exercise testing and prescription chapter 2

those with known CVD should be put through what?

a more in-depth risk stratification procedure than the ACSM preparticipation health screening algorithm

2 or more risk factors:

medical clearance recommended for vigorous activity (there are modifiable and non-modifiable risk factors)

the pre-exercise evaluation helps what?

minimize the need to see a physician prior to starting exercise (one less barrier to starting exercise)

the informed consent should ensure what?

that individuals know and understand the purpose(s) and risks associated with screening, assessment, and the exercise program

ACSM no longer recommends what?

the inclusion of exercise testing for medical clearance (that decision is left to the qualified health care provider)

ACSM's screening algorithm:

-determining current PA levels -identifying signs and symptoms of underlying CV, metabolic, and renal disease -identifying individuals with diagnosed CV and metabolic disease -using signs and symptoms, disease history, current exercise participation, and desired exercise intensity to guide recommendations for preparticipation medical clearance (separate from a periodic medical examination)

medical history:

-gives you more information about your client/patient to guide decisions about exercise testing and program design -can pick up other reasons why medical clearance would be necessary -includes both past and present information

using the algorithm:

-individuals are grouped into one of 6 categories -it is important to continue checking in/monitoring the participant to make sure their categorization doesn't change over time

prior to engaging in physical activity or structured exercise programs:

-informed consent -exercise preparticipation health screening -health history -cardiovascular (CV) risk factor analysis -exercise testing for medical clearance

all of the signs and symptoms should be thought about within the context of the individual's recent history:

-may need follow up questions: -what were you doing during these periods? -were you more breathless that you would have expected for this activity? -compared to recent similar activities, were you more fatigued following the activity?

identifying those with CV, metabolic, or renal diseases:

-or those with signs or symptoms suggestive of cardiac, peripheral vascular, renal, or cerebrovascular diseases, Type 1 and 2 diabetes mellitus

signs or symptoms of CVD:

-pain/discomfort -shortness of breath -dizziness/syncope -orthopnea/paroxysmal nocturnal dyspnea -ankle edema -palpitations/tachycardia -intermittent claudication -known heart murmur -unusual fatigue or shortness of breath

parts of the informed consent:

-purpose and explanation of the test -attendant risks and discomforts -responsibilities of the participant -benefits to be expected -inquiries -use of medical records -freedom of consent signatures

obtaining informed consent (IC) from individuals is an important ethical and legal consideration and should be completed prior to:

-the collection of any personal and confidential information -any form of fitness testing -exercise participation

if medical clearance is recommended, the physician or health care provider then decides the type of evaluation:

-verbal consultations -resting or stress ECG -computed tomography -coronary angiography

exercise participation:

30 min at moderate intensity for at least 3 days a week in the last 3 months

hypertension is considered a what?

CVD risk factor and NOT a cardiac disease

exercise testing is a poor predictor of what?

acute cardiac events in asymptomatic individuals

to be classified as a current exercise:

history of performing planned, structured PA of at least moderate intensity for at least 30 mins on 3 or more days/week during the past 3 months

the preparticipation health screening identifies who?

identifies those who are at risk for adverse exercise-related CV events and which individuals should be referred for medical clearance

preparticipation health screening before initiating PA or an exercise program is a two-stage process: (2 of 2)

if indicated during screening, medical clearance should be sought from an appropriate health care provider (the manner of clearance should be determined by the clinical judgment and discretion of the health care provider)

CVD risk factor analysis:

if one or these risk factors is unknown or not disclosed it should be counted as a risk factor

preparticipation health screening before initiating PA or an exercise program is a two-stage process: (1 of 2)

the need for medical clearance before initiating or progressing exercise programming is determined using the ACSM screening algorithm (self-guided screenings can be an acceptable substitute for this method)

current PA levels (algorithm):

those who are unaccustomed have an increased risk for SCD and AMI

the informed consent should be what?

verbally described, and the individual be given every chance to ask questions before signing