ASSESS Flashcards
ASSESS overview
1. purpose
2. best practices
3. tools
- assess client’s PA, fitness, and lifestyle and discern client’s health benefit rating with the help of objective, EBP tests
- choose appropriate fitness assessment battery given client’s goals and history, ensure testing location has enough space and privacy and equipment is calibrated and maintained, explain purpose of each test and relate to client’s goals, avoid pushing client beyond limit, provide advice after entire assessment is done
- PASB-Q, SOC-Q, body comp, aerobic tests, MSK tests, quick ref health benefit ratings
aerobic assessment data collection sheets
includes data collection form, post-exercise recovery procedure, and equations to predict VO2max specific to each protocol + health benefit ratings
quick reference: health benefit ratings
health benefit rating for PAS-Q, aerobic, and MSK assessments
considerations for body comp testing and prescription
- sex and aging (males more android, females more gynoid, increase FM with age)
- body image and eating disorders
- scale v. other signs of progress
- types of fat and explaining role of each (not all fat same, rid of excess or abnormal adiposity)
body comp assessment methods
1. direct methods
2. indirect methods
- MRI, CT, DEXA
- lab based (hydrostatic weighing, BodPod) or field methods (skin folds, BIA, BMI, waist circumference)
MRI
strong magnetic field causes hydrogen protons to realign, after turning off the magnetic field, H+ lose alignment and releases E, E release depends on the tissue type used to reconstruct 3D image but not whole body measure; accurate but expensive and difficult to access
CT
x-rays pass through body, detector on other side monitor transmitted radiation, transmitter rotates 360 deg along length of body, more accurate for detecting VAT than MRI, reconstruct 3D img, not whole body measure; accurate but expensive and difficult to access, not recommended due to radiation
DEXA
low does x-rays with two distinct E peaks, one peak absorbed by soft tissue, other by bone to create estimation of bone mineral, fat, and lean soft tissue mass, accounts for individual variability in local bone mineral content
two-component model
1. overview
2. 5 assumption
estimates body fat by measuring body density to estimate %BF, population specific equations due to variations in proportion of water and minerals in FFM, based on 5 assumptions (density of fat = 0.901 g/cc, density of FFM = 1.1 g/cc which is most variable since comp bone and muscle, no individual variations in density, density of FFM are constant and proportions are constant, individuals only differ from ref body in amount of fat)
densitometry
estimate %BF, total body density is estimated from ratio of body mass to body volume (Db = BM/BV), body volume measured using hydrostatic weighing or air displacement plethysmography
hydrostatic weighing
determine body density and percent fat, weight loss underwater is proportional to vol of water displaced (BV = BM - UWW) where BV is corrected for air in lunger after max expiration (residual vol) + gastrointestinal vol (100 mL), Db = BM/BV)
hydrostatic weighing: methodological errors
- fixed body density values for FM and FFM, inaccuracy depending on individual variabilty
- inaccurate estimation of residual vol
- failure to eliminate trapped gas in bathing suit or body hair
- failure to exhale to true residual vol
- density of water is variable with temperature, must keep temp constant
air displacement plethysmography (BodPod)
- determine body density and percent fat using air displacement, pressure/vol relation (p1/p2=v1/v2), 1= empty pod, 2 = with person
- front and rear camber connected by diaphragm which oscillates to produce vol changes = pressure changes, body vol is calculated from difference with and without client
- need to account for heat and air in hair, thoracic gas vol, and body surface area; can select pop specific formula
skinfold caliper measurement
- measures thickness of subQ and uses pprediction equations to estimate BF%; requires skill and is not accurate with obese clients (BMI>30 or when waist circumference is greater than 102 for males and 88 cm for females
- assume distribution of subQ and VAT is similar for all individual within each sex and there is relationship between sum of subQ and body density
bioelectircal impedance analysis
- non-invasive technique to estimate total body water by passing low level current through body and measure impedance to predict FFM/FM using population specific equations; similar accuracy to SKF; can use for whole body or segments
- reactance = opposition to current caused by capacitance (electric charge) produced by cell memebrane, associated with greater cell body mass; resitance better predictor for FFM
- methodological error in level of hydration
BMI
- ratio of body weight/height squared, id people at risk for obesity related diseases and monitor changes in BF
- classify as healthy, obese, overweight, and underweight
- does not account for compositon of BW, affected by age, ethnicity, body build, and size frame
waist cirumference
- focused on centralized BF bc VAT better determinant of health outcomes than overall BF since higher waist circumference is also marker for high risk among ppl of normal weight
- individuals with waist circumference above specific thresholds are at further elevated risk of coronary event and diabetes in each BMI cat, except obese class II and III where risk is already extremely high
major central adaptations to training at rest, submax, and max exercise
1. VO2
2. HR
3. SV
4. CO
5. VE
6. max workload, RER, lactate threshold
- no change, no change, increase
- decrease, decrease, no change
- increase, increase, increase
- no change, no change, increase
- no change, no change, increase
- increase due to neurological and hypertrophy, (VCO2/VO2) decrease, increase as % VO2
lactate threshold
lactate threshold is point where switch from aerobic to anaerobic fuel consumption, causing increase in lactate production rate, measures the upper limit of steady state, usually 65-70% of VO2max
critical power
perfect wattage to maintain the same power output throughout exercise, clearing out lactate just fast enough that you are below lactate threshold (steady state)
