A pre-participation evaluation should include markers of health. They are typically looking "for signs or symptoms of underlying disease, or who may be at higher risk of an adverse event during exercise" (Essa, 2018)
The presence of increased risk in a screen should lead to further assessment.
Physical Activity Readiness Questionnaire (PAR-Q)
The PAR-Q has been designed to identify the small number of adults for whom physical activity may be inappropriate or those who should have medical advice concerning the type of activity most suitable for them.
Answer yes or no to the following questions:
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity?
If you answered yes:
If you answered yes to one or more questions, are older than age 40 and have been inactive or are concerned about your health, consult a physician before taking a fitness test or substantially increasing your physical activity. You should ask for a medical clearance along with information about specific exercise limitations you may have.
In most cases, you will still be able to do any type of activity you want as long as you adhere to some guidelines.
If you answered no:
If you answered no to all the PAR-Q questions, you can be reasonably sure that you can exercise safely and have a low risk of having any medical complications from exercise.
It is still important to start slowing and increase gradually. It may also be helpful to have a fitness assessment with a personal trainer or coach in order to determine where to begin.
When to delay the start of an exercise program:
If you are not feeling well because of a temporary illness, such as a cold or a fever, wait until you feel better to begin exercising.
If you are or may be pregnant, talk with your doctor before you start becoming more active.
Keep in mind, that if your health changes, so that you then answer "YES" to any of the above questions, tell your fitness or health professional, and ask whether you should change your physical activity plan.
ESSA designed PPE Stage 1 Questionnaire
Exercise and Sports Science Australia (ESSA), in association with Sports Medicine Australia (SMA) devised a PPE, with some elements that pass criteria mentioned above.
Where this specific evaluation fails is in the following recommendation:
"IF YOU ANSWERED ‘NO’ to all of the 7 questions, and you have no other concerns about your health, you may proceed to undertake light-moderate intensity physical activity/exercise." This recommendation fails to evaluate movement-based risk factors, thus presents probable false negatives for exercising.
ESSA, 2018. https://www.essa.org.au/for-gps/adult-pre-exercise-screening-system/
F-MARC designed PPE
This PPE fails to account for a major risk factor in injury - motor control.
It is recommended that the FMS, SFMA and FCS are used as appropriate (in the absence of pain, presence of pain/injury and passing of the FMS) in addition to specific tests within the F-MARC PPE, for soccer players.