Ideally, regular physical activity should be conceived as a simple, safe, and natural part of healthy living. To help assure it, we are told, “Consult your physician before beginning an exercise program.”
People often ask, “Who should see a doctor,” “What should be examined “or” How extensive of an examination is necessary?” Your risk of an exercise catastrophe is increased if:
• There is a history of fainting or chest pain during physical exertion.
• There is a family history of sudden death at a young age.
• The intensity and duration of activity are much greater than recently experienced.
• Competition, publicity or pride encourages persistence with exercise in the face of warning symptoms.
• The activity involves heavy lifting or prolonged isometric effort.
• The weather is unduly cold or hot.
• You have a viral infection, sense chest discomfort or cardiac irregularity, or do not feel well.
If you are undertaking moderate exercise, and none of these apply to you, many researchers question the need for extensive preliminary screening. Especially given that moderate exercise decreases rather than increases your overall risk of cardiac death. There is general acceptance of a Canadian study which found that in symptom-free people, simple advice and self-administered questionnaires provided the most appropriate method of determining readiness for a modest increase of physical activity.
The current U.S. recommendation for pre-exercise screening has moved close to the Canadian position. It looks at the proposed intensity of effort and associated symptoms or major cardiac risk factors.
If you are planning no more than a moderate increase of habitual activity (an intensity of less than 60% of peak aerobic effort which you can sustain comfortably for an hour or longer), are symptom-free and have no more than one major coronary risk factor, then an extensive preliminary medical examination is no longer recommended.