The new Adult Pre-exercise Screening System (APSS), was developed by a technical committee with membership from ESSA, Fitness Australia and Sports Medicine Australia (SMA). Professor Kevin Norton chaired the committee and the APSS was launched in March 2012 with a series of forums organised by Fitness Australia and conducted around Australia. ESSA was represented at these forums and presented on the application of the APSS. The APSS is now accepted as the industry standard pre-exercise screening system.
The APSS consists of 3 stages of risk assessment; with Stage 1 being compulsory, and Stages 2 and 3 being optional.
Stage 1 - which can be self administered by the client consists of seven questions which are answered YES or NO, and are designed to identify individuals with signs or symptoms of underlying disease, or who may be at higher risk of an adverse event during exercise. If the individual answers NO to all seven questions, then the individual is free to undertake low-moderate intensity exercise, but importantly, not high intensity exercise. Definitions of exercise intensities using a range of objective and subjective criteria are clearly specified in the APSS documentation. A YES to any Stage 1 question, identifies the individual being at “higher risk”, which then requires a referral to an appropriately qualified allied health professional, such as AEP or a GP for additional guidance and assessment, prior to undertaking exercise.
Stage 2 – of the APSS is to be conducted by a qualified exercise professional, and consists of additional questions on cardiac risk factors and medical history. At the completion of Stage 2 a cardiovascular risk score can be determined.
Stage 3 - allows for the objective measurement of the cardiac risk factors. Measures of BMI, waist girth, blood pressure, fasting blood lipid profile and blood glucose can be used to more accurately determine the number of risk factors.
It is important that all ESSA Members take time to familiarize themselves with the APSS. This includes understanding its application in relation to risk stratification and prescribing appropriate exercise intensities, and its implications in terms of referrals from exercise professionals. AEPs should also be ready to respond to requests to conduct fasting lipid profiles and blood glucose tests. AEPs need to clearly understand the medico-legal aspects of the APSS with respect to client negligence and duty of care.