Assessment of American College of Sports Medicine’s Preparticipation Health Screening in Older Adults and Those With Chronic Diseases

Background/Objective : The American College of Sports Medicine preparticipation screening algorithm is designed to identify those with increased risk for adverse exercise-related cardiovascular events. Prior to engaging in an exercise program, individuals are advised to complete a health screening to identify the need for medical clearance. With the potential for referrals to deter exercise engagement, the purpose of this study was to examine the updated guideline’s role in reducing unnecessary medical referrals. Methods : Seventy-one participants (≥40 years of age and/or diagnosed with a chronic disease) were assessed for the need of medical clearance. Participants completed a questionnaire to identify cardiovascular risk factors and to report diagnosed cardiovascular, pulmonary, metabolic, or renal disease in addition to completing a biometric screening. Need for medical clearance was determined based on the criteria for the ninth and 11th editions of the American College of Sports Medicine Guidelines. Participants were assigned a standardized classification for comparison. Results were analyzed using cross tabulation and chi-square test. Results : Compared with the ninth edition, the updated 11th edition reclassified three participants (10%) from high to moderate risk, and 29 participants (100%) from moderate to low risk reducing medical referrals by 41% (χ 2 = 70.0; p < .001). Conclusion : Results suggest the updated guidelines significantly reduce medical referrals as intended but also increase the prevalence of cardiovascular disease risk factors for physical inactivity and hypertension. Significance/Implications : Findings of the present study further support the updated prescreening guidelines in the reduction of medical referrals for those already engaging in physical activity despite having multiple cardiovascular risk factors or various known diseases.