Pre Participation Screening
family history CVD risk factor
MI, revascularization or sudden death before 55 yr in father or other male first degree relative, or before 65 yr in mother or other first degree female
CVD age risk factor
Men > 45 Women > 55
Two stage process before initiating PA or an exercise program
a) need for medical clearance before initiating or progressing exercise programming b) if indicated during screening, medical clearance should be sought from doctor
obtaining informed consent should be done prior to
a) the collection of any personal information b) any form of fitness testing c) exercise participation
paroxysmal nocturnal dyspnea
awakening from sleep with SOB and needing to be upright to achieve comfort
ankle edema
bilateral ankle edema that is most evident at night is a sign of heart failure or bilateral chronic venous insufficiency
cigarette smoking risk factor
current or those who quit in previous 6 months
The need for medical clearance before initiating or progressing exercise programming is
determined using the screening algorithm self guided screenings can be a substitute for this method
ACSM no longer recommends the inclusion of
exercise testing for medical clearance (decision made by healthcare provider)
CVD blood glucose risk factor
fasting plasma glucose >100mg dL or 2 h plasma glucose values in oral glucose tolerance test >140mg dL or HbA1C >5.7%
physical inactivity risk factor
not meeting minimum threshold of 500- 1,000 MET-min of moderate to vigorous intensity
vigorous exercise is associated with
small but measurable acute risk of activity-associated SCD and AMI and those with underlying CVD who perform unaccustomed vigorous activity are at highest
if indicated during screening, medical clearance should be sought from doctor
the manner of clearance should be determined by the clinical judgement and discretion of healthcare provider
syncope
"Passing out", loss of consciousness or fainting
Algorithm components for pre participation screening
-classify individuals who do or do not participate in regular exercise -identify individuals with known CV, metabolic, or renal diseases or those with signs or symptoms of cardiac, peripheral vascular or cerebrovascular disease, type 1/2 DM and renal disease -identifying desired exercise intensity
CVD body mass index/waist circumference risk factor
BMI >30kg or waist girth >102cm (40in for men) >88cm (38in) for women
ischemia
Lack of blood supply
Medical history and CV risk factor analysis
NOT part of preparticipation health screening procedures to reduce health risk
self guided screening
PAR-Q+
CVD Blood pressure risk factor
SBP >130 mmHg DBP >80 based on average of 2 readings anti hypertensive medications
dyspnea
abnormally aware uncomfortableness of breathing
Exercise testing is a poor predictor of
acute cardiac events in asymptomatic individuals
the ACSM preparticipation screening algorithm is designed to
identify individuals at risk for CV complications during or immediately after aerobic exercise
obtaining informed consent from individuals is an
important ethical and legal consideration
CVD Lipids risk factor
in men : LDL-C >130mg dL HDL-C <40mg dL in women: LDL-C <130mg dL HDL-C <50mg dL lipid lowering medication
the IC should ensure that
individuals know and understand the risks and purposes associated with screening, assessment and the exercise program
prior to engaging in PA or structured exercise programs
informed consent exercise preparticipation health screening health history CV risk factor analysis
intermittent claudication
pain that occurs in the lower extremities with an inadequate blood supply that is brought on by exercise. usually a result of atherosclerosis
major signs and symptoms suggestive of cardiovascular, pulmonary, or metabolic disease
pain, shortness of breath at rest/mild exertion, dizziness/syncope, orthopnea/paroxysmal nocturnal dyspnea, ankle edema, palpitations/tachycardia, intermittent claudication, known heart murmur, unusual fatigue
ASCM pre participation screening identifies
those who are at risk for adverse exercise related CV events and those who need medical clearance
palpitations
uncomfortable awareness of heartbeat or rapid beating of the heart
the IC should be
verbally described and the individual should have every chance to ask questions before signing
