UNIVERSITI TEKNOLOGI MARA CAWANGAN PAHANG

FACULTY OF SPORTS SCIENCE & RECREATION

APPLIED EXERCISE AND SPORTS REHABILITATION

SPS609

Individual Assessment

PRE-PARTICIPATION HEALTH SCREENING AND RISK STRATIFICATION

Prepared for:

DR. NURUL DIYANA BINTI SANUDDIN

Prepared by:

No. Name Matric No.

1. WAN MUHAMMAD AFIQ BIN WAN JAHARI 2021373281

Bachelor of Sports Science (Hons) SR 243

Part 05 B

Submission date: 24 May 2021

 TABLE OF CONTENT

NO. CONTENT PAGES

1.0 INTRODUCTION OF PRE-PARTICIPATION HEALTH SCREENING 3
AND RISK STRATIFICATION
2.0 METHOD OF RISK STRATIFICATION QUESTIONNAIRE 4
3.0 RESULTS OF RISK STRATIFICATION QUESTIONNAIRE 5
4.0 DISCUSSION/RECOMMENDATION
4.1 LOW RISK 17
4.2 MODERATE RISK
4.3 HIGH RISK
5.0 CONCLUSION 21
6.0 REFERENCES 21
7.0 APPENDICES 22

2
1.0 INTRODUCTION OF PRE-PARTICIPATION HEALTH SCREENING AND RISK
STRATIFICATION
Physical activity or exercise brings many benefits and indeed is safe for most
people all around the world. All physical activity may enhance individual’s muscle
strength and increase muscle endurance. However not everyone can participate in
every exercise because of the major concern towards the increase risk of sudden
cardiac death and myocardial infarction that is sometimes associated with high
intensity or vigorous physical exertion. A major public health goal is to increase
individual participation in regular and moderate to vigorous exercise. Pursuit of this
goal must include a process for identifying individuals at increased risk to participate
in exercise programs or events. Therefore, it is important for an early detection of
health risk by doing pre-participation health screening or also known as Risk
Stratification Questionnaire.
The risk stratification is a systematic technique that categorized patients based
on their health status and other factors. In addition, it is a precaution step to help
determine if there are potential benefits of risky exercise for an individual that already
fill the risk stratification questionnaire. The objective of pre-participation health
screening is to identify individuals with medical contraindications for exclusion from
exercise programs until those conditions have been subsided or under control and to
recognized a person with clinically significant disease or conditions who should
participate in medically supervised exercise program. Meanwhile, the objective of Risk
Stratification is to segment patients into distinct groups of similar complexity and care
needs.
In risk stratification, the participants will be assign into three categories which
are low risk, moderate risk and high risk. For low risk, the individuals that classified as
low risk are those who do not have any signs or symptoms of diagnosed
cardiovascular, pulmonary and metabolic disease and have no more than one
cardiovascular disease (CVD) risk factor. For moderate risk, individuals that classified
as moderate risk do not have signs or symptoms of diagnosed cardiovascular,
pulmonary and/or metabolic disease but have 2 or more CVD risk factors. For high
risk, individuals that classified as high risk are those who have one or more or more
signs or symptoms of diagnosed cardiovascular, pulmonary and/or metabolic disease.
Basically, this Risk Stratification Questionnaire is a form that used to analyse
the client’s health status or potential health risks. The questionnaire was short and very
easy to be fill and it reveals any health condition from the individual. Then, risk
stratification is used to categorized client into three categories which are low risk,
moderate risk and high risk.

3
2.0 METHOD OF RISK STRATIFICATION QUESTIONNAIRE
For the risk stratification questionnaire, every client must follow this method to
ensure they can complete the questionnaire in the correct way. Below are the method
for risk stratification questionnaire:
 The client will be given a short briefing about the risk stratification
questionnaire.
 The conductor or healthcare professionals will give the questionnaire to the
client.
 The client will read and understand the participant’s responsibility and the risk
stratification questionnaire.
 The client starts answer the form.
 The client finish answering the questionnaire and return it to the conductor.

