Physical Activity Readiness Questionnaire Part 2

Please read the questions below carefully and answer each one honestly: check YES or NO.

1. Do you have Arthritis, Osteoporosis, or Back Problems? *
If yes, answer questions 1a-1c. If no, go to question 2.
1a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)
1b. Do you have joint problems causing pain, a recent fracture or fracture caused by osteoporosis or cancer, displaced vertebra (e.g., spondylolisthesis), and/ or spondylolysis/pars defect (a crack in the bony ring on the back of the spinal column)?
1c. Have you had steroid injections or taken steroid tablets regularly for more than 3 months?
2. Do you have Cancer of any kind? *
If yes, answer questions 2a-2b. If no, go to question 3.
2a. Does your cancer diagnosis include any of the following types: lung/bronchogenic, multiple myeloma (cancer of plasma cells), head, and neck?
2b. Are you currently receiving cancer therapy (such as chemotherapy or radiotherapy)?
3. Do you have Heart Disease or Cardiovascular Disease? This includes Coronary Artery Disease, High Blood Pressure, Heart Failure, Diagnosed Abnormality of Heart Rhythm *
If yes, answer questions 3a-3e. If no, go to question 4.
3a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)
3b. Do you have an irregular heart beat that requires medical management? (e.g. atrial fibrillation, premature ventricular contraction)
3c. Do you have chronic heart failure?
3d. Do you have a resting blood pressure equal to or greater than 160/90 mmHg with or without medication? (Answer YES if you do not know your resting blood pressure)
3e. Do you have diagnosed coronary artery (cardiovascular) disease and have not participated in regular physical activity in the last 2 months?
4. Do you have any Metabolic Conditions? This includes Type 1 Diabetes, Type 2 Diabetes, Pre-Diabetes *
If yes, answer questions 4a-4c. If no, go to question 5.
4a. Is your blood sugar often above 13.0 mmol/L? (Answer YES if you are not sure)
4b. Do you have any signs or symptoms of diabetes complications such as heart or vascular disease and/or complications affecting your eyes, kidneys, and the sensation in your toes and feet?
4c. Do you have other metabolic conditions (such as thyroid disorders, pregnancy- related diabetes, chronic kidney disease, liver problems)?
5. Do you have any Mental Health Problems or Learning Difficulties? This includes Alzheimer’s, Dementia, Depression, Anxiety Disorder, Eating Disorder, Psychotic Disorder, Intellectual Disability, Down Syndrome) *
If yes, answer questions 5a-5b. If no, go to question 6.
5a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)
5b. Do you also have back problems affecting nerves or muscles?
6. Do you have a Respiratory Disease? This includes Chronic Obstructive Pulmonary Disease, Asthma, Pulmonary High Blood Pressure
If yes, answer questions 6a-6d. If no, go to question 7.
6a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)
6b. Has your doctor ever said your blood oxygen level is low at rest or during exercise and/or that you require supplemental oxygen therapy?
6c. If asthmatic, do you currently have symptoms of chest tightness, wheezing, laboured breathing, consistent cough (more than 2 days/week), or have you used your rescue medication more than twice in the last week?
6d. Has your doctor ever said you have high blood pressure in the blood vessels of your lungs?
7. Do you have a Spinal Cord Injury? This includes Tetraplegia and Paraplegia *
If yes, answer questions 7a-7c. If no, go to question 8.
7a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)
7b. Do you commonly exhibit low resting blood pressure significant enough to cause dizziness, light-headedness, and/or fainting?
7c. Has your physician indicated that you exhibit sudden bouts of high blood pressure (known as Autonomic Dysreflexia)?
8. Have you had a Stroke? This includes Transient Ischemic Attack (TIA) or Cerebrovascular Event *
If yes, answer questions 8a-c. If no, go to question 9.
8a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)
8b. Do you have any impairment in walking or mobility?
8c. Have you experienced a stroke or impairment in nerves or muscles in the past 6 months?
9. Do you have any other medical condition not listed above or do you live with two chronic conditions?
If yes, answer questions 9a-c. If no, read the advice on page 4.
9a. Have you experienced a blackout, fainted, or lost consciousness as a result of a head injury within the last 12 months OR have you had a diagnosed concussion within the last 12 months?
9b. Do you have a medical condition that is not listed (such as epilepsy, neurological conditions, kidney problems)?
9c. Do you currently live with two chronic conditions?