Next due date: Review assignment — January 25th
Module 2 — Pre-Participation and Health Screening
● Risk Associated with Exercise
○ Healthy population — very low risk of CV events
■ Low-moderate intensity exercise, low
■ Slightly higher with vigorous exercise but still minimal
○ At risk populations
■ Men = 0.3-2.7 events per 10,000 (event ending in death)
■ Women = 0.6-6.0 events per 10,000
○ General population
■ Active — risk is cut in half for chance of acute MI (0.5)₁
● Active 1-2x a week (~30 fold risk)
● Active 3-4x a week (~8-10 fold risk)
● Active 5+ (~2 fold risk)
■ Sedentary — baseline risk is 1.0 and up to 100 or more when active
○ Athletes
■ American Health Association Screening
● Personal History, Family History, and a Physical Exam is taken
into account ₂
● Exercise testing and risk of cardiac events
○ In a mixed population, the risk of exercise testing is low (~6 cardiac events in
10,000 tests)
○ No screening = higher risk of sudden event
○ Submaximal testing with screening has lower risk than maximal testing
■ When testing submaximally, take a patient’s heart rate at about 70-85% of
HR (rather than max heart rate)
■ Heart rate formula = 208 - 0.7 x age
● **don’t use the [220-age] formula for this course**
● Screening of competitive athletes
○ Congenital heart defects (abnormalities that remained undetected until it is too
late)
■ 12-20 per year die
■ Most common: hypertrophic cardiomyopathy
○ Strength/power athletes at higher risk
■ Heart pumps so hard & so suddenly that cardiac muscles become
hypertrophy, as it grows thicker the ventricles become thicker
● Most at risk for exercise related CVD risk
○ Neglect warm up/cool down
○ Exceed prescribed training heart rate
○ Smokers
○ Male
● ACSM Risk Factors (not used for screening purposes) ₃
○ Age
○ Family History
○ Smoking
○ Inactivity
○ Obesity
○ Hypertension
■ Out of date on table, it is not ≥140 and/or ≥ 90 anymore, it is now ≥130
and/or ≥ 80
○ Dyslipidemia
○ Diabetes
● Pre-participation Health Screening 2 Stages
○ Goal of screening: Determine need for medical clearance & Identify high risk
individuals
■ ACSM screening algorithm
● 1. Currently participating in regular exercise?
○ 30 min at moderate intensity, 3 days/week, for at least 3
months
■ Moderate intensity:
● 40-59% HRR or VO reserve₂
● 3-5 METS
● RPE of 12-13 out of 20
● Noticeable increases in HR and breathing
● 2. Known disease? (diabetes)
○ Can also be cardiac, peripheral vascular, or
cerebrovascular
● 3. Signs/Symptoms
○ Pain/Nausea (men are more likely to experience chest pain
during heart attack, women are more likely to experience
nausea
■ Discomfort in chest, neck, jaw, arms
○ Shortness of breath
○ Syncope (dizziness)
○ Orthopnea
○ Ankle edema
○ Palpitations
○ Intermittent claudication
○ Known heart murmur
○ Unusual fatigue
● 4. Desired Intensity?
● 5. In need of medical clearance
■ PAR-Q+
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MI — Myocardial infarction
