Cardiovascular Physiology and Rehabilitation Laboratory, The University of British Columbia, 6108 Thunderbird Boulevard, Vancouver, BC, Canada.
Appl Physiol Nutr Metab. 2011 Jul;36 Suppl 1:S3-13. doi: 10.1139/h11-044.
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.
最近来自体力活动（PA）参与者、健身专业人员和医生的反馈表明，现有的 PAR-Q 和 PARmed-X 筛查工具在 PA 参与方面的实用性和有效性存在局限性。本研究的目的是让运动和慢性病管理方面的权威人士与专家小组合作，通过循证共识方法和成熟的评估指南研究和评估（AGREE）工具，提高 PA 参与的合格性。系统评价旨在制定新的 PA 合格性方案，包括风险分层和决策树过程。寻求循证支持，使合格的运动专业人员能够在 PA 参与合格性过程中发挥直接作用。PAR-Q+ 的制定是为了使用规范化的探测来澄清有问题的反应，并探讨目前诊断出的慢性疾病或状况所带来的问题。原始的 PARmed-X 工具被一个交互式计算机程序（ePARmed-X+）所取代，用于为有希望参与 PA 的人进行无限制或监督的 PA 合格性，或指导他们获得医疗合格性。还为具有高度资质的受过大学教育的运动专业人员在 PA 合格性过程中发挥直接作用提供了循证验证。此外，还评估了怀孕期间运动相关的风险。系统评价和共识过程符合 AGREE 工具，为增强无症状人群和患有慢性疾病或状况的人群的 PA 参与合格性提供了坚实的循证基础。
