Preparticipation Health Screening, Medical Clearance, and Informed Consent

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PreparticipationHealth Screening, Medical Clearance, and Informed Consent



Dailyexercise has numerous health benefits. However, it comes with somerisks including myocardial infarction and sudden cardiac deathespecially during the intensive exercise by people with heartdiseases or high blood pressure. Therefore, preparticipation healthscreening is necessary to eliminate such risks. In this experiment,Preparticipation health screening was conducted on individual, bybeing allowed fill in PAR-Q+ questionnaires. His results revealedthat he had some bone, muscle, and soft tissue problems. However, hestill qualified to do exercise tests but under supervision.

Keyword:PAR-Q+, Preparticipation, questionnaires, exercise test, ACSM.

Participationin daily exercise is associated with countless health benefits. Inaddition to helping an individual to maintain a healthy weight andshape, it strengthens body muscles, keeps bones strong as well asimproving the skin smoothness and condition. Besides, physicalworkout increase relaxation, sleep and promote good mood, enhancesfunction and more. Even though participations in sports or physicalworkout come with numerous benefits, there are scientifically risksassociated with the activity. Despite the fact, there is a high riskof musculoskeletal injury during body workout the major worry is theincreased risk of myocardial infarction and sudden cardiac death thatis associated with extensive physical exercise.

Themajor goal and objective of public health are to encourage andincrease people’s participation in daily, moderate-to-vigorous bodyworkout. Chase of this goal should incorporate a process thatidentifies people at higher risk for adverse events related to aphysical workout. At the same time, the process of riskstratification should not present a major barrier to participation(Swain, 2014).

Accordingto American of Sports Medicine recommendation (2013), healthy people(adolescents, children, women of less than 55 years, and men of ageless than 45 years) who are free from major coronary risks factors orheart disease are exempted from pre-participatory health screening. The potential participants ought to be screened for the symptoms,signs, presence, and risk factors of different pulmonary,cardiovascular and metabolic diseases and other conditions such asorthopedic injury, a pregnancy that demand special attention tooptimizing safety during workout testing and help to develop aneffective and safe exercise prescription. The reason forpreparticipation health screening is to help (Swain, 2014):

  • Identify people with medical contraindications for barring from workout activity programs until such conditions are under control or abated.

  • Detecting people at risk for disease due to symptoms, age, and risk factor who ought to undergo a clinical assessment and exercise testing before participating in an exercise program or raising the intensity, duration or frequency of their current program.

  • Recognize individuals with clinically significant ailments or conditions who need to participate in an exercise program that is medically supervised.

  • Identifying special requirements of persons that may affect exercise programming and testing.

Accordingto ACSM (2013), preparticipation health screening is a processconsisting of three main steps:

i.Stratification of risk

ii.Workout testing and recommendation for participation depending on thecategory of risk

iii.Exercise testing as well as supervision recommendations testing basedon the type of risk.

Alongsidepreparticipation health screening, participants should also fill inan informed assent document to provide them with clear and preciseinformation of what is required of them during the exercise test.After understanding and accepting the set conditions as per the form,participants will have to sign consent document before beingpermitted to do exercise test. In the case, the results of apreparticipation health screening report reveal that workout maycause a health risk to a participant the person should be encouragedto seek permission from a medical doctor before participating in theexercise. (Swain, 2014).


Todescribe the procedures employed in conducting preparticipationhealth screening.


PAR-Q,Physical Activity Readiness Questionnaire for everyone.


PAR-Q+was administered to the individual before being instructed tocomplete the first seven questions. Persons who answered ‘’yes’’to at least one of the first seven questions were instructed to seekthe permission of a physician before participating in the exercise.These individuals were informed to tell the physician the issues theyhad ‘’yes’’ as answers on the PAR-Q+. The individuals werealso to inquire from the physician which exercise test should orshould not be performed. Persons who had ‘’no’’ answers toall the first seven questions were allowed to do the exercise test. The next step was to conduct pre-exercise testing Statusquestionnaire. The individuals were instructed to complete thegeneral information at the questionnaire top, and Section A throughSection G. The completed questionnaire was evaluated, anddetermination, whether an individual was safe to perform a particularexercise test, was performed. People who seemed to be at health riskduring such exercise were instructed to contact a physician and getmedical clearance before doing the test. The qualified participantwas then given the “informed consent for a bench press 1-RM testform’’ to sign in the presence of a witness and person conductingthe test before proceeding to perform the test.


Theresult for the individual shows that he had a ‘’yes’’ in oneof the first seven questions. The participant is either experiencinga bone, joint, or soft tissue (tendon, ligament, or muscle) problemthat physical exercise could have aggravated the condition. Theparticipant had a normal blood pressure, heart condition, and do notfeel any pain in his chest at rest or while conducting any physicalactivity. The participant had also not fainted in the last 12-months.The participant has not been diagnosed with any other chronicconditions in his life. Lastly, the participants seemed to be wellsince he has not been instructed by the doctor to do only medicallysupervised exercise.

