Chapter 13 Health Screening and Program Design Within the Scope of Practice
Personal Trainer Protocol of Health Screening
Prior to training a client, the client must fill out a PAR-Q, an activ-
ity readiness form. If the client answers ‘yes’ to any of the ques-
tions, they are immediately sent to their physician with a PAR-
med-X.Within our scope of practice, the Personal Trainer can work with
the client if and when the client (a) returns with the PARmed-X
outlining the recommendation of unrestricted physical activity or
(b) the physician has provided a script indicating that the individu-
al may proceed with exercise without restriction.When proceeding with a client after they have received clearance
from their physician, it is advisable to progress the client slowly
and very gradually build their tolerance to exercise. This type of
client may likely possess some risk factors for disease (e.g. in-
creased BMI, increased obesity, sedentary lifestyle, poor nutrition,
etc.), however, they have not yet developed or been diagnosed
with disease.If the PARmed-X is returned with ANY physical restrictions, the in-
dividual must be referred to the appropriate health professional or
therapist (e.g. kinesiologist). The Personal Trainer is not permit-
ted to solely work with individuals that have physical restrictions,
as this is outside of their scope of practice.There are, however, situations that a Personal Trainer might act
as an assistant to the therapist or health professional. In these
situations, there must be written documentation between the
therapist and Personal Trainer outlining the following:
• The therapist is solely responsible for all exercise prescription
and progressions
• The Personal Trainer is only a monitor of the exercise, the cli-
ent’s body mechanics, etc.
• The client must follow up with the therapist on a regular basis
• There must be ongoing communication between the trainer
and the therapist
• Should there be any change, whether as reported by the client
or observed by the Personal Trainer, training should cease,
and the client must immediately follow up with the therapistThe ACSM provides additional guidelines for obtaining medical
clearance prior to commencing an exercise program. As dis-
cussed above, if the individual is not cleared for exercise via the
PAR-Q, they require medical clearance. At times, the PAR-Q may
not indicate the need for medical clearance, however through
initial discussion and history taking, the trainer comes across
other red flags. The ACSM indicates that should the trainer come
across any of the following, that medical clearance is required.