Physical Activity Vital Sign (PAVS): what the questions ask, how to calculate your weekly minutes and how to read them over time

Your doctor's office asked how often you exercise and for how long. Or you want one honest number for your own activity. That is the Physical Activity Vital Sign (PAVS): two questions, one multiplication, minutes per week. A paper diary works, or the workout check-in in Sam asks you every 30 days and sends a reminder.

In Sam, the PAVS belongs to the Workout program (shown as Exercise in the app). It is one of Sam's lifestyle programs. It combines a weekly goal of active days, workouts from Apple Health and this check-in. This text explains what the questions ask, how to calculate and read your number, and how accurate it is.

What does the PAVS ask?

The PAVS is a short form from Exercise is Medicine, an initiative of the American College of Sports Medicine (ACSM). We describe its questions in our own words here.

• The first asks about an average week in the last 30 days. On how many days did you do moderate to vigorous activity? The form's examples include brisk walking, running, dancing, swimming and cycling.
• The second asks how many minutes you usually spent on those days.
• An optional third question asks how often per week you did muscle-strengthening exercise. The form calls it especially important for older adults.

The two core questions come from the Exercise Vital Sign. Kaiser Permanente Southern California built it into its health records in 2009, with input from Exercise is Medicine experts. In a clinic, it takes less than a minute (Coleman et al., 2012). In 2015, ACSM and Kaiser Permanente called for asking it at every visit, for every patient (Sallis et al., 2016).

How do you calculate your weekly minutes?

Multiply the two answers. Four active days of 30 minutes give 120 minutes per week. Five days of 30 minutes give 150. The strength question does not enter this number.

Two details matter when you read the result. First, the total counts every minute the same, whether it was a brisk walk or a hard run. The form itself notes that in the guidelines, one vigorous minute counts like two moderate ones. So 75 vigorous minutes can already meet them. Second, light activity such as a casual stroll is not part of the PAVS. The form still says it benefits health.

For more detail, the IPAQ short form asks about vigorous and moderate activity, walking and sitting in the last seven days. In Sam, the IPAQ belongs to the Movement program, with a daily step goal. The PAVS belongs to the Workout program.

What does your number mean against the guidelines?

For adults, the WHO recommends 150 to 300 minutes of moderate activity a week. Or 75 to 150 minutes of vigorous activity, or a mix. It adds muscle-strengthening on two or more days a week. More than 300 minutes can bring further benefits, and some activity is better than none (Bull et al., 2020).

The PAVS form has no score bands of its own. Studies sort the answers along the 150-minute line.

• At Kaiser Permanente, 0 minutes meant inactive, 1 to 149 insufficiently active, 150 or more sufficiently active. About 1.5 million adults had an answer in their record. Of these, 36 percent said 0 minutes and 33 percent 1 to 149. Another 30 percent reached 150 (Coleman et al., 2012).
• A US family medicine clinic sorted its patients by their answers across all their visits. About 18 percent reported 0 minutes at every visit and 34 percent at least 150 at every visit. The other 48 percent fell in between (Lin et al., 2022).

Sam labels your result with the same guideline marks. Under 150 minutes reads "Insufficiently Active", 150 to 299 "Active", and 300 or more "Highly Active". These labels are Sam's wording on the WHO marks, not part of the PAVS form. A label describes your answer, not your health. How much activity suits you with a heart, lung or joint condition is a question for your doctor.

How accurate is a two-question answer?

It is a self-report. It depends on your memory and on your own sense of what counts as moderate. At Kaiser Permanente, the answers came out lower than in national US surveys. The authors say the questions may give more conservative estimates (Coleman et al., 2012). The pattern still fit: older patients, women, people with obesity and people with more illnesses more often reported no exercise.

A related version at Intermountain Healthcare in Utah also asks about intensity. In 269 patients, it agreed moderately with a longer questionnaire (kappa 0.55). Its weekly minutes correlated with the longer one (r = 0.71). On average, though, it gave about 86 minutes per week less (Ball et al., 2016).

A 2017 review screened 838 articles and found nine studies on five short tools of this kind. In one small group, the Exercise Vital Sign correlated only weakly with an activity sensor (r = 0.27). No study had tested whether using these tools changes how active people become (Golightly et al., 2017).

Translations are a gap. A university psychiatric clinic in Berlin used a slightly changed German version of the two questions. Its authors note that the German wording has not yet been validated (Roempler et al., 2023). The German questions in Sam are a translation as well, not a validated version.

