Physical Activity Readiness Questionnaire: Ready or Not?

May 12, 2011

April Boulter
Fitness, Aquatics and Special Events
Loyola University Chicago

The promotion of physical activity within a comprehensive recreation program is an important component for all Campus Recreation Departments. As part of a risk management assessment, many universities are evaluating the pre-activity screening process. While nearly all universities require participants of their Personal Training program to complete a Physical Activity Readiness Questionnaire (PAR-Q) as well as a health history questionnaire, very few universities require the general population to complete the same paperwork. Although most individuals are at very low risk for an exercise-related cardiovascular event, the risk of adverse cardiac events is considerably higher during or immediately after exercise, especially in habitually sedentary individuals engaging in vigorous physical activity (American College of Sports Medicine [ACSM], 2007). Researchers have concluded that, in general, risk of heart attack is about two to six times higher during strenuous exercise than during light physical activity or rest (Balady, 1998). The risk of a cardiovascular event is highest in persons with known heart disease.

An important challenge facing campus recreation facilities is to provide a motivation toward participation in an exercise program while minimizing the potential risk of an adverse medical event during or after exercise (ACSM, 2007). In years past, some lawyers and risk managers have recommended that fitness professionals not engage in pre-screenings. The advice was based on the concept that if the information was received from clients and misinterpreted, it could create liability for the facility in the event of a later injury to the client (Herbert, 1997). The American College of Sports Medicine’s guidelines require that every facility offering exercise equipment must provide a general pre-activity risk assessment, e.g., Physical Activity Readiness Questionnaire (PAR-Q), to all new/prospective members (ACSM, 2007).

Providing a general pre-activity screening is a challenge for campus recreation and wellness facilities. Many recreational facilities serve such a high volume of users that it is nearly impossible to have every member complete a pre-activity assessment. A recent informal survey of the members of the National Intramural Recreational Sports Association (NIRSA) showed that the majority of responding universities do not offer a pre-activity screening for general users of the campus recreation facility. The results are as follows:

34 total respondents
Respondents enrollment:

  • 5K and under: 12 (35%)
  • 5K -9K: 6 (18%)
  • 10K – 15K: 4 (12%)
  • 15K – 20K: 4 (12%)
  • 20K+: 8 (23%)

– One (1) respondent required a PAR-Q (university enrollment: 6K with 50-100 users per day).
– Two (2) respondents required all users complete a weight room orientation (university enrollment 5K & 12K).
– Five (5) respondents held optional weight room orientations.
– Four (4) respondents enlarged and posted PAR-Qs throughout the facility.

If a university recreation center was able to enforce and police that every member complete a pre-activity screening, the question then becomes, “What next?” There are numerous barriers to requiring that every member complete a PAR-Q:
– Where should the volume of paperwork be stored?
– How long should the PAR-Qs be kept on file?
– Who is required to review the PAR-Qs?
– If a risk is identified with a user, how should they be contacted?

Health and fitness standards mandate that if a facility becomes aware that a member or user has a know cardiovascular, metabolic or pulmonary disease, or two or more major cardiovascular risk factors, or any other major self disclosed medical concern, as a result of a pre-activity screening, that person must be advised to consult with a qualified healthcare provider before beginning a physical activity program (ACSM, 2007).

ACSM provides options regarding the best course of action to provide would-be exercisers with appropriate guidelines and recommendations for safe and effective exercise participation. Pre-activity screenings can be administered by fitness professionals or self-administered by the facility members (ACSM, 2007). There are two options to have users participate in a self-administered pre-activity screening:
– Post a PAR-Q with accompanying signage at the entry to a fitness facility.
– Distribute the PAR-Q to each user at his or her first visit with instructions for a self-administered screening.

At Loyola University Chicago, we do not have professionals administering PAR-Q’s, and we have chosen to go the ‘self-administration’ route. Hence we have enlarged and posted multiple PAR-Qs at various locations in the facility including:
– locker rooms
– entrance to free weight area
– entrance to cardio machines
– entrance to selectorized equipment area
– inside the group fitness studio.

The PAR-Q used at Loyola University Chicago is provided in the appendix of the ACSM manual and uses history, symptoms and risk factors (including age) to direct prospective members to either participate in an exercise program or contact their physician or healthcare provider before participation.


American College of Sports Medicine. ACSM’s Health/Fitness Facility Standards and Guidelines (3rd ed.) Tharrett, S., McInnis, K., Peterson, J.: Champaign, IL, 2007.

Balady, G.J., B. Chaitman, D. Driscoll, et al. Recommendations for cardiovascular screening, staffing, and emergency policies at health/fitness facilities. AHA/ACSM Scientific Statement 1998. Retrieved from:

Hebert, D. (2000). Must Fitness Providers Screen Clients Prior to Providing Service?. The Exercise and Standards and Malpractice Reporter. Retrieved from

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