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Benefits of Physical Activity
- Increased cardiovascular and respiratory function
- Decreased risk of all causes of mortality
- Decreased CVD and CAD risk
- Better overall quality of life, function and mood
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Purpose of Health Screening
- Identify individuals with contraindications for exclusion
- Identify individuals that need medically supervised programs
- Detection of individuals with risk factors that need testing and/or medical clearance
- Recognition of Special needs
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Screening Provide Information on...
- Health history
- Current medical conditions
- Risk factors
- Signs/symptoms
- Current physical activity/exercise habits
- Medications
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Self-guided Screening
Initiated and guided by individual with little or no input from exercise or health/fitness professional
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PAR-Q
Physical Activity Readiness Questionnaire
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Risk Stratification Low
- 1 or less risk factors for CVD
- Examination or clearance not necessary
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Risk Stratification Medium
- 2 or more risk factors for CVD
- Low to moderate intensity OK
- Clearance and testing for Vigorous >60% VO2R
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Risk Stratification High
- 1 or more signs/symptoms or diagnoses of cardiovascular, pulmonary and/or metabolic disease.
- Clearance needed before any physical activity
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Signs and/or Symptoms of cardiovascular, pulmonary or metabolic disease
- Pain/discomfort in arms, chest, jaw, neck or surrounding areas
- Shortness of Breath at rest or mild exertion
- Dizziness or syncope
- Orthopnea or paroxysmal nocturnal dyspnea
- Ankle Edema
- Palpitations or tachycardia
- intermittent claudication
- Known Heart Murmur
- Unusual fatigue or shortness of breath with usual activities
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Atherosclerotic CVD Risk Factors for Risk Stratification
- Age
- Family History
- Cigarette Smoking
- Sedentary Lifestyle
- Obesity
- Hypertension
- Dyslipidemia
- Prediabetes
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RF Age
- Men 45 or older
- Women 55 or older
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RF Family History
Myocardial infarction, coronary revascularization or sudden death of first degree male <55 or woman <65
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RF Cigarette Smoke
Current or within 6 months
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Sedentary Lifestyle
Not doing at least 30min of moderate physical activity (40-60% VO2R) on at least 3 days of the week for at least 3 months
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Obesity
- BMI 30kg*m^2 or higher or
- Waist >40in for men and >35 for women
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Hypertension
- SBP 140mm Hg or higher and/or DBP 90mm Hg or higher on 2 separate occasions
- Or on hypertensive medication
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Dyslipidemia
- Low-density Lipoprotein LDL = 130mm*dl or higher.
- HDL = 40mm*dl or lower
- Or on lipid lowering medication
- If not available total is 200mm*dl or higher
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Prediabetes
- Impaired Fasting Glucose IFG = fasting plasma glucose 100 but under 126mg*dl
- Or Impaired Glucose Tolerance = 2hr oral glucose tolerance test OGTT 140 but less than 200 mg*dl on 2 seperate occasions.
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Negative Risk Factor
HDL 60mg*dl or higher
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