1. GXT 2008-CH 2 HEALTH SCREENING AND RISK STRATIFICATION Occurs prior to testing or exercise participation Allows for risk stratification to ensure safety

2. PREPARTICIPATION SCREENING Identifies people that have complications and may need to be excluded from exercise and testing or screening Identifies people at higher risk Identifies people with disease Identifies people with special needs

3. SCREENING PROCEDURES Must be appropriate for clients (symptomatic or asymptomatic) Must be valid, cost-effective and time efficient Par-Q, Medical History, Lab work Need to be able to evaluate risk factors and symptoms

4. RISK FACTORS Family History-blood male before 55, blood female before 65 Smoking or quit within previous 6 months Hypertension measured on at least 2 separate occasions or on antihypertensive medications Hypercholesterolemia-total>200mg/dl, or HDL 130mg/dl

5. CONTINUED Fasting Glucose> 110 mg/dl measured on 2 separate occasions Obesity (BMI> 30 kg/m2) or waist > 100cm Sedentary Lifestyle-based on Surgeon General’s guidelines Not an all inclusive list of risk factors This will offset a risk factor=HDL>60mg/dl

6. SYMPTOMS See Box 2-1 Can be somewhat subjective Must evaluate accordingly Example: known heart murmur or shortness of breath with normal activities

7. RISK STRATIFICATION Based on likelihood of experiencing an event when considering age, health status, risk factors and symptoms Low risk-asymptomatic young with one or no RF Moderate risk- old or with more than one RF High risk-with one or more symptoms or disease

8. RECOMMENDATIONS FOR TESTING AND PHYSICIAN SUPERVISION Based on intensity of exercise and type of test See Table 2-2 Remember--these guidelines can not cover all situations and each circumstance must be evaluated All exercise test personnel should be ACSM certified and have CPR certification