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Enhancing the effectiveness of clearance for physical activity participation: background and overall process (1) (1) This paper is one of a selection of papers published in the Special Issue entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal's usual peer-review process.
MedLine Citation:
PMID:  21800946     Owner:  NLM     Status:  In-Data-Review    
Recent feedback from physical activity (PA) participants, fitness professionals, and physicians has indicated that there are limitations to the utility and effectiveness of the existing PAR-Q and PARmed-X screening tools for PA participation. The aim of this study was to have authorities in exercise and chronic disease management to work with an expert panel to increase the effectiveness of clearance for PA participation using an evidence-based consensus approach and the well-established Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument. Systematic reviews were conducted to develop a new PA clearance protocol involving risk stratification and a decision-tree process. Evidence-based support was sought for enabling qualified exercise professionals to have a direct role in the PA participation clearance process. The PAR-Q+ was developed to use formalized probes to clarify problematic responses and to explore issues arising from currently diagnosed chronic disease or condition. The original PARmed-X tool is replaced with an interactive computer program (ePARmed-X+) to clear prospective PA participants for either unrestricted or supervised PA or to direct them to obtain medical clearance. Evidence-based validation was also provided for the direct role of highly qualified university-educated exercise professionals in the PA clearance process. The risks associated with exercise during pregnancy were also evaluated. The systematic review and consensus process, conforming to the AGREE Instrument, has provided a sound evidence base for enhanced effectiveness of the clearance process for PA participation of both asymptomatic populations and persons with chronic diseases or conditions.
Veronica K Jamnik; Darren E R Warburton; Julie Makarski; Donald C McKenzie; Roy J Shephard; James A Stone; S Charlesworth; Norman Gledhill
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Applied physiology, nutrition, and metabolism = Physiologie appliquée, nutrition et métabolisme     Volume:  36 Suppl 1     ISSN:  1715-5312     ISO Abbreviation:  Appl Physiol Nutr Metab     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-08-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264333     Medline TA:  Appl Physiol Nutr Metab     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  S3-S13     Citation Subset:  IM    
a Cardiovascular Physiology and Rehabilitation Laboratory, The University of British Columbia, 205 Unit II Osborne Centre, 6108 Thunderbird Boulevard, Vancouver, BC V6T 1Z3, Canada.
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