chapitre 4 Flashcards
Is Pre-exercise and health screening more important in OA vs younger adults? Yes or No and why?
Prevent risk of injury
Yes important, bc OA are more likely to have risk factors for CAD or other conditions vs. Young adults
Purpose of Pre-Exercise Screening
- Become familiar with the physical condition of each OA who wishes to join your program
- Identify relevant health problems, the amounts and types of medications used, and current level of PA
- Identify risk level and determine the need for medical referral
4.Choose the correct type of follow-up fitness and mobility tests
- Identify the client’s goal, interests, barriers, motivators, quality of life, family support, and psychological state
pre-exercise screening
Helps identify clients who:
have ________, symptoms, or ______ that require medical examination and clearance
Are _______of a cardiac event
Should be _____ from participation in an exercise program
Should only be involved in a medically supervised
program because their risk is too great
disease, risk facror
at risk
excluded
CONTRAINDICATIONS to Exercise Testing or Participation
During Pre-Activity Screening:
Identify any of the following signs or symptoms of cardiovascular or pulmonary diseases:
- Pain or discomfort in the chest
Due to _angina - Shortness of breath at rest or with mild exertion
Due to _coronary heart disease - Dizziness or fainting
Due to syncope - Swelling around the ankles
Due to congestive heart failure
Contraindications to Exercise Testing or Participation (cont’d)
Identify any of the following signs or symptoms of cardiovascular or pulmonary diseases:
- Fast or irregular heart beat
- pain in the lower leg or intermittent claudication
- heart murmur
- undue fatigue
where is the pain in the lower leg coming from
lack of O2 to the muscle
what is a sign of intermittent claudication
limping
Risk Factors for Coronary Artery Disease
- important to identify participant with
- sudden cardiac arrest (most serious risk associated with vigorous exercise)
- know CV disease
- symptom of CV disease
- risk factors associate with CV disease
Long-term benefits of PA on cardiac risk far __ the _ in risk during exercise = TRUE
outweigh, temporary elevation
Initial Risk Stratification: goal
determine participant level of risk -≥ more likely to develop Coronary artery disease
explain the classification of initial risk stratification
- low risk: younger individual (under 45 men and under 55 women), asymptomatic, no more than one risk factor
- moderate risk: older individual (45 + men, 55+ women) having two or more risk factor
- high risk: with one or more S/S or CV or pulmonary disease or with knee CV, pulmonary or metabolic disease
what to do with every classification risk factor
low: no med check up needed
moderate: mod intensity = no med check up, high intensity = med check up
high: med check up
what are the risk factor of coronary artery disease: age and family history
- age: 45 +(M), 55 + (W)
- family history of CAD: parent and sibling before 55 (M), before 65 (W)
what are the risk factor of coronary artery disease: smoking, cholesterol et hypertension
- Smoking : On a daily basis or having smoked on a regular basis during the past 2 years
- Hypertension (high BP)
Systolic = 140 mmHg or greater
Diastolic 90 mmHg or greater
-Cholesterol: Total of 200 milligrams per deciliter or higher
Low levels of HDL, less than 35 mg/deciliter
what are the risk factor of coronary artery disease: diabetes,
- Type 1 and over the age of 30years
- Type 1 for more than 15 years
- Type 2 and over the age of 35 years
what are the risk factor of coronary artery disease: BMI and sedentary lifestyle
BMI 30+ with waist girth greater Thant 102 cm men, 88cm for W
combination of non participant in any regular exercise or recreational PA or having a job that does not involve PA
What are the 4 screening steps before beginning an exercise program?
- Informed consent
- The PA readiness questionnaire (PAR-Q)
- Physician consent
- Health history and activity questionnaire
participant consent form shoulde include:
Purpose
Procedures
Risks
Benefits
Signature
the questionnaire is self-administered or done by a physician and what are the age that PAR-Q is for
at what age should they check with their doctor
self, 15 and 69 years
69years + and not active
Difference between PAR-Q and PAR-Q +
PAR-Q: age limit (15 to 69), valid 12 month, med referral for chronic disease and disability (can create barrier to PA participation)
PAR-Q +: no age limit, valid 12 month, no med referral if chronic disease and disabilities are stable and under control ( decrease barrier to participation)
The results of this new screening (PAR-Q +) is that only a small % of participants
__+/-1% are referred for additional medical screening
Sample Medical Clearance Form should include:
Description of performance testing (1)
Major components of the program (2)
Your contact info
Physician’s consent (with or without conditions)
Physician’s denial (+ reason)
Physician’s signature
Health History and Activity Questionnaire should include:
- Demographics (Q 1)
- Existing chronic or acute diseases (Q 2-8)
- _Assistive devices_____ (Q 9-11)
- Perceived health status (Q 12)
- Family history of heart disease (Q 13)
- __Medications___ (Q 14)
- Smoking behavior (Q 15)
- Fall history (Q 17-19)
- Functional limitations and disability (Q 16, 20-22, 30)
- __Current levels of PA__ (Q 23-26)
- Perceived quality of life (Q 29)
what is the scoring range of composite physical function scale and what can we do with this info
Scoring range /24:
22-24 = _high function______
16-21 = _moderate function___
↓ 16 = _low function____
You can use this info to set goals and help you design your exercise program
Final Step: Feedback to Participants and Confidentiality
- Inform your participants about their health and disability status
- Review goals_____ with your participant
- Avoid technical__ terms
- Explain the results in a positive manner (give a copy to your participant)
- Info must be kept secure and not left in an area with unrestricted access (e.g., locked cabinet)
When should we update pre-activity screening tests
on a yearly basis and when participant show a decline in health or function
if its not possible to screen a new participant what do you do
completed PAR-Q +
You have a new participant coming to your exercise program: Edward is 47 years (MODERATE) old and has a family history of coronary artery disease (CAD) because his father started suffering from CAD when he was 54 years old. In addition, Edward often complains of fast and irregular heart beats (HIGH). According to the ACSM initial risk stratification, Edward is classified as:
high risk because of fast/irregular heart beat and sign of CVD
You have a new participant coming to your exercise program: Mary is 72 years old (Moderate) and has a family history of coronary artery disease (CAD) because her mother started suffering from CAD when she was 66 years old. In addition, Mary’s diastolic BP is of 95 mmHg (HIGH) and she shows cholesterol values of 180 mg/deciliter and of 32 mg/deciliter for Total and HDL levels (HIGH), respectively. According to the ACSM initial risk stratification, Mary is classified as:
moderate risk b/c hypertension and low HDL value
