Safe engagement in physical activity through pre-exercise risk assessment: an observational study at a single facility over 16 years

BackgroundRegular and appropriate physical activity has health benefits; however, to ensure safety, a pre-exercise medical check based on health information is important. In this study, we aimed to clarify the relationship between risk classification by physicians at a health promotion facility in J...

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Main Authors: Akihiro Hirata, Yoshifusa Takao, Tomoaki Seto, Satoshi Kurose, Yoshinobu Saito, Shinji Sato, Shigeki Tsuzuku, Yuko Oguma
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1563385/full
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author Akihiro Hirata
Akihiro Hirata
Yoshifusa Takao
Tomoaki Seto
Satoshi Kurose
Yoshinobu Saito
Yoshinobu Saito
Shinji Sato
Shigeki Tsuzuku
Yuko Oguma
Yuko Oguma
author_facet Akihiro Hirata
Akihiro Hirata
Yoshifusa Takao
Tomoaki Seto
Satoshi Kurose
Yoshinobu Saito
Yoshinobu Saito
Shinji Sato
Shigeki Tsuzuku
Yuko Oguma
Yuko Oguma
author_sort Akihiro Hirata
collection DOAJ
description BackgroundRegular and appropriate physical activity has health benefits; however, to ensure safety, a pre-exercise medical check based on health information is important. In this study, we aimed to clarify the relationship between risk classification by physicians at a health promotion facility in Japan and the occurrence of adverse events during facility use.MethodsWe evaluated 3,571 individuals, excluding those with an unknown sex, age, medical assessment of exercise limitations, and facility usage status. Based on the results of the medical checkups conducted by a physician, the participants were divided into an exercise-prohibited group and an exercise-permitted group (exercise-permitted group, subdivided into non-restricted, orthopedic-restricted, internal medical-restricted, and combined-restricted groups). The risk of adverse events was examined.ResultsThe group in which exercise was prohibited comprised 72 participants, and that in which exercise was permitted comprised 1935, 612, 456, and 496 participants in the non-restricted, orthopedic-restricted, internal medical-restricted, and combined-restricted groups, respectively. Logistic regression analysis was performed on the four subgroups of the exercise-permitted group, and the odds ratios for adverse events adjusted for individual attributes were 1.04 [95% confidence interval (CI), 0.59–1.84; p = 0.89], 0.97 (95% CI, 0.53–1.78; p = 0.93), and 0.80 (95% CI, 0.42–1.54; p = 0.51) for the orthopedic-restricted, internal medical-restricted, and combined-restricted groups, respectively. A power analysis revealed that the study had a high level of power (0.99), based on a Cox–Snell R2 of 0.05 and a sample size of 3,499, indicating sufficient sensitivity to detect differences between groups.ConclusionNo significant difference in the odds of adverse events was found regardless of the presence or absence of exercise restrictions. Therefore, despite exercise-related risks, pre-exercise screening can help ensure that exercise is performed as safely as it is by individuals without such risks. However, further discussion is required regarding the necessity of screening for all exercise participants.
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spelling doaj-art-ca905981bb8a4e72bbd3ac5e0dc5bd362025-08-20T02:36:14ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.15633851563385Safe engagement in physical activity through pre-exercise risk assessment: an observational study at a single facility over 16 yearsAkihiro Hirata0Akihiro Hirata1Yoshifusa Takao2Tomoaki Seto3Satoshi Kurose4Yoshinobu Saito5Yoshinobu Saito6Shinji Sato7Shigeki Tsuzuku8Yuko Oguma9Yuko Oguma10Research Fellow of Japan Society for the Promotion of Science, Tokyo, JapanSports Medicine Research Center, Keio University, Yokohama, JapanLIFE Medical Fitness, Fujisawa, JapanLIFE Medical Fitness, Fujisawa, JapanHealth Science Center, Kansai Medical University, Hirakata, JapanFaculty of Sport Management, Nippon Sport Science University, Yokohama, JapanGraduate School of Physical Education, Health and Sport Studies, Nippon Sport Science University, Tokyo, JapanDepartment of Sport and Medical Science, Teikyo University, Tokyo, JapanCenter for Student Success Research and Practice, The University of Osaka, Toyonaka, JapanSports Medicine Research Center, Keio University, Yokohama, JapanGraduate School of Health Management, Keio University, Fujisawa, JapanBackgroundRegular and appropriate physical activity has health benefits; however, to ensure safety, a pre-exercise medical check based on health information is important. In this study, we aimed to clarify the relationship between risk classification by physicians at a health promotion facility in Japan and the occurrence of adverse events during facility use.MethodsWe evaluated 3,571 individuals, excluding those with an unknown sex, age, medical assessment of exercise limitations, and facility usage status. Based on the results of the medical checkups conducted by a physician, the participants were divided into an exercise-prohibited group and an exercise-permitted group (exercise-permitted group, subdivided into non-restricted, orthopedic-restricted, internal medical-restricted, and combined-restricted groups). The risk of adverse events was examined.ResultsThe group in which exercise was prohibited comprised 72 participants, and that in which exercise was permitted comprised 1935, 612, 456, and 496 participants in the non-restricted, orthopedic-restricted, internal medical-restricted, and combined-restricted groups, respectively. Logistic regression analysis was performed on the four subgroups of the exercise-permitted group, and the odds ratios for adverse events adjusted for individual attributes were 1.04 [95% confidence interval (CI), 0.59–1.84; p = 0.89], 0.97 (95% CI, 0.53–1.78; p = 0.93), and 0.80 (95% CI, 0.42–1.54; p = 0.51) for the orthopedic-restricted, internal medical-restricted, and combined-restricted groups, respectively. A power analysis revealed that the study had a high level of power (0.99), based on a Cox–Snell R2 of 0.05 and a sample size of 3,499, indicating sufficient sensitivity to detect differences between groups.ConclusionNo significant difference in the odds of adverse events was found regardless of the presence or absence of exercise restrictions. Therefore, despite exercise-related risks, pre-exercise screening can help ensure that exercise is performed as safely as it is by individuals without such risks. However, further discussion is required regarding the necessity of screening for all exercise participants.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1563385/fulladverse eventshealth promotion facilitiesmedical screeningfitness clubswimmingsquash
spellingShingle Akihiro Hirata
Akihiro Hirata
Yoshifusa Takao
Tomoaki Seto
Satoshi Kurose
Yoshinobu Saito
Yoshinobu Saito
Shinji Sato
Shigeki Tsuzuku
Yuko Oguma
Yuko Oguma
Safe engagement in physical activity through pre-exercise risk assessment: an observational study at a single facility over 16 years
Frontiers in Public Health
adverse events
health promotion facilities
medical screening
fitness club
swimming
squash
title Safe engagement in physical activity through pre-exercise risk assessment: an observational study at a single facility over 16 years
title_full Safe engagement in physical activity through pre-exercise risk assessment: an observational study at a single facility over 16 years
title_fullStr Safe engagement in physical activity through pre-exercise risk assessment: an observational study at a single facility over 16 years
title_full_unstemmed Safe engagement in physical activity through pre-exercise risk assessment: an observational study at a single facility over 16 years
title_short Safe engagement in physical activity through pre-exercise risk assessment: an observational study at a single facility over 16 years
title_sort safe engagement in physical activity through pre exercise risk assessment an observational study at a single facility over 16 years
topic adverse events
health promotion facilities
medical screening
fitness club
swimming
squash
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1563385/full
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