高齢者における運動の心血管系安全基準および対策

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Although regular physical activity has many beneficial health-related effects for the elderly, inappropriate or excessive exercise has been known to exaggerate or be associated with risk of cardiovascular events. Therefore, appropriate initial health screening, including medical evaluation and risk stratification, is vital to ensure or increase exercise safety. In the elderly, medical evaluation needs to focus on identifying the coronary risk factors or signs suggestive of cardiovascular disease, since coronary artery disease has been demonstrated to be the most common cause responsible for cardiovascular events during physical activity in the elderly. It is noteworthy that variability of physical fitness is high in the elderly and cardiovascular risk during exercise is greater in subjects with lower physical fitness. In risk stratification, therefore, pre-assessment of physical fitness in addition to routine medical evaluation is pivotal. Exercise prescription must be based on risk stratification and/or complicating cardiovascular disease severity. Low-level exercise, for example, 40% of V^^・O_2max is recommended for high-risk subjects such as those with two or more coronary risk factors, suggestive cardiovascular disease, lower physical fitness, or flail order adults. Since most subjects have reported at least one prodromal symptom within one week of sudden death, it is very important to check the physical condition before exercise on each day. Although various arrhythmias are likely to be responsible for cardiac events during exercise, their complete prediction is seldom possible. Therefore, monitoring ECG during exercise contributes greatly to exercise safety. Further investigation is required for improvement of exercise safety for the elderly.
日本体力医学会の論文
2003-08-01

高齢者における運動の心血管系安全基準および対策

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