In the 80s gyms were seen as the place for shiny big muscles and neon spandex gear where the bodybuilders manifested their egos. These days gyms are one of the most popular venues for exercise not only to build muscles, but mostly to improve health and fitness.
Regular exercise reduces the risk of cardiovascular events. Yet, the chances of a cardiovascular event during exercise in patients with cardiac disease can be 10 times higher than in healthy individuals (Fletcher et al., 1995). Leading national and international major industry bodies (e.g. ACSM, EIM, SMA, ESSA, Fitness Australia) recommend that client health screening is undertaken before exercise prescription to minimise the risk of serious injury or cardiovascular events through prudently designed training programs (Goodman, Thomas, & Burr, 2011). Therefore, pre-exercise screening can act as a strong line of defence against legal claims associated with personal injury sustained through an exercise program.
Fitness facilities and professionals in Australia are advised to use the most current Adult Pre-Exercise Screening System (APSS), developed by Fitness Australia, Exercise and Sports Science Australia (ESAA), and Sport Medicine Australia (SMA), to meet their duty of care to their clients (Fitness Australia, 2019). Acknowledging the scientific developments in risk probability and impact assessments an extensive review of the APSS was conducted by a Working Group of experts for a more globalised consistent approach to screening of people wanting to achieve the health and fitness benefits of exercise. The revised version of the APSS has been published in May 2019 which includes an updated two-stage Screening Tool and a User Guide.
The first stage of the APSS is compulsory and based on the identification of: (1) the presence of major signs or symptoms suggestive of chronic diseases or injuries; and (2) an individual’s current level of participation in exercise or physical activity for healthy and safe progression. The second stage of the APSS is recommended to be completed with an exercise professional to determine appropriate exercise prescription based on established risk factors such as age, body composition, blood pressure, cholesterol, musculoskeletal injuries, prescribed medications, and pregnancy.
Overall, the revised national standardised two-staged system aims to improve the ability of the exercise professionals to build referral relationships and engage in professional communication with the allied health and medical professionals about client conditions for most appropriate program design. Exercise professionals can download the freely available new APSS and user tools from: www.fitness.org.au/APSS
Pre-activity screening alone cannot save lives
Fitness professionals should bear in mind that a pre-exercise screening tool cannot detect or prevent hidden health risks. Therefore, screening should be made an integrated part of a comprehensive risk management program. Exercise prescription to clients, especially if they are unaccustomed to exercise, should incorporate both stages of the APSS tool and a progressive transitional phase up to 3 months during which the duration and intensity of exercise are increased gradually with appropriate warm-up and cool-down (Magal & Riebe, 2016). Clients and personal trainers should also be familiarised with the warning signs and symptoms of a cardiovascular event in order to be able to seek and/or apply immediate medical assistance in the event of an emergency situation (Sekendiz, 2014; Sekendiz, Gass, Norton, & Finch, 2014).
References:
Fitness Australia. (2019). Adult Pre-exercise screening system: Guide to the Australian adult pre-exercise screening system. Retrieved from https://fitness.org.au/articles/industry-business-support/adult-pre-exercise-screening-system/94/18/20
Fletcher, G. F., Balady, G., Froelicher, V. F., Hartley, L. H., Haskell, W. L. and Pollock, M. L. (1995). Exercise standards: A statement for healthcare professionals from the American Heart Association Writing group. Circulation, 91(2), 580-615.
Goodman, J.M., Thomas, S.G., & Burr, J. (2011). Evidence-based risk assessment and recommendations for exercise testing and physical activity clearance in apparently healthy individuals. Appl Physiol Nutr Metab, 36(Suppl 1), S14–S32.
Sekendiz, B., Gass, G., Norton, K. & Finch, C. F. (2014). Cardiac Emergency Preparedness in Health/Fitness Facilities in Australia. The Physician and Sportsmedicine, 42(4), 14-19. doi:10.3810/psm.2014.11.2087
Sekendiz, B. (2014) Personal fitness trainers giving tough love: risks and consequences. ACSM’s Health & Fitness Journal, 18(3):8-11.
This article was authored by Dr Betul Sekendiz.