Policies and Guidelines

You can add additional questions that you might ask a new client (e.g. client contact information, risk warnings/disclaimer statements or other information collected for the purposes of delivering your services). However, the questions and the process of the APSS must be used in their entirety, as they are in the tool, and must be referenced appropriately (Exercise and Sports Science Australia, AUSactive, Sports Medicine Australia and Exercise is Medicine Australia, 2019).

The reason for this is that they are evidence based and have been carefully designed to elicit client responses that will uncover health risks that might contra-indicate exercise and which require further guidance from a medical or allied health professional. Using only part of one of the stages or altering the intended process may prevent accurate risk factor calculation and risk assessment which could lead to unsafe and unsuitable exercise prescription and advice.

Stage 1 of the APSS tool is the compulsory stage, and so is expected to be used for all casual gym visits (either using gym facilities or participating in a group exercise class) to ensure businesses and professionals are meeting their duty of care in screening for high risk clients.
In relation to casual swim clients, the APSS would generally be applied for structured exercise as opposed to casual swimming; however Stage 1 could still be applied. AUSactive recommends that professionals and businesses liaise with Royal Life Saving and other Aquatics peak bodies for guidance in these situations.

No, one form is sufficient for ongoing attendance. It is recommended that the client management process that is used by a business or trainer should enable screening results to be kept on file and easily checked for casual visitors who wish to participate in a class or use a service

Pre-exercise screening enables exercise professionals to gather information about the state of health or disease of a person, to help reduce the possibility of a problem occurring during exercise. There are no guarantees that an adverse event might or might not occur. However, this prior knowledge will assist in appropriate exercise prescription and can significantly reduce the probability of serious injury or life-threatening incidents.

The Adult Pre-Exercise Screening System (APSS) is the evidence-based Australian standard for conducting pre-exercise screening.

In a rehabilitation situation, a treating Physiotherapist is an appropriate allied health professional to be overseeing the exercise program. If a client attends without a Physiotherapist, having them complete stage 1 of the APSS and provide written confirmation from their treating Physiotherapist to guide exercise prescription is required. In this case it may also be appropriate for the Exercise Professional to phone the Physiotherapist to gain verbal advice about the client’s conditions as well (and to document this).

Clients with a disability should be treated in the same way as able-bodied clients and in both cases, pre-exercise screening is imperative to identify any health risks that require further direction and to guide exercise prescription. In any case, referral to a health professional is not about denying access but rather about seeking guidance prior to developing an appropriate exercise program.

ABS statistics demonstrate that approximately one in five Australians or 4 million people have a disability (such as mobility, vision, hearing and learning disabilities) and disability rates increase with age. Therefore, failing to incorporate disability and seniors facilities and services into your business strategy will place your business at a disadvantage. In addition, businesses have a legal obligation to provide equality of experience for all. Remember that staff training (not just of fitness staff but front desk and customer service staff as well) is an essential component of delivering an inclusive service and ensuring that appropriate practices are delivered when dealing with disabled clients.

It is true that clients have often overcome quite a few hurdles to even make an inquiry with a fitness or health service, and that the last thing we want to do is turn them away (potentially to competition down the road).

It is also true that the fitness and health industry has to date employed relatively inconsistent pre-exercise screening practices and for some sectors there has been little or no screening at all.

Aim to:

• Re-frame the situation, so that rather than denying access you are seeking guidance prior to developing an appropriate exercise program. Focus on the good that will come out of the process.
• Re-educate your clients about why screening is important, why we do it and what to expect from our industry. A client would be unlikely to be dissatisfied with a Physiotherapist or GP who wanted to ask health screening questions prior to prescribing treatment. This is because they expect it, based on the existing reputation of such professions.
• Be flexible. Does the client need to book an appointment with a medical or allied health professional, or if they are an existing patient, can you contact their treating professional by phone or email to gain further advice to assist in exercise prescription?

The APSS user guide stipulates that Stage 2 be “administered by a qualified exercise professional (Minimum Certificate III in fitness with completion of screening and assessment units SISFFIT301A and SISFFIT307A)”. SISFITT301A – Provide fitness orientation and health screening; SISFITT307A – Undertake client health assessment.

