A & B: Initial Interview & Medical history/health appraisal Flashcards
What is a PAR-Q?
Questionnaire that requires self-recall of observations and signs and symptoms by client, in addition to confirmation of diagnosis by a physician
What are some advantages to the PAR-Q?
Cost-effective
Easy to administer
Sensitate (identifies people who need additional medical screening, while not excluding those who would benefit from participation in low-intensity activity
What is a limitation to the PAR-Q
Designed primarily to determine the safety of exercise and not necessarily the risk of coronary disease
What is a health/medical questionnaire?
Tool for assessing the appropriateness of moderate and vigorous levels of exercise.
It can identify positive coronary risk factors associated with coronary artery disease, sudden cardiac death risk factors, existing diagnosed pathologies, orthopedic concerns, recent operations, personal history of suggested sign and symptoms, medications, supplements, and lifestyle management
What are key areas to evaluate coronary risk factors, disease, and lifestyle?
Positive risk factors associated with CAD (coronary artery disease)
Medical conditions & diagnosed disease
Current lifestyle
How many CAD risk factors are there?
What are they?
7 risk factors: Family history Smoking Hypertension Dislipidemia Impaired fasting glucose levels Obesity Sedentary lifestyle
What is the threshold for Age as a CAD risk factor?
Men ≥ 45 y.o
Women ≥ 55 y.o
What is the threshold for family history as a CAD risk factor?
Sudden death before 55 y.o. in biological father or other male first-degree relative (immediate family)
Before 65 y.o. in biological mother or other female first-degree relative
What is the threshold for cigarette smoking as a CAD risk factor?
Current smoker or quit less than 6 months prior
Exposure to environmental tobacco smoke
What is the threshold for obesity as a CAD risk factor?
BMI ≥ 30kg/m2
Waist girth of >102 cm for men
>88 cm waist girth for women
Men are more likely to develop CAD than women (True or false)
True
What is the threshold for hypertension as a CAD risk factor?
Systolic ≥140 mmHg
Diastolic ≥90 mmHg
Stage 1: 130-139/ 80-89
Stage 2: ≥140 / ≥90
What is the threshold for sedentary lifestyle as a CAD risk factor?
< 30 min of moderate activity (40-60% VO2) < 3x/w less than 3 months
What is the threshold for dislipidemia as a CAD risk factor?
LDL-C > 130 mg/dl (more predictive than total cholesterol)
HDL-C <35 mg/dl
On lipid medications
Total cholesterol ≥200 mg/dl
What is the threshold for prediabetes as a CAD risk factor?
Impaired fasting glucose (IFG) ≥ 100 but < 126 mg/dl
Impaired glucose tolerance (IGT) ≥140 mg/dl but < 200mg/dl
Both have to be confirmed on two separate measurements
What is a negative risk factor for CAD?
High serum HDL-C ≥60mg/dl
What is introjected regulation?
When we view exercise and training as means to a valued end
What is external regulation?
Adhering to an exercise behaviour to satisfy others or avoid punishment
How does one’s physiological arousal/anxiety affect self-efficacy?
The way we interpret our physiological state before or during exercise can either decrease or increase our confidence.
The difference between “I’m nervous” & “I’m ready”
How does performance accomplishments affect self-efficacy?
It has the strongest influence on self-efficacy.
It builds confidence
What does modelling effects have on self-efficacy?
Seeing people perform a desired behaviour/goal can increase our self-efficacy by enhancing imitating behaviour
What has the most impact on increasing self-efficacy?
Performance accomplishments. Any win, however small.
What is amotivation?
Part of the self-determination theory.
It is a complete lack of intrinsic or extrinsic motivation
How does verbal persuasion affect self-efficacy?
When somebody we trust/respect has expertise in a area and encourage us, it increases our self-efficacy
What is stage of readiness?
How many levels are there?
It is the degree to which a client is ready to begin an exercise program.
