Shephard R J
School of Physical and Health Education, Faculty of Medicine, University of Toronto.
Sports Med. 1988 Mar;5(3):185-95. doi: 10.2165/00007256-198805030-00005.
Procedures for the preliminary screening of asymptomatic adults who wish to exercise are reviewed with particular reference to experience gained through the mass use of the physical activity readiness questionnaire (PAR-Q) and the Canadian Home Fitness Test (CHFT). It is argued that both a brief submaximal exercise test and a subsequent moderate increase of habitual activity are extremely safe tactics to recommend to a symptom-free adult. There are some useful minor modifications which could be made to the PAR-Q instrument, but its sensitivity and specificity relative to such criteria as medical examination, hypertension, CHFT completion and exercise-induced ECG abnormalities compare favourably with alternative self-administered procedures. The basic difficulty of screening an asymptomatic population (highlighted by Bayes theorem) is the high percentage of false positive and false negative test results. One remedy would be to stratify the population in terms of known cardiac risk factors and to restrict detailed pre-exercise screening to the high risk segment of the population.
对希望进行锻炼的无症状成年人进行初步筛查的程序进行了回顾，特别参考了通过大规模使用体力活动准备情况问卷（PAR-Q）和加拿大家庭健身测试（CHFT）所获得的经验。有人认为，向无症状成年人推荐简短的亚极量运动测试以及随后适度增加日常活动量都是极其安全的策略。PAR-Q工具可以进行一些有用的小修改，但其相对于医学检查、高血压、CHFT完成情况和运动诱发的心电图异常等标准的敏感性和特异性与其他自行管理的程序相比具有优势。筛查无症状人群的基本困难（由贝叶斯定理突出显示）是假阳性和假阴性测试结果的比例很高。一种补救方法是根据已知的心脏危险因素对人群进行分层，并将详细的运动前筛查限制在该人群的高风险部分。
