5 - Prescreening - ASK GAQ

Question 1

list the requirements for GAQ completion

Answer 1

• client must read and answer questions on GAQ without interpretation from the CSEP-CPT (unless visually impaired no reading aloud)
• form must be signed with ink pen and witnessed by 3rd party on pg 2

Question 2

client’s answer to the GAQ determine _

Answer 2

whether client falls within the CSEP-CPT SOP or requires clearance from a physician before either doing the active portions of fitness assessment or starting an exercise program

Question 3

how long is a GAQ form valid?

Answer 3

12 months or unless health condition changes

Question 4

The GAQ is designed to be self-administered by the client. Client should be instructed to:

Answer 4

• complete pages 1-2 completely and honestly
• answer YES to any question on page 1 if client is unsure
• review the GAQ reference document, if the client has a YES response on page 1
• sign and date the declaration
• bring completed GAQ to their initial appointment with CSEP certified member

Question 5

what should a client do if if they’re unsure about a GAQ question?

Answer 5

answer YES
*don’t interpret, “if it feels accurate say yes”
*covers you if they actually have a condition - LIABILITY

Question 6

what should be done if the client responds YES to any reponse on page 1 of GAQ?

Answer 6

review GAQ reference document

Question 7

page 1 of the GAQ contains:

Answer 7

• 4 questions to identify clients who MAY need to seek advice from an appropriate health care provider or qualified exercise professional before becoming more physically active
  *check YES answers with reference document before moving to page 2

Question 8

page 2 of the GAQ contains:

Answer 8

• assessment of current physical activity levels
• general advise for becoming more physically active
• declaration

Question 9

how can understanding client’s current PA levels help cardiovascular risk

Answer 9

• the cardiovascular risks associated with exercise lessen as individuals become more physically active

Question 10

how can understanding client’s current PA levels help determine level of physical activity in program

Answer 10

• clients who do regular physical activity can usually begin at a level of physical activity that they are currently doing and progress as appropriate
• clients who are inactive should begin with light to moderate physical activity and progress gradually as tolerated

Question 11

what should you do if a client is interested in vigorous activity but has a lower risk medical condition?

Answer 11

should be referred to a CSEP-CEP

Question 12

in the declaration, even if client selects either of the boxes under ‘I answered yes to any question on page 1’…

Answer 12

CSEP-CPTs MUST stay within their scope of practice

Question 13

The reference document is designed to _

Answer 13

give the client advice about any YES response

Question 14

the reference document allows_

Answer 14

• the client to make an informed decision about the appropriateness of physical activity/exercise
• OR client may be prompted to obtain guidance from an appropriate health care provider or QEP

Question 15

when assisting the client with a YES response on the GAQ…

Answer 15

• ensure you are QUALIFIED (advice is within the scope of practice of your certification)
• ensure you are COMPETENT (you have the knowledge, skills and abilities to provide such advice)
  *otherwise refer client to another professional

Question 16

what are the limitations of the GAQ?

Answer 16

• possible for clients to have a diagnosed medical condition or take medications despite answering NO to all of the questions on page 1

Question 17

How can we overcome the limitations of the GAQ?

Answer 17

MUST ask clients about medical history
- any suspected or diagnosed conditions? if yes, any symptoms associated with the condition?

• taking any medications (over the counter or prescribed)? If yes, taking meds as directed?
  *frequency?

*CHART all of this information

Question 18

if the client gives all NO answers, can you work with them?

Answer 18

assuming you’ve asked about everything else, yes

Question 19

if you have a yes response on the GAQ, can you work with that client?

Answer 19

look at reference document, look at cutoffs
- might need to ask some questions (ex. shotness of breath might be ok if asthma is controlled, relieved by medication, and not changed)

Question 20

what’s the purpose of the CSEP-CPT health screening tool?

Answer 20

• used when clients identify as part of the pre-screening process that they have one medical condition
• tool helps the CSEP-CPT determine if he client’s medical condition is LOW RISK (aka stable health condition)
• not a substitute for the GAQ (or any other evidence-informed pre-participation health screening tool

Question 21

describe “apparently healthy”

Answer 21

• no diagnosed medical condition AND
• no overt signs and symptoms suggesting any potential underlying medical conditions AND
• able to exercise independently

Question 22

describe “lower risk medical condition”

Answer 22

Client with diagnosed medical condition and meets ALL the following criteria:
- condition is being medically managed & client is asymptomatic
- no change in meds/treatment plan in the past 6 months (taken as directed if prescribed)
- client can exercise independently
- benefits of physical activity clearly outweight risks

Question 23

describe “higher risk medical condition”

Answer 23

client that has a diagnosed medical condition and meets ANY of the following criteria”
- may not be medically managed
- may be symptomatic
- treatment may have recently changed
- may not be able to exercise independently
- benefits of physical activity may NOT outweigh risks, thus clinical monitoring or restrictions may be necessary

Question 24

any positive response in the CSEP-CPT health screening tool means:

Answer 24

NOT in scope of practice

Question 25

CSEP-CPT health screening tool is not comprehensive. What are the medical conditions included?

Answer 25

• asthma
• heart disease
• hypertension
• osteoarthritis
• osteoporosis
• type 2 diabetes

Question 26

for other medical conditions not included in health screening tool:

Answer 26

• the CSEP-CPT who is interested in other examples of lower risk medical conditions should taks an appropriate continuing education course

Question 27

There is a higher risk of an adverse event during exercise if client has:

Answer 27

• experienced cardiac symptoms during a cardiac rehabilitation program and/or in last 6 months
• diagnosed or suspected: aneurysm, valve disease, angina (any kind), acute myocardia infarction, acute myocarditis, arrhythmia, heart failure
• not completed a supervised cardiac rehabilitation program

Question 28

if client’s BP is over limit of 160/90 for BP_

Answer 28

refer client to a CSEP-CEP for exercise advice

Question 29

encourage clients who do not have diagnosed hypertension but have resting BP greater than 140 mmhg to _

Answer 29

discuss recent resting BP with physician

Question 30

if client answered YES to “dizzyness or lightheadedness during physical activity”…

Answer 30

recommend client speak to an appropriate health care provider to identify reasons and minimize risk

Question 31

if client answered yes to “loss of consciousness/fainting for any reason”

Answer 31

recommend client speak to an appropriate health care provider to identify reasons for loss of consciousness/fainting and minimize risk

Question 32

name the other reasons to refer beyond GAQ YES answers

Answer 32

• client not able to exercise independently
• client at risk for adverse event/has unstable health condition
• client wishes to engage in maximal/near-maximal exercise
• client has 2 or more co-morbid conditions
• client has resting HR or BP above screening requirements
• don’t feel you have the knowledge, skills or abilities to work with the client

Question 33

GAQ recommends that clients who wich to engage in maximal/near-maximal exercise and are not accustommed to maximal effort to_

Answer 33

be referred to a CEP or physician for evaluation and clearance

Question 34

If you need to refer to a physician, use which form?

Answer 34

physician guidance for physical activity form (formerly physician physical activity readiness clearance form)

Question 35

describe the physician referral steps

Answer 35

• client must take completed GAQ as well as the physician guidance form to physician
• page 1-2 is to be completed and signed by a physician
• page 3 procides additional info about the CSEP-CPT qualifications, the CSEP-PATH, and the Canadian 24hr movement guidelines