Goal for preparticipation screening?
- To identify who should receive medical clearance prior to initiating a
vigorous-intensity exercise program or increasing the frequency, intensity,
and/or volume of their current exercise program - To identify those with clinically significant disease
- To identify those with medical conditions which should be restricted from participating in an exercise program until their disease conditions are
abated or better controlled
How do we identify various diseases and assess in preparticipation screening?
This will be accomplished by collecting:
- Individual’s current physical activity level
- Individuals with signs and symptoms of CVD, metabolic disease, and
renal disease - Individuals with diagnosed CVD, metabolic disease, and renal disease
- Individual’s desired exercise program intensity
What four steps are involved in a preparticipation health screening?
The algorithm follows these steps to determine if an
individual should seek medical clearance prior to exercise:
1) Identify if the individual currently participates in
regular exercise.
* Exercising at least 30 minutes on 3 or more days per week at a
moderate intensity for at least 3 months
2) Identify if the individual has been diagnosed with CVD,
metabolic disease, or renal disease.
3) Identify if the individual has any signs or symptoms
suggestive of the same diseases (Table 3.1).
4) Identify the individual’s desired exercise program
intensity.
Major Signs or Symptoms to Note in a preparticipation screening?
- Pain, esp. of unknown origin; discomfort in the chest, neck,
jaw, or arms- Esp. if described as constricting, squeezing, burning,
“heaviness”
- Esp. if described as constricting, squeezing, burning,
- Shortness of breath at rest or w/ mild exertion
- Dizziness/Syncope
* More significant if occurring during exercise instead of
after - Orthopnea/Paroxysmal nocturnal dyspnea
- Ankle edema
- Palpitations/Tachycardia
- Intermittent claudication
- Pain (often described as a cramp) in lower extremities
brought on by exercise
- Pain (often described as a cramp) in lower extremities
- Known heart murmur
- Unusual fatigue or dyspnea with usual activities
The most common self-guided screening form is the
____ ____ ____ ____ (____)?
The most common self-guided screening form is the
Physical Activity Readiness Questionnaire for Everyone
(PAR-Q+).
A more in-depth screening process (Beyond the PAR-Q) is needed for
individuals in ____ ____ or ____ ____ ____?
A more in-depth screening process (Beyond the PAR-Q) is needed for
individuals in cardiac rehabilitation or medical fitness
facilities.
The informed consent should include the following?
- Comprehensive explanation of the risks and
benefits associated with exercise testing - Indication that the participant is free to withdraw
without consequence - Statement that “emergency procedures and
equipment are available” - The form should be explained verbally.
- The individual should be given time to ask questions.
- If the participant is a minor, the parent or legal
guardian provides consent, whereas the minor provides
assent.
CVD risk factors should be identified and controlled to/for?
- Aid in development of individual’s ExRx
- Lifestyle modification
- Disease prevention and management
- CVD risk factors do not predict risk for exercise
Steps for determining CVD risk?
1) Determine if patient meets any positive risk factors from Table 3.2.
* If patient does not know if he or she meets the criteria for a
risk factor, it should be counted.
2) Sum the positive risk factors.
3) If client meets negative risk factor from Table 3.2, subtract one
from the total of positive risk factors.
8 positive and 1 negative risk factors for CVD?
Age
Family History
Cigarette smoking
Physical inactivity
BMI/waist circumference
BP
Lipids
Blood glucose
HDL-C
Blood pressure is typically measured using ____?
Blood pressure is typically measured using auscultation
In order to avoid BP assessment errors, all of the following should be considered?
- Appropriate testing procedures (Box 3.5)
- Type of instrument used
– Auscultatory or oscillometric - Posture of subject
– Supine, seated, or standing - Common sources of assessment error (Box 3.6)
Inaccurate sphygmomanometer
Improper cuff size
Faulty equipment
Auditory acuity of technician
Experience of technician
Reaction time of technician
Improper stethoscope placement or pressure
Not having the cuff at heart level
Certain physiological abnormalities (Damaged brachial artery, subclavian steal syndrome, arteriovenous fistula)
Background noise
Allowing patient to hold treadmill handrails or flex elbow.
Blood pressure ranges?
- A resting blood pressure (BP) measurement is a vital
component of any prescreening evaluation. - BP is typically classified as follows:
- Normal BP = <120 mm Hg systolic blood pressure
(SBP) and <80 mm Hg diastolic blood pressure
(DBP) - Prehypertension = 120–129 mm Hg SBP or <80
mmHg DBP - Stage 1 hypertension = 130–139 mm Hg SBP or 80–
89 mm Hg DBP - Stage 2 hypertension = ≥140 mm Hg SBP or ≥90 mm
Hg DBP
The new screening algorithm is based on?
- Low risk of CV events with the adoption of new
exercise programs - Risk associated with vigorous exercise can be mitigated
if the individual begins at a lower intensity and
progresses over time.
Preparticipation screening is used to identify individuals who
are at risk to experience ___ ____ ____-____ _____ ____.
Preparticipation screening is used to identify individuals who
are at risk to experience an adverse exercise-related CV
event.
How is blood pressure measured?
Exercise professional listens for the sounds of
Korotkoff.
* BP cuff is inflated to a suprasystolic pressure, which occludes
the brachial artery.
* As cuff is deflated, pulsatile flow is reestablished and is
accompanied by sounds, which can be heard with a
stethoscope.
* Typically, five Korotkoff sounds can be heard (Box 3.4).
Once through the screening process, an appropriate exercise
mode and protocol should be chosen to assess _________________________________________?
Once through the screening process, an appropriate exercise
mode and protocol should be chosen to assess any or all of
the health-related components of fitness
Detailed instructions should be provided to participants
prior to exercise testing?
Instructions should include the following:
* Avoid eating and smoking 3 hours prior to testing.
* Wear comfortable footwear and loose-fitting clothing.
* Directions for medication usage prior to testing
* Avoid unusual physical efforts for 12 hours prior to
testing.
- Preparticipation screening and physical exam should be
completed. - Contraindications to exercise testing should be determined (see Chapter 4, Box 4.1).
- Informed consent should be reviewed and signed.
In addition to preparticipation screening, the exercise
professional should administer a ____ ___ and ____ ____ ____ ____.
In addition to preparticipation screening, the exercise
professional should administer a medical history and CVD risk
factor assessment.
