Are You Ready for Exercise?
Each year about 75,000 Americans each year suffer a heart attack during or after exercise. These victims tend to be individuals who are usually sedentary and at high risk for heart disease. During unaccustomed exercise, a chain of physiological events takes place in these individuals which leads to their heart attack. In order to help reduce these numbers, the American College of Sports Medicine and the Canadian Society for Exercise Physiology have developed highly respected "screening" questionnaires. These questionnaires help to identify people who should be referred to medical facilities for more extensive testing. By performing such testing and by then providing an active living plan that follows the guidelines that result, we know that the incidence of cardiovascular problems during exercise can be greatly reduced.
To this end, and prior to initiating an exercise program, a complete picture of your background, current medical and health status, motivation, and personal goals should be carefully reviewed with an exercise leader. You will then be classified as being at Low, Moderate or High Risk for complications during exercise. Alternately, if using the Canadian screening questionnaire, you may be classified as "Apparently Healthy" or "At Risk."
Based on your classification, appropriate judgments can be made regarding your readiness for exercise and for fitness testing. Here are each of the classification categories along with the recommendations of the American College of Sports Medicine.
Category 1: Low Risk / Apparently Healthy
If you have been classified in this category, there is no overt sign that exercise presents a risk for you. Also, if you are a man, your age is less than 45 and, if a woman, your age less than 55.
Category 2: Moderate Risk
Men 45 years of age and over and women who are 55 or older are automatically considered to be at "Moderate Risk." If you answered "yes" to two or more coronary risk factors (high cholesterol, sedentary lifestyle) then you will be classified in this category even if you are a younger adult. Note that the American College of Sports Medicine recommends but does not require that a medical exam be provided for people starting a program of moderate exercise. However, people in this category should have a medical exam if they are going to exercise or be tested at a more vigorous level.
Category 3: High Risk
People in the High Risk category have known heart or lung disease, diabetes or other metabolic disorders. If you have been classified as "High Risk" then a medical exam with treadmill test is required prior to starting any type of exercise program.
According to the American College of Sports Medicine, this "risk stratification" is important to ensure the safety of exercise testing and participation, to determine the appropriate type of exercise program, to identify those in need of more extensive medical evaluation, and to make appropriate recommendations for an exercise program.
In general, most individuals-except for those with known serious disease-can begin a moderate exercise program (such as walking) without a medical evaluation or treadmill exercise test. Whenever one is in doubt about their own personal safety while exercising, a medical evaluation is recommended.