What is pre-exercise health screening?

“Pre-exercise health screening is a process of identifying people who may have health-related conditions which increase the risk of an adverse event during exercise” (Norton, Eston & Taylor 2018). An adverse event occurs as a consequence of an exercise session resulting in physical harm, ill health, or death to an individual like a sudden cardiac arrest (SCA) or sudden cardiac death (SCD). The absolute risk of SCD in the general adult population is extremely low with a median value of reported rates about 0.3 per million hours (Norton, Eston & Taylor 2018).

Therefore, screening is a filter, or ‘safety net’ to help determine if the potential benefits of exercise outweight the risks for an individual. Moreover, an extension of the process invovles measuring the number and type of health risk factors a person has which can help trailor movements and exercise interventions specific to the needs of the individual. All of the health-related information provided to the exercise programmer helps avoid certain activities, or to modify the intensity and duration of a particular exercise to minimise the risk to the participant. In turn it will help demonstrate the health benefits of regular physical activity and track improvements overtime.

General Structure of Pre-exercise Screening Systems

Pre-exercise screening and health risk factor assessment serve a number of purposes including identifying individuals: (a) who have signs or symptoms of diseases or medical problems, (b) with medical contraindications to exercise, (c) who have specific risk factors that need to be considered when prescribing safe exercises, and (d) with other special needs of exercise limitations.

Importantly, given the high proportion of adults not sufficiently active and the increasing problem of overweight and obesity prevalence, the major systems described all have stated aims to encourage more people to be physically active without burdensome barriers. Hence, the challenge is to accomplish this while still having the sensitivity of the screen tool and associated screening system to identify those at increased risk of an adverse event and for whom further allied health professional, or medical assistance may be recommended.

Physical Activity Patterns

National and International Physical Activity guidelines suggest that adults should achieve at least 150 minutes of weighted physical activity per week in order to confer health benefits. If an individual fails to reach this level they are classified as insufficiently active. Weighted physical activity means time spent doing vigorous intensity activity is multiplied by two in recognition of the greater health-related benefits of high-intensity exercise compared to lower-intensity exercise.

Lifestyle changes, especially diet and physical activity, can help to maintain quality of life and reduce the gap between disability-free years and life expectancy. Physical activity, a strong determinant of fitness, has also been shown to be among the most important risk factors for preventable disease and injury burn in global analysis. Due to the growing interest in the effects of sedentary behaviour on risk of chronic illness, it has been shown that a few hours of inactivity can reduce insulin sensitivity on tissue membranes. Over time, these consistent bouts of sedentary behaviour (or long period os sitting) can lead to impaired glucose control and increase the risk of type 2 diabetes and metabolic syndrome (Norton, Eston & Taylor 2018).

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Norton, K, Eston, R & Taylor, F 2018, Kinanthropometry and Exercise Physiology, 4th edn, Routledge, UK. ISBN: 9781315385662