Chapter 5 - Preparticipation Health Screening

Question 1

Purpose of Preparticipation Health Screening

Answer 1

1. Help ensure that the client is physically and mentally prepared to start a structured exercise program.
2. To remove any unnecessary barriers to becoming more physically active.

Question 2

What type of individuals are at increased risk for harm from vigorous to near maximal intensity exercise?

Answer 2

1. Those who are unhealthy presenting with exertional signs and symptoms suggestive of a disease.
2. Those who have been diagnosed with an existing cardiovascular, metabolic, or renal disease.

Question 3

When to perform a PHS?

Answer 3

For all new participants, regardless of age, upon entering a facility that offers exercise equipment or services. Screening should be valid, simple, cost-efficient, time efficient, and appropriate.

Question 4

Three factors the health screening process is based on.

Answer 4

1. Current level of activity
2. Diagnosed cardiovascular, metabolic, or renal disease &/or the presence of symptoms of these diseases.
3. The desired exercise intensity

Question 5

Goal of health screening process is to identify individuals:

Answer 5

1. Who should receive medical clearance before starting an exercise program, increase frequency, intensity, or volume of current program.
2. With clinically significant diseases who may benefit from a medically supervised exercise program
3. With medical conditions that may require exclusion from exercise until those conditions are resolved.

Question 6

Preparticipation Health Screening Algorithm - for a non-exerciser

Answer 6

Medical clearance not needed when - no CVD, metabolic or renal disease & no symptoms.
Medical clearance recommended - when above things are present. Light to moderate intensity allowable after medical clearance.

Question 7

Preparticipation Health Screening Algorithm - for a regular exerciser

Answer 7

Medical clearance not needed when - no CVD, metabolic or renal disease & no symptoms. AND when asymptomatic with these diseases.
Medical clearance recommended - when symptoms are present. Light to moderate intensity allowable after medical clearance.

Question 8

Definition of dyspnea

Answer 8

Shortness of breath at rest or mild exertion

Question 9

Definition of orthopnea

Answer 9

Shortness of breath at rest or mild exertion (dyspnea) when in a reclined position

Question 10

Definition of syncope

Answer 10

Dizziness

Question 11

Definition of myocardial ischemia

Answer 11

Blockage of blood supply to the heart. Can cause angina, pain in chest

Question 12

Screening for resistance training

Answer 12

Limited data is available to show the need for prescreening but it appears the risk is low for low to moderate resistance training.

Question 13

PAR-Q+

Answer 13

Physical Activity Readiness Questionnaire for everyone

1. Can be used as self guided tool or by PT
2. Updated regularly
3. Other versions available (ePARmed-X+ which is more comprehensive)

Question 14

Lifestyle and Health-History Questionnaire

Answer 14

More detailed medical & health info including:

1. Past & present exercise & physical activity
2. Medications/supplements
3. Recent illnesses, injuries, chronic or acute pain
4. Surgery or injury history
5. Family medical history
6. Lifestyle info - stress, sleep, nutrition, work

Question 15

Medical Release Form

Answer 15

From for clients physician to provide info to personal trainer regarding physical activity limitations and/or guidelines.

Question 16

Medications - Antihypertensives

Answer 16

Affect one of 4 areas:
Heart - reduce force of contraction (beta blockers)
Peripheral Blood vessels - dilate them to allow more blood flow
Brain - reduce sympathetic nerve outflow
Kidneys - reduce blood volume by excreting more fluid (diuretics)

Question 17

Medications - Beta Blockers (Antihypertensives)

Answer 17

Limits sympathetic nerve system stimulation, reducing resting, exercise and maximal heart rate

Question 18

Medications - Bronchodilators

Answer 18

Asthma medication which relaxes the air passages allowing better air exchange. It stimulates the sympathetic nervous system. It increases exercise capacity but has minimal effect on HR & BP.

Question 19

Medications - Cold Medications

Answer 19

Minimal effect on exercise capacity

1. Antihistimines - don’t affect BP & HR but cause drying of upper airways
2. Sympathomimetic - (decongestants) mimic sympathetic nervous system to reduce swollen tissue. May raise HR & BP

Question 20

Medications - Antihypertensives

Answer 20

1. Beta Blockers
2. Calcium Channel Blockers - prevents calcium dependent contraction of smooth muscles causing them to dilate
3. Angiotensin-converting Enzyme Inhibitors - ACE inhibitors block enzyme secreted by kidneys preventing formation of hormone (angiotensin) which constricts blood vessels.
4. Angiotensin II Receptor Antagonists - New, a blocker, well tolerated, don’t adversely affect blood lipids
5. Diuretics - increases secretions of water & electrolytes through kidneys. May predispose an exerciser to dehydration. Taking diuretics for weight loss is a dangerous practice. No effect on HR.