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SHANNON’S ACE KEY CONCEPTS > Chapter 6 Building Rapport And The Initial Investigation Stage > Flashcards

Chapter 6 Building Rapport And The Initial Investigation Stage Flashcards

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1
Q

Define Empathy

A

The ability to experience another person’s world as if it were one’s own

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2
Q

Define warmth

A

An unconditional positive regard, or respect, for another person regardless of his or her individuality and uniqueness. This quality will convey a climate that communicates safety and acceptance to the client

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3
Q

Define genuineness

A

Authenticity; The ability to be honest and open

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4
Q

What are the four essential stages in building client-trainer relationships?

A
  1. Rapport
  2. Investigation
  3. Planning
  4. Action
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5
Q

What are the specific steps of the Investigation Stage?

A
  1. Identify readiness to change behavior
  2. Identify the stage of behavioral change and personality style of the client
  3. Collect health and safety information
  4. Learn about lifestyle preferences, interests, and attitudes
  5. Understand previous experiences
  6. Conduct Assessments
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6
Q

What are the details of the Rapport Stage?

A
  • Impressions of professionalism
  • Developing Trust
  • Demonstrating warmth/genuineness
  • exhibiting empathy
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7
Q

What are the steps of the Planning Stage?

A
  1. Collaborative goalsetting with the client
  2. Programming considerations
    3 . Designing motivation and adherence strategies
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8
Q

What are the steps of the Action Phase of the Client-Trainer Relationship?

A
  1. Instruction, demonstration, execution (tell, show, do)
  2. Implementing strategies to improve motivation and promote long-term adherence
  3. Providing feedback and evaluation
  4. Making necessary adjustments to the program
  5.  Monitoring overall exercise experience and progression towards goals
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9
Q

When is the “counseling communication style” most effective?

A

A counseling style is supportive, utilizing a collaborative effort to problem solve and help the client make an informed decision. This is the most effective style and is recommended when implementing a plan and/or modifying a program design

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10
Q

When is a “directing communication style” most effective?

A

A directing style is more instructive, and that the trainer provides instructions and direction. The style is most effective when safety and proper form and technique essential

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11
Q

What are some good questions to ask a client “pre-exercise stage” to get to know their lifestyle better?

A
  1. “ Tell me about a typical week in your life”

2 “ What types of physical activities are part of your daily routine )for example things to do at work or around the house)?”

  1. “ Do you participate in consistent business activities, such as traveling or entertaining, then extend the hours of your work day or week?”
  2. “How do you spend your time away from work?”
  3. “ Do you participate in any regular exercise or recreational sports?”
  4. “ When was the last time you engaged in an outdoor activity?”
  5. “ Do you experience any pain during movement?”
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12
Q

What is a medical contraindication?

A

A health condition or risk factor

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13
Q

What is the purpose of the preparticipation screening?

A
  1. Identify the presence or absence of known cardiovascular, pulmonary, and/or metabolic disease, or signs or symptoms suggestive of cardiovascular, pulmonary, and/or metabolic disease
  2. Identifying individuals with medical contraindications who should be excluded from exercise or physical activity until those conditions have been corrected or are under control
  3. Detecting at-risk individuals who should first undergo medical evaluation and clinical Exercise testing before initiating an exercise program
  4. Identifying those individuals with medical conditions who should participate in medically supervised programs
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14
Q

What is a PAR-Q and when is it appropriate?

A

PAR-Q = The Physical Activity Readiness Questionnaire

This serves as a minimal health risk appraisal prerequisite. It is quick, easy and non-invasive to administer. It is, however, limited by its lack of detail and may overlook important health conditions, medications, and past injuries

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15
Q

What is normal blood pressure for most adults?

A

<120 systolic bp/<80 diastolic bp

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16
Q

According to the Atherosclerotic Cardiovascular disease risk factor thresholds for use with ACSM risk stratification, what is a “risk factor” for Hypertension blood pressure +1?