Equivalent units from the fitness training packages (after 2001) are also acknowledged as appropriate for undertaking Stage 2 of the APSS. Such units include:
SISFFIT001 – Provide health screening and fitness orientation;
SRFFIT001B – Provide orientation to clients prior to undertaking a fitness program;
SRFFIT003B – Undertake client induction and screening.

If you are not sure whether you have the necessary units within your qualification, please email your query to info@ausactive.org.au and we can look into it for you.

Many people who have high blood pressure don’t know it, so just because they have not been told they have high blood pressure (BP) does not mean they don’t – they may just not know it. In fact they may go on to have it measured in stage 3 and find they do have high BP. This may feel like an inefficient method, rather than simply going ahead to measure it (as per common industry practice).

The reason for the Stage 2 question is to enable identification of elevated BP as a risk factor via a questionnaire, in the absence of it being measured, for example an exercise professional may not have the tools to measure BP (i.e. if outdoors). If an Exercise, Yoga or Pilates Professional chooses to take a measure at this point to confirm the actual BP status, this would be appropriate, and in fact is likely given accepted industry practice.

The health and fitness industry tends to stay away from using BMI as a health indicator as we are aware that lean people with a high muscle mass can present as “Obese” even though they have low body fat. However, Body mass index [BMI] is internationally the most commonly used metric to describe the level of fatness among populations and is useful for determining population trends. It is also easy for self-report data to be collected on this measure, hence its widespread use, despite the obvious limitations.

Many studies have found that overweight or obesity is associated with a wide range of elevated risk factors and an increase in death and disability rates. The most important of these are elevated rates of cardiovascular disease, diabetes and some forms of cancers [specifically breast and bowel] that occur as fatness levels increase among the population. The standard BMI cut-offs categorise people in terms of their population risk for such diseases and related mortality. As such, BMI adds to the health risk picture being put together throughout the Stage 2 & 3 process and should provide valuable information to assist in making a professional judgment about exercise intensity prescription. APSS Textbook provides further information about the prevalence and impact of high BMI.

The minimum qualification required for measures 1-3 (BMI, waist girth and resting blood pressure) is a Certificate III in Fitness
The minimum qualification required for measures 4 and 5 (fasting lipid profile and fasting blood glucose) is an Exercise Physiologist
It is important that the professional administering these measures has additional skills and knowledge to be able to safely perform metabolic measures, including a deeper understanding of blood lipids, the various sub-fractions, what dietary and lifestyle factors can influence these values and what the cut-offs and recommended levels are for optimal health.

To complete this stage, a business might aim to develop a network of Exercise Physiologists to refer to or may aim to have one that can contract their services on specific days. Alternatively, given that this stage is optional, a business may choose to only include the BMI, waist girth and resting blood pressure measures, utilising the skills of Certificate III & IV qualified trainers.

The reason that the APSS Stage 1 is compulsory is that it screens for high risk. If someone is high risk, they will require guidance from a medical or allied health professional prior to commencing exercise. Stages 2 and 3 screen for those at moderate or low risk, and in both instances the person can safely begin moderate intensity activity without further guidance from a medical or allied health professional.

While it is preferable for all stages to be completed and for the process to be as thorough as possible, it is acknowledged that this will not always be possible. Therefore Stage 2 is not deemed mandatory.

While many fitness facilities and individual providers ask their clients to sign waivers, they may not always protect the provider. Courts have held that you can’t “waive” your right to provide a duty of care and contracts saying you waive the right for personal injury may not protect you in all circumstances.

Given that there can never be complete safety in recreational and sporting activities that involve significant physical exertion, it is good practice to advise people of the potential risks when undertaking exercise [via a risk warning, rather than a waiver] and to include a disclaimer or notice that highlights the client’s responsibility to disclose all information that may affect exercise prescription and advice.

AUSactive recommends that professionals and businesses seek independent legal advice to determine the best wording for business protection.

In line with health and medical records, the APSS results should be kept on file for 7 years. The length of time that client APSS results remain “current” greatly depends on the results. If the client is considered low-moderate risk (i.e. does not tick YES to any of the Stage 1 questions), then it would be advisable to aim for a periodic review (e.g. annually) to ensure that nothing has changed. It is important to also remind clients that if any health conditions change at any time, their centre or trainer needs to be kept informed so that they can adjust prescribed exercise or refer accordingly (this should be included in a risk warning or disclaimer).

