Ch 2 Preliminary Health Screening and HR-BP Flashcards
Why do we do preliminary health screening
determine client readiness for exercise
Detect presence of, or suggestion of, disease
Assess likelihood of unexpected cardiovascular event related to exercise
Protect yourself from litigation
Does not exercise
does not have a known disesase
is not symptomatic
Do they need medical clearance
Not necessary
Exercise intensity - 2-5.9 METs
Progress gradually 6+ METs OK
Does not exercise regularly
Has a known disease
Is not symptomatic
Do they need medical clearance
Required
Exercise intensity - 2-5.9 METs
Progression gradually as tolerated
Does not exercise regularly
possibly has known disease
is symptomatic
Do they need medical clearance
Required
Exercise intensity - 2-5.9 METs
progression gradually as tolerated
Exercises regularly
has no known disease
is not symptomatic
Do they need medical clearance
Not necessary
Exercise intensity - 3-6+ METs
Progression gradually 6+ METs OK
Exercises regularly
has known disease
is not symptomatic
Do they need medical clearance
Not necessary for exercise less than 5.9 METs. Required if no change in signs and symptoms in past year for exercise greater than 6 METs
Exercise intensity - 3-5.9 METs
Progression gradually as tolerated after clearance
Exercises regularly
has known disease
is symptomatic
Do they need medical clearance
Required, discontinue exercise until cleared.
Exercise intensity - resume after clearance
Progression - gradually as tolerated
To answer yes for currently exercise what are the requirements
PLANNED physical activity
At least moderate intensity (> 3 METs)
At least 30 minutes for at least 3 days/week
Known cardiovascular diseases examples
Heart Disease
Peripheral Vascular Disease
Cerebrovascular Disease
Known Metabolic diseases examples
Type 1 and Type 2 Diabetes
Known renal disease example
Kidney disease
Examples of client being symptomatic
-Discomfort in cheek, jaw, neck, arms, back and so on due to Ischemia
-Shortness of Breath when performing normal activites
-Dizziness or Syncope
-Edema in ankles
-Heart palpitations or Tachycardia
-Intermittent Claudication
-known hear murmur
-unusual fatigue
Preliminary Health Evaluation
Minimal Screening Elements
- Par-Q+
- Informed Consent
- Lifestyle questionnaire
- Medical History
- Coronary disease risk factors
- Medical clearance
What should your informed conset describe
Procedures
Risks
Benefits
Confidentiality
Voluntary participation
Lifestyle evaluation components
clients living habits
daily behavior patterns
barriers to physical activity
What does a medical history questionnaire help with
identify previous diagnoses and symptoms of disease within the past year
Determine need for medical clearance
Modifiable coronary risk factors
cigarette smoking
hypertension
diabetes
dyslipidemia
obesity
sedentary lifestyle
Unchangeable coronary risk factors
age
family history
Positive risk factors for coronary heart disease
Age
Age - Men: >45 yr, Women: >55 yr
Positive risk factors for coronary heart disease
Family History
Myocardial infarction, coronary revascularization or sudden death before age 55 in father or first degree male relative. Or before age 65 in mother or first degree female relative
Positive risk factors for coronary heart disease
Cigarette smoking
Current cigarette smoking, exposure to environmental smoke, or smoking cessation within previous 6 months
Positive risk factors for coronary heart disease
Hypertention
Systolic BP >130 mmHg or diastolic >80mmHg
Positive risk factors for coronary heart disease
Dyslipidemia
HDL-C <40 mmdl or LDL-C >130; on lipid lowering medication; use TC >200 mgdl, or HbA1C >6.5%
Positive risk factors for coronary heart disease
Diabetes
Fasting plasma glucose > 126 mmdl or 2 hr oral glucose tolerance test values >200 mgdl, or HbA1c > 6.5%
Positive risk factors for coronary heart disease
Obesity
BMI >30 kg/m or waist circumference >102cm for men or >88 cm in women
Positive risk factors for coronary heart disease
physical inactivity
Not participating in >30 min moderate-intensity physical activity on at least 3 days/week for at least 3 mo
Negative risk factor for coronary heart disease
High HDL-c
Serum HDL-C >60 mgdl
Normal values for selected blood variables
Triglycerides
< 150 mgdl
Normal values for selected blood variables
Total cholesterol
< 200 mgdl
Normal values for selected blood variables
LDL-cholesterol
< 100 mgdl
Normal values for selected blood variables
HDL-cholesterol
> 40 mgdl
Normal values for selected blood variables
TC/HDL-cholesterol
<3.5
Normal values for selected blood variables
Blood Glucose
60-99 mgdl
give an example of absolute contraindications
ongoing unstable angina
give an example of a relative contraindication
acquired advanced or complete heart atack
Heart rate testing procedures
Allow 5 min seated rest before HR assessment
Methods for heart rate testing
Auscultation (stethoscope)
Palpation
HR monitors
ECG
Some causes for HR fluctuations
Stressors
Medication
Caffeine
Time of Day
Body position
Meals
Smoking
Drinking
Give a type of BP medication and what it does
Beta-Blockers
Reduce HR and cardiac output
Normal blood pressure category
Systolic less than 120 AND diastolic less than 80
Elevated blood pressure category
Systolic 120-129 AND Diastolic less than 80
High Blood Pressure (hypertension) state 1 Blood pressure category
Systolic 130-139 OR Diastolic 80-89
High Blood Pressure Stage 2 blood pressure category
Systolic 140 or higher OR diastolic 90 or higher
Hypertensive Crisis (consult dr immediately) blood pressure category
Systolic higher than 180 AND/OR diastolic higher than 120
Hypertenisve lifestyle modification
lose weight
lots of fruits and veggies
Reduce sodium intake
Aerobic exercise > 150 min/week
Limit alcohol consumption
FMS certification movements
Deep squat
Hurdle step
in line lunge
shoulder mobility
rotary and trunk stability
active straight leg raise
FMS scoring
3 (green light) able to complete movement
2 (yellow light) - able to complete with compensatory methods
1 (red light) - unable to complete movement
0 - any pain during movement
