Table 4. Components of physical examination prior the exercise testing and
physical training programmes (adapted from ACSM 2000).


Body weight: body mass index (BMI), waist girth, body composition (percent body fat)

Apical pulse rate and rhythm

Resting blood pressure (seated, supine, standing)

Auscultation of the lungs (absence of rales, wheezes, and other breathing sounds)

Palpation of the cardiac apical impulse- PMI (point of maximal impulse)

Auscultation of the heart (murmurs, gallops, clicks, rubs)

Palpation and auscultation of carotid, abdominal, and femoral arteries

Evaluation of the abdomen (bowel sounds, masses, visceromegaly, tenderness)

Palpation and inspection of lower extremities (oedema, presence of arterial pulses, painful joints)

Palpation of the tendons (tendon xanthomas)

Evaluation of the skin (skin xanthelasma, diabetic ulcers, neuropathy)

Tests of neurologic function (including reflexes, cognition)

Oftalmoskopy (diabetic retinopathy)

Follow-up examination of any medical condition limiting exercise