Health Screening and Evaluation

Exam 1

health related components of fitness

cardiorespiratory endurance

muscular endurance

muscular strength

flexibility

body comp

skill related components of health

agility

balance

coordination

power

reaction time

speed

4 pre-exercise evaluation components

informed consent

exercise screening

health history

CV risk assessment

purpose of the participation health screening (PARQ)

identify those at high risk for adverse event and who need medical clearance

Inactive, no disease, no symptoms

light to moderate

Inactive, known disease but asymptomatic

medical clearance recommended

Active, known disease but asymptomatic

may continue moderate, clearance before progression

sudden cardiac death (SCD)

death due to cardiovascular cause occurring within 1 hour or less of symptom onset, often arrhythmic

bradycardia

< 60bpm

tachycardia

> 100 bpm

elevated BP

120-129/80

stage 1 hypertension

130-139 or 80-89

stage 2 hypertension

>140 or >90abs

absolute hypotension

SBP <90 mmHg

orthostatic hypotension

SBP drop >20 and DBP drop > 10mmHg upon standing

symptoms requiring deferral & referral

chest pain

unexplained syncope or near-syncope

unexplained dyspnea at rest or light effort

palpitation with hemodynamic compromise

cyanosis, pallor, dizziness

when should informed consent be completed

before collecting any confidential info

before any fitness testing

before exercise participation

2-stage process of pre-participation health screening

1. the need for medical clearance before starting/progressing exercise programming using ACSM screening algorithm

2. medical clearance if indicated

high risk of cardiac event in individual with known CVD

Left ventricular ejection fraction <40%

Abnormal hemodynamics with exercise,

maximal functional capacity <5.0 METS

moderate risk of cardiac event in individual with known CVD

Left ventricular ejection fraction = 40-50%,

Mild to moderate silent ischemia

low risk of cardiac event in individual with known CVD

Left ventricular ejection fraction >50%, Maximal functional capacity at least 7.0 METS

major signs and symptoms suggestive of CV, metabolic, and renal disease

shortness of breath with mild exertion

paroxysmal nocturnal dyspnea

intermittent claudication

ACSM considers these 4 information when determining starting/progressing exercise

current activity status

known CV/met/renal disease

signs/symptoms of disease

desired intensity

3 purposes of preparticipation health screening

identify those at risk for adverse CV events & who need medical clearance.

to acknowledge that vigorous exercise is associated with risk of SCD & AMI

to reduce barriers to exercise