Using a Heart Rate Monitor to Screen for Heart Health in Physical Education©
“One of the reasons I first became interested in the Heart Zones System was for its ability to ‘screen’ students for potential heart health challenges. A number of years ago, I had a 4th grade student go down in my PE class with chest pain. This student was struggling to breathe and unable to walk. After an ambulance ride to the hospital and further examinations, it was discovered he had a blood supply issue to his heart which surgery later corrected. I was told that this student could have died if his issue was not discovered/corrected. I could not have predicted that this student was the one who had a heart ailment in my classes. If I had the use of a heart rate sensor at that time, maybe it would have allowed me to discover this student’s heart health issue. Personally speaking, it was because of the onset of heart rate monitor technology years ago that led to my discovery of my own heart health issue – cardiomyopathy. The Heart Zones System has many uses in a PE class one of which is to ‘screen’ our students for healthy heart functionality.”
Rod Holler, Elementary Physical Educator Arboretum Elementary School, Waunakee, WI
What are Abnormal Heart Rate Numbers?
For the first time, the PE teacher is able to see live biofeedback on a student’s response to different exercise intensities. But, what if the numbers on the Big Board are unusual? What if the heart rate numbers appear abnormally high or low?
★ Above 100 bpm for ambient heart rate.
★ Delta heart rate assessment above 30 bpm
★ Exercise heart rate that do not increase with increase effort.
★ HRV, Heart Rate Variability trends downward.
★ Recovery Heart Rate less than 12 bpm (for adults and children are different).
★ Erratic heart rate numbers that do not change with corresponding changes in exercise intensity.
Here are four steps to verify the data you’re looking at and might lead you to take responsible and professional action:
- Repeat the physical activity to verify that the heart rate data is accurate and not a one-time anomaly.
- Verify that the abnormal numbers are real and not a sensor or software abnormality.
- Print the individual student report for validation.
- Find out if the student is on medication that might affect heart rate numbers.
What Should You Do If You Observe Abnormal Heart Rate Numbers in Your Physical Education Classes?
The questions to consider are, Is it possible to diagnose some of the underlying conditions that can lead to heart abnormalities such as SCD particularly in school environment before a cardia incident occurs? Are there any simple non-invasive tests that could be administered by a school nurse or physical education teacher that might indicate some heart or health irregularity that could be used as early warning sign?
Several simple tests using a heart rate sensor might provide you with the following:
- Low cost way to screen students
- Early detection signs
- Increased student safety
One heart abnormality leading to nearly 200 deaths per year in the USA is called Sudden Cardiac Death or SCD. It cannot be diagnosed in advance. That’s because anyone who experiences SCD is already dead. Possibly there’s a way to prevent such deaths by using heart rate sensors and Smart PE assessments to provide a way for early detection.
This author recommends that you consult with your school nurse or other health professional in your district to start the conversation about using the Heart Zones System assessments to support early detection or other signs. If you have a student with unusual heart rate data, print several reports and provide them to your school nurse along with your insights.
Statistically about 100-150 students per year die from SCD. Identification of abnormal heart rate responses to physical activity as a screening tool might lead to prevention and diagnosis of an unhealthy heart rate response prior to an incident occurring. The statistics are as follows:
- 1 student in the USA dies from SCD every 3 days
- Most common cause of death in athletes is SCD
- 65% of athlete deaths are from SCD
- 514 out of 4.2 million college athletes died from all causes last year
- 5 to 10 college athletes die per year from SCD
These statistics have to be cushioned in the fact that there are about 80 million students in school in the USA today. The risk of SCD is statistically extremely low. However, as a young Physical Education teacher, I lost one of my 13-year old student to SCD. She was playing basketball collapsed on the court and I immediately started CPR. I tried to revive my student, but failed. She died as I tried to revive her. As would anyone, I was deeply affected by this tragedy. And, the incident has led me to believe there is something that we can do about SCD.
Being Smart about Heart Health
Safety is the number one priority during the school day. Heart health is part of providing a safe and healthy environment for students to learn. A simple screening protocol using a heart rate sensor that provides ranges of healthy and unhealthy responses provides you with one more tool to create a healthy school environment for both athletes and students.
Heart Health Assessments Using a Heart Rate Device:
For the past 40 years, I have been giving heart rate tests to all ages and all fitness levels. I have administered literally tens of thousands of these different heart health tests. During those four decades, I have discovered that there are six heart rate tests that provide cardiac beats-per-minute data on the current physical status of the individual:
1. Recovery Heart Rate: A one-minute recovery heart rate test.
2. Ambient Heart Rate: Sitting quietly heart rate number.
3. Delta Heart Rate: Sometimes called orthostatic, this is the difference in heart rate number in beats-per-minute from lying down to standing up.
4. Resting Heart Rate: Heart rate when you first wake up in the morning
5. Exercise Heart Rate: The ability to exercise within normal heart rate ranges
6. HRV | Heart Rate Variability: Assessment of the status of the autonomic nervous system using time between heart beat analysis.
These six tests can be administered using simple heart rate tests that any credentialed Physical Education teacher can administer using the wearable tool of a heart rate sensor in small or large group situations. All six tests combined can be conducted in less than an hour. All of the data can be captured by the Heart Zones PE software platform. You can then analyze the results using accurate data that might provide insight about those individual students whose heart rate numbers are outside the healthy and normal ranges.
The heart rate tests I am suggesting do not require expensive EKG equipment. They do not require a physician to be present. They do not require specialized training. These heart rate tests require that physical educators and school health practitioners learn how to administer the tests, understand the heart rate data, and have the knowledge to respond to the test results professionally.
According to the recent report titled “Screening for Sudden Cardiac Death in the Young” from the National Heart, Lung, and Blood Institute Working Group, “Sudden cardiac death in the young is a critical public health issue.” I believe that it is time for us to address this life and death issue. I believe that if there’s a way to save even one student or faculty member’s life it is worth the challenges posed in this article. I believe it is time for a change that leads to safer and healthier schools.
Sally Edwards, CEO & Founder, Heart Zones, Inc. Sacramento, CA
Christopher R. Cole, M.D., Eugene H. Blackstone, M.D., Fredric J. Pashkow, M.D., Claire E. Snader, M.A., and Michael S. Lauer, M.D. N Engl J Med 1999; 341:1351-1357October 28, 1999DOI: 10.1056/NEJM199910283411804
This is not the EKG or electrocardiogram data but the simple heart rate numbers.
Atkins DL, et al. Epidemiology and outcomes from out-of-hospital cardiac arrest in children. Circulation 2009. (https://www.ncbi.nlm.nih.gov/pubmed/19273724)
Nick of Time, a Seattle, Washington non-profit organization to prevent SCD: https://www.youtube.com/watch?v=ZBi5ms97maY
Roberts, William O. MD, MS, FACSM. Preparticipation Cardiovascular Screening — Finding the Middle Ground. Current Sports Medicine Reports: March/April 2016 – Volume 15 – Issue 2
Edwards, Sally. The Heart Rate Monitor Guidebook, 2010 (includes most of the assessments listed in this article)