Take a Par Q

1.Has your doctor ever said that you have a heart condition ?

NoYes

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It is important that you make sure your doctor gives you a clear bill of health to continue with this program. Take a printout of this questionnaire as well as the provided information sheet about the program when you go to see your doctor.

2.Do you feel pain in your chest when you do physical activity?

NoYes

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You need to make sure that this pain that you are experiencing is not caused by your heart. There are many things that might cause chest pain, but to be save, it is always good to make sure what the cause is.

3.To your knowledge, do you have high blood pressure?

NoYes

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Your Blood pressure should be well under control if you want to take part in higher intensity exercise. Make sure you doctor knows about the exercise you are about to embark on. Take a printout of this questionnaire as well as the provided information sheet about the program when you go to see your doctor It is natural for your blood pressure to raise during exercise. If you are on medication, you should take it diligently to make sure you blood pressure does not elevate too high during exercise.

4.Do you have Diabetes mellitus or any other metabolic disorder?

NoYes

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Please go to the Exercise and Diabetes tips to learn more about what you should and shouldn’t do if you undertake an exercise program. Most important is to always test your sugar levels before you start and always have a sweet snack close at hand to take when you feel a hypo coming on. Also make sure your instructor knows your are diabetic and your doctor knows that you are undertaking this program. Take a printout of this questionnaire as well as the provided information sheet about the program when you go to see your doctor.

5.Has your doctor ever said that you have raised cholesterol ?

NoYes

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Exercise is very beneficial for high cholesterol levels. If you have had elevated cholesterol levels for a long time or have a family history of heart disease it is important to regularly go for a checkup of your heart. Elevated blood fats (Cholesterol) can clog up your arteries, which make it hard for the blood to go to your heart or brain and can then cause heart attack or stroke. Keep on top of your health.

6.Is your doctor currently prescribing you any drugs or medication?

NoYes

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Some medications can cause some ‘side effect’, or hide symptoms when you exercise, therefore it is important that your doctor gives you the go-ahead to take part in this program.

	7.Is there any history of Coronary Heart Disease within your family?
	NoYes Invalid Input
	Heart disease is hereditary. If it is prevalent in your family, you should have yourself checked out by your doctor. They would usually check your cholesterol levels, blood pressure etc. Start a healthy lifestyle as soon as possible.

	8.Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?
	NoYes Invalid Input
	We don’t want you to aggravate any current injury that you have, make sure your doctor gives you the go-ahead to do weight bearing exercise. You can also contact one of your Biokineticists or physiotherapists for a full evaluation and some recommendations. If you experience pain or discomfort during any of the exercises, make sure to tell your instructor, so that they can give you an alternative exercise.

	9.Do you ever feel faint, have spells of dizziness or have ever lost consciousness?
	NoYes Invalid Input
	Dizziness or fainting can be caused by low blood pressure and many other things. Have you blood pressure checked and or any other problems that might cause these spells. It is also important to warm up and cool down, before and after exercise to give your body the time to adjust to the change. This can also prevent dizzy spells.

	10.Are you, or is there any possibility that you might be pregnant?
	NoYes Invalid Input
	The intensity of this program is probably too high for you if you are pregnant. You can safely exercise during pregnancy, but it is better to do it under supervision to start. Your doctor should definitely give you permission to exercise. Your heart rate needs to be closely monitored as well as you body temperature among other things. Contact your biokineticist for further information.

	11.Do you currently suffer from asthma or exercise induced asthma?
	NoYes Invalid Input
	If your doctor is happy for you to exercise, then make sure you bring your asthma pump if you use one. Also make sure your instructor knows about your condition and that someone know where to find your pump if needed.

	12.Do you suffer from any kidney problems?
	NoYes Invalid Input
	Exercise puts extra strain on you circulatory system and thus extra strain on your kidneys. In the long run, an exercise program is mostly beneficial, but is usually advised you start with moderate exercise and build to more vigorous exercise. This also depends on the severity of you kidney problem, so make sure your doctor gives you clearance to take part.

	13.Do you suffer from Depression?
	NoYes Invalid Input
	Due to the endorphins (Feel-good hormones), your body secretes during exercise, it serves as a very powerful antidepressant. There are also secondary effects due to the fact that you sleep better etc. Make sure to go to Exercise and Diabetes tips for more information.

	14.Do you get cramps in your legs?
	NoYes Invalid Input
	Muscle cramps are most often caused by a low level of Magnesium (Mg) and Calcium (Ca) in your body. Ask your doctor to prescribe a Magnesium supplement. This will most likely sort out your problem. If the problem persist make sure to follow up with your doctor.

	15.Do you suffer from epilepsy?
	NoYes Invalid Input
	It is obviously very important to get medical clearance form your doctor before you enter into the program. Make sure your instructor knows about your condition and who your emergency contact person is.

	16.Do you have any infections or flue at the moment?
	NoYes Invalid Input
	You cannot exercise when you have an infection or suffer from the flu. While you exercise, the body is using its energy for Physical activity and this gives the virus a chance to attack the body more aggressively. Exercising with can cause a serious infection of the sack around your heart, which in turn can cause long term damage to your heart.

	17.Do you suffer from arthritis or gout?
	NoYes Invalid Input
	Exercise has been found to be beneficial for these conditions in the long run. Do not exercise when you are experiencing an acute attack of gout or of your arthritis flames up. Consult with your doctor before your undertake the type of weight bearing exercise.

	18.Do you smoke?
	NoYes Invalid Input
	Smoking is one of the leading causes of health disease. Quitting will probably prolong your life and decrease your risk of heart disease and cancer by at least 50 %. Go to the Quit smoking tips for more information and statistics.

	19.Do you know of any other reason why you should not participate in a programme of physical activity?
	NoYes Invalid Input
	Please make sure you get full clearance from your doctor before you embark on any exercise program, to make sure that you can take part safely.

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