1. Pressessment Screening Chapter 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) Risk Classification Medical ExamExercise TestMD Supervision of Ex Test LowMod Ex – No Vig Ex – No Mod Ex – No Vig Ex - No Submax – No Max - No ModerateMod Ex – No Vig Ex – Yes Mod Ex – No Vig Ex - No Submax – No Max - No HighMod Ex – Yes Vig Ex - Yes Mod Ex – Yes Vig Ex - Yes Submax – Yes Max - No