Posts Tagged: health screening

Medical Screening of Participants

July 14, 2011

Are you ready (or able) to do this?

Ian McGregor, Ph.D.
Ian McGregor & Associates Inc.

If someone suffers a heart attack while participating in one of your programs, the courts may ask whether the participant was medically screened before participation. In other words, what attempts were made to determine whether the person was medically fit to participate?

Although it may not be practical or even reasonable to medically screen all participants, there may be some programs where it might be wise to determine if there are any medical reasons to exclude a participant. For example, taking a scuba class requires a medical examination by a physician, yet many fitness programs rely only on a simple screening tool such as the PAR-Q (Physical Activity Readiness Questionnaire). Is this a reasonable approach, or should certain high-risk participants in fitness programs (e.g. seniors) also be required to be screened by their physician prior to participation? Read more

Over Exercise: How Should the Recreation Facility Respond?

July 04, 2011

Karen S. Miller
Registered Dietitian/Nutrition Educator
Edited by Christopher Dulak, Dr. Janet Crawford, Katie James
University of Nebraska-Lincoln

Imagine you are walking by a sauna and you see a woman doing steps on the benches; or you see a male participant who has moved an exercise bike into a sauna to exercise. Imagine you are seeing a middle aged women exercising on a treadmill, her body emaciated to the point of having no muscle tone. Or you see a “normal” weight participant who has been working out in the building for three hours. What is your response, what action is appropriate?

You may ask: “So what?” What “should” we do? What is appropriate? We know it’s an issue, but what action do we take?”

Occasionally there will be a story of over-exercise to bring the subject to the headlines. People Magazine reported on Peach Friedman in “Exercise Almost Killed Her” (Souter, et al, 2006). In a side bar segment they also mentioned actress Jamie-Lynn Sigler and her bout with “exercise bulimia.” Today’s Dietitian reported: “Exercise Abuse: Too Much of A Good Thing” (Jackson, 2005). And Fitness Magazine carried: “I Am an Exercise Addict” (Schein & Copeland, 1994).

In a society that idealizes and promotes the perfect body; with role models like The Biggest Loser (at least 4-5 hours of exercise daily) and with the pursuit of rock hard abs and tight butts, how much exercise is too much? When is it time for the fitness profession to step in and say ENOUGH IS ENOUGH!?
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Physical Activity Readiness Questionnaire: Ready or Not?

May 12, 2011

April Boulter
Fitness, Aquatics and Special Events
Loyola University Chicago

The promotion of physical activity within a comprehensive recreation program is an important component for all Campus Recreation Departments. As part of a risk management assessment, many universities are evaluating the pre-activity screening process. While nearly all universities require participants of their Personal Training program to complete a Physical Activity Readiness Questionnaire (PAR-Q) as well as a health history questionnaire, very few universities require the general population to complete the same paperwork. Although most individuals are at very low risk for an exercise-related cardiovascular event, the risk of adverse cardiac events is considerably higher during or immediately after exercise, especially in habitually sedentary individuals engaging in vigorous physical activity (American College of Sports Medicine [ACSM], 2007). Researchers have concluded that, in general, risk of heart attack is about two to six times higher during strenuous exercise than during light physical activity or rest (Balady, 1998). The risk of a cardiovascular event is highest in persons with known heart disease.

An important challenge facing campus recreation facilities is to provide a motivation toward participation in an exercise program while minimizing the potential risk of an adverse medical event during or after exercise (ACSM, 2007). In years past, some lawyers and risk managers have recommended that fitness professionals not engage in pre-screenings. The advice was based on the concept that if the information was received from clients and misinterpreted, it could create liability for the facility in the event of a later injury to the client (Herbert, 1997). The American College of Sports Medicine’s guidelines require that every facility offering exercise equipment must provide a general pre-activity risk assessment, e.g., Physical Activity Readiness Questionnaire (PAR-Q), to all new/prospective members (ACSM, 2007).

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SOP — Suspicion of Unhealthy Eating or Exercise Behaviors

May 12, 2011

Sarah DiSabato
Associate Director, Facilities
Recreation and Wellness
University of Central Florida

Today, University Recreation Facilities are attracting a diverse and large number of participants. A significant number of staff who operate our facilities and run our programs are student employees. As they strive to provide the best recreation facilities and programs, an important goal is to deliver great customer service – and doing this means you need to know your participants and what their needs are. A sensitive topic which continues to be a challenge is the issue of student users who appear to be exercising excessively and/or those who exhibit behaviors of unhealthy eating habits (restricting food or binge eating and utilizing exercise to purge). How do our student employees and professional staff handling this? A framework that the University of Central Florida devised provides the staff with some guidelines as we work our way through responding to those with unhealthy eating or exercise behaviors:

– When a building employee has identified the behavior of a user to be characteristic of someone with an eating disorder or overly obsessive exercise habits, the employee should immediately notify the Fitness Coordinator.
– During this time, the employee should also begin to initiate causal conversations with the user in hopes of forming a relationship; the users name should be one of the first pieces of information gathered.
– The same employee should remain in contact with the user – not different or multiple employees.
– The Fitness Coordinator will start a file on the user documenting all interactions with building employees and facility usage.
– All interactions with the user should be reported to the Fitness Coordinator immediately and it will be the job of the Fitness Coordinator to keep the file updated.
– The intent is to have the employee try to form a genuine relationship with the user in hopes the user will open up to the employee.
– If a good relationship is established, the employee and the Fitness Coordinator will speak to the user about possible avenues for getting help, such as the Counseling Center. The Fitness Specialist may assist the user in scheduling an appointment and may even accompany to the appointment if need be.
– Follow up with the user will be conducted by the employee and the Fitness Coordinator.

Using a team approach, the department uses many resources to try and be of help in situations such as these. Relationship building is our primary emphasis in establishing the communication needed for intervention and referral.

Collecting Medical Information for Camp Programs

April 10, 2011

Debbie Marinoff Shupe
Manager, Recreation Services
McMaster University

Many university recreation and athletics programs are in the camp ‘business’. For a whole host of reasons, it’s a great idea — from summer employment for university students, to community building, to fund raising – the benefits to the university are numerous. Are you prepared for this risky business?

When parents register their children in a university camp program, they have high expectations (and rightfully so!). They expect that children will be safe, have fun and learn lots of new skills. They also expect that camp staff will be able to handle any medical emergency that comes their way.

There are many important elements related to running a camp. Collection of campers’ medical information and addressing the first aid needs of campers are just two of these elements.

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Health Screening in Group Fitness Classes

April 05, 2011

Fitness Coordinator, Johns Hopkins University

If you supervise any group fitness classes, you’ve likely mulled over the professional standards for screening the participants that take part in the classes. The American Council on Exercise (ACE) states that a health-risk appraisal or medical health history should be obtained from every participant in an activity program. Strictly from a managerial and logistical perspective, the more participants that are in the program, the more general the health screening may need to be, and the less able you are to track individual health conditions. But from a prudent perspective, you should at least offer something to gauge a participant’s risk and it should be as in-depth as you can handle. When choosing how to screen for health problems, consider the following issues:

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