Carnegie School of Sport, Leeds Beckett University, Leeds, UNITED KINGDOM.
Med Sci Sports Exerc. 2019 May;51(5):1047-1054. doi: 10.1249/MSS.0000000000001868.
Preparticipation health screening is recommended to detect individuals susceptible to serious adverse cardiovascular complications during exercise. Although expert opinion and best available scientific evidence have informed recent modifications, there remain limited experimental data to support or refute current practice. We therefore aimed to quantify the impact of change to the preparticipation health screening guidelines of the American College of Sports Medicine (ACSM) on risk classification and referral for medical clearance in a large cohort of undergraduate university students.
Participants attended the laboratory on a single occasion to undergo preparticipation health screening. Information concerning health status was obtained via self-report questionnaire and objective physiological assessment with all data recorded electronically and evaluated against the ACSM screening guidelines (9th and 10th editions).
Five hundred and fifty-three students completed the study. The 9th edition screening guidance resulted in 82 subjects (15%) classified as high risk, almost one-quarter (24%) classified as moderate risk, and almost two-thirds (61%) classified as low risk. In comparison, the updated 10th edition screening guidance resulted in a significant reduction in those previously classified as either high risk (5%) or moderate risk (2%), respectively. The majority of subjects (93%) were therefore cleared to begin a structured exercise program. Taken together, approximately one-third (32%) fewer medical referrals were required when applying the updated 10th edition guidance (χ4 = 247.7, P < 0.001).
The updated ACSM 10th edition preparticipation screening guidance reduces medical referrals by approximately one-third. These findings are in keeping with previous reports and thus serve to consolidate and justify recent modification-particularly when applied to young adult or adolescent populations. The findings and arguments presented should be used to refine and inform future guidance.
建议进行参赛前健康筛查，以发现易在运动中发生严重心血管并发症的个体。尽管专家意见和最佳现有科学证据为最近的修改提供了依据，但仍缺乏支持或反驳当前实践的有限实验数据。因此，我们旨在量化美国运动医学学院（ACSM）参赛前健康筛查指南的改变对大量大学生队列的风险分类和医疗许可转诊的影响。
参与者在一次实验室就诊时接受参赛前健康筛查。通过自我报告问卷和客观生理评估获取健康状况信息，所有数据均以电子方式记录，并根据 ACSM 筛查指南（第 9 版和第 10 版）进行评估。
553 名学生完成了研究。第 9 版筛查指南导致 82 名受试者（15%）被归类为高风险，近四分之一（24%）被归类为中风险，近三分之二（61%）被归类为低风险。相比之下，更新后的第 10 版筛查指南显著降低了之前被归类为高风险（5%）或中风险（2%）的人数。因此，大多数受试者（93%）被批准开始结构化运动计划。总的来说，当应用更新的第 10 版指南时，需要转诊的医学建议减少了约三分之一（χ4=247.7，P<0.001）。
更新的 ACSM 第 10 版参赛前筛查指南使医学转诊减少了约三分之一。这些发现与之前的报告一致，因此支持并证明了最近的修改，特别是当应用于年轻成年人或青少年人群时。提出的发现和论点应被用于完善和指导未来的指南。
