Chapter 6: Fitness Assessment Flashcards
physical inactivity exposes adults to unnecessary risk for developing what?
a variety of chronic diseases, disabilities, and even musculoskeletal pain
as little as how many hours per week of moderate aerobic physical activity can lead to significant health benefits?
2.5
what is one of the most important goals of the 2008 physical activity guidelines for Americans?
to promote the fact that even in small doses, regular physical activity can help prevent, treat, and in some cases even cure more than 40 of the most common chronic health conditions encountered by primary care physicians, as well as reduce health-care costs and improve the quality and quantity of life for millions of Americans
what percentage of US adults engage in regular leisure-time physical activity?
31%
the specific tests used in an assessment depend on what?
- the health and fitness goals of the individual
- the trainer’s experience
- the type of workout routines being performed
- the availability of fitness assessment equipment
what do fitness assessments provide?
an ongoing way of communicating information between the personal trainer and the client, ensuring that fitness program goals are constantly being monitored and evaluated to make sure the client’s individual health and wellness goals are achieves
what do fitness assessments allow for the fitness professional to do?
continually monitor a client’s needs, functional capabilities, and physiologic effects of exercise, enabling the client to realize the full benefit of an individualized training program
true or false: a health and fitness assessment is designed to diagnose medical and/or health conditions
FALSE
- it is designed to serve as a way of observing and documenting a client’s individual structural and functional status
- it is not intended to replace a medical examination
what should the personal trainer do if a client is identified as high-risk after a preparticipation health screening, or exhibits signs or symptoms of underlying health problems or extreme difficulty or pain with any observation or exercise?
they should refer the client to his or her physician or qualified health-care provider to identify any underlying cause
DO NOT do these things as a personal trainer…
- diagnose medical conditions
- prescribe treatment
- prescribe diets
- provide treatment of any kind for injury or disease
- provide rehabilitation for clients
- provide counseling services for clients
instead of diagnosing medical conditions, DO this…
- obtain exercise or health guidelines from a physician, physical therapist, or registered dietician
- follow national consensus guidelines of exercise prescription for medical disorders
- screen clients for exercise limitations
- identify potential risk factors for clients through screening procedures
- refer clients who experience difficulty or pain or exhibit other symptoms to a qualified medical practitioner
instead of prescribing treatment, DO this…
- design individualized, systematic, progressive exercise programs
- refer clients to a qualified medical practitioner for medical exercise prescription
instead of prescribing diets, DO this…
- provide clients with general information on healthy eating according to the food pyramid
- refer clients to a qualified dietician or nutritionist for specific diet plans
instead of providing treatment of any kind for injury or disease, DO this…
- refer clients to a qualified medical practitioner for treatment of injury or disease
- use exercise to help clients improve overall health
- assist clients in following the medical advice or a physician or therapist
instead of providing rehabilitation services for clients, DO this…
- design exercise programs for clients after they are released from rehabilitation
- provide post-rehabilitation services
instead of providing counseling services for clients, DO this…
- act as a coach for clients
- provide general information
- refer clients to a qualified counselor or therapist
what are some things a comprehensive fitness assessment provides?
- preparticipation health screening
- resting physiologic measurements (e.g., heart rate, blood pressure, height, weight)
- a series of measurements to help determine the fitness level of a client (health-related fitness tests)
in addition to documenting resting physiologic measurements and fitness assessment test results, what else should personal trainers discuss with their clients?
- past experiences with exercise
- current goals
- exercise likes or dislikes
subjective components of a fitness assessment
general and medical history: occupation, lifestyle, medical and personal information
objective components of a fitness assessment
- physiologic assessments
- body composition testing
- cardiorespiratory assessments
- static and dynamic postural assessments
- performance assessments
what are some cardiovascular disease risk factors?
- cigarette smoking
- dyslipidemia
- impaired fasting glucose
- obesity
- a sedentary lifestyle
what must personal trainers do before allowing a new client to participating in any physical activity, including fitness testing?
conduct a preparticipation health screening
what does a preparticipation health screening include?
