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