C6: Building Rapport and the Initial Investigation Stage

Question 1

What are the 4 essential stages of a successful client-trainer relationship?

Answer 1

1. Rapport
2. Investigation
3. Planning
4. Action

Question 2

What is motivational interviewing?

Answer 2

A client-centred, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. (Get clients “off-the-fence” about exercise)

Question 3

What are the purposes of the pre-participation screening?

Answer 3

1. Identifying signs, symptoms, presence or absence of known cardiovascular, pulmonary, and/or metabolic disease
2. Identifying medical contraindications (health conditions and risk factors)
3. Detecting at-risk individuals who should undergo medical evaluation and clinical exercise testing before participating in a program
4. Identifying individuals with medical conditions who should participate in medically supervised programs

Question 4

What is the Physical Activity Readiness Questionaire (PAR-Q)?

Answer 4

Good for a minimal, yet safe, pre-exercise screening measure for low-to-moderate but not vigorous, exercise training.

Question 5

What is the risk stratification process?

Answer 5

1. Identifying coronary artery disease (CAD) risk factors
2. Performing a risk stratification based on CAD risk factors
   3 Determining the need for a medical exam/clearance and medical supervision

Question 6

What is the negative risk factor in the CAD risk assessment?

Answer 6

High level of high-density lipoprotein (HDL) cholesterol score that >= 60mg/dL

Question 7

What are the positive risk factors in the CAD risk assessment?

Answer 7

1. Age
2. Family History
3. Cigarette Smoking
4. Sedentary Lifestyle
5. Obesity
6. Hypertension
7. Dyslipidemia
8. Prediabetes

Question 8

What other forms should trainers review, keep accessible and utilize as needed with their clients?

Answer 8

• Informed consent/Assumption of risk (NOT a liability waiver, does not provide legal immunity)
• Agreement and release of liability waiver (trainer not protected for negligence)
• Health history questionnaire
• Exercise history and attitude questionnaire
• Medical release
• Testing forms (record testing and measurement data during fitness assessment)

Question 9

What are the primary systems that experience stress during physical activity?

Answer 9

Cardiovascular, Respiratory and Musculoskeletal systems. Metabolic systems may be affected as well.

Question 10

What is the process which fatty deposits of cholesterol and calcium accumulate on the walls of the arteries, causing them to thicken, harden, and lose elasticity?

Answer 10

Atherosclerosis

Question 11

What is angina?

Answer 11

Pressure/tightness in the chest. Can also be experienced in the arm, shoulder or jaw. Pain can be accompanied by shortness of breath, nausea, sweating and palpitations.

Question 12

How does hypertension (high BP) affect the individual?

Answer 12

Individual’s risk of CAD, stroke, and kidney disease increases progressively with higher levels of systolic blood pressure and diastolic blood pressure. If person’s BP is already high, may elevate to dangerous levels causing stroke.

Question 13

How do antihypertensives affect the body?

Answer 13

1. Heart - reduce force of contraction
2. Peripheral blood vessels of heart - open/dilate them
3. Brain - reduce sympathetic nerve outflow
4. Kidneys - reduce blood volume by excreting more fluid

Question 14

What are the effects of beta blockers?

Answer 14

Block effects of catecholamines (epinephrine & noempinephrine), reduce resting, exercise and maximal heart rate.

Question 15

What are the effects of calcium channel blockers?

Answer 15

Prevent calcium dependent contraction of the smooth muscles in the arteries, causing them to dilate, lowering blood pressure. May increase/decrease/no effect on heart rate.

Question 16

What are the effect of angiotensin-converting enzyme (ACE) inhibitors?

Answer 16

Blocks enzyme secreted by the kidneys that prevents formation of a portent hormone that constricts blood vessels. Decreases blood pressure at rest and exercise.

Question 17

What are the effects of diuretics?

Answer 17

Increases excretion of water and electrolytes - may lead to dangerous cardiac arrhythmias and can reduce blood volume, causing dehydration.

Question 18

Where are the most common locations to take the pulse rate?

Answer 18

1. Radial artery (wrist on right side of the thumb)
2. Ulnar artery (pinky side)
3. Carotid artery (in the neck, lateral to trachea)

Question 19

What is Systolic Blood Pressure?

Answer 19

(Higher number) Pressure created by the heart as it pumps blood into circulation via ventricular contraction.

Question 20

What is Diastolic Blood Pressure?

Answer 20

Pressure exerted on artery walls as blood remains in the arteries during the filling phase of the cardiac cycle, or between beats when the heart relaxes.

Question 21

What are Korotkoff sounds?

Answer 21

Sounds made from vibrations as blood moves along the walls of the vessel. Blood pressure is measured indirectly through this. Under pressure of a blood pressure cuff, walls of arteries deform which allow the sounds to be heard.