The physical examination should include the following:
- Body weight or body composition
- Pulse rate and heart rhythm
- Blood pressure
- Heart and lung auscultation
- Palpation of peripheral arteries and inspection of limbs for edema
- Presence of xanthoma or xanthelasma
- Follow up for orthopedic or other medical conditions that would limit exercise
- Neurological function and reflexes
The following table modified from the Canadian Standardized Test Manual (Canadian Society for Exercise Physiology and the Fitness Program, 1995) provides information on absolute and relative contraindications, and special prescriptive conditions for aerobic exercise training:
Absolute Contraindications | Relative Contraindications | Special Prescriptive Conditions | |
No exercise until condition is treated, stable, or past the acute phase. | Exercise ability is based on the individual's condition. Exercise may be restricted or require medical supervision | Exercise training may require medical monitoring, special limitations, or special exercises. |
|
Cardiovascular |
Aortic aneurysm |
Aortic stenosis (moderate) Subaortic stenosis (severe) Marked cardiac enlargement Supraventricular dysrhythmias Ventricular ectopic activity Ventricular aneurysm Hypertension (uncontrolled) Hypertrophic cardiomyopathy Compensated congestive heart failure |
Aortic or pulmonary stenosis |
Infections | Acute infectious diseases | Subacute, chronic, recurrent infectious diseases | Chronic infections HIV |
Metabolic | Uncontrolled metabolic disorders (diabetes mellitus, thyrotoxicosis, myxedema) | Renal, hepatic and other metabolic insufficiency |
|
Pregnancy | Complicated pregnancy | Advanced pregnancy |
(Modified from the Canadian Standardized Test Manual, Canadian Society for Exercise Physiology and the Fitness Program, 1995.)