Chapter 10 - Client Strategy Part 1 Passive screening and assessments

Question 1

What do we mean when we say that a Personal Training Specialist has a “duty of care”

Answer 1

It means the PTS has a legal and ethical obligation to ensure that their clients are safe and that you only recommend exercises that will not injure the client.

Question 2

Why is pre-exercise screening a crucial first step in the personal training process?

Answer 2

It helps the PTS to understand the client’s health and their abilities before planning their exercise program.

Question 3

What is the purpose of pre-exercise screening?

Answer 3

1. it is part of a PTS’ standard of practice and a legal responsibility
2. Identify a possible need to refer clients to a qualified health professional.
3. Understand your client better and establish a good communication
4. Identify potential areas of strength or weakness
5. Identify diagnosed diseases or illness or condition
6. Spot signs or symptoms of a disease that is not yet diagnosed
7. Identify if there is increased cardiac risk
8. identify if client has health risks in starting a new activity

Question 4

What should you recommend to a client with a diagnosed condition?

Answer 4

1. Client must get guidelines for exercise from their health professional.
2. client should complete the ePARmed-X and visit a qualified professional to understand the results and receive recommmendations for exercise.

Question 5

What are the signs and symptoms of cardiorespiratory, metabolic or respiratory disease?

Answer 5

• pain an discomfort in the chest, lower jaw or left shoulder
• ankle swelling
• feelings of rapid heart rate
• severe pain in leg muscles when walking
• unusual fatigue
• difficulty breathing when standing or at night
• shortness of breath at rest or during light activity
• feelings of dizziness or fainting

Question 6

What are the cardiac risk factors that the PTS should be aware of?

Answer 6

• Family history of heart disease
• If client smokes
• If client has high blood pressure (systolic pressure greater than 140 or diastolic pessure greater than 90
• High cholesterol levels
• sedentary lifestyle

Question 7

HOw should a PTS proceed in their exercise program if the client is unaccustomed to regular vigorous to maximal-effort exercise?

Answer 7

The PTS must incorporate in the client’s training program a slow progression of exercise intensity over a period of months.
Monitor the client’s blood pressure before and after exercise to ensure they are making cardiorespiratory improvements.

Question 8

What questionnaire should you use to begin the client screening process?

Answer 8

Client must complete and sign a Physical Activity Readiness Questionnaire (PAR Q+). This form is at the end of chapter 10 .

You have a legal responsibilityt o have a signed PAR Q+ form for all clients you train and to adhere to the physical activity guidelines presented in the form.

Question 9

In addition to the PAR Q+ questionnaire what are other questions you can include in your pre-exercise screening interview?

Answer 9

• Their name, contact info, emergency contact info.
• Current medical conditions
• Past medical conditions
• past or present disability or impairment (Eg. hearing or visually impaired
• Medication and allergies
• current or past injuries
• treatment from qualified health professional
• cardiac risks
• Family health history
• past and present exercise history
• past and present nutritional information (eating habits and food preferences or intolerances)
• Alcohol, tobacco, cannabis use -
• Past and present work history - mostly to understand if the client’s job is physical or sedentary; also if there is a lot of work stress
• pregnancy

Question 10

What is client risk stratification?

Answer 10

the PTS must evaluate the client’s answers to the PAR Q+ and other questions and place them in a risk category:
low risk
increased risk
high risk

Question 11

What is considered a low risk client?

Answer 11

• client answered no to all questions on the PAR Q+
• exhibits no signs or symptoms of disease
• have no more than one major cardiac risk factor

A low risk client can start a moderate-intensity exercise program and undergo fitness assessments without a referral from from a medical practitioner.

Anyone unacustome to regular vigorous to maximal-effort exercise should slowly progress under the supervision of a PTS

Question 12

What is considered an increased risk client?

Answer 12

• a client who has two or more cardiac risk factors
• does not exihibit signs or symptoms of cardiorepiratory disorders.

These clients may start a progressive moderate-intensity physical activity program under close supervision.

Question 13

What is considered a high risk client?

Answer 13

• has two or more cardiac risk factors
• exhibits some signs of disease e.g. high BP
• has severe limitations or has diagnosed cardiac, pulmonary or metabolic disorders.

These clients must be referred to a qualified health professional for assessment and exercise guidance.

Question 14

What are three types of passive assessments?

Answer 14

• Passive postural assessment
• Cardiovascular health assessment
• body composition assessment

Question 15

When would you do a passive postural assessment?

Answer 15

When client’s goals are things like: higher levels of energy, improving posture, reducing back pain

Question 16

What are the five areas of assessment in a five point passive postural assessment?