6 influences of VO2max
- mode of exercise: treadmill>bike>rowing bc of body mass used
- hereditary: heart size, lung capacity (affects VE), RBC (hematocrit)
- age: after 25 yrs decrease by 1% per year, shaper curve beyond 65 due to loss of muscle mass
- females have 10% lower abs VO2 due to greater fat distribution, no difference before puberty
- physical training can increase by 6-20%, 5-6% increase is clinically relevant
- body comp: more muscle means more metabolic tissue
aerobic fitness measurement
1. maximal aerobic power: peak v. max
2. assessment of aerobic power
- no further increase in O2 consumption is VO2peak, plateau is when hit peak but working at peak without increase in %VO2 is VO2max
- precision is direct, submax tests indirectly predict VO2 using linear relation between HR/VO2/work, performance is measured using Cooper 12 min run but can also be used as a predictive factor for health risk
4 considerations when selecting an aerobic fitness test
- what are the reasons for the test; occupation, PA, sport, health
- who is the client: goals and activity preference
- what equipment and personnel are available
- how accurate is the test for client: validity, reliability, comparison to norms, and economy of test (how accurately it measures VO2 due to % of muscle mass used)
assessing aerobic fitness
1. direct tests
2. indirect test
- VO2max test using metabolic chart
- uses HR or time to predict VO2max; submax tests are mCAFT, YMCA, and Ebbeling, field tests is Rockport 1 mile walk
submax aerobic tests
1. theory
2. assumptions
- person with higher VO2max can perform the exercise with less effort (lower HR) or more exercise at a given HR
- linear relationship between HR, VO2, and workload, HRmax is age given uniform, mechanical efficiency of activity is uniform; error is +-10-20% VO2max therefore not high validity but good enough for insight into health outcomes; is reliable therefore always same error pre to post-training, good for tracking progress
general proceduceres for exercise testing
- explain test
- familiarize client with equiment
- monitor HR at rest and exercise, RPE, BP at rest, and signs of intolerance
- follow post exercise recovery procedure
reasons to stop aerobic test/session
- voluntarily asks to stop
- reaches 85% of predicted HRmax
- cannot maintain cadance in mCAFT/YMCA
- HR fails to increase as intensity increases
- phys or verbal manifestations of severe fatigue
- onset of angina or angina like symptoms
- signs of intolerance/distress
- accident/emergency
- finishes stage 8 of mCAFT
signs of exercise intolerance to exercise and intolerance protocol
- chest pain, facial pallor, laboured breathing, staggering, complains of dizziness or nausea, extreme leg pain
- discontinue test if client shows signs of intolerance; lie client supine, elevate legs, provide them with electrolyte drink (talk to client beforehand to ensure no allergies) monitor BP and HR, if needed, initiate EAP
protocol, validated pop, and time of submax aerobic tests
1. mCAFT
2. treadmilll walking test
3. one mile walk
4. cycle ergometer test
- multi-stage step, validated for 15-69 y/o of many fitness levels (up to certain point), 15-20 mins
- single stage treadmill walking (5% grade) for sedentary adults 20-59 y/o, 15-20 mins
- brisk walking over 1 mile flat measured distance for sedentary or older adults 20-69 y/o, 25-35 mins
- multistage cycle test for 15-69 y/o with difficulty with balance or coordination/prefer cycling, 20-30 mins
muscular strength v. muscular power v. muscular endurance
- peak force or torque during MVC
- rate at which mech work performed, max amount of force one can exert in least amount of time
- ability to exert submax force repeated or sustain static contraction without fatigue
considerations when choosing and conducting strength test
- client’s goals, specificity, equipment, client’s condition
- ensure client is warmed up and familiar with all equipment
- keep motivation consistent
protocol, validated pop, and contraindications
1. grip strength
2. push-ups
3. sit and reach
4. vertical jump
5. back extension
6. forearm plank
7. one leg stance
8. Y balance test
- forearm strength, 15-69 years, no contraindication
- chest, shoulder, arms endurance, 15-69 yrs, not suitable for clients with OP, LBP, or shouldder/wrist problems
- hamstring and low back flexibilty, 15-69 yrs, not for clietns with OP or LBP
- leg power, 15-69 yrs, not for clients with OP, LBP, or knee/ankle problems
- back endurance, 15-69 yrs, must pass prescreening test
- upper body endurance, variable age, not for OP, LBP, or shoulder/wrist problems
- static balance of legs, 18-69 yrs, not for lower leg injury or history of falls
- dynamic standing balance, young adults, not for lower leg inj or history of falls
1 RM test
1. overview
2. purpose
3. limitations
4. testing
- max amt lifted in one complete rep with proper tech
- used to rate health status, est exercise prescription workloads, and monitor res training program
- inj, tech, economy of test
- warm up at 40-50% of estimated 1 RM for 5-10 reps (RPE 10), correct form, allow 5 mins rest, attempt 1RM, if successful wait 3-5 mins and repeat with higher weight, if not in 3-5 trials, wait 48 hours to repeat
predicting 1 RM
1. theory
2. submaximal predicted 1RM test
3. predicting 1 RM
- muscular endurance has direcct relation with strength, can predict 1 RM from submax 6-10 RM test
- warmup at 40-60% of estimated 1 Rm for 5-10 reps, 5 mins rest, 1 set of 10 reps at 75-85% of estimated 1 RM (if more than 10 reps completed then client rests for 3-5 mins), increase weight, client attempts up to 10 reps, if not done in 3 sets then wait 48 hours
- use Baechle and Earle scale to match number of reps to %1RM and divide weight lifted by %1RM
predicting 1 RM: error
- client: form, CON/ECC timing, testing time of day, nutrition
- equipment: machines create more standardized conditions than weights
- technician skill: provide feedback and correct form
- environment: distraction and rest period consistency
ADVISE goals
- discuss assessment results with clients using the perspective of HBR and explain how changes in PA can help them achieve better health and wellbeing
- use results to help the client move toward committing to making needed changes to work toward their goals
