communicate
Poor balance May require individual to hold on during lower extremity task
Poor coordination May require additional stabilization or guidance
Safety flags during exercise* (not an exhaustive list)
Angina (chest pain/tightness) Facial expressions that signify distress
Shortness of Breath or Dyspnea Significant pain
Excessive sweating (diaphoresis) Pale, or blueish/greyish appearance (pallor or cyanosis)
Nausea Light-headedness or confusion
Heart palpitations
Numbness/tingling
Exercise related musculoskeletal injury like repetitive strain (risk is low with task-oriented skill practice)
Other unmanaged health concerns Blurred vision
  1. The listed concerns require follow up with physician. See ACSM’s Guidelines for Exercise Testing and Prescription, 11th ed. [30] for other contraindications to exercise