Hirata Akihiro, Takao Yoshifusa, Seto Tomoaki, Kurose Satoshi, Saito Yoshinobu, Sato Shinji, Tsuzuku Shigeki, Oguma Yuko
Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
Sports Medicine Research Center, Keio University, Yokohama, Japan.
Front Public Health. 2025 Jul 10;13:1563385. doi: 10.3389/fpubh.2025.1563385. eCollection 2025.
Regular and appropriate physical activity has health benefits; however, to ensure safety, a pre-exercise medical check based on health information is important. In this study, we aimed to clarify the relationship between risk classification by physicians at a health promotion facility in Japan and the occurrence of adverse events during facility use.
We evaluated 3,571 individuals, excluding those with an unknown sex, age, medical assessment of exercise limitations, and facility usage status. Based on the results of the medical checkups conducted by a physician, the participants were divided into an exercise-prohibited group and an exercise-permitted group (exercise-permitted group, subdivided into non-restricted, orthopedic-restricted, internal medical-restricted, and combined-restricted groups). The risk of adverse events was examined.
The group in which exercise was prohibited comprised 72 participants, and that in which exercise was permitted comprised 1935, 612, 456, and 496 participants in the non-restricted, orthopedic-restricted, internal medical-restricted, and combined-restricted groups, respectively. Logistic regression analysis was performed on the four subgroups of the exercise-permitted group, and the odds ratios for adverse events adjusted for individual attributes were 1.04 [95% confidence interval (CI), 0.59-1.84; = 0.89], 0.97 (95% CI, 0.53-1.78; = 0.93), and 0.80 (95% CI, 0.42-1.54; = 0.51) for the orthopedic-restricted, internal medical-restricted, and combined-restricted groups, respectively. A power analysis revealed that the study had a high level of power (0.99), based on a Cox-Snell of 0.05 and a sample size of 3,499, indicating sufficient sensitivity to detect differences between groups.
No significant difference in the odds of adverse events was found regardless of the presence or absence of exercise restrictions. Therefore, despite exercise-related risks, pre-exercise screening can help ensure that exercise is performed as safely as it is by individuals without such risks. However, further discussion is required regarding the necessity of screening for all exercise participants.
规律且适度的体育活动有益健康；然而，为确保安全，基于健康信息进行运动前医学检查很重要。在本研究中，我们旨在阐明日本一家健康促进机构中医生进行的风险分类与机构使用期间不良事件发生之间的关系。
我们评估了3571名个体，排除了那些性别、年龄、运动限制的医学评估及机构使用状况不明的个体。根据医生进行的体检结果，将参与者分为运动禁止组和运动许可组（运动许可组再细分为无限制组、骨科限制组、内科限制组和综合限制组）。检查不良事件的风险。
运动被禁止的组有72名参与者，运动被许可的组中，无限制组、骨科限制组、内科限制组和综合限制组分别有1935名、612名、456名和496名参与者。对运动许可组的四个亚组进行逻辑回归分析，经个体属性调整后的不良事件优势比，骨科限制组为1.04[95%置信区间（CI），0.59 - 1.84；P = 0.89]，内科限制组为0.97（95%CI，0.53 - 1.78；P = 0.93），综合限制组为0.80（95%CI，0.42 - 1.54；P = 0.51）。功效分析显示，基于Cox - Snell P值为0.05和样本量为3499，该研究具有较高的功效（0.99），表明有足够的敏感性来检测组间差异。
无论有无运动限制，不良事件的发生几率均未发现显著差异。因此，尽管存在与运动相关的风险，但运动前筛查有助于确保运动能像无此类风险的个体一样安全地进行。然而，对于所有运动参与者进行筛查的必要性仍需进一步讨论。
