搜索
運動前體適能與安全評估台灣師大方進隆教授2007,4.2.很榮幸來嘉義大學分享•歡迎大家參與•分享就是最佳的學習•上兩週介紹•體適能與健康促進•體適能與全人健康演講大綱•前言•運動前ACSM危險分類與評估•體適能檢測的目的與步驟•國內體適能檢測方法•美國體適能學生檢測方法•如何提升體適能•結語體適能•體適能是所有活動的基礎•如何增加身體活動量與養成運動習慣提升體適能是很重要課題•參與運動或參加體適能檢測皆需要注意安全運動處方或計畫目的•主要目的如下•促進健康(減少疾病危險因素)•增進體能•確保運動安全•養成規律運動習慣運動處方前要有危險評估與體適能檢測•美國運動醫學會幫助個案的三個步驟•1,Screeningandriskstratification.過濾評估危險分類•2,Assessmentofthecomponentsoffitness.評估體適能的每個成分•3,Exerciseprescription.運動處方過濾與危險分類Screeningandriskstratification•Becausethemanypeoplewithundiagnosedheartdiseaseareparticularlyatrisk,screeningclientsiscriticaltoinsuresafety.•因許多人有未被診斷出來的心臟病,運動時特別危險,因此需要過濾確保安全.Screeningandriskstratification•Beforeperformingexercisetestingonclients,andbeforeenrollingthemintoanexerciseprogram,youshouldevaluatetheclientstodeterminetheirlevelofriskandtodecideifitisreasonablysafetoproceed.•未參與運動測驗和未參與運動前,需要評估參與者的危險程,度再決定運動進行是否安全.ACSM’sRiskLevels危險分類三類•Low-risk:young,withnomorethan1coronarydiseaseriskfactor,andwithoutsymptomsorknowndisease.低危險•Moderate-risk:Older;orwith2ormorecoronarydiseaseriskfactors.中危險•High-risk:with1ormoresymptomsofcardiopulmonarydisease;orwithknowncardiovascular,pulmonary,ormetabolicdisease.高危險ACSM’sRiskLevels危險分類三類•低危險年輕(男生45歲以下,女生55歲以下),不超過一種危險因素且沒有疾病症狀.•中危險年紀大,(男生超過45歲女生超過55歲),或二種危險因素以上.•高危險ㄧ種心肺疾病以上症狀或已經有心臟病,肺病或代謝疾病.ExercisescreeningquestionnaireusingACSMCriteria•美國運動醫學會標準的過慮問卷•Riskfactors危險因素(2ormoreplaceindividualasmoderaterisk)兩個以上危險因素為中危險問卷•__1,haveanyofyourparents,brothers,orsistershadaheartattack,bypasssurgery,angioplasty,orsuddendeathpriortotheageof55(malerelatives)or65(femalerelatives).Firstdegreerelative.•您的ㄧ等親,雙親,兄弟姐妹是否有心臟病,動脈繞道手術,血管整形或猝死?(男性親戚55歲前女性親戚65歲前)Riskfactors•__2.Haveyousmokedcigarettesinthepast6months?最近六個月有抽菸嗎?•__3.Whatisyourusualbloodpressure(大於140/90)?Doyoutakebloodpressuremedication?您的血壓過高嗎?(大於或等於140/90mmHg)服用高血壓藥物嗎?Riskfactors•__4.WhatisyourLDL低密度脂蛋白cholesterol?Ifyoudon’tknowyourLDL,Whatisyourtotalcholesterol膽固醇?WhatisyourHDL高密度脂蛋白cholesterol?血脂肪,膽固醇,高低密度脂蛋白膽固醇?•[eitherLDL130(usetotalcholesterol200ifLDLnotknown)orHDL35isarisk.Note:HDL60isa‘negative’riskfactor.ortakinglipid-loweringmedication.•危險因素:低密度脂蛋白高於130•膽固醇200HDL35或服藥•高密度脂蛋白60為負的危險因素可減一個危險因素Riskfactors•__5.Whatisyourfastingglucose(=110)?空腹血糖•__6.Whatisyourheightandweight(BMI=30)?Also,whatisyourwaistgirth(100cm)?身高體重BMI多少•__7.Doyougetatleast30minutesofmoderatephysicalactivitymostdaysoftheweek(oritsequivalent)?•每星期有好幾天有從事三十分鐘適度運動嗎?Riskfactors•Positive正:familyhistory家庭遺傳;cigarettesmoking抽菸‘;hypertension高血壓;hypercholesterolemia高血膽固醇;impairedfastingglucose空腹血糖過高;obesity肥胖;sedentarylifestyle靜態生活方式.