4
3.0 RESULTS OF RISK STRATIFICATION QUESTIONNAIRE

1. Have you ever had a heart attack, coronary revascularization

surgery or a stroke?

No Yes

Diagram 1 shows bar chart for question 1 in Risk Stratification Questionnaire

2. Has your doctor ever told you that you have heart trouble or
vascular disease?

No Yes

Diagram 2 shows bar chart for question 2 in Risk Stratification Questionnaire

5
 3. Has your doctor ever told that you have heart murmur?

No Yes

Diagram 3 shows bar chart for question 3 in Risk Stratification Questionnaire

4. Do you suffer from pains in your chest especially with exercise?

No Yes

Diagram 4 shows bar chart for question 4 in Risk Stratification Questionnaire

6
 5. Do you ever get pains in your calves, buttock or at the back of your
legs during exercise which are not due to soreness or stiffness?

No Yes

Diagram 5 shows bar chart for question 5 in Risk Stratification Questionnaire

6. Do you ever feel faint or have spells of severe dizziness,

particularly with exercise?

No Yes

Diagram 6 shows bar chart for question 6 in Risk Stratification Questionnaire

7
 7. Do you experience swelling or accumulation of fluid about the
ankles?

No Yes

Diagram 7 shows bar chart for question 7 in Risk Stratification Questionnaire

8. Do you ever get feeling that your heart is suddenly beating faster,
racing or skipping beats, either at rest or during exercise?

No Yes

Diagram 8 shows bar chart for question 8 in Risk Stratification Questionnaire

8
 9. Do you have chronic obstructive pulmonary disease, interstitial
lung disease or cystic fibrosis?

No Yes

Diagram 9 shows bar chart for question 9 in Risk Stratification Questionnaire

10. Have you ever had an attack of shortness of breath that

developed after you were not doing anything strenuous, at any time in
the last12 month?

No Yes

Diagram 10 shows bar chart for question 10 in Risk Stratification Questionnaire

9
 11. Have you ever had an attack of shortness breath that developed
after you stopped exercising, at any time in the last 12 month?

No Yes

Diagram 11 shows bar chart for question 11 in Risk Stratification Questionnaire

12. Have you ever been woken at night by an attack of shortness of

breath at any time in the last 12 month?

No Yes

Diagram 12 shows bar chart for question 12 in Risk Stratification Questionnaire

10
 13. Do you have diabetes? If so do you have trouble controlling
diabetes?

No Yes

Diagram 13 shows bar chart for question 13 in Risk Stratification Questionnaire

14. Do you have any ulcerated wound or cuts on your feet that do not
seem to heal?

No Yes

Diagram 14 shows bar chart for question 14 in Risk Stratification Questionnaire

11
 15. Do you have any liver, kidney or thyroid disorder?

No Yes

Diagram 15 shows bar chart for question 15 in Risk Stratification Questionnaire

16. Do you experience unusual fatigue or shortness of breath with

usual activities

No Yes

Diagram 16 shows bar chart for question 16 in Risk Stratification Questionnaire

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 17. Is there any other physical reason or medical condition, or are
you taking any medication which could prevent you from undertaking
an exercise program?

No Yes

Diagram 17 shows bar chart for question 17 in Risk Stratification Questionnaire

18. Do you have smoke cigarettes regularly or have you quit smoking
in the last 6 month?

No Yes

Diagram 18 shows bar chart for question 18 in Risk Stratification Questionnaire

13
 19. Do you have a family history of cardiovascular disease? (This
refers to a primary relative i.e parent, child or sibling who has had a
myocardial infarction, coronary revascularization or died suddenly
due to heart attack before age of 55 years (male)

No Yes

Diagram 19 shows bar chart for question 19 in Risk Stratification Questionnaire

20. Have you been told you have a systolic blood pressure measure
at greater 140mmHg on two separate occasion OR a diastolic blood
pressure measure at greater than 90 mmHg? Or you are taking
antihypertensive medication?

No Yes

Diagram 20 shows bar chart for question 20 in Risk Stratification Questionnaire

14
 21. Have you been told you have impaired fasting glucose? (Fasting
glucose less than 6.1 mmol/L on two separate occasions).

