Chapter 2: Exercise Pre-participation Health Screening
Absence of angina or other significant symptoms:
(unusual shortness of breath, light-headedness, or dizziness, during exercise testing and recovery)
Non-exercise Testing Findings AT LOWER RISK Resting ejection fraction ≥ _____% Uncomplicated _____________ or re-vascularization procedure Absence of complicated ventricular _________ at rest Absence of ________ heart failure Absence of signs or symptoms of postevent/postprocedure ________ Absence of clinical _______
1) 50% 2) myocardial infraction 3)Dysrhythmias 4) Cognitive 5) Ischemia 6)depression
Functional capacity ≥___ metabolic equivalents (METs)
7
Characteristics of patients at lowest risk for exercise participation
Absence of complex ventricular dysrhythmias during exercise testing and recovery
What is the difference of Cardiac arrest and Myocardial infarction
Cardiac arrest: Something caused the Heart to stop Myocardial infarction: Part of the heart has a lack of blood flow.
T/F CV complications during resistance training, this risk can currently be determined but appears to be low
False: It CANNOT
Stage 2 of Pre-participation health screening:
If indicated during screening (see Figure 2.2), 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
What are the major signs or symptoms suggestive of Cardiovascular, metabolic, and renal disease?
Pain; discomfort (or other anginal equivalent) in the chest, neck, jaw, arms, or other areas that may result from ischemia Shortness of breath at rest or with mild exertion Dizziness or syncope Ankle edema Palpitations or tachycardia
PAR-Q stands for?
Physical Activity Readiness Questionnaire
Self-Guided Methods
Preparticipation health screening by self-reported medical history or health risk appraisal should be done for all individuals wishing to initiate a physical activity program.
Characteristics of patients at MODERATE risk for exercise participation:
Presence of angina or other significant symptoms (e.g., unusual shortness of breath, light-headedness, or dizziness occurring only at high levels of exertion Mild to moderate level of silent ischemia during exercise testing or recovery Functional capacity <5 METs
Characteristics of patients at HIGH risk for exercise participation
Presence of complex ventricular dysrhythmias during exercise testing or recovery Presence of angina or other significant symptoms (e.g., unusual shortness of breath, light-headedness, or dizziness at low levels of exertion [<5 METs] or during recovery) High level of silent ischemia (ST-segment depression ≥2 mm from baseline) during exercise testing or recovery Presence of abnormal hemodynamics with exercise testing (i.e., chronotropic incompetence or flat or decreasing systolic BP with increasing workloads) or recovery (i.e., severe postexercise hypotension)
Nonexercise Testing Findings for MODERATE RISK:
Rest ejection fraction 40% to 49%
Nonexercise Testing Findings at HIGH RISK
Rest ejection fraction <40% History of cardiac arrest or sudden death Complex dysrhythmias at rest Complicated myocardial infarction or revascularization procedure Presence of congestive heart failure Presence of signs or symptoms of postevent/postprocedure ischemia Presence of clinical depression Reprinted from (32), with permission from Elsevier.
What is SCD?
Sudden Cardiac Death
Pre-participation health screening process is based on:
The individual's current level of structured physical activity The presence of major signs or symptoms suggestive of CV, metabolic, or renal diseases The desired exercise intensity
T/F Among adults, the risk for activity-associated SCD and AMI is known to be highest among those with underlying CVD who perform unaccustomed vigorous PA
True
T/F Exercise professionals are encouraged to complete a CVD risk factor assessment with their patients/clients as part of the pre-exercise evaluation
True
T/F The relative risk of a Cardiovascular event is transiently increased during vigorous intensity exercise as compared with rest but that the absolute risk of an exercise-related acute cardiac event is low in healthy asymptomatic individuals
True
Pre-participation health screening before initiating PA or an exercise program is a what?
Two-stage process
How can self-guided method be easily accomplished?
Using PAR-Q+
Insufficient evidence is available to suggest that the presence of CVD risk factors ____________ underlying disease confers substantial risk of adverse exercise-related CV events
Without
When screening someone who is ambiguous about their answers on PAR-Q what should you write down regarding risk factors?
You should check that they have a risk factor even if you don't know.
What is AMI?
acute myocardial infarction
Presence of normal hemodynamics during exercise testing and recovery
appropriate increases and decreases in heart rate and systolic blood pressure with increasing workloads and recovery
The ACSM pre-participation screening algorithm is a new instrument designed to:
identify participants at risk for CV complications during or immediately after aerobic exercise
current evidence is ____________ regarding CV complications during resistance training to:
insufficient warrant formal prescreening recommendations
CVD risk factor-based exercise preparticipation health screening ______________________ due to the __________________- and may generate excessive physician referrals, particularly in older adults
may be overly conservative high prevalence of risk factors
Exercise professionals working with patients with known CVD in exercise-based cardiac rehabilitation and medical fitness settings are advised to:
use more in-depth risk stratification procedures
Stage 1 of Pre-participation health screening: The need for medical clearance before initiating or progressing exercise programming is determined _____________:
using the updated and revised ACSM screening algorithm In the absence of professional assistance, interested individuals may use self-guided methods
