ch4:pre-exercise and health screening Flashcards
why is pre screening more imp in OA
prevent risk of injury, more meds, more likely to have risk factors for CAD or other conditions
purpose pf pre-exercise screening
- become familiar with physical condition of each OA who wishes to join
- identify relevant health problems, the amount and types of medication used and current level of PA
- identify risk level and determine the need for medical referral
- choose the correct type of follow-up fitness and mobility tests
- identify the clients goal, interest, barriers, motivators, quality of life, fam support and psychological state
pre-exercise screening helps identify clients who:
- have diseases, symptoms or risk factors that require medical examination and clearance
- are at risk of cardiac event
- should be excluded form participation in an exercise program
- should only be involved in a medically supervised program bc their risk is too great
contraindications to exercise testing/participation during pre-activity screening
- pain or discomfort in the chest (due to angina)
- shortness of breath at rest or w/ mild exertion (due to coronary heart disease)
- dizziness or fainting (due to syncope)
- swelling around the ankles
(due to congestive heart failure)
relative contraindications to exercise
- severe arterial hypertension
- tachyarrhmya or bradycardia
- ## uncontrollable metabolic diseases such as diabetes, thyrotoxicosis,myxedema
absolute contraindicaitions to exercise
- high-risk unstable angina (chest pain)
- uncontrolled cardiac arrhythmia causing symptoms or compromised cardiac function
signs and symptoms of cardiovascular or pulmonary disease
- fast and irregular heart beat
- pain in the lower legs or intermittent claudication
- heart murmur
- undue fatigue
values of severe arterial hypertension
systolic over 180mmHg
diastolic over 110mmHg
risk factors to performing PA for people w/ coronary artery disease
- sudden cardiac death
(most serious risk associated w/ vigorous exercise)
(primary associated with indv having at-risk medical condition)
which at-risk medical condition is imp to identify in idv
- known cardiovascular disease
- symptoms of cv disease
- risk factors associated with cv disease
ACSM initial risk stratification identifies:
participants having risk factors more likely to dev coronary artery disease
what identifies as high risk in the risk stratification
indv w/ one or more signs and symptoms of cardiovascular OR pulmonary disease OR indv w/ known cardiovascular, pulmonary, or metabolic disease (medical check-up needed)
what identifies as moderate risk in the risk stratification
older indv (men 45y/o or older, women 55 y/o or older) OR idv of any age having two or more RISK factors
(medical check up needed for high intensity)
what identifies as low risk in the risk stratification
younger indv (M under 45, W under 55) who are asymptomatic AND have no more than one risk factor
risk factors for coronary artery disease
- family hx of CAD
- smoking
- hypertension
- cholesterol
-diabetes - body mass index
- sedentary lifestyle
risk factor for CAD specification: family hx
parents and siblings
male before age 55
women before age 65
risk factor for CAD specification: smoking
on a daily basis or
having smoked on a regular basis during past 2 years
risk factor for CAD specification: hypertension
systolic= 140mmHg or greater
diastoli = 90mmHg or more
risk factor for CAD specification: cholesterol
total of 200 mg/dL or higher
low levels of HDL, less than 35mg/dL
risk factor for CAD specification: diabetes
- type 1 and over the age of 30
- type 1 for more than 15 years
- type 2 and over the age of 35
risk factor for CAD specification: body mass index
BMI of 30+ with waist girth greater than 102cm for men 88cm for women
risk factor for CAD specification: sedentary life style
combination of non-participation in any regular exercise or recreational PA and having a job that does not involve PA
what are the 4 screening steps before beg and exercise prog
- informed consent
- the PA readiness questionaire
- physician consent
- health hx and activity questionnaire
what should the participation consent form include
- purpose
- procedures
- risks
- benefits
- signature
PAR-Q
- establish readiness to participate in low to mod intensity exercise prog
- self-administered
- encourages indv to seek medical advice if answering yes to any question
- limited in scope
- btw 15-69 y/o
- valid 12months
- med referrals for chronic diseases and disabilities
PAR-Q+
- no age limit
- valide for 12months
-no med referrals if chronic diseases and disabilities are stable and under control
result of new screening w/ PAR-Q+
+/- 1% are referred for additional medical screening
what should a medical clearance form include
- description of performance testing
- major components of the program
- your contact info
- physicians consent(w/ or w/o cond)
- physicians denial +reason
- physicians signature
what should health history and activity questionnaire include
- demographics
- existing chronic or acute diseases
- assistive devices
- family hx of heart disease
- medications
- smocking behaviour
- fall hx
- func limitations and disability
- current lvl of PA
- perceived quality of life
physical activity questionnaire scoring
22-24 = high function
16-21 = mod function
<16 = low function
final step feedback to participants and confidentiality info:
inform pt on health status
- set goals w/ pt
- avoid technical terms
- explain results in a positive manner
- info must be kept secure and not left in an area with unrestricted access
what should be completed if not possible to screen a new participant
PAR-Q+
special consideration on pre-activity screening
- imp for legal responsibility
- if more info needed. refer
- do not hesitate to exclude OA who fail to complete questionnaires
