On the preliminary screening of elderly exercise volunteers

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Abstract
As part of the pre-screening for an exercise stress test and possible entry into a subsequent exercise training programme, 74 members of the University community aged 45–75 were given a full clinical examination. They subsequently responded to the Cornell Medical Index (CMI) and the Physical Activity Readiness (PAR-Q) questionnaires. The exercise stress test was judged as contraindicated in 9 of the 74 subjects on the basis of the clinical examination. Possible uses of the CMI were rated against this criterion. Failure to complete the CMI and/or 2 or more positive responses to section C yielded a sensitivity of 66.7% and a specificity of 86.1%. Excluding subjects with more than 40 responses to section A-M substantially reduced sensitivity (55.5%), with only a small gain of specificity (90.7%). The PAR-Q had a sensitivity of 66.7% and a specificity of 92.5%. It was considered clinically advisable to halt the exercise test in 11 of the 65 subjects who had been initially cleared. Summing medical rejections and aborted tests, the basic use of the CMI showed a sensitivity of 50.0% and a specificity of 90.7%. Excluding subjects with a high response rate, sensitivity was 35.0% and specificity 92.6%. Corresponding figures for the PAR-Q procedure were 55.0% and 83.3%. It is suggested that (i) future exercise screening should combine the basic PAR-Q questions with a more specific and up-dated version of the CMI, and (ii) complaints should not be ignored because of a high overall response rate.

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