•Negative負:HighserumHDLcholesterol.高的高密度脂蛋白Symptoms(1ormoreplacesindividualathighrisk)症狀•__1.Doyoueverhavepainordiscomfortinyourchestorsurroundingareas(I.e.,ischemia)胸部附近不舒服?•__2.Doyoueverfeelfaintordizzy(otherthanwhensittinguprapidly)?會頭昏?•__3.Doyoufinditdifficulttobreathewhenyouarelyingdownorsleeping?躺著或睡覺呼吸困難?Symptoms•__4.Doyourankleseverbecomeswollen(otherthanafteralongperiodofstanding)?踝部腫脹?•__5.Doyoueverhaveheartpalpitations,oranunusualperiodofrapidheartrate?•心悸或有時心跳過快嗎?•__6.Doyoueverexperiencepaininyourlegs(I.e.,intermittentclaudication)?•腳部會痛嗎?間歇性跛足?Symptoms•__7.Hasaphysicianeversaidyouhaveaheartmurmur?(hashe/shesaiditisOK,andsafeforyoutoexercise?)•心有雜音?運動安全嗎?•__8.Doyoufeelunusuallyfatiguedorfinditdifficulttobreathewithusualactivities?從事一般活動感覺疲憊或者呼吸困難嗎?其他others•1,Howoldareyou?(男性大於45歲女性大於55歲即屬中危險)•2,doyouhaveanyofthefollowingdiseases:心臟病,週邊血管疾病,腦血管疾病,慢性呼吸道阻礙疾病,氣腫或慢性氣管炎,肺病,氣喘,糖尿病,甲狀腺異常,腎臟病,肝病.(如有一種即屬高危險)others•__1.Howoldareyou?(men=55areatmoderaterisk.)你幾歲?•__2.Doyouhaveanyofthefollowingdiseases:有下列疾病嗎?heartdisease,chronicobstructivepulmonarydisease(emphysemaorchronicbronchitis),asthma,diabetesmellitus,thyroiddisorder,renaldisease,orliverdisease等疾病?(yestoanydiseaseplacesindividualathighrisk)others•__3.Doyouhaveanyboneorjointproblems,suchasarthritisorapastinjury,thatmightgetworsewithexercise?(exercisetestingmayneedtobedelayedormodified運動測驗需要延期或修正).有骨或關節問題?運動會惡化?其他•__4.Doyouhaveacoldorflu,oranyotherinfection?感冒或其他感染?(exercisetestingmustbedelayed.運動測驗需要延期)others•__5.Areyoupregnant?懷孕嗎?(exercisetestingmayneedtobedelayedormodified).•__6.Doyouhaveanyotherproblemthatmightmakeitdifficultforyoutodostrenuousexercise?有參與激烈運動會有困難的症狀?Interpretation解說•Lowrisk(young,andnomorethan1riskfactor):candomaximaltestingorenteravigorousexerciseprogram.低危險可做最大運動測驗或者參與激烈運動•Moderaterisk(older,or2ormoreriskfactor):candosubmaximaltestingorenteramoderateexerciseprogram.•可以做非最大運動測驗或者從事適度的運動計畫•Highrisk(oneormoresymptomsordisease)candonotestingwithoutphysicianpresence;canenternoprogramwithoutphysicianclearance.•沒有醫師在場,不能從事運動測驗.•沒有醫師的同意,不能參加運動.ACSMrecommendationsfor(A)currentmedicalexaminationandexercisetestingpriortoparticipationand(B)physiciansupervisionofexercisetests•lowrisk•A.Moderateexercisenotnecessary•Vigorousexercisenotnecessary•從事中度與激烈運動前不需進一步健康檢查•B.Sub-maximaltestnotnecessary•Maximaltestnotnecessary•中度運動表示3-6METs.•激烈運動表示6METs以上•notnecessary表示運動參與或測驗時不需醫師在場ACSMrecommendationsfor(A)currentmedicalexaminationandexer