Fitness Medicals

Pre-exercise screening is part of exercise professionals’ duty of care.

Why screen pre-exercise?

Personal Trainers, Fitness Instructors and fitness business owners are all too aware of the risks involved in prescribing exercise and the need for a consistent standard of professional practice in the New Zealand health and fitness industry.

Pre-exercise screening is used to identify people who may have medical conditions that put them at a higher risk of an adverse event during physical activity/exercise. It’s a filter or ‘safety net’ to help determine if the potential benefits of exercise outweigh the risks for an individual.

Pre-exercise screening should be completed whenever any one or more of the following conditions are met: 

  • Beginning an exercise program from a sedentary or low baseline. Examples may include a client who has been relatively inactive for an extended period of time and decides to join a walking-for-fitness group, a circuit class or a community sports club. 
  • Significantly upgrading an exercise program especially when the intensity is elevated substantially. Examples may include progressing from a walking-based program to a running or High Intensity Interval Training (HIIT)-based program. 
  • When personal health status changes significantly. Examples may include the recent diagnosis of a chronic disease, recovery from a significant injury, or general perception of lack of improvement within an exercise program despite specific attempts to enhance performance.

The Science behind Fitness Screening 

It is irrefutable that across the population the health benefits of physical activity outweigh the risks many fold. However, it is also recognised that for some individuals there may be an unacceptably high acute risk associated with starting a physical activity program or substantially increasing their level of activity.

While the overall risk of a cardiovascular or cerebrovascular event (for example, heart attack, stroke or sudden death) increases during physical activity in the acute phase, there is a protective effect over the longer term for those who regularly exercise. The main cause of these specific adverse events in adults is prior disease.

Regular physical activity reduces the build-up of fatty plaques that lead to disease as well as increasing blood vessel compliance, capillary density and heart size and strength. There are other acute problems that may occur in some people who have other pathologies. These are typically related to the respiratory and metabolic systems but may occasionally involve other physiological systems.

If health and fitness professionals can easily gather more information about the state of health or disease of a person, it might help to reduce the possibility of a problem occurring during exercise.

There are no guarantees that an adverse event might or might not occur. However, this prior knowledge will assist in appropriate exercise prescription and can significantly reduce the probability of serious injury or life threatening incidences.

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