ACSM[042-082]

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>>>>>>>>>>>>>>>>>>>>>IISECTIONExercise Testing
>>>>>>>>>>>>>3CHAPTERPre-Exercise EvaluationsThis chapter contains information related to pre-exercise testing procedures andserves as a bridge between the risk stratification concepts presented in Chapter 2,the fitness assessment (Chapter 4), and/or clinical exercise testing concepts(Chapters 5 and 6). Although each of the chapter elements (e.g., medical history,physical examination, identification of exercise contraindications, informedconsentprocedures) relate to health/fitness and clinical exercise settings, the lowerriskpopulation typically encountered in the health and fitness setting generallyjustifies a less sophisticated approach to the pre-exercise test procedures. Therefore,abbreviated versions of the medical history and physical examination proceduresdescribed within this chapter are reasonable within the health and fitnesssetting.The extent of medical evaluation necessary before exercise testing dependson the assessment of risk as determined from the procedures outlined in Chapters1 and 2. For many persons, especially those with atherosclerotic cardiovasculardisease (CVD) and other cardiovascular disorders, the exercise test andaccompanying physical examination are critical to the development of a safeand effective exercise program. In today’s healthcare environment, not all personswarrant extensive testing; however, it is important to work with healthcareproviders in understanding the importance of the baseline exercise evaluation.This evaluation provides greater assurance of exercise safety by identifyingresidual myocardial ischemia, significant dysrhythmias, and the effect of certainmedical therapies.A comprehensive pre-exercise test evaluation in the clinical setting generallyincludes a medical history, physical examination, and laboratory tests. The goalof this chapter is not to be totally inclusive or to supplant more specific referenceson each subject, but rather to provide a concise set of guidelines for thepre-exercise test participant assessment.MEDICAL HISTORY, PHYSICAL EXAMINATION,AND LABORATORY TESTSThe pre-exercise test medical history should be thorough and include both pastand current information. Appropriate components of the medical history are presentedin Box 3.1. A preliminary physical examination should be performed by aphysician or other qualified personnel before exercise testing moderate- and42
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ACSM[042-082]

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