Assessments Flashcards
Health Risk Assessment (HRA)
A screening tool used to evaluate the risks & benefits of starting an exe program.
Physical Activity Readiness Questionnaire (PAR-Q+)
A detailed questionnaire to assess a client’s physical readiness to engage in structured exe.
Will show:
A client’s current level of physical activity
Presence of cardio/pulmonary/renal/metabolic disease
Desires level of exercise intensity (light/moderate/vigorous)
Part I: 7 questions, looking for all NO
Part II: Only if any YES. Aimed at reducing false-positives for med review. 10 questions. Any further signs/symptoms to be eval by med provider only.
Health-History Questionnaire (HHQ)
Another pre-exercise screening tool.
Unlike the PAR-Q+, it is not industry standard. Meant to complement it.
It seeks to learn a client’s health history, habits, exercise history, eating behavior & general lifestyle.
Private & confidential:
Age
Gender
Height
Weight
Dr. name & contact
Emergency contact
Skinfold body fat testing: rested or after exe?
Should be done in rested state, due to thermoregulation & peripheral vasodilatation.
Indications to terminate Exe Test
Chest pain
A drop in systolic bp by 10 mm/hg below pre-exe measure
Exceeds sbp 250 or dbp 115
Unusual fatigue, dyspnea
Abnormal skin coloration, cyanosis
Dizziness
Sharp leg pain that abates when exe stops
Malfx of equip
HR measurements: at rest vs. exe
Radial pulse. 60s at rest. 10s during exe.
Android (apple) vs Gynoid (pear) shape
Android: more fat around the midsection. more disease risk.
Gynoid: more fat around hips. less disease risk.
Waist size and health risk
Men: greater or equal to 40”
Women: greater or equal to 35”
Waist to Hip Ratio (WHR): meaning of high or low ratio
Waist measurement/ Hip measurement
High: android shape. incr. health risk
Low: gynoid shape. lower health risk
SKF measurements
The amt of subcutaneous fat present is equivalent to total proportion of body fat.
-min of 2 measurements per site
-avoid mea. obese
-not after exe
Jackson & Pollock 7-site & 3-site SKF
Durmin-Womersley protocol
Other SKF methods. All est body fat %
Durmin not for older adults, best for ages 17-49. Less invasive, only upper body.
Bioelectrical Impedance Analysis (BIA):
Advantages & Disadvantages
-non invasive
-faster
-skewed results b/c hydration levels
Hydrostatic Underwater Weighing: how it works
Displacement. Compare land weight to water weight & take difference.
Cardiorespiratory fitness: def.
The ability of the circulatory & respiratory to provide the body w/ o2 during exe.
Vo2 Max
The most valid mea of cardio fitness
Vo2 mea o2 consumption & diff betw. Inspired & expired o2.
Shows the body’s ability to deliver o2 to the exercising muscles and to the mitochondria for energy production.
Peaks 25-30. Decr by 5% per decade in fit ppl, by 10% in untrained ppl
YMCA 3-min step test: purpose
For de-conditioned clients.
Uses recovery heart rate, w/ 60 measurement directly after the 3 mins.
96 bpm/ 24 steps per min
Rockport walking test
For newer exercisers & de-conditioned.
A 1-mile walking test w/ results based on time or HR.
HR taken right after.
1.5 mile test: validity compared w/ 1 mile test
More valid b/c it applies to wider population.
Ventilatory threshold vt-1 test
An aerobic test designed to estimate exe intensity when the body is using 50%-50% carbs/fats.
Done in stages if incr intensity
SS HR must be obtained
Vt1 is reached when the talk test becomes challenging but not difficult
Vt2 talk test
For a performance-centric client
The point at which can sustain its highest SS intensity for more than a few mins.
Maintain highest pace for 20 mins. Report on the last 5 mins. of HR & RPE.
Relies on anaerobic energy systems that challenge the blood’s lactic acid buffering system. Glucose provides almost all energy.
Cannot speak during exe.
Static vs Dynamic Posture
Standing still vs In motion.
A dynamic posture assessment is know as a Movement Assessment.
Further measurements of strength & agility are known as Performance Assessments.
Pes planus
Collapsed foot arch. Flat foot.
Muscle imbalances: overactive vs underactive
Overactive: excessive neural drive, causing muscle contraction in static position.
Under-active: limited neural drive, and thus resulting in neural inhibition and overly long muscle position in static posture.
Elements of Static Postural Assessment
An standing eval of the 5 Kinetic Chain Checkpoints from both anterior & posterior views.
Use imaginary lines to bisect horiz & vert.
Anterior:
Foot/Ankle: not flat/rot
Knees: not valgus/varus
LPHC: not tilted, rot, or hiked up
Shoulders: not elev or rounded
Head/Neck: not fwd, tilted or rot
Posterior:
Foot/Ankle: equal bal betwn left & right. Calcaneus not excessively everted & are straight & parallel. Achilles are vertical.
Knees: neutral, no valgus/varus
LPHC: level
Shoulders: level, scaps not elevated or protracted
Head: neutral
Anterior Pelvic Tilt
Excessive forward rotation of the pelvis, resulting in lumbar extension (lordosis).
