1.1 Client Consultation and Assessment Flashcards
What 7 components of PT services assed to determine compatibility.
mnemonic = avoidsnotty client
MEEWCUS
- Mission statement
- Education
- Experience
- When and where services available
- Certifications expertise/specialization
- Unique features of delivery system
- Success rate
What 6 things should be discussed/considered in client motivation assessment?
Take clients to DAATOP
- Describe past exercise experiences
- Appreciation for exercise
- Availability of support
- Time management
- Organizational skills
- Potential obstacles that may affect adherence
What tool is used to assess safety of client participation in exercise?
- Physical Activity Readiness Questionnaire - PAR-Q
- 7 questions that determine safety of exercise via self-recall of observations and signs/symptoms + existing diagnosis
What 9 things should be discussed/agreed upon prior to initial training session
CCCPPETTS
- Cancellation policy
- Cost structure
- Circumstances doccument → void
- Parties involved
- Payment Process
- Expectations of parties
- Timeline of delivery
- Termination of contract
- Services
What is informed consent and what is purpose/benefit?
A protective legal document that informs the client of any inherent risks associated with fitness testing and participation in an exercise program.
What are 3 reasons for assessing attitude and readiness inventory?
- Identify any potential risks associated with client’s present health status
- Evaluate positive risk factors associated with Coronary Artery Disease (CA), medical conditions and diagnosed disease, and current lifestyle
- Stratify risk and refer clients to physicians as necessary
Define Stage of Readiness.
What are the 5 stages?
Motivation exists on a contimum of readiness
-
Precontemplation
- No desire or thout about↑ physical activity
-
Contemplation
- Not yet physically active, but wants/thinking about ↑ physical activity
-
Preparation
- @ Least > 30 min moderate exercise 1-3 days/week
-
Action
- @ Least 30 min exercise 5 ≥ days/week, for < 6 months
-
Maintenance
- @ Least 30 min exercise 5 ≥ days/week, for > 6 months
- What is lack of self-efficacy? Give an example
- What 4 tools improve self-efficacy?
- Lack of self-efficacy = lack of confidence in his/her ability to perform specific actions leading to a successful behavior outcome
- Poor self-concept/lack social physique anxiety → lack of confidence in ability to perform actions to improve physique
- 4 things ↑ Self efficacy:
- Performance accomplishments
- Goal accomplishments build confidence
- Modeling effects
- Seeing other perform target behavior → imitative behavior
- Verbal persuasion
- Encouragement from a respected source = “you have potential”
- Physiological arousal or anxiety
- Client may judge arousal negatively (“I’m too nervous”) or positively (“I’m ready”)
- Performance accomplishments
- Define Self-Motivation theory, intrinsic and extrinsically motivated behavior.
- What are the 4 stages on continuum?
-
Self-determination/internalization = people operate on motivational continuum of intrinsic and extrinsic motivation.
- Intrinsically motivated behavior - behavior engaged in for sense of enjoyment/fun
- Extrinsically motivated behavior - behavior to achieve external goal or outcome
-
Amotivation
- total lack of intrinsic or extrinsic motivation
-
External regulation
- Engages in behavior to avoid punishment, not for personal satisfaction
-
Introjected regulation:
- exercise as means to valued end (e.g. correct form during training internalized to please trainer)
-
Identified regulation
- Sees PT’s instructions as beneficial
- Follows PT’s leadership instead of initiating behavior
-
Integrated regulation
- Client has internalized value of exercise behavior
- Engages in it freely
- client and PT agree on goals
Why do people procrastinate in fitness and what should PT do?
- Procrastination = too many options to must decide between, decision-making itself often leads to stagnation.
- Personal trainers must help clients so that they aren’t left weighing options in a state indecision.
Give 4 examples of questions that help identify false beliefs
- What is your ideal approach to getting in shape?
- What have you tried int he past to achieve the fitness results you want?
- What exercise/nutrition strategies do you feel are important?
- What do you feel you need to do to reshape your body and improve your health and fitness?
4 steps for identifying and modify negative self talk.
If you don’t modify self-talk, consequences may be dire.
- Develop awareness of self-talk
- Identify self-talk it @ specific time each day, (e.g b4 training session)
- Record self-talk and identify what more supportive/motivating alternatives
- Swap 3 common self-talk phrases and 3 better phrases, write them as affirmations
Define visualization including benefit/purpose and give 3 examples
- Visualization = uses ability of brain to draw/recall mental images that can help learn how to create positive emotional responses and improve motivation
- Witness past success
- Witness future success
- Witness value (e.g. see the result/valued outcome immediately before, during, or after workout)
- What are relaxation exercises for mental imagery and what is our default state when sitting?
- Describe example of progressive relaxation and what it teaches
- Relaxation Exercise for mental imagery = mental conditioning exercises, must be performed in a relaxed state. Often our muscles are tense even when we are sitting.
- Progressive relaxation = individual tightens each muscle group, one at a time and follows contraction with full relaxation Teaches to differentiate between sensations of muscle tension/relaxation
What are 3 objectives of medical/health appraisal
- Identify any potential risks associated with client’s present health status
- Evaluate positive risk factors associated with Coronary Artery Disease (CA), medical conditions and diagnosed disease, and current lifestyle
- Stratify risk and refer clients to physicians as necessary
What are 3 benefits of PARQ what are 2 drawbacks?
