运动前风险评估表（jacky 国内原创）
(2012-03-11 11:35:13)
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CHECK ALL THAT
APPLY |
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Male age 40 or
above
40或40岁以上的男性 |
|
Female age 50 or
above
50或50岁以上的男性 |
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Pregnant
您怀孕了 |
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More than 20 pounds
overweight
超重20以上 |
|
Tobacco
use
您抽烟 |
|
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CHECK IF
YES |
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Have you been seen by a
physician within the last 12 months?
前12个月您有没有去看过医生？ |
|
Are you cleared by a
physician to exercise?
您已经获得医生的许可，许可您参加运动锻炼？ |
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Are you between the ages
of 18 and 40 and in good health?
您是否是18-40岁并身体健康良好？ |
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ARE YOU CURRENTLY
EXPERIENCING ANY OF THE FOLLOWING 您是否当前有下列的状况？ |
|
Common
cold/influenza
着凉/流感 |
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Fever/infection/vomiting
发烧/感染/呕吐 |
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Recent
surgery/wound
近期手术/创伤 |
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Fracture/dislocation/sprain
骨折/错位/扭伤 |
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Pneumonia/hacking
cough
肺炎/干咳 |
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Other recent physical
problem
其他当前的身体问题 |
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Currently on
medications
当前正在服用药物 |
|
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HAVE YOU EVER
EXPERIENCED ANY OF THE FOLLOWING
您是否当前有如下状况？ |
Pain of any kind, including chest
pain or numbness
任何形式的疼痛，包括胸痛和胸部麻木 |
|
Fainting/dizziness
昏晕/头晕 |
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Allergic reaction to
exercise
对锻炼过敏 |
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Cancer
癌症 |
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Heart
disease
心脏病 |
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Stroke
中风 |
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Previous heart
attack
曾经心脏病发作 |
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High blood pressure/no
medications
高血压/没有用药 |
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High blood pressure/with
medications
高血压/正在服用药物 |
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Pulmonary
disease
肺部疾病 |
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asthma
哮喘 |
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Shortness of breath
climbing stairs
爬楼梯时气短 |
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Type 1 Diabetes (insulin
dependent)
一型糖尿病（胰岛素依赖型） |
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Type 2 Diabetes
(non-insulin dependent)
二型糖尿病（非胰岛素依赖型） |
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Seizure/epilepsy
癫痫 |
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Arthritis/joint
problem
关节炎/关节问题 |
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Low back
pain
下背痛 |
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