Topic Progress:

Until recently, the ACSM made specific recommendations about the use of investigations – especially exercise tolerance tests – for specific clinical scenarios. There is, however, a lack of evidence that medical exams and exercise testing are effective in mitigating the risk of exercise-related cardiovascular deaths. In the updated guidelines, a “medical clearance” has replaced these specific recommendations. This leaves decisions up to the individual healthcare provider.

Exercise tolerance test

An exercise tolerance test or stress test is one of the most commonly used investigations to assess a patient’s ability to exercise. It is a functional test used to look for underlying cardiovascular disease. The test involves progressively increasing exercise loads while monitoring the player for symptoms and monitoring the heart’s electrical activity.

Exercise tolerance tests have been reported to have a sensitivity of about 80% and a specificity of 70% in detecting coronary artery disease. As a result, a negative test may not necessarily be accurate. The accuracy is also particularly poor in women.

Dr Mark Fulcher

Sport and Exercise Physician