Prescreening
To optimize safety
 To permit the development of a sound and
effective exercise prescription.

Prescreening

Before assessing your client’s physical
fitness profile, you should classify the
individual’s health status and lifestyle.
Prescreening

You will use information from the initial
health and lifestyle evaluations to screen
clients for physical fitness testing.
Prescreening
The purpose of the pre-participation health
screening include:
 Identification and exclusion of individuals
with medical contraindications to exercise.

Prescreening

Identification of individuals with disease
symptoms and risk factors for disease
development who should receive medical
evaluation before starting an exercise
program.
Prescreening

Identification of persons with clinically
significant disease considerations who
should participate in a medically supervised
exercise program.
Prescreening

Identification of individuals with other
special needs.
Prescreening

It is essential that health screening
procedures be valid, cost effective, and time
efficient.
Prescreening

The PAR-Q has been recommended as a
minimal standard for entry into low-tomoderate intensity exercise programs.
Prescreening

The PAR-Q was designed to identify the
small number of adults for whom physical
activity might be inappropriate or those who
should have medical advice concerning the
most suitable types of activity.
Prescreening
Prescreening may be composed of:
 Medical history
 Risk stratification
 Medical clearance

Prescreening
Lifestyle evaluation
 Informed consent
 Exercise testing

Medical History

You should require your clients to complete
a comprehensive medical history
questionnaire that includes questions
concerning personal and family health
history.
Medical History
Use the questionnaire to:
 Examine the client’s record of personal
illnesses, surgeries, and operations.

Medical History

Assess previous medical diagnoses and
signs and symptoms of disease that have
occurred within the past year or are
currently present.
Medical History

Analyze your client’s family history of
diabetes, heart disease, stroke and
hypertension.
Medical History

Also, when reviewing the medical history,
you should carefully focus on conditions
that require medical referral.
Medical History

If any of these conditions are noted, refer
your client to a physician for a physical
examination and medical clearance prior to
exercise testing or starting an exercise
program.
Medical History

It is also important to note the types of
medication being used by the client.
Medical History

Drugs such as digitalis, beta-blockers,
diuretics, vasodilators, bronchodilators, and
insulin may alter the individual’s heart rate
blood pressure, ECG, and exercise capacity.
Medical History

If your client reports a medical condition or
drug that is unfamiliar to you, be certain to
consult medical references or a physician to
obtain more information before conducting
any exercise tests or allowing the client to
participate in an exercise program.
Medical Clearance

Your prospective exercise program
participants should obtain a physical
examination and a signed medical clearance
from a physician, especially if they are:
Medical Clearance

Men >40 years of age with two or more
major coronary risk factors.
Medical Clearance

Women >50 years of age with two or more
major coronary risk factors.
Medical Clearance

Individuals of any age with known
cardiovascular, pulmonary, or metabolic
disease.
Lifestyle Evaluation

Planning a well-rounded physical fitness
program for an individual requires that you
obtain information about the client’s living
habits.
Lifestyle Evaluation

The lifestyle assessment provides useful
information regarding the individual’s risk
factor profile.
Lifestyle Evaluation

Factors such as smoking, lack of physical
activity, and diets high in saturated fats or
cholesterol increase the risk of CAD
atherosclerosis, and hypertension.
Lifestyle Evaluation

Additionally the lifestyle evaluation should
gather information on drug and alcohol use,
physical activity level and psychological
stress levels of the individual.
Lifestyle Evaluation

These factors can be used to pinpoint
patterns and habits that need modification
and to assess the likelihood of the client’s
adherence to the exercise program.
Risk Stratification
See ACSM’s Guidelines for risk factors - p.
18.
 See ACSM’s Guidelines for risk
stratification - p. 19.

Informed Consent

Prior to conducting any physical fitness
tests or exercise programs, you should see
that each participant signs an informed
consent.
Informed Consent

This form explains the purpose and nature
of each physical fitness test, any inherent
risks in the testing, and the expected
benefits of the tests.
Informed Consent

The informed consent also ensures your
clients that the results will remain
confidential, and that their participation is
strictly voluntary.
Informed Consent

If your client is underage (<18 years), a
parent or guardian must also sign the
informed consent.
Informed Consent

All consent forms should be approved by
your institutional review board or legal
counsel.
Risks of Exercise Testing.

Clinical exercise testing is a relatively safe
procedure, although complications may
arise.
Risks of Exercise Testing.
The risk of death during or immediately
after an exercise test is < 0.01%.
 The risk of MI during or immediately after
an exercise tests is < 0.04%.

Risks of Exercise Testing.

The risk of a complication requiring
hospitalization (including MIs) is
approximately 0.1%.
Risks of Exercise Testing.

The data do suggest that the rate of
complications during exercise testing is
higher in populations undergoing diagnostic
testing, compared with persons being tested
as part of a preventive medical examination.
Risks of Exercise Testing.

The risks associated with submaximal
physical fitness testing appear to be even
lower.
Risks of Exercise Testing.

Submaximal physical fitness testing appears
to have an extremely low risk when
accompanied by appropriate pretest
screening such as the PAR-Q and can be
administered safely by qualified personnel
in non-medical settings.
Risks of Exercise Testing.

No set of guidelines for exercise testing and
participation can cover all situations.