New Straits Times

Pre-exercise medical screening

- I am diabetic. My blood sugar is wellcontro­lled with medication. I want to start exercising. Do I need to undergo pre-participat­ion health screening for exercise?

DO I need to do a pre-exercise medical screening before I engage in regular exercises? Generally, exercise is safe for everybody. There is a risk of getting a heart attack during exercise. However, the incidence is very low. The risk is usually higher in a person with known or occult heart disease while he is doing vigorous intensity exercise.

It is therefore good to have a medical screening to detect any medical condition so you can tailor your exercises accordings to those conditions.

Pre-participat­ion medical screening is done before any person performs an exercise. If an active person has not done a medical screening yet, he can do it any time.

Here are some reasons why it is good to have pre-participat­ion screening:

1. The medical screening is able to recognise individual­s with clinically significan­t disease(s) or conditions that require medicallys­upervised exercise programmes.

2. It is also able to detect individual­s at increased risk for diseases because of age, symptoms and/ or risk factors - who should undergo a medical evaluation and/or exercise testing. This is important to ensure and optimise safety during exercise.

3. Individual­s with medical contraindi­cations for exercise can also be identified during the screening process.

This is how the screening is done: Before you see a doctor,go through the Physical Activity Readiness Questionna­ire (PAR-Q), which is available online. There is a risk of getting a heart attack during exercise. However, the incidence is very low. The risk is usually higher in a person with heart disease while he is doing vigorous intensity exercise.

If you suffer from chest pain, stop exercising and see a doctor to make sure the discomfort is

not heart-related. The medical screening is able to recognise individual­s with clinically significan­t disease(s) or conditions that require medically-supervised exercise programmes.

The Physical Activity Readiness Questionna­ire (PAR-Q).

It is a set of seven questions, with “yes” and “no” options. If all the answers are “no”, you may not have any medical condition that may hinder you from doing exercise.

However, if you are not sure, or you have one or more questions marked “yes”, see a doctor for further screening.

Screening is done based on three aspects:

1. The individual’ s current level of structured physical activity.

2. The presence of major signs or symptoms suggestive of cardiovasc­ular, metabolic or renal diseases.

3. The desired exercise intensity.

Other tests will also be done if deemed necessary.

In some situations, medical clearance by a specialist is required, especially in a situation where the person is known to have medical problems, has signs and symptoms of heart disease or wants to do vigorous intensity exercises when he is known to have a medical problem. It is good for any patient with hypertensi­on to engage in regular exercise. You may benefit

from it as its helps lower your blood pressure, reducing the need for medication and improving your general well-being. In the long run, it will prevent heart disease.

Chest discomfort during exercise may be caused by many conditions. It may arise from muscle around the chest, bone and joint and also any structure in the abdomen. It is advisable that you stop doing any exercise and see a doctor as soon as possible for an examinatio­n to make sure the chest discomfort is not heart-related.

The doctor will screen you to see if you have other symptoms including dizziness or syncope, breathless­ness at rest or while doing exercise or while lying flat, abnormal heart beat, ankle swelling and postural hypotensio­n. Further tests will be done if deemed necessary. You may continue doing exercise with the advice of the doctor. It is excellent to include exercise as part of your diabetic control. You may have better blood sugar control with exercise. Furthermor­e, your dose of medication may be reduced. Exercise regularly to tap the maximum benefit.

Any person who wants to start exercise is advised to see a doctor for pre-participat­ion health screening, including a person with diabetes.

The doctor will examine and look for any other medical conditions especially silent heart problems and look for any evidence of diabetic complicati­ons in the eye, kidneys, nerve and foot. In some situations, an exercise stress test may be necessary especially if the person wants to do vigorous intensity exercise.

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