Article Title



Kyle W. Reason, Lauren G. Killen, Victor A. Alves, Jacquelyn A. Allen, James M. Green, FACSM. University of North Alabama, Florence, AL.

BACKGROUND: The ACSM exercise preparticipation algorithm is designed to identify increased risk for adverse exercise-related cardiovascular events. It is recommended that individuals complete a health screening to identify the need for medical clearance prior to participating in an exercise program. With the potential for screening to deter exercise engagement, it is important to determine if the updated 11th edition reduces (as intended) unnecessary medical referrals while remaining conservative enough to identify those who may truly benefit from a medical referral. METHODS: Seventy-one participants (≥ 40 yrs of age and/or diagnosed with cardiovascular, metabolic, renal and/or pulmonary diseases) were assessed for the need of medical clearance. Participants completed a self-reporting questionnaire to identify their risk factors (based on both 9th edition and 11th edition criteria) and diagnosed cardiovascular, metabolic, renal and pulmonary diseases. They also completed a biometric screening consisting of resting heart rate, resting blood pressure, body mass index, waist circumference, and lipid profile). Need for medical clearance was determined based on the criteria for the 9th and 11th editions of the ACSM Guidelines. Results were analyzed using cross tabulation and chi-squared test to compare 9th and 11th editions. RESULTS: The 9th edition preparticipation screening guidelines resulted in 30 participants (42%) classified as high risk, 29 participants (41%) classified as moderate risk, and 12 participants (17%) classified as low risk. In comparison, the updated 11th edition guidelines resulted in 3 participants (10%) being reclassified from high to moderate risk, and 29 participants (100%) being reclassified from moderate to low risk; resulting in a 41% decrease in medical referrals (χ2 = 70.0; p < 0.001). CONCLUSION: Current results suggest the updated guidelines significantly reduce unnecessary medical referrals as intended, but also remain conservative enough to identify those who need medical clearance prior to the start of a new exercise program.

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