BIOLOGY OF HUMAN ATHLETIC

PERFORMANCE
KINESIOLOGY 343
Class 10
Assessing Health and Fitness

Class Outline
The key concepts that will be discussed in todays class are:
1) To describe the risks associated with exercise
2) To provide a rationale for conducting an exercise test prior to
activity
3) To define risk factors that might affect exercise prescription
4) To describe relative contra-indicators to exercise

The Exercise Dilemma

Lack of habitual physical activity is considered to be a major
risk factor for coronary heart disease
On occasion, trained and apparently healthy athletes die
suddenly during exercise
Habitual physical activity may protect from heart disease, yet
exercise per se may be an important risk factor for sudden
death

Risks Associated with Exercise

There is approximately 1 death in every 15-18,000 adult
exercisers per year
Sudden death among young individuals (< 35 years)
often results from occult disease
(Diseases that are unseen or hidden to tests)

What might be other causes of

exercise-induced fatalities?

Could the type of activity be to

blame?
When do most nonfatal exerciseinduced heart attacks occur?

What Types of Activities Are Safer?

Alberto Salazar (49, marathoner) collapsed during during a
training run
Two runners died during the an ultra-marathon (90 km) in
South Africa
Antonio Puerta (age 22, soccer player) died during a match in
Spain
Chad Schieber (age 35, policeman) died during the Chicago
Marathon

Could the individual be to blame?

Describe the typical individual exercising
in the gym. What about the typical
individual participating in a triathlon.

The Exercise Dilemma

We need to assess the individual prior to activity

All physical activity carries risk

We need to assess the type of activity

Why Assess Health Before Exercise?

1. Educate participants about their health (relative to norms)
2. Providing data that will help in developing activity plans
3. Collecting baseline and follow-up data (progression)
4. Motivating participants by establishing fitness goals
5. Identifying health risks

Pre-Exercise Evaluations

A comprehensive pre-exercise test evaluation in a clinical

setting generally includes a medical history, physical
examination, and laboratory tests
The purpose of conducting a pre-exercise test evaluation is to
record baseline measurements, identify any health issues,
and to determine risk stratification

Pre-Exercise Evaluations
Components of the medical history might include:
Family health history
Previous physical examination findings
History of symptoms
Medication use
Exercise habits
Personal habits (drug use, caffeine consumption, alcohol intake)

Pre-Exercise Evaluations

Components of the physical examination might include:

Body weight
Resting pulse rate and blood pressure
Auscultation (listening) of the heart and lungs
Testing neurological function (reflexes and cognition)
Inspection of the skin (looking for abrasions that are slow to heal)

Pre-Exercise Evaluations
The initial screening is designed to yield information regarding
risk stratification and the need for medical clearance prior to
beginning or significantly increasing exercise
The process requires identification of:
Risk factors
Signs of cardiovascular, pulmonary, and/or metabolic disease
Known cardiovascular, pulmonary, and/or metabolic disease

Risk Factors
1. Family History of coronary heart disease
2. Smoking both current smokers and those that have recently quit
3. Hypertension or a high blood pressure that negatively impacts health
4. Dyslipidemia or abnormal amount of lipids in the blood
5. Impaired Fasting Glucose which affects energy regulation in the
body
6. Obesity or an excess of body fat that negatively impacts health
7. Sedentary Lifestyle or not meeting the minimal activity guidelines

Defining the Risk of Activity

Low Risk Individuals
Males younger than 45 years old
Females younger than 55 years old
AND
1 risk factor
Low risk individuals can perform vigorous activity
May consider conducting a maximal exercise test

Defining the Risk of Activity

Moderate Risk Individuals
Males older than 45 years old
Females older than 55 years old
OR

2 or more risk factors

Moderate risk individuals should start with moderate activity
May consider conducting a submaximal exercise test
Should conduct a test if the goal is to work above moderate intensity

Defining the Risk of Activity

High risk individuals
It is about the presence or absence of disease
Show signs of cardiac complications

Signs of ischemia: discomfort in the chest, neck, jaw

Syncope: dizziness or loss of consciousness due to cerebral hypoxia
Edema: abnormal accumulation of fluid beneath the skin
Tachycardia: increased heart rate (leads to a decrease in blood flow)
Heart murmurs: narrowing or leaking of heart valves
Intermittent claudication: cramping pains in the legs

Defining the Risk of Activity

High risk individuals
It is about the presence or absence of disease
Show signs of pulmonary distress
Dyspnea: shortness of breath at rest or with mild exertion
Orthopnea: the inability to breathe easily unless upright

Have a metabolic disease

Contraindications to Exercise

Should high risk individuals exercise?

Must seek medical clearance before activity
Requires medically-supervised exercise test
Often involved in medically-supervised exercise programs

Assessing Health Prior to Activity

The screening process encourages individuals to
understand their own limits
The screening process may involve doctors who sign off on
an activity program
The screening process should include documentation of
medical history, PAR-Q / ACSM questionnaire
The screening process is ultimately about encouraging
exercise while minimizing risk

Things to Consider BEFORE Testing

Obtain informed consent from the participant
Legally driven process
Being exposed to possible injury

Explanation of the purpose and procedures

Opportunity to ask questions

Explanation of the risks and benefits

Opportunity to withdraw (at any time)

Empowering to the participant

Person chooses to participate

Things to Consider BEFORE Testing

Things for the participant to avoid prior to an exercise test
Eating too much may promote nausea
A full bladder increases HR and BP
Alcohol may elevate blood pressure
May provoke arrhythmia

Tobacco increases HR and respiratory rates

Acute increase in BP (but not in chronic smokers)

Caffeine may lead to a temporary increase in BP

Also produces an irregular responses in HR

Things to Consider BEFORE Testing

Avoid exercise 24 hours prior
Being fresh and ready to perform

Dress appropriately
Freer range of movement
Improved temperature regulation

Get a good night sleep

Chronic lack of sleep affects hormone levels in the body
Cortisol production (poor appetite regulation)
Insulin levels (increased fat storage)
Growth hormone (loss of strength)