A
  • 140 or more systolic bp and/or 90Hg diastolic bp

- If taking antihypertensive medication

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17
Q

What is a risk factor +1 for dislipidemia (LDL cholesterol)?

A
  • LDL greater than or equal to 130 mg/dl or HDL less than 40mg/dl
  • If taking lipid-lowering medication
  • Total serum cholesterol is greater than or equal to 200mg/dl
  • If HDL cholesterol is greater than or equal to 60 mg/dl then -1 point
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18
Q

What is a risk stratification for obesity? +1

A

Men:
-BMI of 30 kg/meter squared or a waist girth of more than 40 inches

Women:
-BMI of 30 kg/meter squared or a waist girth of more than 35 inches

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19
Q

What is a risk stratification for Prediabetes +1?

A

More than 45 years old with a BMI greater than 25 kg/m2

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20
Q

How to handle a client with a Low Risk (Asymptomatic) Client with less than 2 risk factors?

A
  • No medical exam needed
  • No exercise test before exercise
  • No doctor supervision during exercise test
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21
Q

How to handle a client with a Moderate Risk (Asymptomatic) Client with 2 or more risk factors?

A
  • Medical exam NOT need for moderate exercise
  • Medical exam NEEDED for vigorous exercise
  • No exercise test needed
  • No doctor supervision required during exercise test
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22
Q

How to handle a client with a High Risk (Symptomatic) Profile? They have known cardiovascular, pulmonary, renal, or metabolic disease?

A
  • Medical exam recommended before exercise of any kind

- Exercise Teat prior to exercise with doctor supervision is recommended

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23
Q

What is “moderate” and “vigorous” intensity?

A

Moderate: 40-60% VO2R; 3-6 METs

Vigorous: 60% or more VO2R; 6+ METs

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24
Q

What are some signs and symptoms that could be risk stratifications?

A

-

  • Pain(tightness) ANGINA in the chest, neck, jaw or arms resulting from ischemia (inadequate blood supply to the heart of an organ)
  • Shortness of breath or difficulty breathing with mild exertion (dyspnea)
  • Orthopnea (dyspnea in a reclined position usually 2-5 hours into sleep
  • Ankle edema
  • Palpitations or tachycardia (above normal resting heart rate)
  • Intermittent claudication (pain sensations or cramping in the lower extremities associated with inadequate blood supply
  • Known heart murmur
  • Unusual fatigue or difficulty breathing with usual activities
  • Dizziness or syncope most commonly caused by reduced perfusion to the brain
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25
Q

What are the three basic steps for performing risk stratification?

A
  1. Identify CAD risk factors
  2. Performing a risk stratification based on CAD risk factors
  3. Determining the need for medical clearance/supervision
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26
Q

What is an “Informed Consent/Assumption of Risk Form?

A
  • client is acknowledging risks associated with the activity
  • intended only to communicate risks/dangers of exercise when individual had a condition
  • used prior to assessments and provides evidence of disclosure of the purposes, procedures, risks, and benefits associated with assessments
  • THIS IS NOT A LIABILITY WAIVER so it doesn’t provide the Trainer with legal immunity
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27
Q

What is an “Agreement and Release of Liability Waiver”?

A
  • a document to release the Trainer from liability for injuries resulting from the exercise program
  • does not necessarily protect against negligence
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28
Q

What is the “Health-History Questionnaire”?

A
  • a form which collects more medical and health info such as:
  • past & present exercise and physical activity information
  • Medications and supplements
  • Recent/current illnesses, injuries, chronic or acute pain
  • Surgery and injury history
  • family medical history
  • Lifestyle info (work, sleep, stress, nutrition)
29
Q

What is an “Exercise History & Attitude Questionnaire”?

A
  • a form which provides a detailed background of the client’s previous exercise experience and adherence
30
Q

What is a “medical release?”

A
  • this form provides the personal trainer with the client’s medical information and explains physical activity limitations or guidelines as outlined by their physician
31
Q

What are “Testing Forms?”