- a medical history questionnaire (such as the PAR-Q)
- a review of their chronic disease risk factors and presence of any signs or symptoms of disease
low risk
individuals who do not have any signs or symptoms of cardiovascular, pulmonary, or metabolic disease and have ≤1 cardiovascular disease risk factor
moderate risk
individuals who do not have any signs or symptoms of cardiovascular, pulmonary, or metabolic disease but have ≥2 cardiovascular disease risk factors
high risk
individuals who have one ore more signs or symptoms of cardiovascular, pulmonary, or metabolic disease
Physical Activity Readiness Questionnaire (PAR-Q)
a questionnaire that has been designed to determine the safety or possible risk of exercising for a client based on the answers to specific health history questions
he PAR-Q primarily aimed at…
identifying individuals who require further medical evaluation before being allowed to exercise because they are at high risk for cardiovascular disease (CVD)
what happens when a client answers yes to one ore more questions on the PAR-Q?
the personal trainer should refer them to a physician for further medical screening before starting an exercise program
health history
a collection of information that is generally part of a medical physical or medical health history, which discuss relevant facts about the individual’s history, including biographic, demographic, occupational, and general lifestyle (physical, mental, emotional, sociocultural, sexual, and sometimes spiritual) data
what are two important areas for the personal trainer to focus on?
the relevant answers provided about a client’s occupation and general lifestyle traits
sample PAR-Q questions
- heart condition- only perform physical activity recommended by doctor?
- chest pain during physical activity?
- chest pain when not performing physical activity?
- lose balance because of dizziness / lose consciousness?
- bone or joint problem that could be made worse with physical activity?
- any medications for blood pressure or for a heart condition?
- any other reason why you should not engage in physical activity?
collecting information about a client’s occupation helps personal trainers determine what?
- common movement patterns
- typical energy expenditure levels during the course of an average day
how does collecting occupation information help a personal trainer?
it helps them to begin to recognize important clues about the client’s musculoskeletal structure and function, potential health and physical limitations, and restrictions that could affect the safety and efficacy of an exercise program
sample occupation questions
- current occupation?
- extended periods of sitting?
- extended periods of repetitive movements?
- wear shoes with a heel?
- cause you anxiety / mental stress?
effects of extended periods of sitting
- hips flexed for prolonged periods of time, which can lead to tight hip flexors (rectus femoris, tensor fascia latae, iliopsoas) and postural imbalances within the human movement system
- tendency for the shoulders and head to fatigue under the constant effect of gravity, which can lead to postural imbalances including rounding of the shoulders and a forward head
- indicative of low energy expenditure throughout the day and potentially poor cardiorespiratory condition
repetitive movement
a persistent motion that can cause musculoskeletal injury and dysfunction
effects of repetitive movements
they can create a pattern overload to muscles and joints, which may lead to tissue trauma and eventually kinetic chain dysfunction, especially in jobs that require a lot of overhead work or awkward positions such as construction or painting
working with the arms overhead for long periods of time may lead to…
- shoulder and neck soreness that may be the result of tightness in the latissimus dorsi and weakness in the rotator cuff
- this imbalance does not allow for proper shoulder motion stabilization during activity
effects of wearing shoes with a heel
- puts the ankle complex in a plantarflexed position for extended periods
- can lead to tightness in the gastrocnemius, soleus, and Achilles tendon, causing postural imbalance, such as decreased dorsiflexion and overpronation at the foot and ankle complex, resulting in flattening of the arch of the foot
effects of mental stress of anxiety
- elevated heart rate, blood pressure, and ventilation at rest and exercise
- can lead to abnormal (or dysfunctional) breathing patterns that may cause postural or musculoskeletal imbalances in the neck, shoulder, chest, and low-back muscles, which collectively can lead to postural distortion and human movement system dysfunction
what do lifestyle or personal questions pertain to?
a client’s general lifestyle activities and habits
- smoking
- drinking
- exercise
- sleeping habits
- recreational activities
- hobbies
sample lifestyle questions
- recreational activities (gold, tennis, skiing, etc.)?
2. hobbies (reading, gardening, working on cars, etc.)?
recreation
refers to a client’s physical activities outside the work environment, also referred to as leisure time
how does finding out what recreational activities a client performs help personal trainers?
it allows them to better design an exercise program that fits the needs of the client
hobbies
refers to activities that a client might enjoy participating in on a regular basis, but are not necessarily athletic in nature
examples of hobbies
- gardening
- working on cars
- playing cards
- reading
- watching TV
- playing video games
true or false: hobbies do not need to be taken into account to create a training program
FALSE
-many common types of hobbies do not involve any physical activity, and yet still need to be taken into account to create a properly planned integrated exercise training program
why is obtaining a client’s medical history important?
