THE ROLE OF PRE-EXERCISE SCREENING IN PROFESSIONAL PRACTICE: RISK ASSESSMENT AND CLINICAL DESCISION-MAKING.

Pre-exercise screening is a cornerstone of practice for exercise specialists, ensuring client safety and aligning with professional standards of care. Whether using the Australian Adult Pre-Exercise Screening System (APSS) or an alternative approach, the primary objective remains consistent: to gather comprehensive health information before initiating exercise. This process applies to all clients - walk-ins, GP referrals, or individuals with recent health changes that may influence exercise risk. Importantly, there has been a shift away from the concept of ‘medical clearance’ toward clinical guidance and collaboration, recognising that appropriately trained exercise professionals possess the competencies to deliver safe and effective exercise assessment to guide intervention. Current guidelines suggest that adverse signs or symptoms, perhaps only revealed during exercise assessment, should prompt physician consultation. However, ambiguity persists around terms such as “signs or symptoms suggestive of unstable chronic disease,” which exist on a continuum between elevated risk and absolute contraindication. Clinical reasoning is central to this process. For example, moderate-to-severe hypertension, or blood glucose levels outside desirable range often trigger automatic referral, yet this may be unnecessary when the client has been referred specifically for exercise intervention. These scenarios demand nuanced risk stratification to balance safety with timely access to health-enhancing physical activity. This presentation will examine best-practice approaches to pre-exercise screening, clarify referral guidelines, and address common misconceptions. By reinforcing screening as a dynamic, decision-making process rather than a rigid checklist, the aim is to strengthen its role as a foundation of professional behaviour and client care. Additionally, it highlights the unique skillset of exercise professionals in conducting individualised functional assessments that can reveal previously undetected signs or symptoms – expertise that typically extends beyond the static evaluations most physicians have the capacity to perform.