A
  • used to record testing and measurement data during fitness assessment
  • Tables are used to determine the client’s ranking in each fitness test
32
Q

What are the three primary systems of the body that are utilized during exercise?

A
  • Cardiovascular System
  • Respiratory System
  • Musculoskeletal System
33
Q

What are some health conditions that affect physical activity?

A 
Cardiovascular Disease
Respiratory Problems
Metabolic Disorders
Pregnancy
Antihypertensive Medication
Cold Medications
Hypertension
Musculoskeletal Problems
Hernia
Illness or infection
Bronchodilators
34
Q

Atherosclerosis

A

Fatty deposits of cholesterol and calcium accumulate in the arterial walls causing them to harden

35
Q

CAD

A

Coronary Artery Disease

Hardening of the arteries which supply the heart

36
Q

Angina

A

Pressure in the heart, chest, arm, shoulder or jaw

Shortness of breath, sweating, nausea, palpitations

37
Q

Hypertension

A

Prevalent in the African American community (older adults)

Increases risk of CAD, stroke, or kidney disease

38
Q

Dyspnea

A

Labored breathing

39
Q

Common respiratory conditions that call for a doctor’s recommendation

A

Bronchitis
Emphysema
Asthma
Chronic Obstructive Pulmonary Disease (COPD)

40
Q

What is the most common type of injury sustained by someone participating in physical activity?

A

Overuse injuries caused by poor training techniques or poor body mechanics

For example: shin splints, tennis elbow, ITBS (iliotibial band syndrome)

41
Q

What are some common musculoskeletal conditions to screen for in the health-history interview?

A 
Sprains or strains
Herniated discs
Bursitis (joint inflammation)
Tendinitis
Arthritis
42
Q

How does exercise help people with diabetes?

A

Exercise helps regulate blood glucose and facilitates fat loss

43
Q

What is a metabolic disease?

A

A disease which interferes with metabolism (the utilization of energy)

44
Q

What are some examples of metabolic disorders?

A

Diabetes and thyroid disorder

45
Q

What is the main function of the thyroid

A

The thyroid secretes hormones thyroxine and triiodothyronine

These hormones increase oxygen consumption and heat production

Hyperthyroidism= more of these hormones

Hypothyroidism= less of these hormones

46
Q

What are Beta Blockers?

A

A medication (antihypertensives) which block the affects of epinephrine and norepinephrine, thus reducing heart rate

Can’t use HR to monitor intensity; must use RPE

47
Q

What are Calcium Channel Blockers?

A

Lower BP and May affect heart rate

48
Q

ACE Inhibitors

A

Angiotensin-converting Enzyme Inhibitors

They lower bp at rest and during exercise

49
Q

Angiotensin-II Receptor Antagonists

A

Prescribed to treat hypertension

50
Q

Diuretics

A

Increase excretion of water and electrolytes for people retaining fluid, as occurs with congestive heart failure

51
Q

Brochiodilators

A

Asthma medications that open air passages in the lungs

Increase exercise capacity for people who experience bronchiospasms

52
Q

What are the effects of cold medication

A

Decongestants stimulate vasoconstriction which might result in raised blood pressure and increased heart rate

53
Q

What is the purpose of conducting a physiological assessment at the beginning of the trainer-client relationship?

A

Identify areas of health/injury risk for potential referral to the appropriate health professionals

Collect baseline data that can be used to develop personalized fitness programs and allow for comparisons of future evaluations

Educate client about his or her present physical condition and health risks by comparing their results or normative data for age and gender

Motivate client by helping them establish realistic goals

54
Q

When might it not be appropriate to conduct a physiological health assessment?

A

When the client could be embarrassed about their current condition

Note: A health risk appraisal is always necessary pre-participation

55
Q

What does a physiological assessment generally include?

A

Resting vital signs (HR, BP, height, lbs)

Static Posture and Movement Screens

Joint Flexibility and muscle length

Balance and Core Function

Cardiorespiratory Fitness

Body Composition

Muscular Endurance & Strength

Skill-related Parameters (agility, power, coordination)

56
Q

When should a Trainer perform the physiological assessment?

