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Testing & Prescription Exam 1

Terms in this set (86)

- All individuals wishing to initiate a physical activity program should be screened at minimum by a self-reported medical history or health risk appraisal questionnaire. The need and degree of follow-up is determined by the answers to these self-guided methods.
- Individuals at moderate risk with two or more CVD risk factors (see Table 2.2 and Figures 2.3 and 2.4) should be encouraged to consult with their physician prior to initiating a vigorous intensity, physical activity program. Although medical evaluation is taking place, the majority of these individuals can begin light-to-moderate intensity exercise programs such as walking without consulting their physician.
- Individuals at high risk with symptoms or diagnosed disease (see Table 2.1) should consult with their physician prior to initiating a physical activity program (see Figure 2.4).
- Routine exercise testing is recommended only for individuals at high risk (see Table 2.3 and Figures 2.3 and 2.4) including those with diagnosed CVD, symptoms suggestive of new or changing CVD, diabetes mellitus, and additional CVD risk factors, end-stage renal disease, and specified lung disease.
- Exercise testing of individuals at high risk can be supervised by nonphysician health care professionals if the professional is specially trained in clinical exercise testing with a physician immediately available if needed. Exercise testing of individuals at moderate risk can be supervised by nonphysician health care professionals if the professional is specially trained in clinical exercise testing, but whether or not a physician must be immediately available for exercise testing is dependent on a variety of considerations.
- These recommendations are made to reduce barriers to the adoption of a physically active lifestyle because (a) much of the risk associated with exercise can be mitigated by adopting a progressive exercise training regimen; and (b) there is an overall low risk of participation in physical activity programs (24).
- Participants should refrain from ingesting food, alcohol, or caffeine or using tobacco products within 3 h of testing.
o Participants should be rested for the assessment, avoiding significant exertion or exercise on the day of the assessment.
o Clothing should permit freedom of movement and include walking or running shoes. Women should bring a loose fitting, short-sleeved blouse that buttons down the front and should avoid restrictive undergarments.
o If the evaluation is on an outpatient basis, participants should be made aware that the exercise test may be fatiguing and that they may wish to have someone accompany them to the assessment to drive them home afterward.
o If the exercise test is for diagnostic purposes, it may be helpful for patients to discontinue prescribed cardiovascular medications, but only with physician approval.
o Currently prescribed antianginal agents alter the hemodynamic response to exercise and significantly reduce the sensitivity of ECG changes for ischemia.
o Patients taking intermediate- or high-dose β-blocking agents may be asked to taper their medication over a 2- to 4-d period to minimize hyperadrenergic withdrawal responses (see Appendix A).
o If the test is for functional or exercise prescription purposes, patients should continue their medication regimen on their usual schedule so that the exercise responses will be consistent with responses expected during exercise training.
o Participants should bring a list of their medications including dosage and frequency of administration to the assessment and should report the last actual dose taken.
- Participants should drink ample fluids over the 24-h period preceding the test to ensure normal hydration before testing.