No Yes

Diagram 21 shows bar chart for question 21 in Risk Stratification Questionnaire

22. Have you ever been told that you have a total serum cholesterol
concentration of greater than 5.2mmol/L or a high density lipoprotein
concentration of less than 0.9mmol/L? or you on lipid lowering
medication?

No Yes

Diagram 22 shows bar chart for question 22 in Risk Stratification Questionnaire

15
 23. Do you have an occupation where you are seated for long periods
of time AND do no regular exercise? (Regular exercise defined as
more than 150 minutes of moderate intensity physical activity per
week).

No Yes

Diagram 23 shows bar chart for question 23 in Risk Stratification Questionnaire

NAME LOW RISK MODERATE RISK HIGH RISK

Hamim Muzzamil Bin Yusof /
Mohamad Nur Ikhmal Bin Maizu /
Mohamad Akid Akram Bin Rosly /
Nik Muhammad Hafizuddin Bin Nik /
Rasly
Muhammad Fahmi bin Mohd Izuddin /
Muhammad Aiman Bin Azmar /
Muhammad Hisyamuddin Bin /
Mahmud
Muhammad Hazim Hakim Bin Uzi /
Arif Haziq Bin Azlan /
Amir Farhan Bin Mamat /

Table 1 shows the clients’ risk to participate in any physical activities

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 Risk Stratification Questionnaire
Among 10 Clients

20%

20% 60%

Low Risk Moderate Risk High Risk

Diagram 24 shows pie chart of Risk Stratification Questionnaire among 10 clients

4.0 DISCUSSION/RECOMMENDATION
In the diagram 24, there are 6 clients that are low risk, clients are moderate risk
and 2 clients are high risk. There are only 3 clients of the low risk that are totally have
no signs and symptoms at all but the other 3 only has one risk factor that they should
be concern about. For moderate risk client, 2 of them has a few severe signs and
symptoms that can lead to chronic or cardiovascular disease. For the high risk client,
there are also 2 of them. They should be aware because they have chronic or
cardiovascular disease or signs and symptoms that has high potential to lead to
chronic or cardiovascular disease.
4.1 LOW RISK
The Client 1 is Hamim Muzzamil Bin Yusof. He is 20 years old and his
BMI is normal. Hamim does not have any signs and symptoms for chronic
disease and any risk factors for cardiovascular disease. He plays volleyball that
trained 5 days a week and that may be the reason why he does not have any
signs or symptoms for chronic and cardiovascular disease. However, he must
be careful with his job because sitting too long might cause back pain problem
that could be severe if not treated. Therefore, I suggest Hamim to start doing
some exercises that are suitable during the job hour.
The subject 2 is Mohamad Nur Ikhmal Bin Maizu. He is 22 years old and
a full-time student. His BMI is normal. Ikhmal also low risk because he does not
have any signs or symptoms for chronic and cardiovascular disease due to the
healthy lifestyle which he always playing football every evening for 5 days per