There are 5 stages
What is maintenance in the stage of readiness?
Individual has been participating in physical activity for at least 6 months for at least 30 minutes of moderate intensity (40-60%) at least 5x/w
In what order come the stages of readiness
Precontemplation Contemplation Preparation Action Maintenance
What is contemplation in the stages of readiness?
Individual is thinking about being more physically active but has not done so yet
What is precontemplation in the stages of readiness?
Individual has no interest in being more physically active
What is preparation in the stages of readiness?
Individual is physically active for at least 30 minutes at moderate intensity (40-60%), but only 1x/w
What is action in the stages of readiness?
Individual is physically active for at least 30 minutes at a moderate intensity (40-60%) 5x/week but has been doing it for less than 6 months
What is the role of the PT?
Motivate Assess Train Educate Refer
What is an example of the delivery process for client consultation and health appraisal?
Schedule an appointment
Conduct interview
Implement and complete health appraisal forms
Evaluate for coronary risk factors, lifestyle, and diagnosed disease
Assess and interpret results
Refer to health professional if necessary
Obtain medical clearance if needed
There is no standardized process. It is usually predicated on 4 factors: Credentials of PT, Site of delivery, Population served, Legal statutes
How many parts are there for the client consultation?
What are they?
3 parts
Assess compatibility between client and PT
Discussion of goals
Establish client-trainer agreement
How many steps are there to assessing client-trainer compatibility?
What are they?
3 steps
PT providing detailed description of services available
PT may need to evaluate exercise readiness through motivation and commitment of client
Assess suitability & appropriateness
How can you assess exercise readiness of client?
Discussion of past experiences
Appreciation for exercise, availability of support
Time management & organization skills
Potential obstacles to exercise adherence
What does it mean to assess suitability & appropriateness for client-trainer compatibility?
Agree on boundaries, roles, resources & expectations, & address concerns from issues or information from initial interview
What services should PT give a detailed description of?
Formal education Professional experience Expertise or specializations Certifications Mission statement Success rate Logical aspects Unique features of program
What should be part of the client-trainer agreement?
Services provided Cost structure Parties involved Time of delivery Payment process Cancellation policy Termination of contract Circumstances that would render agreement void
What additional screening forms can be handed for extra info?
Lifestyle inventories
Informed consent
Release/assumption of risk agreement
What is an informed consent?
What are its essential elements?
It gives the client info about the content & process of program delivery system. Its essential elements are: Detailed description of program Risks & benefits associated w/ participation Confidentiality clause Responsibilities of participant Documentation of acknowledgement Acceptance of terms
What is part of lifestyle inventories?
Personal choices & patterns regarding dietary intake
Stress management
Level of physical activity
Other practices that may affect person’s health
What is an assumption of risk agreement?
Agreement preparticipation to give up participant’s rights to legal remedy (damages) in the event of injury
What forms can be used to screen health appraisal?
Physical Activity Readiness Questionnaire (PAR-Q)
Health/Medical questionnaire
What is self-efficacy?
Powerful predictor of exercise behaviour
A person’s confidence in their own ability to perform specific actions leading to successful outcome
It is related to persistence in striving for a goal achievement
What is integrated regulation in self-determination theory?
Person values behaviour, internalizes it, & voluntarily engages in it
What is identified regulation in self-determination theory?
Person accept instruction as beneficial but mainly follows leadership instead of initiating behaviour
How many types of influences affect self-efficacy?
What are they?
Four Performance accomplishments Verbal persuasion Modelling effects Physiological anxiety/arousal
What is self-determination theory / internalization?
How many levels are there?
What are they?
Which is best?
The continuum b/w intrinsic & extrinsic motivation. 5 levels Amotivation External regulation Introjected regulation Identified regulation Integrated regulation Best match is when someone is intrinsically and extrinsically motivated
In what order is the continuum for self-determination?
Amotivation External regulation Introjected regulation Identified regulation Integrated regulation