So read your number as a rough estimate. It is most useful next to your own earlier answers.

How do you read your trend over several months?

One answer describes an average week, and weeks vary. A cold, a trip or a busy month can move the number without a lasting change. Look at three or four answers in a row. Then ask yourself three questions.

• Does the line rise, fall or stay flat across several check-ins?
• Does a dip match something you know about, like an illness or travel?
• Did you cross 150 minutes once, or stay above it for two check-ins or more?

The questions cover the last 30 days, so answering once a month gives answers that do not overlap. For the strength question, the WHO mark is two or more days a week. If your trend surprises you, take it to your next appointment and talk it through.

How does the PAVS check-in work in Sam?

You answer the PAVS when you start the Workout program in Sam, then every 30 days. When a check-in is due, Sam sends a reminder and one follow-up three days later. You can also answer in between. That extra answer does not move the monthly schedule.

Sam asks the three PAVS questions in its own slightly shortened wording. Days run from 0 to 7, minutes per day from 0 to 180 in steps of five. The strength question asks for days per week and is part of every check-in. Sam multiplies days by minutes and shows the result with its label. Unless your answers already show a solid routine, Sam picks one focus for the month: build a base, add a moderate session or add a challenge.

Apart from the questionnaire, Sam counts your workouts. Every workout in Apple Health of 15 minutes or more counts, walks aside. Two on one day count as one active day. Your weekly goal is 1 to 7 such days. So the program holds both: what you remember and what Apple Health recorded.

Your check-ins stay in a history. "Export for your doctor" creates a PDF with your scores, labels, changes, a chart and your latest answers. It covers up to the 12 most recent check-ins. The monthly report shows your latest score, the change since your first check-in and a trend line. The monthly report guide walks through it. If you like, share your program progress with a person you choose through Friends & Family. They see it read-only, including your check-in scores.

Track your weekly minutes in Sam and bring the trend to your doctor

You arrive with months of answers instead of a guess about last week. The workout check-in in Sam asks the PAVS every 30 days.

• Instead of a note you lose: every answer stays in one history. It carries a label against the 150-minute mark and the change since last time.
• Instead of telling it from memory: the PDF for your doctor shows your scores, a chart and your latest answers.
• Instead of the questionnaire alone: your weekly goal counts Apple Health workouts of 15 minutes or more, in the same app.
• Instead of a calendar note: a reminder comes when the next check-in is due.

Sam records what you answer and what Apple Health holds. It does not plan your training.

Try Sam for free

Sam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any condition or health state. Always consult qualified professionals for medical decisions.

Related reading

• How to measure weekly physical activity with the IPAQ
• How to read your monthly health report, page by page
• How to use the MOS Sleep Scale and read your score
• How to read your MIDAS migraine disability score
• Heart rate recovery after exercise

Sources

Updated: October 2026

• Exercise is Medicine (ACSM): Physical Activity Vital Sign, patient form, copyright 2025. Copy hosted by Endicott College. The form's former address on exerciseismedicine.org now redirects to acsm.org.
• Sallis RE et al.: Call to Action on Making Physical Activity Assessment and Prescription a Medical Standard of Care. Curr Sports Med Rep 2016;15(3):207-214, PDF on acsm.org.
• Coleman KJ et al.: Initial Validation of an Exercise "Vital Sign" in Electronic Medical Records. Med Sci Sports Exerc 2012;44(11):2071-2076, DOI 10.1249/MSS.0b013e3182630ec1.
• Ball TJ et al.: Concurrent Validity of a Self-Reported Physical Activity "Vital Sign" Questionnaire With Adult Primary Care Patients. Prev Chronic Dis 2016;13:150228, CDC.
• Golightly YM et al.: Physical Activity as a Vital Sign: A Systematic Review. Prev Chronic Dis 2017;14:170030, CDC.
• Lin CY et al.: Implementation of a Physical Activity Vital Sign in Primary Care. Prev Chronic Dis 2022;19:210457, CDC.
• Roempler J et al.: physical activity during an inpatient stay at a psychiatric clinic in Berlin, asked with two questions. Eur Arch Psychiatry Clin Neurosci 2023;273(4):983-994, Europe PMC.
• Bull FC et al.: World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020;54(24):1451-1462, DOI 10.1136/bjsports-2020-102955.