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Screening for Activity: Identifying Medical Concerns and Risk Factors

This chapter explains the importance of screening individuals before engaging in physical activity to identify potential medical contraindications, the need for medical clearance or supervision, and other health concerns such as musculoskeletal issues. It discusses medical history, health habits, the PAR-Q form, ACSM risk stratification, CAD risk factors, signs/symptoms suggestive of CV, pulmonary, or metabolic disease, and ACSM recommendations for medical exams and testing prior to exercise.

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Screening for Activity: Identifying Medical Concerns and Risk Factors

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  1. Pressessment ScreeningChapter 2

  2. Why Screen for Activity? • To identify those with medical contraindications • To identify those who need medical clearance • To identify those who need medical supervision • To identify those with other health/medical concerns like musculoskeletal issues

  3. Medical History/Health Habits • Family history • History of illness & disease • Surgical history • Health behaviors (smoking, alcohol, etc) • Current medications • Signs & symptoms suggesting disease

  4. PAR-Q Form • Has you doctor ever said you have a heart condition? • Do you feel pain in your chest when you do physical activity? • Do you have chest pain when not doing activity? • Do you lose balance because of dizziness or do you every lose consciousness?

  5. ACSM Risk Stratification • Low Risk • Asymptomatic and meet no more than one risk factor threshold. • Moderate Risk • Those who meet the threshold for 2 or more risk factors. • High Risk • Individuals with any signs/symptoms of CV or pulmonary disease or renal disease or diabetes

  6. CAD Risk Factors (Table 2.1) Positive Risk Factors • Age • Family History • Cigarette smoking • Sedentary Lifestyle • Obesity • Prediabetes • Hypertension • Dyslipidemia Negative Risk Factors • High HDL cholesterol

  7. Signs/Symptoms Suggestive of CV, Pulmonary or Metabolic Disease • Pain, discomfort in the chest, neck, jaw, arms which may due to ischemia (Angina Pectoris) • Shortness of breath at rest or mild exertion • Dizziness or syncope • Orthopnea or nocturnal dyspnea • Ankle edema • Palpitations or tachycardia • Intermittent claudication • Known heart murmur • Unusual fatigue or shortness of breath • Intermittent claudication • Unusual fatigue or shortness of breath with usual activities

  8. ACSM Recommendations for Medical Exam and Testing Prior to Exercise (Fig. 2.4)

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