17
week. However, he has been told by the doctor that his systolic blood pressure
was greater than 140mmHg. So, I suggest he takes a healthy diet and
decreasing amount of salt to reduce the systolic blood pressure but the most
effective way for him is to go see the doctor and get the advice from the doctor.
The Client 3 is Mohamad Akid Akram Bin Rosly. He is 22 years old and
his BMI is normal. Akid is a full-time student. He is low risk because he does not
have any signs or symptoms for any chronic and cardiovascular disease. The
reason is Akid always playing volleyball every evening for 4 times per week.
However, he smokes regularly. Smoking is very dangerous because it contains
many chemical substances and it can harm the health of a person. Smoking also
very dangerous to cardiovascular health especially for addicted smoker. In my
opinion, I suggest Akid to stops smoking from time to time until he stops smoking
forever. It may be hard but if he sets his mental, he can overcome it. The easiest
way to start in stop smoking is go see the doctor and get the advice from him.
The Client 4 is Nik Muhammad Hafizuddin Bin Nik Rasly and he is 21
years old. His BMI is 22.7 which is normal. Nik does not have any signs and
symptoms for chronic and cardiovascular disease. He also does not have any
signs and symptoms for any risk factors or medical conditions due to healthy
lifestyle which he plays volleyball for 5 times a week and he do his workout
routines when he has free time. He also shares that he always eats a balance
and healthy diet for every day to ensure his body is in a great shape. This means
he is very healthy and fit to do any physical activities.
The Client 5 is Muhammad Fahmi bin Mohd Izuddin. He is 22 years old
this year. His BMI is normal. Fahmi does not have any signs and symptoms for
chronic and cardiovascular disease due to his healthy lifestyle which he always
playing football and futsal for 5 days a week. However, his family history has
cardiovascular disease. So, he must be aware of it and ensure he lives in healthy
lifestyle such as eating healthy diet, do exercise regularly, not smoking, control
the blood pressure and others. By doing this, he can prevent his family history
cardiovascular disease to him.
The Client 6 is Muhammad Aiman Bin Azmar. He is 22 years old and his
BMI is normal. Aiman also does not have signs and symptoms for chronic and
cardiovascular disease. He also does not have any signs and symptoms for any
risk factors or medical condition because he always practice healthy lifestyle.
For example, he always playing volleyball for 5 days and 2 days for physical
conditioning. Aiman also takes care of his eating where he eats a balance diet
every day. This shows that Aiman can do any physical activities without having
problem because he is in good condition and healthy.

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4.2 MODERATE RISK
The Client 7 is Muhammad Hisyamuddin Bin Mahmud and he is 28
years old. His BMI is normal. He is categorized as moderate risk because he
has three moderate medical condition problem which are chest pain during
exercise, feel pains at the back of your legs during exercise which are not due
to soreness or stiffness and feel wanted to faint particularly with exercise.
Hisyamuddin also not practice healthy lifestyle where he always playing games
from midnight until morning and do not exercise regularly. He also did not eat
balance diet in his daily life and he enjoys eating fast foods and carbonated
drinks. The good news is he has low tendency of getting high risk because he
does not have any signs or symptoms of chronic disease. However, if he still
following his unhealthy lifestyle, the probability of getting high risk will increase.
So, my suggestion is Hisyamuddin should start getting sleep early at night to
ensure the body recover properly, doing physical activities regularly especially
during free time to ensure the body always fit and start eating healthy diet by
following a good meal planning. This sound tough but if he wants some
improvement in his life, he must change his unhealthy lifestyle into healthy
lifestyle.
The Client 8 is Muhammad Hazim Hakim Bin Uzi. He is 27 years old and
his BMI is normal. He is categorized as moderate risk because he has two
moderate medical condition problem which are he sometimes experience
swelling or accumulation of fluid at the ankles and he also feels that his heart is
suddenly beating faster sometimes especially at rest. The probability of getting
high risk is low because Hazim does not have any signs and symptoms of
chronic disease. Hazim also enjoys his sedentary lifestyle which is not good for
our body and he does not have a good meal planning in his life where he just
eats anything that he likes and throw anything he dislikes especially vegetables.
In my opinion, I suggest Hazim to go see the doctor that specialized in ankle to
identify his ankle problem. He also should start practicing a healthy lifestyle such
as involve in physical activities, sleep early and others. Lastly, he should start
planning a meal schedule that is healthy and also start eating veggies because
there are lots of good vitamins in the veggies that is good for the body health.

