Background

As part of the induction process members should be asked to complete medical screening in the form of a PAR-Q form (Physical Activity Readiness Questionnaire), commonly known as a Health Questionnaire.  PAR-Qs can normally be downloaded from the training provider’s website or completed at the venue.

The PAR-Q was created by the British Columbia Ministry of Health and the Multidisciplinary Board on Exercise, and although the exact wording and questions on PAR-Q forms varies between training providers, the general health information is the same.  It was designed to be a self-screening tool that can be used by anyone planning to start an exercise programme and it is often used by fitness professionals to determine the safety or possible risk of exercising for an individual based upon their answers to specific health history questions.

Although being physically active is very safe for most people there are some people who should check with their medical professional before they increase their current level of physical activity.  With this in mind, the PAR-Q has been designed to identify the small number of adults for whom physical activity may be inappropriate or those who should have medical advice concerning the type of activity most suitable for them.

There a number of versions of the PAR-Q depending upon your requirements:

• PAR-Q and YOU: this is a 2-page form to see if you should check with your medical professional before becoming much more physically active.
• PAR-Q+: this is a 4-page form for pre-screening prior to physical activity participation and includes additional questions on chronic conditions for further probing by qualified exercise physiologists (this form should not be offered by fitness instructors).
• PARmed-X: this is a 4-page physical activity-specific checklist to be used by a medical professional with patients who have had positive responses to the PAR-Q and YOU.
• PARmed-X for Pregnancy: this is a 4-page guideline for health screening prior to participation in a prenatal fitness class or other exercise.   It is for use by health care providers and fitness professionals.
• GPPAQ (General Practice Physical Activity Questionnaire): this is a 1-page validated screening tool for use in primary care by general practitioners that can be used to assess adult (16-74) physical activity levels (NICE, 2006).  The tool generates a simple 4-level Physical Activity Index (PAI) categorising people as:
  • Inactive: sedentary job and no physical exercise or cycling.
  • Moderately inactive: sedentary job and some but <1 hour physical exercise and/or cycling per week; or standing job and no physical exercise or cycling.
  • Moderately active: sedentary job and 1-2.9 hours physical exercise and/or cycling per week; standing job and some but <1 hour physical exercise and/or cycling per week; or physical job and no physical exercise or cycling.
  • Active: sedentary job and ≥3 hours physical exercise and/or cycling per week; standing job and 1-2.9 hours physical exercise and/or cycling per week; physical job and some but <1 hour physical exercise and/or cycling per week; or heavy manual job.

All persons who receive a score less than ‘Active’ should be offered a brief intervention supporting behaviour change to increase their physical activity. It is used as part of the NHS Health Check programme to assess people’s risk of heart disease, stroke, kidney disease and diabetes.

PAR-Q Questions

Although the format and structure of the PAR-Q may vary between training providers, generally a trial member will be asked the following questions:

Serial	Question	Answer
1	Do you have a bone or joint problem such as arthritis, which has been aggravated by exercise or might be made worse with exercise?	Yes/No
2	To your knowledge, do you have high blood pressure?	Yes/No
3	To your knowledge, do you have low blood pressure?	Yes/No
4	Do you have Diabetes mellitus or any other metabolic disorder?	Yes/No
5	Has your doctor ever said that you have raised cholesterol (serum level above 6.2mmol/L)?	Yes/No
6	Do you have or ever suffered a heart condition?	Yes/No
7	Have you ever felt pain in your chest when you do physical exercise?	Yes/No
8	Is your doctor currently prescribing you drugs or medication?	Yes/No
9	Have you ever suffered from shortness of breath at rest or with mild exercise?	Yes/No
10	Is there any history of Coronary Heart Disease within your family?	Yes/No
11	Do you ever feel feint, have spells of dizziness or have ever lost consciousness?	Yes/No
12	Do you currently drink more than the average amount of alcohol per week? 21 units for men and 14 units for women (1 unit = 1⁄2 pint of beer/cider or 1small glass of wine)	Yes/No
13	Do you currently smoke?	Yes/No
14	You do NOT currently exercise regularly (at least 3 times per week) and/or work in a job that is physically demanding.	Yes/No
15	Are you, or is there any possibility that you might be pregnant?	Yes/No
16	Do you know of any other reason why you should not participate in a programme of physical activity?	Yes/No

PAR-Q and Self-declaration

One of the issues with self-declaration is probity.  A fitness professional will review the completed PAR-Q form, and may need to ask further questions, to make a reasoned judgement on whether a trial member should proceed onto an exercise programme or be referred to a medical professional for assessment.  As noted in the associated page ‘Medical Screening: Military Perspective‘ self-declaration has some problems.

Downloadable Forms

Please go to the downloads section of the blog.

Adult Pre-Screening System

In 2014 the Adult Pre-Exercise Screening System (APSS) was published. The new APSS provides an evidence-based system for identifying and managing health risks for exercise. APSS was developed in partnership by Fitness Australia, Exercise and Sports Science Australia (ESSA) and Sports Medicine Australia (SMA).

Exercise Professionals are all too aware (or should be) of the risks involved in prescribing exercise and the need for a consistent standard of professional practice in the fitness industry. Besides the actual Pre-Exercise Screening Tool there are a number of other useful media:

• Pre-Exercise Screening Tool;
• Pre-Exercise Screening Textbook;
• Recorded Pre-Exercise Screening System webinar;
• Factsheet; and
• Frequently Asked Questions (FAQs).