Answer 16

• ankles and feet
• knees
• hips
• Shoulders
• head and neck

Question 17

How to assess the ankles?

Answer 17

What is the position of the feet and ankles:
* pronated - means there’s no arch in the foot
* supinated - there is too mcuh arch so there’s pressure on the outside of the foot
* neutral - appropriate arch in the foot

Question 18

How to assess the knees?

Answer 18

are knees:
* hyperextended - arch towards the outside
* Knock-kneed - the knees move inward toward each other
* knees are in a normal position

Question 19

HOw to assess the Hips?

Answer 19

• anterior pelvic tilt - towards the front
• posterior pelvic tilt - pelvis tilts towards the back
• Normal position

Question 20

HOw to assess the shoulders?

Answer 20

look for:
* shoulders are pushed to the back away fromthe midline(adduction)
* shoulders are rounded towards the front midline
* shoulders are too elevated towards the ears
* shoulders are too depressed.
* shoulders are a normal position

Question 21

HOw to assess the neck and head

Answer 21

• is the head in a neutral position or
• is the head pushed forward (often due to daily user of computers)

Question 22

How to conduct a Cardiovascular health assessment?

Answer 22

• measure the resting heart rate (use a blood pressure reader or count their pulse rate for 15 seconds and mulitply by 4 to get beats per minute (BPM)
• or use their fitbit readings etc. - a resting heart rate of 100 beats per minute (BPM) is a warning sign.
• measure resting blood pressure - a resting blood pressure of 120/80 or lower is good. A resting blood pressure where the systolic measure is 140 or higher and the diastolic measure is 100 or higher is a warning sign.

Resting heart rate or resting blood presure is measured when the client is sitting quietly for 5 minutes and has not started exercising.

to measure resting heart rate place middle and index fingers on pulse site Count the number of heart beats during 15 seconds and multiply by 4.

Question 23

What does adiposity mean?

Answer 23

Adiposity = Excessive body fat

Question 24

HOw to conduct a body composition assessment?

Answer 24

If a client has a body composition goal, you may wish to track measurements to assess change. These are the measurements you may want to keep track of:
1). Neck
2)Shoulders (at the widest point shoulder to shoulder with both arms down)
3)Chest (just above the nipples)
4) Bicepts
5) Forearm
6) Waist (2 centimetres above the navel
7) Hips - at teh widest part of the buttocks
8) Thigh
9) calf

Female - a waist greater than 88 centimeters (35 inches) is considered a health risk
Male - a waist greater than 102 centimeters (40 inches) is considered a health risk

Question 25

Body composition assessment - BMI as a method to assess

Answer 25

A PTS can measure teh client’s BMI (body mass index) as it changes over time: a person’s weight in kg divided by height in meters squared. Eg. 86 kg (190 pounds) divided by 3.17 (178 in meters squared = BMI of 27

Question 26

Body Composition assessments - bioelectric impedance

Answer 26

Bioelectric impedance measures the percentage of body fat.

Question 27

Which body composition assessment should you use?

Answer 27

Depends on the client’s goal:
1). if client wants to reduce body fat content - use bioelectric impedance measurements over time.
2)if client wants to fit in a specific size, use body measurements
3)if client wants to grow muscle, get bigger, use body measurements
4)if client wants to be a certain weight use the traditional scale

Question 28

List four factors that pre-exercise screening accomplishes

Answer 28

1. the PST can fulfill legal responsibilites
2. identify a possible need to refer client to a qualified health professional
3. Understand clients better and establish good communciaiton
4. identify potential aras of strength or weakness

Question 29

List three passive assessments

Answer 29

passive postural assessment
cardiovascular health assessment
body composition assessment

Question 30

The PAR Q+ should be givn to clients to complete
a. at initial intake
b. on an annual basis
c. if they have been away fro you for more than one month
d. all of the above.

Answer 30

all of the above

Question 31

How would you test for resting heart rate with a clident during a passive assessment.

Answer 31

to measure resting heart rate place middle and index fingers on pulse site Count the number of heart beats during 15 seconds and multiply by 4.

Question 32

If your client has a body composition goal, the best practice is to:
a). use skinfolds and waist girth measurements only to set a specific goal
b). use multiple body composition assessment tools to create the best picture of adipose tissue distribution and the relation to their overall health
c). use bioelectrical impedance to determnine the weights of fat free mass and fat mass and report the ration of these values in percent body fat as your qualifier
d). use photo comparisons at set assessment dates to visually mark changes in body composition bsed on image alone

Answer 32

use multiple body composition assessment tools to create the best picture of adipose tissue distribution and the relation to their overall health