Pre-ex­er­cise med­i­cal screen­ing

New Straits Times - - Heal - 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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