Table 3.

American College of Sports Medicine exercise preparticipation health screening and recommendations.

Underlying diseases symptoms and/or signs [41]	Medical clearance or approval from a healthcare professional requirement [41]	Activity recommendations
Non-regular exercisers
Category 1: •Without cardiovascular, metabolic, and renal disease •Without symptoms and/or signs	Not necessary	•Light- to moderate-intensity activity recommended •May gradually progress to vigorous-intensity activity
Category 2: •With cardiovascular, metabolic, and renal disease •Without symptoms and/or signs	Recommended	•Follow medical clearance •Light- to moderate-intensity activity recommended •May gradually progress as tolerated
Category 3: •With cardiovascular, metabolic, and renal disease •With symptoms and signs	Recommended	•Follow medical clearance •Light- to moderate-intensity activity recommended •May gradually progress as tolerated
Regular exercisers
Category 4: •Without cardiovascular, metabolic, and renal disease •Without symptoms and/or signs	Not necessary	•Continue moderate- or vigorous-intensity activity •May gradually progress
Category 5: •With cardiovascular, metabolic, and renal disease •Without symptoms and/or signs	•Not necessary for moderate-intensity activity •Recommended for vigorous-intensity activity	•Continue moderate-intensity activity •Follow medical clearance •May gradually progress as tolerated
Category 6: •With cardiovascular, metabolic, and renal disease •With symptoms and signs	Recommended	•Discontinue activity •May return to activity following medical clearance •May gradually progress as tolerated