APA assessments Flashcards
What is the Steadward Centre’s vision and mission?
- Vision: To facilitate Adapted Physical Activity and Para Sport opportunities for everyone.
- Mission: To foster community, and individual achievement and excellence in Adapted Physical Activity and Para Sport by applying innovative research, sharing our expertise, and delivering quality programs, with and for, individuals experiencing disability
What are the Steadward Centre’s core values?
- Embodied ways of knowing
- Connection
- Collaboration
- Leadership
- Learning
- Accessible
What are the 4 key program areas of the Steadward Centre?
- Adult Fitness and Recreation
- Free2BMe
- Athlete Development for Para Sport
- FES (Functional Electrical Stimulation) For people who have paralyzed muscles
Define impairment
The loss or reduction of functional ability and/or activity (WHO 2014). It is a condition that exists regardless of the environment and can be temporary or permanent.
Define disability
Any restriction to perform an activity caused by impairment. It is a social construct that people experience regardless of their environment
What is Adapted Physical Activity (APA)?
“Adapted physical activity (APA) is a professional branch of kinesiology/physical education/sport & human movement sciences, which is directed toward persons who require adaptation for participation in the context of physical activity…”
Who is APA for?
In many cases, APA involves individuals with disabilities, but its principles may also apply to including obese, aged, young individuals and any other individual difference that may restrict participation in regular (non-adapted) physical activity. Thus, APA is for anyone.
What are the key principles of Adapted Physical Activity?
- Individualizing instruction
- Matching personal strengths and interests with appropriate activities
- Adapting environments to promote full participation in physical activity, regardless of the population being engaged
- APA uses adaptation/modification.
- APA is based on strengths as opposed to deficits
What are some barriers to physical activity
- Physical barriers
- Social barriers
- Psychological barriers
- Physical environment (layout of facility)
- Energy levels (e.g., in M.S.)
- Time
- Financial constraints
What are Normative Referenced Tests? What are their characteristics?
Normative Referenced tests have normative data available to compare results to. Their protocol is standardized
What are Criterion Referenced Tests? What are their characteristics?
Criterion Referenced tests are more flexible, allowing the number of trials to vary to achieve the best result. Task Analysis or Active ROM is used to determine if the exercise is suitable.
What are some limitations of Normative Referenced Tests for individuals experiencing disability?
- Limited normative data to compare results with.
- Not many standard assessment protocols.
- Small body of research focused on assessment protocol for people experiencing disability.
What type of data is often collected when assessing individuals with disabilities?
Relative data - data that can be compared to the individual who is being assessed.
What are some considerations for fitness assessments for individuals experiencing disability?
- Level of Impairment/Mobility/Function
- Secondary Conditions
- Lower Extremity Swelling
- Medications
- Environmental Questions
- Cognitive Impairment
- Contraindications
List some contraindications for fitness assessments
- Atlantoaxial Instability
- Autonomic Dysreflexia
- Associated Effects of Brain Injury
- Seizure
- Allergies
- Shunts
- Pressure Sores
- Contractures
- Heat Sensitivity
- Orthostatic Hypotension
- Spasticity
What safety information should be obtained before an assessment?
- Consent to waiver form
- Allergies
- Seizures
- Medication
- Emergency Contact
What information is typically gathered in the “Get to Know You Form” for the Free2BMe program?
- Participant Information and EAP: Name, age, allergies, medication, seizures, emergency contact, individuals authorized for pick-up
- Likes and Dislikes: Likes, dislikes, goals
- Behavioural Needs: Environmental stimuli, behavioural expression/communication, support
- Additional Information
What initial information is gathered for Adult Fitness and Recreation (AFR) assessments?
- Specific fitness goals
- Past and present exercise
- Purpose of the exercise program
- Other health/safety information (GAQ used previously)
- What can we do to ensure a safe experience?
- How can we contribute to full, meaningful participation?
- Additional information
- Understanding their strengths and how to improve them
- What they want to get out of the program and what motivates them
What are the physical clearance requirements before an assessment?
- Resting heart rate
- Resting blood pressure
- If HR is >99 bpm, or BP is >160/90 mmHg, physician clearance is required.
What does Active Range of Motion (AROM) testing involve?
Assessing the able, limited, or unable range of motion for various joints and movements on both the left and right sides of the body. Visual guides and in-depth explanations can be helpful
What should be considered regarding range of motion variation?
Contractures
What are some components of the Functional Movement Screen (FMS) mentioned?
- Shoulder Mobility
- Active Straight Leg Raise
- Shoulder Clearing
- Hip mobility is important
- Active straight leg raise is important for walking
What is the purpose of cardiovascular testing?