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4.3 HIGH RISK
The Client 9 is Arif Haziq Bin Azlan. He is 28 years old and his BMI is
obesity. Arif was categorized as high risk because he has 1 signs and symptoms
of chronic disease which are he has diabetes. Next, he has 3 moderate medical
condition problem which are the doctor tells him that he is having heart murmur,
had an attack of shortness of breath that developed after not doing anything
strenuous, at any time in the last 12 months and lastly, had an attack of
shortness breath that developed after stopped exercising, at any time in the last
12 months. He also does not practice healthy lifestyle and always eat junk foods
and carbonated drinks. This is dangerous because high risk stratification could
lead to death. So, my suggestion is Arif should start practicing healthy lifestyle
and instead of eating any junk foods and carbonated drinks, he should eat
healthy foods especially veggies and fruits. The most important thing that he
must do is he should make an appointment with the doctor and discuss with the
doctor about his health issues regarding obesity as soon as possible.
The last client is Client 10, Amir Farhan Bin Mamat. He is 31 years old
and his BMI is obesity. Amir was categorized as high risk because he has 1
signs and symptoms of chronic disease which are he is obesity. Then, he has 3
moderate medical condition problem which are he has heart murmur, he has
been attack by shortness of breath after woken at night in the last 12 months
and lastly, he had experience with unusual fatigue and shortness of breath with
usual activities. He also has one risk factor which is he do smoke cigarettes
regularly in last 6 months. Amir also lives a sedentary lifestyle and loves eating
junk foods, beverages, sweets and carbonated drinks compared to healthy
foods. So, I suggest Amir to start changing his lifestyle into a healthy lifestyle
and start eating healthy foods. He should stops eating any junk foods,
carbonated drinks and sweets. Besides, Amir should start doing physical
activities regularly at least twice a week. Lastly, he should stop smoking because
smoking could affect his health to chronic disease and even worst is death. For
recommendation, Amir should start make an appointment with doctor to solve
his obesity issues and smoking problem because it can solve his problem and
he can live a healthy life.

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5.0 CONCLUSION
In the end, healthy lifestyle is one of the key to ensure your health and body
always in good condition. It can boost your immune system and also avoid any disease
especially the chronic disease. In order of preventing chronic disease, people
nowadays need to start eating balanced and healthy diet, start doing exercise regularly
and sleeps early at night. So, we can say that healthy lifestyle has many benefits to
every individual in the world. It can increase your social life as well as personal life.
More importantly, a person who practicing healthy lifestyle may live longer compared
to those who do not.
In conclusion, pre-participation health screening and risk stratification are very
important for every individual in the whole world to determine the degree of clients’
health and clients’ class either low risk, moderate risk or high risk. It is also acts as
filter to recognize if there are any potential advantages or disadvantages of doing
exercise for every individual. To sum it up, it is essential for every person to start doing
a risk stratification questionnaire before doing any kinds of sports activities. It is best
for us to identify our health and body capacity first who may have medical condition
that will finally give them a higher risk or harmful incident when doing the physical
activities.

6.0 REFERENCES
Emelia Arquilla, D. (2021, January 6). Healthy Lifestyle Benefits: 5 Tips for Living
Your Strongest, Healthiest Life Yet. Retrieved from Healthline:
https://www.healthline.com/health/fitness-nutrition/healthy-lifestyle-benefits

Green, M. (2010). Risk stratification: Effective use of ACSM guidelines and

integration of professional judgment. ACSM s Health & Fitness Journal, 22-
28.

JAMES DOM DERA, M. (2019). Risk Stratification: A Two-Step Process for

Identifying Your Sickest Patients. American Academy of Family Physicians,
21-26.

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7.0 APPENDICES

Figure 1 shows Risk Stratification Questionnaire from Hamim Muzzamil Bin Yusof

Figure 2 shows Risk Stratification Questionnaire from Mohamad Nur Ikhmal Bin Maizu

22
Figure 3 shows Risk Stratification Questionnaire from Mohamad Akid Akram Bin Rosly

Figure 4 shows Risk Stratification Questionnaire from Nik Muhammad Hafizuddin Bin Nik
Rasly

23
Figure 5 shows Risk Stratification Questionnaire from Muhammad Fahmi bin Mohd Izuddin

Figure 6 shows Risk Stratification Questionnaire from Muhammad Aiman Bin Azmar

24
 Figure 7 shows Risk Stratification Questionnaire from Muhammad Hisyamuddin Bin
Mahmud

Figure 8 shows Risk Stratification Questionnaire from Muhammad Hazim Hakim Bin Uzi

25
 Figure 9 shows Risk Stratification Questionnaire from Arif Haziq Bin Azlan

Figure 10 shows Risk Stratification Questionnaire from Amir Farhan Bin Mamat

26