Usually from time spent sitting, resulting in overactive hip flexors vs. glute max
Knee valgus
Knees collapse inward due to hip adduction and internal rot. (Medial knee displacement & genu valgum)
Knee varus
Knees bow outward (genu varum)
The 3 Postural Distortion Patterns to be eval in static postural assessment
Pes Planus Distortion Syndrome:
-Flat feet
-knee valgus
-adducted & int. rotated hips
Lower Crossed Syndrome:
-Anterior Pelvic Tilt
-Excessive Lordosis (lumbar extension)
Upper Crossed Syndrome:
-Forward Head
-Rounded shoulders (protracted scaps)
-Thoracic spine in excessive kyphosis (hunchback)
Pes Planus: Muscle imbalances
Observed:
Ankles: pes planus
Knees: valgus
Hips: adducted
Overactive:
Gastrocnemius and Soleus
Adductor complex
Hip Flexors
Underactive:
Anterior & Posterior Tibialis
Glute Max & Med
Lower Crossed Syndrome: muscle imbalances
Observed:
LPHC: anterior pelvic tilt & excessive lordosis
Overactive:
-Hip Flexors
-Lumbar Extensors
Underactive:
-Glute Max & Med
-Hamstring complex
-Abs
Upper Crossed Syndrome: muscle imbalances
Observed:
Thoracic spine: excessive kyphosis
Shoulders: Rounded forward (protracted & internally rot).
Head/Neck: jutted forward
Overactive:
-Pectoralis major & minor
-Levator scapula & sternocleidomastoid
-Upper trapezius
Underactive:
-Middle & lower trapezius
-Rhomboids (mid-back muscles)
-Deep cervical flexors
True or False: A client with observably perfect posture during a static postural assessment will not have movement impairments during a dynamic postural assessment.
False. It is only true that a client with impairments in the static postural assessment will often show impairments in the dynamic postural assessment.
Overhead Squat Assessment (OHSA)
The first movement observed in Dynamic Postural assessment.
Displays:
-dynamic posture
-core stability
-neuromuscular control
Movement impairments seen in the OHSA are predictive of injury risk during exe.
Can indicate stiff ankles & knee varus
Shoes off
Arms above head
Squat till femurs are parallel w/ floor
View from anterior & lateral
OHSA key observations
Anterior view:
Feet: should be pointed straight
Knees: straight
Lateral view:
LPHC: no excessive fwd lean or low back arch
Shoulders: arms should not be falling fwd
OHSA key observations
Anterior view:
Feet: should be pointed straight
Knees: straight
Lateral view:
LPHC: no excessive fwd lean or low back arch
Shoulders: arms should not be falling fwd
Key method of treatment for overactive & underactive muscles
Overactive: must be stretched
Underactive: must be strengthened
OHSA: Indications for movement impairment in foot/ankle.
Impairment: Foot/ankle turned out.
Imbalances:
- Overactive gastrocnemius/soleus & HM complex
-Underactive: anterior & posterior tibilias, glute max & med
OHSA: Indications for movement impairment in knees
Impairment: knee valgus
Imbalances:
-Overactive: TFL, Adductors
-Underactive: Glute Max & Med, anterior & posterior tibilias
OHSA observation in LPHC: Low Back Arches
Impairment: low back arches
Imbalances:
-Overactive: Hip flexors (rectus femoris, TFL & psoas), lumbar extensors, latissimus dorsi
-Underactive: Glute Med, HM complex & Abd
OHSA observation: LPHC excessive FORWARD trunk lean
Impairment: Excessive forward trunk lean
Imbalance:
-Overactive: Hip flexors, Gastrocnemius/Soleus, Abd & obliques
-Underactive: Glute Med, HMs, Lumbar extensors
OHSA observation: Arms fall forward
Impairment: Arms fall forward
-Imbalances:
-Overactive: Latissimus dorsi, Pectoralis major/minor, Teres major (posterior shoulder muscle)
-Underactive: middle/lower trapezius, Rhomboids, Posterior deltoids, Rotator cuff
Single-Leg Squat Assessment
Eval dynamic posture, lower extremity strength, balance & coordination.
Strong reliability between raters
Observe from anterior
Single-Leg Squat Assessment: knee
Impairment: valgus
Overactive: TFL & Adductors
Underactive: Glute Max & Med, Anterior/Posterior tibilias
Pushing Assessment
Assesses trunk, upper extremities & c-spine for stability.
Use standing chest press w/ narrow split stance for 10 reps (5 & switch stance)
Pushing Assessment: LPHC
Lateral observation
Impairment: low back arches
Overactive:
-Hip flexors (rectus femoris, psoas, TFL)
-lumbar extensors
Underactive:
Glute Max, HM complex & Abds
Pushing Assessment: shoulders
Impairment: scapular elevation
Overactive:
Levator scapulae (posterior nexk muscles)
Upper trapezius
Underactive:
Lower trapezius
Pushing Assessment: c-spine (head/neck)
Impairment: head juts forward
Overactive:
Levator scapulae
Sternocleidomastoid (anterior neck muscles)
Underactive:
Deep cervical flexors (neck stabilizer muscles)
Pulling Assessment
Assess LPHC, trunk, upper extremities, c-spine & head stability during pulling exercise.
Standing dual cable row in narrow split stance (5 & switch stance)
Pulling Assessment: LPHC
Impairment: low back arches
Overactive:
Hip flexors (rectus femoris, psoas, TFL)
Lumbar extensors
Underactive:
Glute max
HM complex
Abds
Pulling Assessment: shoulders
Impairment: Scapular elevation
Overactive:
Levator scapulae
Upper trapezius
Underactive:
Lower trapezius
Pulling Assessment: c-spine (head/neck)
Impairment: head juts forward
Overactive:
Levator scapulae
Sternocleidomastoid
Underactive:
Deep cervical flexors
