Evidence-based risk assessment and recommendations for physical activity clearance: an introduction

Appl Physiol Nutr Metab. 2011 Jul;36 Suppl 1:S1-2. doi: 10.1139/h11-060.


The Physical Activity Readiness Questionnaire (PAR-Q) and the Physical Activity Readiness Medical Evaluation (PARmed-X) are internationally renowned and extensively used preparticipation screening tools. However, recent feedback from end-users has identified limitations to the existing PAR-Q and PARmed-X screening process. As such, a systematic evaluation of the PAR-Q and PARmed-X forms was conducted, adhering to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. Recognized experts in physical activity (PA) and prominent health conditions worked with an expert consensus panel to increase the effectiveness of the PAR-Q and PARmed-X PA participation clearance process. The systematic review process established that the health benefits of PA participation far outweigh the risks in the vast majority of asymptomatic and symptomatic individuals. A new risk continuum and decision tree process was created to allow for the effective risk stratification of prominent health conditions, reducing greatly the barriers to PA participation for the majority of individuals. The new PA participation clearance process is available in new paper and online versions (PAR-Q+) and the PARmed-X was replaced with an online interactive computer programme (ePARmed-X+). It is anticipated that this new risk stratification and PA clearance process will reduce markedly the barriers for PA participation for both asymptomatic and symptomatic individuals.

Publication types

  • Introductory Journal Article

MeSH terms

  • Consensus
  • Decision Support Techniques
  • Decision Trees
  • Evidence-Based Medicine
  • Exercise Therapy* / adverse effects
  • Exercise Therapy* / standards
  • Health Status Indicators*
  • Health Status*
  • Humans
  • Mass Screening / methods*
  • Mass Screening / standards
  • Motor Activity*
  • Physical Fitness*
  • Practice Guidelines as Topic
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires* / standards