To find a form of aerobic exercise suitable for the participant and their goals, and to find a workload they can safely exercise at. RPE can be taken every minute.
How do beta blockers affect heart rate, and what is recommended for RPE?
Beta blockers lower heart rate; therefore, the RPE scale will be more accurate for assessing exertion
What is a general guideline for maximum heart rate for individuals with Spinal Cord Injury (SCI) above T1?
Max HR is generally between 120 – 130 bpm (Bhambhani, 2007). This is determined by the amount of functional muscle
How might maximum heart rate be different for individuals with Developmental Disabilities?
Maximum heart rate may be 8 – 20% lower
What should be considered regarding cardiovascular assessment for individuals with asymmetries or amputations?
Functional Muscle Measurements; assessment might need to be taken on another body part.
What are some examples of musculoskeletal tests mentioned?
- Grip Strength (CSEP-PATH Protocol)
- Various musculoskeletal exercises targeting upper body, lower body, and specific muscle groups based on goals
What should be recorded during musculoskeletal testing?
- Weight
- Reps/hold time
- RPE
What is the “reps in reserve” method?
This method is used in musculoskeletal testing and indicates the potential to adjust the number of repetitions
What factors should be considered when selecting an assessment protocol?
- Performance
- Ability
- Body Management
- Locomotor skills
- Body Awareness
- Learning or behavioral challenges considered
- What are we choosing the test for? (e.g., level of function, independence, gait movement patterns)
When is a full fitness assessment especially useful?
When an individual is using the program for gym access or in the community and coming in on their own
When is a condensed fitness assessment best utilized?
With programming that will have regular follow-ups
What are some general clarifying pre-screening questions for FES assessment?
- Known shoulder issues
- Autonomic Dysreflexia (if yes, what are the triggers?)
- Muscle sensation
- Muscle volition
- Goals
What physical clearance assessments are recommended before FES?
- Resting heart rate and blood pressure
- Range of motion of hip flexion, knee flexion, knee extension, shoulder extension, shoulder flexion and elbow extension, and shoulder abduction
What are some components of the FES assessment process?
- Type of set-up (arms, legs, unilateral or bilateral)
- Height of pegs
- Pedal position
- Neck height
- Other set-up notes
- Electrode information (size, channel, placement)
- Muscle testing
- Coaching Notes
What are some examples of assessments used for para athletes?
- Cooper Test (aerobic fitness) (can be done in a wheelchair)
- Three Hop Test (leg power)
- Backward Overhead Ball Throw (core/body power)
- Competition and time trials, data during a workout
How are assessments conducted for the Development Group in Para Swimming?
Observational and skill acquisition focused, looking at milestones and goal dependency.
How are assessments conducted for the Competitive Group in Para Swimming?
Observational and skill acquisition focused, looking at technique, time aspect, drills in practice (e.g., Kick for Time, Broken 200, races), and legally performing strokes.
What is considered for “New Swimmers” moving to the competitive Para Swimming group?
25m swim ability and getting their head underwater
List some other cardiovascular assessment options.
- Arm Ergometer VO2max Test
- Six or Twelve-Minute Push Test
- Multistage Field Test
- Wingate Test - Arm Cycle
- Wheelchair Shuttle Ride Test
What are some anthropometry and body composition measurements that can be taken?
- Weight
- Height
- BMI
- Skin Folds
- Girth Measurements
What are some “Gold Standards” for body composition assessment mentioned?
DEXA and Hydrostatic weighing
What are some measures of Muscular Strength?
Handgrip and 1-RM or Multiple-RM testing
What is a measure of Muscular Power mentioned?
Medicine ball throw
What are some measures of Muscular Endurance mentioned?
Push-up test and Curl-up test
What are some respiratory conditions where adaptation might be needed during exercise?
CI (conus medullaris at L1), stroke, CP, MS, etc.. Respiratory adaptation can occur due to impairment
What are some assessment considerations for respiratory function during exercise for individuals with impairments?
Take breaks and monitor breathing
What are the principles of “Making Help Positive”?
- Did the person ask for help?
- Is your help offered with good intentions and does it ensure the person can assist and be a part of the process too?
- Is your help natural or is it unexpected?
- Before helping, did you ask if the person needs help and then wait for a response?
- Was the supervision of help listened to and honoured? Did you ensure that the person was still in control?
- If help is ignored or declined, you do not help. (Braithwaite and Cunningham, 2003)
List some general considerations when working with individuals with disabilities.
- Gather as much information as possible
- Remember autonomy
- Focus on ability
- Use person-first language
- Be creative
- Realize common barriers
- Ensure accessibility
- Ensure effective communication