- it provides personal trainers with information about known or suspected chronic diseases, such as coronary heart disease, high blood pressure, or diabetes
- provides information about the client’s past and current health status, as well as any past or recent injuries, surgeries, or other chronic health conditions
what can previous history of musculoskeletal injury predict?
future history of musculoskeletal injury during physical activity
effects of ankle sprains on the human movement system
- decrease the neural control to the gluteus medius and maximus
- lead to poor control of the lower extremities during many functional activities, which can eventually lead to injury
effects of knee injuries involving ligaments
- decrease in the neural control to muscles that stabilize the patella (kneecap) and lead to further injury
- knee injuries that are not the result of contact (noncontact injuries) are often the result of ankle or hip dysfunctions, such as the result of an ankle sprain
- the knee is caught between the ankle and the hip: if the ankle or hip joint begins to function improperly, this results in altered movement and force distribution of the knee
- with time, this can lead to further injury
sample medical history questions
- pain or injuries?
- surgeries?
- chronic diseases?
- medications?
effects of low-back injuries
- decreased neural control to stabilizing muscles of the core, resulting in poor stabilization of the spine
- this can further lead to dysfunction in the upper and lower extremities
effects of shoulder injuries
-altered neural control of the rotator cuff muscles, which can lead to instability of the shoulder joint during functional activities
other injuries that result from human movement system imbalances
- repetitive hamstring strains
- groin strains
- patellar tendonitis (jumper’s knee)
- plantar fasciitis (pain in the heel and bottom of the foot)
- posterior tibialis tendonitis (shin splints)
- biceps tendonitis (shoulder pain)
- headaches
effects of surgical procedures
- create trauma for the body
- may have similar effects on the functioning of the human movement system and safety and efficacy of exercise as those of injuries
common surgical procedures
- foot and ankle surgery
- knee surgery
- back surgery
- shoulder surgery
- caesarean section for birth (cutting through the abdominal wall to deliver a baby)
- appendectomy (cutting through the abdominal wall to remove the appendix)
what happens if a surgery is not rehabilitated properly?
-will cause pain and inflammation that can alter neural control to the affected muscles and joints
over what percentage of the American adult population does not engage in at least 30 minutes of low-to-moderate physical activity on most days of the week?
75%
examples of chronic diseases
- cardiovascular disease, coronary heart disease, coronary artery disease, or congestive heart failure
- hypertension (high blood pressure)
- high cholesterol or other blood lipid disorders
- stroke or peripheral artery disease
- lung or breathing problems
- obesity
- diabetes mellitus
- cancer
true or false: it is the role of the personal trainer to administer, prescribe, and educate clients on the usage and effects of any form of legally prescribed medication by a licensed physician or other health-care provider
FALSE- it is not their role
-personal trainers should always consult with their client’s physician or medical professionals regarding the client’s health information and which if any medications they may be currently taking
basic function of beta-blockers
generally used as antihypertensive (high blood pressure), may also be prescribed for arrhythmias (irregular heart rate)
basic function of calcium-channel blockers
generally prescribed for hypertension and angina (chest pain)
basic function of nitrates
generally prescribed for hypertension, congestive heart failure
basic function of diuretics
generally prescribed for hypertension, congestive heart failure, and peripheral edema
basic function of bronchodilators
generally prescribed to correct or prevent bronchial smooth muscle constriction in individuals with asthma and other pulmonary diseases
basic function of vasodilators
used in the treatment of hypertension and congestive heart failure
basic function of antidepressants
used in the treatment of various psychiatric and emotional disorders
effects of beta-blockers
decreased heart rate, decreased blood pressure
effects of calcium-channel blockers
increased heart rate, decreased blood pressure (or same or decreased heart rate)
effects of nitrates
increased heart rate, same blood pressure (or same heart rate, decreased blood pressure)
effects of diuretics
same heart rate, same blood pressure (or decreased blood presssure)
effects of bronchodilators
same heart rate, same blood pressure
effects of vasodilators
increased heart rate, decreased blood pressure (or same or decreased heart rate)
effects of antidepressants
increased or same heart rate, decreased or same blood pressure
the assessment of resting heart rate (HR) and blood pressure (BP) is a sensitive indicator of…
a client’s overall cardiorespiratory health as well as fitness status
resting HR is a ____ indicator of overall cardiorespiratory fitness
fairly good `
exercise HR is a ___ indicator of how a client’s cardiorespiratory system is responding and adapting to exercise
strong
how is a pulse created?
- by blood moving or pulsating through arteries each time the heart contracts
- each time the heart contracts or beats, one wave of blood flow or pulsation of blood can be felt by placing one or two fingers on an artery
- the artery contracts and relaxes periodically to rhythmically force the blood along its way circulating throughout the body
- this coincides with the contraction and relaxation of the heart as it pumps the blood through the arteries and veins
true or false: the pulse rate is also known as the heart rate
TRUE
how many pulse points are there?
7
pulse point
places where arteries come close enough to the skin to be able to have a pulse felt
2 most common pulse points
- radial arteries
2. carotid arteries
what is the preferred pulse?
radial pulse
radial arteries
inside of the wrist
carotid arteries
on the neck to the side of the windpipe
what should you teach clients in order to gather an accurate pulse reading?
- to record their resting HR on rising in the morning
- instruct them to test their resting heart rate 3 mornings in a row and average the 3 readings
how to find the radial pulse
- lightly place two fingers along the right side of the arm in line and just above the thumb
- once a pulse is felt, count the pulses for 60 seconds
- record the 60 second pulse rate and average over the course of 3 days
things to consider when taking the radial pulse
- the touch should be gentle
- the test must be taken when the client is calm
- all 3 test must be taken at the same time to ensure accuracy
how to find the carotid pulse
- lightly place two fingers on the neck, just to the side of the larynx
- once a pulse is identified, count the pulses for 60 seconds
- record the 60 second pulse rate and average over the course of 3 days
how many seconds should a pulse reading be?
60
how many pulse readings should you take before taking the average?
3
things to consider when taking the carotid pulse
- the touch should be gentle
- excessive pressure can decrease HR and blood pressure, leading to an inaccurate reading, possible dizziness, and fainting
- the test should be taken when the client is calm
- all 3 tests should be taken at the same time to ensure accuracy
typical resting heart rate
between 70 and 80 beats per minute
average male resting heart rate
70 beats per minute
average female resting heart rate
75 beats per minute
what can personal trainers calculate with a client’s resting HR?
the target heart rate (THR) zones in which a client should perform cardiorespiratory exercise
2 most common ways to calculate THR
- use a percentage of the client’s estimate heart rate (straight percentage method)
- use a percentage of heart rate reserve (Karvonen method)
purpose of training zone one
builds aerobic base and aids in recovery
purpose of training zone two
increases aerobic and anaerobic endurance
purpose of training zone three
builds high-end work capacity
straight percentage method (peak maximal heart rate)
- a client’s estimated maximal heart rate is found by subtracting their age from the number 220
- once their HR max is determined, multiply the estimated HR max by the approximate intensity (65-95%) at which the client should work while performing cardiorespiratory exercise to calculate THR
hr reserve (hrr) method (karvonen method)
-a method of establishing training intensity on the basis of the difference between a client’s predicted maximal heart rate and their resting heart rate
percentage of HR max for zone one
65-75%
percentage of HR max for zone two
76-85%
percentage of HR max for zone three
86-95%
heart rate and oxygen uptake are ___ related during dynamic exercise
linearly
what is the most common and universally accepted method of establishing exercise training intensity?
selecting a predetermined training or target heart rate (THR) based on a given percentage of oxygen consumption
HRR method formula
THR + [(HRmax-HRrest x desired intensity] + HRrest
blood pressure (BP)
the pressure of the circulating blood against the walls of the blood vessels after blood is ejected from the heart
2 parts to a blood pressure measurement
- systolic
2. diastolic
systolic
- first/top number
- represents the pressure within the arterial system after the heart contracts
diastolic
- second/bottom number
- represents the pressure within the arterial system when the heart is resting and filling up with blood
acceptable systolic blood pressure measurement
≤120 mm Hg
acceptable diastolic blood pressure measurement
≤80 mm Hg
what is blood pressure measured with?
- aneroid sphygmomanometer
- consists of an inflatable cuff, a pressure dial, a bulb with a valve, and a stethoscope
steps to recording blood pressure
- instruct the client to assume a comfortable seated position and place the appropriate size cuff on their arm just above the elbow
- rest the arm on a supported chair and place the stethoscope over the brachial artery, using a minimal amount of pressure
- continue by rapidly inflating the cuff to 20-30 mm Hg above the point at which the pulse can no longer be felt at the wrist
- release the pressure at a rate of about 2 mm Hg per second, listening for a pulse
how to determine systolic pressure
listen for the first observation of the pulse
how to determine diastolic pressure
determined when the pulse fades away
true or false: you should measure blood pressure on the right arm
FALSE
-you should start on one arm and then move to the next for greater reliability
body composition
the relative percentage of body weight that is fat versus fat-free tissue, or more commonly reported as “percent body fat”