Explain how to analyse client responses to the physical activity Readiness Questionnaire

Physical activity comes with risks. Athletes may get injured. Some may have conditions or lifestyles that make participating riskier, and others may take risks by taking performance-enhancing drugs.

ischaemic heart disease. The latter study questioned the

ability of screening methods to identify those who were at

risk because of exercise. The investigation included ‘self-

administered procedures’, ‘clinical examination’ and ‘lab-

oratory procedures’ (Shephard, 1984). Shephard (1984)

stated that the PARQ was ‘reasonably successful in

predicting undesirable acute outcomes to exercise’.

Flaws in the PARQ had been highlighted (Shephard et al.,

1981; Shephard, 1988) but little was done to address these

concerns until Cardinal et al. (1996) attempted to ‘improve

the PARQ’s specificity without unduly sacrificing its

sensitivity’ by altering the wording to clarify the questions.

These alterations achieved the desired results as far as they

reduced needless exclusion from exercise participation

(Cardinal et al., 1996).

Currently, the Revised Physical Activity Readiness

Questionnaire (rPARQ) is recommended as the bare

minimum medical screening tool, by the American College

of Sports Medicine (ACSM), for those starting ‘low –

moderate intensity exercise’ (ACSM, 1997, 1998). Heyward

(1991) identified the PARQ as a general pre-exercise

screening tool. However, there are no viable alternatives

to the PARQ and rPARQ except specialist forms such as the

RISKO Coronary Heart Disease Risk Appraisal (McArdle

et al., 1981).

The pre-exercise screening questionnaires are often

employed alongside additional lifestyle questionnaires that

attempt to gain a broader picture of a client’s lifestyle,

habits and exercise limitations. This study evaluated the

effectiveness of a variety of pre-exercise screening tools,

singularly and in combination, in an applied setting.

2. Methodology

The subjects were new and existing clients using, or

intending to use, the fitness suite at a leisure centre in South

Wiltshire. The size of the group ðn¼50Þwas dictated by

the number of volunteers who met the inclusion criteria of

the questionnaires used (i.e. aged between 16 and 69 years

old). The age characteristics of the group presented a mean

value of 36.06 years with a standard deviation of 13.32

years. In addition, 54% of the sample were male, 46%

female and 96% ‘White European’ while the remaining 4%

were ‘Other’ (e.g. West Indian and South African).

Each subject was asked if he/she would mind taking part

in the study. Participants were escorted into the centre’s

induction room where they completed the questionnaires

and were interviewed. The data collection was carried out

throughout the autumn of 1999 and the spring of 2000. Any

subject found to be unsuitable for exercise, because of a

positive rPARQ or high blood pressure, was referred to their

doctor (as per normal practice at the leisure centre).

Due to the lack of ECG equipment availability, the

decision was taken to make use of the RISKO coronary

heart disease appraisal questionnaire, which looks at an

individual’s coronary heart disease risk factors (McArdle

et al., 1981). These results could then be compared with the

findings of the other two questionnaires.

The subjects received the three questionnaires in

chronological order with the original PARQ first, followed

by the rPARQ, the RISKO coronary heart disease appraisal

form and finally the subject interview. The decision to

present the questionnaires in this order was made because it

was felt that the rewording of the PARQ may have biased

the subjects’ responses and this order represented the stages

of development. All subjects were given the same scripted

instructions before completing each questionnaire. The

debriefing interviews were conducted in a less formal,

unscripted manner than the previous stages.

Notes of each subject’s comments were recorded, which

was compared with the information obtained using the

questionnaires (PARQ, rPARQ and RISKO forms). The

interview also gave the researcher the opportunity to gain

clarification concerning subject responses, obtain infor-

mation (e.g. when subjects failed to understand a question)

and to answer any questions that arose. It also gave the

subjects the opportunity to pass comment and make

criticisms concerning the questionnaires.

The blood pressure of each subject was taken using a

mercury sphygmomanometer and stethoscope on the left

arm, following ACSM guidelines (ACSM, 1995). This was

chosen as a simple indicator of the subject’s health and to

corroborate responses given in the questionnaires. Follow-

ing ACSM guidelines, the blood pressure level at which a

subject was excluded from exercise was set at 160/100, with

contraindication occurring if either observed figure was

higher than these limits (ACSM, 1995).

The statistical element of the study consisted of

comparisons between the numbers of subjects excluded by

the screening methods using Chi-squared. Results were

analysed in order to make comparisons with the results from

other studies, and between the methods employed. The 5%

level of significance was selected as the minimum

acceptable level of probability. The Yates correction was

employed during the statistical analyses due to the small

sample size, relative to the United Kingdom population.

3. Results

All 50 subjects completed the PARQ and the rPARQ. As

hypothesised and observed by Cardinal et al. (1996), the

PARQ excluded more subjects than the rPARQ. Table 1

shows the rate of subject inclusion/exclusion found between

the PARQ and the rPARQ in this study.

Statistical analysis of the PARQ and rPARQ was carried

out. Both were found to include significantly more than they

excluded. However, the critical value for chi-squared was

lower ð

x

2ðdf ¼1Þ¼3:94;P,0:05Þfor the PARQ than

that observed for the rPARQ ð

x

2ðdf ¼1Þ¼6:50;P,

0:05Þ:When the PARQ and rPARQ were compared,

R.A. Humphrey, J. Lakomy / Physical Therapy in Sport 4 (2003) 187–191188