Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Phys Sportsmed. 2024 Feb;52(1):77-83. doi: 10.1080/00913847.2023.2176161. Epub 2023 Feb 10.
Currently, there are five international screening tools that are recommended to identify individuals who require pre-exercise medical clearance to reduce the risk of medical encounters during exercise. Therefore, the aim was to determine the percentage of race entrants who are advised to obtain pre-exercise medical clearance and the observed agreement between these five different international pre-exercise medical screening tools.
In all, 76,654 race entrants from the Two Oceans Marathon (2012-2015) that completed an online pre-race screening questionnaire. Five pre-exercise medical screening tools (American Heart Association (AHA), pre-2015 American College of Sport Medicine (ACSM), post-2015 ACSM, Physical Activity Readiness Questionnaire (PAR-Q), and the European Association of Cardiovascular Prevention and Rehabilitation (EACPR)) were retrospectively applied to all participants. The % (95%CI) race entrants requiring medical clearance identified by each tool and the observed agreement between tools (%) was determined.
The % entrants requiring medical clearance varied from 6.7% to 33.9% between the five tools: EACPR (33.9%; 33.5-34.3); pre-2015 ACSM (33.9%; 33.5-34.3); PAR-Q (23.2%; 22.9-23.6); AHA (10.0%; 9.7-10.2); post-2015 ACSM (6.7%; 6.5-6.9). The observed agreement was highest between the pre-2015 ACSM and EACPR (35.4%), for pre-2015 ACSM and PAR-Q (24.8%), PAR-Q and EACPR (24.8%), and lowest between the post-2015 ACSM and AHA (4.1%).
The percentage of race entrants identified to seek medical clearance (and observed agreement) varied considerably between pre-exercise medical screening tools. Further research should determine which tool has the best predictive ability in identifying those at higher risk of medical encounters during exercise.
目前，有五种国际筛查工具被推荐用于识别需要进行运动前医学检查以降低运动中发生医疗事件风险的个体。因此，本研究旨在确定被建议进行运动前医学检查的参赛选手的比例，以及这五种不同的国际运动前医学筛查工具之间的观察一致性。
共纳入参加 2012-2015 年双海洋马拉松比赛的 76654 名在线完成预赛前筛查问卷的选手。回顾性地应用五种运动前医学筛查工具（美国心脏协会（AHA）、2015 年前的美国运动医学学院（ACSM）、2015 年后的 ACSM、体能活动准备问卷（PAR-Q）和欧洲心血管预防和康复协会（EACPR））对所有参与者进行评估。确定了每种工具识别出需要医学检查的选手的比例（%），以及工具之间的观察一致性（%）。
五种工具识别出的需要医学检查的选手比例从 6.7%到 33.9%不等：EACPR（33.9%；33.5-34.3）、2015 年前的 ACSM（33.9%；33.5-34.3）、PAR-Q（23.2%；22.9-23.6）、AHA（10.0%；9.7-10.2）、2015 年后的 ACSM（6.7%；6.5-6.9）。2015 年前的 ACSM 和 EACPR 之间的观察一致性最高（35.4%），2015 年前的 ACSM 和 PAR-Q 之间、PAR-Q 和 EACPR 之间的观察一致性次之（24.8%），2015 年后的 ACSM 和 AHA 之间的观察一致性最低（4.1%）。
参赛选手需要医学检查的比例（以及观察一致性）在运动前医学筛查工具之间差异较大。进一步的研究应确定哪种工具在识别运动中发生医疗事件风险较高的个体方面具有最佳的预测能力。
