Week 4 - Pre Exercise Screening

Question 1

What is the main cause of sudden cardiac death in exercise, in people over 35 years old?

Answer 1

Coronary artery disease

Question 2

What are the main causes of sudden cardiac death and exercise, in people under 35 years old?

Answer 2

• 67% structural abnormality
• 33% electrical abnormality
• Genetic or congenitial conditions

Question 3

What is the main cause of sudden death in young athletes?

Answer 3

Hypertrophic cardiomyopathy
(common cordis, coronary artery disease, left ventricular hypertrophy)

Question 4

What needs to be determined prior to fitness testing and prescribing exercise?

Answer 4

• Health status
• Risk status
• Safety/intensity of exercise

Question 5

What is the purpose of pre-exercise screening?

Answer 5

• Identify those with risk factors and symptoms requiring medical evaluation prior exercise
• Identify individuals with conditions needing medically supervised exercise testing & programs
• Identify individuals with contraindications to exercise
• Identify individuals with additional needs for safe fitness testing and exercise (eg. pregnancy)

Question 6

What are the 3 types of pre-exercise screening?

Answer 6

1. Pre-exercise questionnaire
2. Medical evaluations
3. Musculoskeletal assessments

Question 7

What is assessed in a pre-exercise questionnaire? (6)

Answer 7

• History of diseases and illnesses
• Past family medical history
• Surgical history
• Past and present health behaviours (eg. smoking)
• Current use of drugs/medications
• History/signs of cardiopulmonary disease

Question 8

What is the ESSA Adult Pre-Exercise Screening Tool (APSS)?

Answer 8

Developed by ESSA (Exercise and Sports Science Australia) and SMA (Sports Medicine Australia)
- Used to classify people into 3 risk categories
- Stage 1: compulsory - any “yes” answers requires medical clearance before new exercise program/aerobic fitness testing
- Stage 2: recommended

Question 9

What are some signs and symptoms of CPD? (9)

Answer 9

• Chest pain
• SOB
• Dizziness or syncope
• Dyspnoea, especially at night
• Ankle oedema
• Claudication with exercise
• Heart murmur
• Undue fatigue

Question 10

Any other conditions that requires a medical opinion?

Answer 10

• Serious MSK conditions (OA, OP, back pain) or bone fractures
• History of blood clots
• Recent substantial weight loss without trying
• Epilepsy
• Undiagnosed symptoms of indigestion
• Regular use of prescribed medications/OTC drugs
• Any other chronic medical condition affecting ability to exercise

Question 11

What is the HR intensity guideline?

Answer 11

Sedentary: <40%
Light: 40-55%
Moderate: 55-70
Vigorous: 70-90%
High: ≥ 90% +

Question 12

In stage 2 of the APSS, what risk factors are assessed?

Answer 12

• Age and sex (higher risk if male 45_yo, female 55+yo/lower with menopause complications)
• Family Hx of CVD (CABG, sudden cardiac death)
• Smoking status
• Body composition
• High BP
• Cholesterol
• Medications, hospitalisations, pregnancy, MSK injuries

Question 13

What assessments are part of the medical evaluation’s screening?

Answer 13

• Resting BP, RHR, and ECG
• Exercise stress test
• Blood tests (FBC, blood glucose/cholesterol)
• Musculoskeletal assessment

Question 14

What is included in the functional movement screening as part of the “musculoskeletal assessments” screening tool?

Answer 14

• Deep squat
• Hurdle step
• In line lunge
• Shoulder mobility
• Active straight leg raise
• Trunk stability push-up
• Rotary stability
  Mainly used for sport