Steven has hypertension and high cholesterol although both are well controlled on medication He has no signs symptoms of disease and has no diagnosed disease Steven was a previousl active tennis player playing for fun with friends twice each week and competing regularly a fev mes a year at a local senior tennis center However he states that he has not engaged in activity since he was in his early 60 s and began developing arthritis in his knees which made nim fearful of exercise He has knee pain occasionally and he believes that avoiding activity a avoring his knees will help his arthritis 4 Does Steven need medical clearance prior to beginning an exercise training program Why why not answer according to the acsm No CV Metabolic or Renal Disease AND No Signs or Symptoms Suggestive of CV Metabolic or Renal Disease Medical E Clearance Not Necessary Light to Moderate Intensity Exercise Recommended May Gradually Progress to Vigorous Intensity Exercise Following ACSM Guidelines No Known CV Metabolic or Renal Disease AND Asymptomatic Medical Clearance Recommended Following Medical Clearance Light to Moderate Intensity Exercise Recommended May Gradually Progress as Tolerated Following ACSM Guidelines Participates in Regular Exercise Any Signs or Symptoms Suggestive of CV Metabolic or Renal Disease Regardless of disease status Medical Clearance Recommended no Following Medical Clearance Light to Moderate Intensity Exercise Recommended May Gradually Progress as Tolerated Following ACSM Guidelines No CV Metabolic or Renal Disease AND No Signs or m Symptoms Suggestive of CV Metabolic or Renal Disease Medical 818 Clearance Not Necessary Continue Moderate or Vigorous Intensity Exercise May Gradually Progress Following ACSM Guidelines CN Yes Known CV Metabolic or Renal Disease AND Asymptomatic Medical for Clearance Moderate Intensity Exercise Not Necessary Medical Clearance within the last 12 months if no change in signs symptoms Recommended Before Engaging in Vigorous Intensity Exercise Continue with Moderate Intensity Exercise Following Medical Clearance May Gradually Progress as Tolerated Following ACSM Guidelines Any Signs of On Symptorns Suggestive of CV Metabolic or Renal Disease Regardless of disease status Discontinue Exercise and Seek Medical Clearance May Return to Exercise Following Medical Clearance Gradually Progress as Tolerated Following ACSM Guidelines FIGURE 2 Exercise preparticipation health screening logic model for aerobic exercise participation Exercise participation performing planned structured physical activity at least 30 min at moderate intensity on at least 3 dwk for at least the last 3 months Light intensity exercise 30 to 40 HRR or VO R 2 to 3 METS 9 11 RPE an intensity that causes slight increases in HR and breathing Moderate intensity exercise 40 to 60 HRR or VO R 3 to 6 METS 12 13 RPE an intensity that causes noticeable increases in HR and SPECIAL COMM