A

After the initial rapport-building stage:

  • Identify Client’s Personality
  • Identify readiness to change behavior
  • Identify Stage of Behavioral Change
  • Identify Client General Goals
  • Conduct Physical Assessment
57
Q

When conducting a physiological assessment, what are some signs and symptoms that would merit immediate termination of the assessment?

A
  1. Angina; Uncomfortable pressure in the chest
  2. Significant drop (more than 10mmHG) in SBP despite an increase in exercise intensity
  3. Excessive rise in BP (greater than 250mmHG SBP or greater than 115 mmHG DBP
  4. Fatigue, shortness of breath, difficult or labored breathing, wheezing
  5. Lightheadedness, paleness, nausea, dizziness, confusion
  6. Leg cramping or claudication
58
Q

How can a Trainer be professional and prepared prior to conducting a physiological assessment of a client?

A
  1. Giving client instructions prior to assessment (what to eat, wear, hydration, abstaining from stimulants)
  2. Obtaining a signed informed consent from the client and ask of the client has any questions about it
  3. Organization of all forms and tables
  4. Communication and demonstration of skills; clearly explaining the test and it’s sequence
  5. Calibration of all exercise equipment
  6. Environmental control (room temperature between 68•-72•F with relative humidity below 60%….environmental should be private to reduce testing anxiety
  7. Being prepared for emergencies (exits, first aid equipment)
59
Q

Why do cardiovascularly fit people have a lower resting heart rate?

A

One of the cardiovascular adaptations the body makes is it increases stroke volume thus lowering HR

60
Q

What are some factors that influence Resting Heart Rate?

A
  1. Caffeine
  2. Fitness Levels
  3. Fatigue
  4. Body composition
  5. Drugs/medication/alcohol
  6. Stress
61
Q

What is average resting heart rate?

A

Males: 60-60 BPM

Females: 72-80 BPM

62
Q

What are some factors that increase resting HR?

A

Drugs, stimulants, sitting upright as opposed to lying down, digestion

63
Q

What are some factors that result in a lower blood pressure?

A

Exercise, weight loss, sodium restriction, smoking cessation, stress management

64
Q

How do men and women perceive exertion differently?

A

Men: Tend to underestimate exertion

Women: Tend to overestimate exertion

65
Q

When should the Borg Scale of Perceived Exertion be used?

A

Only when an HR is needed; even then it can be inaccurate because of factors such as medications

15 point scale (from 6-20)

6 = 60bpm
12 = 120 bpm
20 = 200 bpm
66
Q

How do conditioned clients under-estimate their RPE?

A

If they’re focused on muscular tension rather than cardio respiratory effect then they might under-rate their exercise intensity

67
Q

What is the Exercise Induced Feeling Inventory (EFI) ?

A

The EFI quantifies the clients emotions related to exercise. It’s basically taking inventory of how they feel about exercise following the session.

Can and should be used periodically to promote positive feelings associated with exercise and thus ADHERENCE

68
Q

How is the EFI used to promote adherence?

A
  1. Administer during the initial interview regarding past experiences
  2. Use it every other session for the first 2 weeks
  3. Taper off (to account for desensitization)
  4. Readminister when program changes
  5. Track sub scales over a period of 4-6 weeks to create of graph showing how clients feelings towards exercise improves and perceived exhaustion decreases
69
Q

After all this is said and done, what is the basic order of initiating a new client?

A
  1. Get to know the client and build rapport (trust) using appropriate communication and interviewing techniques
  2. Conduct a thorough health assessment utilizing appropriate health risk appraisals and risk stratifications to ensure the client is mentally and physically prepared to begin their fitness journey
  3. Measure HR and BP to further clarify the health status of the client
  4. Perceive the clients thoughts and feelings towards exercise, and tailor a balanced fitness program that will meet the client’s specific wants and needs

SHANNON’S ACE KEY CONCEPTS (18 decks)

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