No. Organisations cannot brand the tool and infer that it is part of their intellectual property as this is in breach of copyright law.

Options available include:

Use a cover sheet with your branding that introduces and refers to the attached APSS.
Re-produce the content in its entirety and make reference to the copyright owners (Exercise and Sports Science Australia, Fitness Australia, Exercise is Medicine and Sports Medicine Australia 2019).
Using the national standard that has been endorsed by the national fitness, exercise and sports medicine peak bodies will deliver enhanced credibility and confidence to your clients.

For issues such as risk management and safety, demonstrating that you meet evidence-based national standards that re supported by industry authorities will make more of an impact than promoting your own logo in isolation.

AUSactive registered professionals should ensure that the group participant number allows for appropriate supervision and safe instruction for each individual during the group session.

Variables that may influence this professional judgement are:

• The setting and space – dimensions and size of the area available and the environment in which the class is delivered (i.e. indoor/outdoor, quality of facilities, ability to see and hear participants)
• The suitability for all participants to undertake the activities considering the varied risk profiles, health status, exercise histories and abilities
• Complexity of the activities and equipment selection
• Whether all activities/stations can be safely used and supervised simultaneously
• Whether activities can be modified and the group dynamic managed adequately for the number and range of participants
• The AUSactive professionals skill and experience

Remember that if a client is injured in your class or your facility, the above issues will be explored to determine whether duty of care has been carried out.

Our policies and guidelines are designed to give direction and support to health and fitness professionals and business owners.

We want nationally recognised health and fitness industry standards and best practice in the Australian health and fitness industry to be met.

Our policies and guidelines can be found here.

The Code of Ethics is intended to act as a clear guide to all AUSactiveprofessionals in their professional practice and those registered by AUSactive will be held accountable to the Code.

The Register of Exercise and Health Professionals requires its members and their practice to discharge their duties and responsibilities at all times in a manner which professionally, ethically, legally and morally compromises no individual with whom they have professional contact.

The Code of Ethics does not replace the principles and procedures adopted by employing bodies, relevant legislation nor do they deny other rights within society not specifically mentioned.

Refer to fitness.org.au/code-of-ethics

If you are training clients that are aged 50+ years of age, consider the following:

The core units within Certificate III in Fitness will qualify you to work with healthy adults over the age of 50 (i.e. a participant in a group exercise class or client who requests a fitness program).

If you are working with adults over the age of 50 that have managed conditions (as identified through pre-exercise screening) or if you are providing specific services that target older adults (programs, classes or personal training services), you need to have completed the elective unit (or equivalent): SISFFIT015 Collaborate with medical and allied health professionals in a fitness context.
Within the Fitness Australia exercise professional registration system, this would mean that you are registered as a Gym Instructor, Group Exercise Instructor or Personal Trainer and also have the Older Adults delivery knowledge and skill listed on your public registration profile.

Remember that when assessing risk using the Adult Pre-Exercise Screening System, age related risk is higher for ≥ 45yrs Males or ≥ 55yrs Females. Refer to the Adult Pre-Exercise Screening tool

If you are training clients that are under 18 years of age, consider the following:
To plan and deliver fitness services to children and young people, AusREPs must be appropriately qualified and should continually update their related knowledge and skills. The following minimum education is required:
1. Certificate lll in Fitness
2. Completion of the relevant units of competency (or equivalent):
SISFFIT012 Instruct movement programs to children aged 5 to 12 years;
SISFFIT013 Instruct exercise to young people aged 13 to 17 years.
Within the Fitness Australia exercise professional registration system, this would mean that they are registered as a Gym Instructor, Group Exercise Instructor or Personal Trainer and also have the Children – Young Children &/or Adolescents delivery knowledge and skill listed on their public registration profile.
It should be noted that the AUSActive Professionals Scope of Practice allows for the provision of independent advice and/or exercise programs for children and young people who are free of health conditions or injury.
National guidelines for delivery of children’s health and fitness services can be found here: