GXT 2008-CH 2

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< 35mg/dl or on lipid lowering meds, LDL>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