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Evidence-based risk assessment and recommendations for physical activity clearance: established cardiovascular disease (1) (1) This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal's usual peer review process.
MedLine Citation:
PMID:  21800942     Owner:  NLM     Status:  In-Data-Review    
Physical activity is an effective lifestyle therapy for patients at risk for, or with, documented cardiovascular disease (CVD). Current screening tools - the Physical Activity Readiness Questionnaire (PAR-Q) and the Physical Activity Readiness Medical Evaluation (PARmed-X) - require updating to align with risk/benefit evidence. We provide evidence-based recommendations to identify individuals with CVD at lower risk, intermediate risk, or higher risk of adverse events when participating in physical activity. Forms of exercise and the settings that will appropriately manage the risks are identified. A computer-assisted search of electronic databases, using search terms for CVD and physical activity risks and benefits, was employed. The Appraisal of Guidelines for Research and Evaluation were applied to assess the evidence and assign a strength of evidence rating. A strength rating for the physical activity participation clearance recommendation was assigned on the basis of the evidence. Recommendations for physical activity clearance were made for specific CVD groups. Evidence indicates that those who are medically stable, who are involved with physical activity, and who have adequate physical ability can participate in physical activity of lower to moderate risk. Patients at higher risk can exercise in medically supervised programs. Systematic evaluation of evidence indicates that clinically stable individuals with CVD may participate in physical activity with little risk of adverse events. Therefore, changes in the PAR-Q should be undertaken and a process of assessment and consultation to replace the PARmed-X should be developed. Patients at lower risk may exercise at low to moderate intensities with minimal supervision. Those at intermediate risk should exercise with guidance from a qualified exercise professional. Patients at higher risk should exercise in medically supervised programs.
Scott G Thomas; Jack M Goodman; Jamie F Burr
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Applied physiology, nutrition, and metabolism = Physiologie appliquée, nutrition et métabolisme     Volume:  36 Suppl 1     ISSN:  1715-5312     ISO Abbreviation:  Appl Physiol Nutr Metab     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-08-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264333     Medline TA:  Appl Physiol Nutr Metab     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  S190-213     Citation Subset:  IM    
a Graduate Department of Exercise Sciences, Faculty of Physical Education and Health, 55 Harbord St, University of Toronto, Toronto, ON M5S 2W6, Canada.
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