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
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.