- Benefits
- Identifies individuals who require additional medical screening
- Does not exclude those who would benefit from participation in low-intensity activity
- Cheap
- Drawbacks
- Designed to determine exercise safety and not necessarily CAD risk factors.
- Limited ability to identify medications and contraindications to exercise
- What is a Health/Medical Questionnaire?
- What does it identify?
- How does it differ from PARQ?
- What sorts of questions does it ask?
- Health/Medical Questionnaire = tool for assessing the appropriateness of moderate and vigorous levels of exercise in that it can:
- Identify positive coronary risk factors associated with:
- CAD
- Sudden cardiac death risk factors
- Existing diagnosed pathologies
- Orthopedic concerns
- Recent operations
- Personal history of suggested signs and symptoms, medications, supplements, and lifestyle management.
- Identifies risk factors (which PAR-Q does not) and some contraindications.
- Present/Past medical symptoms/conditions, family history
What are 2 purposes of administering lifestyle questionnaire?
- Evaluate personal choices, and patterns related to dietary intake, management of stress, level of physical activity and other practices that may affect person’s health, CAD risk factors, and risk stratification.
- Clarify and confirm personal issues possibly perceived as assets or obstacles to client’s success. Info for developing goals.
What 3 categories of questions on lifestyle questionnaire and what is benefit/insight of these questions?
- Dietary intake
- Correlation b/w dietary sat fat and cholesterol and development of atherosclerosis (plaque buildup)
- Under consumption → osteoporosis
- Over consumption → obesity and diabetes
- Sodium → chronic elevation of SBP/worsen heart failure
- Physical activity levels
- Note signs and symptoms associated with activity
- No/low physical activity ↑ risk of CAD
- Stress management
- Correlation between stress and CAD Type A behavior patterns may contribute to overall risk for developing CAD
- What defines moderate risk client?
- Medical exam + graded exercise test requirements: for
- Mod exercise
- Vigorous exercise
- MD supervision recommedations for
- Sub max testing
- Max testing
- Asymptomatic with ≥ 2 CVD risk factors
- Medical exam requirments
- Mod ex = not nec
- Vig ex = recommended
- MD supervision reccomendations
- Submax = not nec
- Max = recommended
- What defines low risk client?
- Medical exam + graded exercise test requirements:
- Mod exercise
- Vigorous exercise
- MD supervision recommendations for
- Submax exercise test
- Max exercise test
- Asymptomatic ≤ 1 CVD risk factors
- Medical exam + graded exercise test prior to exercise
- Mod ex = not nec
- Vig ex = not nec
- MD supervision for exercise test reccomended
- Submax = not nec
- Max = not nec
- What defines high risk client?
- Medical exam + graded exercise test requirements:
- Mod exercise
- Vigorous exercise
- MD supervision exercise test recommendations
- Submax
- Max
- Symptomatic, or known cardiac, pulmonary, or metabolic disease
- Medical + graded exercise test recommendations
- Mod ex = recommended
- Vig ex = recommended Submax = recommended Max = recommended
- What are 8 positive CAD risk factors?
- Age
- Family history
- Cigarette smoking
- Sedentary lifestyle
- Obesity
- Hypertension
- Dyslipidemia
- Prediabetes
- What is 1 negative CAD risk factor?
- Positive risk factors
- Age = M ≥ 45, W ≥ 55
- Family history = myocardial infraction, coronary revascularization, or sudden death before 55 in 1st degree male relative or before 65 in 1st degree female relative
- Cigarette smoking = current, environmental, or quit w/in 6 months
- Sedentary lifestyle ≤ 30 minutes mod intensity (40-60% VO2 reserve) 3 x week for @ least 3 months
- Obesity = BMI ≥ 30, or male waist girth 102cm/40in, female waist girth = 88cm/35
- Hypertension = either/and/or
- SPB ≥ 140
- DBP ≥ 90
- Dyslipidemia = any of 3
- LDL ≥ 130
- HDL < 40
- Total serum ≥ 200
- Prediabetes
- Impaired fasting glucose = 100 ≤ fasting glucose < 126
- Impaired glucose tolerance = 140 ≤ glucose levels < 200
- Negative risk factor = High serum HDL ≥ 60
Who requires medical exam prior to exercise? (4 situations)
- Moderate risk clients
- Wishing to engage in vigorous exercise
- MD supervision on a maximal test
- High risk clients
- Wishing to engage in moderate or vigorous exercise.
- MD supervision on submaximal and maximal tests
- Clients who answered yes to 1 or more PAR-Q questions
- Clients who exhibits signs/symptoms of cardiovascular or pulmonary disease
What 6 pieces of information should be included on a physician’s referral form?
- Assessment of individual’s functional capacity
- Classification of ability to participate based on evaluation
- Class 1 = presumably healthy without apparent heart disease, eligible to participate in unsupervised program
- Class 2 = presumably healthy with > 1 risk factors for heart disease, eligible to participate in supervised program
- Class 3 = patient not eligible for this program, and a medically supervised program
- Identification of preexisting conditions that may be worsened by exercised
- Prescribed medications
- Fitness program recommendations
- Continuing education