Chapter 6 Building Rapport & Initial Investigation Stage Flashcards
1
Q
Attributes of a Successful
Relationship
A
- Rapport implies a relationship of mutual trust, harmony, or emotional affinity.
- Three attributes are essential to successful relationships:
- Empathy
- Warmth
- Genuineness
2
Q
Empathy
A
- Trainers must be attentive and empathetic, regardless of personal opinion.
- Separate meaningful content from superfluous information.
- Be aware of how the client’s emotional patterns change based on the nature of the content being discussed.
- Be conscious of how cultural and ethnic differences affect communication.
3
Q
Motivational Interviewing
A
- Motivational interviewing helps the client feel in control.
- A client-centered, directive method for enhancing intrinsic motivation by exploring and resolving ambivalence
- It involves careful listening and strategic questioning.
- It is an interviewing technique to help get clients “off the fence” about exercise or behavior change.
- A client-centered, directive method for enhancing intrinsic motivation by exploring and resolving ambivalence
4
Q
Risk Stratification
A
- The purpose for performing a risk stratification prior to engaging in a physical-activity program is to determine:
- The presence or absence of known cardiovascular, pulmonary, and/or metabolic disease
- The presence or absence of cardiovascular risk factors
- The presence or absence of signs or symptoms suggestive of cardiovascular, pulmonary, and/or metabolic disease
- Specific risk factor categories are used to score client risk for stratification.
- Client risk is stratified (categorized) as low, moderate, or high.
5
Q
Cardiovascular Conditions
A
- Atherosclerosis is a process in which fatty deposits of cholesterol and calcium accumulate on the walls of the arteries.
- When this process affects the arteries that supply the heart, it is called (CAD).
- If the vessels that supply this blood to the heart are narrowed from atherosclerosis, the blood supply is limited.
6
Q
Respiratory Conditions
A
- The lungs extract oxygen from inhaled air and deliver it to the body’s tissues via the cardiovascular system.
- A problem in the respiratory system will interfere with the body’s ability to provide enough oxygen for aerobic exercise.
- Bronchitis, asthma, and chronic obstructive pulmonary disease (COPD) are common respiratory problems.
- Anyone with a respiratory system disorder should have a physician’s clearance.
7
Q
Musculoskeletal Conditions
A
- Most minor sprains and strains are easily managed, but a persistent problem or a more serious injury requires physician referral.
- Overuse injuries are the most common type of injury sustained by persons participating in physical activity.
- Any musculoskeletal disorder that a trainer is not qualified to deal with should be referred.
8
Q
Metabolic Conditions
A
- Diabetes
- A group of diseases that results in too much sugar/glucose in the blood
- Thyroid disorders
- Hyperthyroid
- Hypothyroidism
9
Q
Medications
A
- Drugs alter the biochemistry of the body and may affect a client’s ability to perform or respond to exercise.
- Many prescription and over-the-counter medications or illicit drugs affect the heart’s response to exercise.
- The following two slides list many medication categories that may affect a person’s response to exercise.
10
Q
Types of Antihypertensive
Medications
A
- Beta Blockers
- Beta-adrenergic blocking agents, or beta blockers, block beta-adrenergic receptors and limit sympathetic nervous system stimulation.
- Calcium channel blockers
- prevent calcium-dependent contraction of the smooth muscles in the arteries.
- Angiotensin-converting Enzyme (ACE) Inhibitors
- ACE inhibitors block an enzyme secreted by the kidneys.
- Diuretics
- Increase the excretion of water and electrolytes through the kidneys.
- They are usually prescribed for high blood pressure, or when a person is accumulating too much fluid
- Asthma medications
- also known as bronchodilators, relax or open the air passages in the lungs, allowing better air exchange.
11
Q
Physiological Assessments
A
- Conduct baseline physiological assessments in the first initial sessions in order to:
- Identify areas of health/injury risk for potential referral
- Collect baseline data
- Educate client about his or her present physical condition and health risks
- Motivate client by helping them reach established realistic goals
12
Q
Typical Physiological Assessments
A
- The physiological assessments that merit consideration generally include:
- Resting vital signs
- Static posture and movement screens
- Joint flexibility and muscle length
- Balance and core function
- Cardiorespiratory fitness
- Body composition
- Muscular endurance and strength
- Skill-related parameters
13
Q
Sequencing Assessments
A
- Physiological influences on an assessment must be considered when establishing the testing sequence and timeline for a client.
- Resting BP and HR should be measured before any exertion.
- Skinfold measures for body composition should be taken before activity.
- Cardiovascular testing following resistance exercise may elevate HR responses and invalidate the results.
14
Q
Criteria for Exercise Test Termination
A
- Trainers must be aware of signs or symptoms that merit immediate test termination and referral.