Forthe follow-up a medical condition, the individual reported of havingback problems, osteoporosis, or arthritis. He also indicateddifficulty in controlling his conditions with medications or otherprescribed therapy by physicians. The participant is currently undermedication. In addition, he either has had steroid injections or hadtaken steroid tablet for more than three months. However, theparticipant did not report joint issue causing pain, recent fracturedue to cancer or osteoporosis. The individual’s heart orcardiovascular condition and blood pressure was normal. Theparticipant also reported normal metabolic conditions includingdiabetes. The participant’s mental conditions were normal andhealthy and never has learning difficulties. It means he is free fromconditions such as Alzheimer’s, depression, dementia, eatingdisorder, Down syndrome, intellectual disability, anxiety disorderand psychotic disorder. The individual has also never suffered anyspinal cord injury including paraplegia and tetraplegia. Theparticipant was also free from stroke and any other medicalconditions.


Q.1 Based on the results from the questionnaires, could the individualsafely perform the following exercise tests?

BenchPress-Repetition maximum (1-RM), Strength test— (NO)

RMbench press test is an RM test mainly for the upper body. Thisexercise test measures maximum strength of muscles groups of thechest. This type of exercise test might be suitable for thisparticipant because he suffers from bone, joint, or soft tissue(tendon, ligament, or muscle problem. RM bench press test thus cancause more harm to the participant.

LegExtension one-repetition Maximum (1-RM) Strength Test— (yes)

Thegoal of the leg extension test is to measure the strength ofquadriceps of an athlete or participant. The leg extension testrequires that the participant complete as many leg extensions aspossible with no rest. The individual can perform this exercise testsafely only if he begin by completing leg extensions as slowly aspossible and within few seconds or a minute. As, his conditionimproves, the participant can increase the intensity of the exercisegradually. This test is mainly suitable for active people but notindividuals where the test exercise would be contraindicated

SubmaximalCycle Ergometer Test – (No)

Themethod normally uses the bike for exercise. It tests the fitness ofcardiovascular. Being that the participant still suffers from painingsoft tissue, muscle joint, and bone joint, he can safely perform thisexercise.

MaximalCycle Ergometer test—(no)

Thisexercise test is mainly used for cardiorespiratory fitness.

MaximalTreadmill Test—(no).

Thistest exercise is used to increase the exercise rate of the heart toits maximum. Therefore, it involves vigorous activity. Due the bone,soft tissue, and muscle pain the participant is facing. It is notsafe for him to perform this type of exercise,

Thesafest exercise for the participant considering his condition is arange of motion workouts. These exercises can relieve stiffness aswell increasing the participant ability to move his joints throughtheir maximum motion range. Such exercise tests can include armsraising of your head and rolling your shoulder backward and forward.


Myanswer to the first seven questions were all ‘’no’’ andtherefore, I qualified for the above exercise tests. I have alwaysbeen healthy in all the time and a football player for my collegeteam. Before, we begin training as footballers we always undergofitness exercise of varying intensity and strength. I count myselflucky because for the last fifteen years I have never been treatedfor any medical condition. Football requires agility, strength,agility, explosiveness, and speed. Therefore, one can only achieveall these various qualities through a complete workout. As afootballer in our college, I am expected to be all round athleteirrespective of the position I play. Some aspects may be important toa given position than another bust still plays a big role in myabilities as a player. Before, starting training we normally dothorough warm-up comprising dynamic stretching, to get muscle warm upand running. The work of us normally does incorporate 3-days ofweight lifting, lower body, upper body and full body, a day of forplyometrics as well one for agility work and speed. Based on thesefactors above, I can safely perform the entire exercise tests listedin question one.


Theresult was successful, and the participants were found to have a softtissue, bone, or muscle pain problem. However, he qualified to otherlight exercises to help improve his conditions. While daily exercisecomes with numerous benefits, it can also cause deaths to some groupof patients, especially those with heart and high blood pressureconditions. Therefore, preparticipation test is an important exerciseaiming at saving lives. In addition to preparticipation healthscreening, participants should also fill in an informed assentdocument to provide them with clear and precise information what isrequired of them during exercise test.


AmericanCollege of Sports Medicine. (2013). ACSM`s Guidelines for ExerciseTesting and Prescription. Philadelphia, Pennsylvania: LippincottWilliams &amp Wilkins.

Swain,D. P., American College of Sports Medicine., &amp American Collegeof Sports Medicine. (2014). ACSM`sresource manual for Guidelines for exercise testing and prescription.Philadelphia: Wolters Kluwer Health/Lippincott Williams &ampWilkins.

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