- Onset of angina pectoris or angina-like symptoms that center around the chest
- Significant drop (>10 mmHg) in SBP despite an increase in exercise intensity
- Excessive rise in blood pressure: SBP >250 mmHg or DBP >115 mmHg
- Fatigue, shortness of breath, difficult or labored breathing, or wheezing (does not include heavy breathing due to intense exercise)
- Signs of poor perfusion: lightheadedness, pallor (pale skin), cyanosis, nausea, or cold and clammy skin
- Increased nervous system symptoms
- Leg cramping or claudication
- Physical or verbal manifestations of severe fatigue
15
Q
Testing Environment
A
- Environmental conditions can limit a client’s performance on a cardiorespiratory endurance test.
- Privacy issues and distractions can also have a negative impact on testing outcomes.
- Trainers should be aware of the following considerations for testing:
- Proper calibration and routine maintenance (documented) of all equipment
- The ability of equipment to accommodate a range of exercise intensities and body sizes, as well as the client’s specific needs
- Adequately illuminated areas for testing
- Proper emergency response protocol and access to emergency supplies
- Appropriate temperature range between 68 and 72º F (20 to 22º C)
- Avoid outdoor testing on excessively hot and humid days
16
Q
Conducting Assessments: Heart Rate
A
- The pulse rate is measured where an artery’s pulsation is close to the surface.
- Commonly palpated sites:
- Radial artery
- Carotid artery
17
Q
Resting and Exercise Heart Rates
A
- A traditional classification system exists to categorize resting heart rate (RHR):
- Sinus bradycardia HR (slow HR): RHR <60 bpm
- Normal sinus rhythm: RHR = 60 to 100 bpm
- Sinus tachycardia HR (fast HR): RHR >100 bpm
- Average RHR is approximately 70 to 72 bpm, averaging 60 to 70 bpm in males and 72 to 80 bpm in females.
- The higher values found in the female RHR is attributed in part to a few key physiological differences.
18
Q
Key Notes About Heart Rate
A
- Any elevation in RHR >5 bpm over the client’s normal RHR that remains over a period of days is good reason to taper training intensities
- Certain drugs, medications, and supplements can directly affect RHR.
- Body position affects RHR.
- Digestion increases RHR.
- Environmental factors can affect RHR.
19
Q
Methods of Measuring Heart Rate
A
- Several methods are used to measure heart rate, both at rest and during exercise:
- 12-lead electrocardiogram (ECG or EKG)
- Telemetry (often two-lead)
- Palpation
- Auscultation with stethoscope
- Telemetry and palpation are the most common methods used in a fitness setting.
20
Q
Measuring Exercise Heart Rate
A
- Measuring for 30 to 60 seconds is generally difficult.
- Therefore, exercise heart rates are normally measured for shorter periods.
- Generally a 10- to 15-second count is recommended.
21
Q
Blood Pressure
A
- Blood pressure is the outward force exerted by the blood on the vessel walls.
- SBP represents the pressure created by the heart as it pumps blood into circulation via ventricular contraction.
- DBP represents the pressure that is exerted on the artery walls as blood remains in the arteries during the filling phase of the cardiac cycle.
- Blood pressure is measured within the arterial system.
22
Q
Korotkoff Sounds
A
- Blood pressure is measured indirectly by listening to the Korotkoff sounds.
- These sounds are only present when some degree of wall deformation exists.
- Under pressure of a blood pressure cuff, vessel deformity facilitates hearing these sounds.
23
Q
Blood Pressure Measurement Errors
A
- Common mistakes associated with measuring blood pressure include:
- Cuff deflation that is too rapid
- Inexperience of the test administrator or inability of the test administrator to read pressure correctly
- Improper stethoscope placement and pressure
- Improper cuff size
- Inaccurate/uncalibrated sphygmomanometer
- Auditory acuity of the test administrator or excessive background noise
24
Q
Blood Pressure Measurement During Exercise
A
- Accurate blood pressure is very difficult to obtain during exercise due to excessive movement and noise.
- A sphygmomanometer with a stand and a hand-held gauge are better choices for measuring BP during exercise.
25
Q
Application of Blood Pressure
Measurement Results
A
- For individuals 40 to 70 years old, each 20 mmHg increase in resting SBP or each 10 mmHg increase in resting DBP above normal doubles the risk of cardiovascular disease.
- If the trainer discovers an abnormal BP reading, it is prudent to recommend that the client visit his or her physician.
- Blood pressure can be reduced with medication or certain behavior modifications, including:
- Exercise
- Weight loss
- Sodium restriction
- Smoking cessation
- Stress management
26
Q
Recommendations for Using
RPE (Ratings of Perceived Exertion)
A
- The 6-to-20 scale is difficult to use:
- Use when HR equivalents are needed and the actual exercise HR is not a reliable indicator of exertion.
- The 0-to-10 scale should always be used to gauge intensity when the trainer does not need to measure HR equivalents via the RPE.
27
Q
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