Chapter 6 - PT Manual Flashcards
PAR-Q form does NOT INCLUDE (3)
current health conditions
medications
past injury
RF: Age
men 45 yrs or older
women 55 yrs or older
RF family history (3)
heart attack, coronary revascularization, sudden death
Sudden death RF ages
father
mother
father - before 55 in or 1st male relative
mother - before 65 or 1st female relative
Smoking RF (3)
current smoker
quit within the last 6 months
exposure to second hand smoke
Sedentary lifestyle (3)
NOT doing (physical activity)
30 min
3 days/week
3 months
Obesity RF
BMI 30 or greater
waist 40 - men
waist 35 - women
Hypertension RF
2
SBP greater than 140
DBP greater than 90
OR
currently on antihypertensive medications
Dyslipidemia RF
3
LDL 130 or greater
HDL less than 40
*serum cholesterol 200 or greater
only use serum if all that is available
Pre-diabetes RF
fasting plasma glucose 100 mg/dl or greater
Negative RF
HDL cholesterol greater than 60 mg/dl
Basis for performing risk stratification is to determine
3
- presence/absence of known cardiovascular, pulmonary or metabolic disease
- presence/absence of cardiovascular risk factors
- presence/absence of signs/symptoms of cardiovascular, pulmonary or metabolic disease
Client can only receive _ point per risk factor
1
Empathy
ability to experience another person’s world as i were your own
Warmth
*promotes
unconditional positive regard for another person regardless of his/her individuality and uniqueness
*safety and acceptance
Genuineness
authenticity, ability to be open/honest
Rapport
mutual trust, ability to communicate effectively
Investigation (4)
collection of all relevant information to identify needs
- readiness to change
- health history
- lifestyle preferences
- assessments
Planning (3)
goal setting
programming considerations
design motivation and adherence strategies
Action (5)
- implementation of program
- feedback
- strategies for adherence
- strategies for motivation
- monitor progression toward goals
Primary nonverbal communication skill
effective listening
Active listening
trainer shows empathy and listens as if he/she was in the trainers shoes
Restating essence of client’s content of his/her communication
paraphrasing
Restating the feelings and/or content of what the speaker coveys but with different words - feelings or attitudes may be included
relfecting
Expanding upon shared information - providing factual information
informing
Mild to strong feedback, can encourage accountability
*can be used when there’s lack of motivation
confronting
key to effective listening
active listening
Cognitive messages
factual
Affective messages
feelings, emotions and behaviors
-verbal and nonverbal
Deflecting
changing the focus off one individual - only use when trainer is sharing an appropriate experience
Directing - most effective when teaching
safety and proper form
_model identifies clients readiness to change
TTM model
Stages of change
pre-contemplation contemplation preparation action maintenance
Client centered method for enhancing change in intrinsic motivation - getting client off the fence about exercise
motivational interviewing
Self-directed pre-participation screen
PAR-Q
3 steps for risk stratification
- identify coronary artery disease risk factors
- perform risk stratification based on risk factors
- determine the need for medical eam/clearance
Low risk = asymptomatic # of risk factors medical exam, exercise test, dr supervision of exercise test
less than 2
no for all
Moderate risk = asymptomatic # of risk factors medical exam, exercise test, dr supervision of exercise test
2 or more
yes- medical exam before vigorous exercise
no to exercise test and dr supervised
High risk = symptomatic
medical exam, exercise test, dr supervision of exercise test- symptomatic
symptomatic or known cardiovascular, pulmonary, renal or metabolic disease
yes to all
CAD signs/symptoms (9)
tightness in chest (angina)
SOB
orthopnea (can only breathe sitting or standing)
ankle edema
palpitations or tachicardyia (HR elevated 100BPM)
claudication (cramps in lower extremeties)
known heart murmur
unusual fatigue
dizziness, syncope (fainting)
Informed consent
client is informed about risks associated with activity
-not a liability waiver
Agreement and release of liability waiver
release trainer from liability
Form that collects detailed medical and health information - medications, activity history, illness, surgery
health history questionnaire
Form that provides detailed background of previous exercise history and adherence
exercise history and attitude questionaire
Questionaire safe for pre-screening for low to moderate exercise
PAR-Q
2 risks associated with regular physical activity
cardiac arrest
musculoskeletal injury - most commonly injured system
How does CAD affect exercise?
can cause _
physician’s release Y or N
narrowed vessels (atherosclerosis) limit oxygen to the heart
heart attack
Yes
Hypertension - BP can elevate during exercise and cause
stroke
Respiratory disorder requires physicians release Y/ N
Yes
Atrophy can begin after _days of inactivity
2 days
Physicians release required for any injury more severe than a strain or sprain
Yes
Diabetes and thyroid require physicians release
Yes
*especially with insulin use
Pregnancy requires physician’s approval y/n
yes
Beta blockers (3)
- block the effects of epinephrine and norepinephrine
- reduced resting, exercising and maximal HR
- use RPE
Calcium channel blockers (2)
BP
HR
lower BP
-may increase, decrease, not effect HR
ACE Inhibitors (2)
BP
HR
- prevent blood vessels from constricting
- decrease BP at rest and at exercise
- no effect on HR
Diuretics
- decrease blood volume
- cause dehydration
Bronchodialators
dilate air passages - increase exercise capacity
Cold medications
raise BP b/c of vasoconstriction
- increase BP abd HR rest and exercise
- reduces volume of swollen tissues
Test termination signs (5)
- angina
- changes in BP
- signs of poor perfusion
- cramps
- severe fatique
Test environment temp
68 to 72
2 common pulse sites to measure pulse rate
carotid artery (neck) radial (wrist)
Sinus brachycardia
Sinus tachycardia
Normal sinus rhythm
slow HR: RHR less than 60 BPM
fast HR: RHR greater than 100 BPM
60 -100 BPM
Average RHR
men average
women average
70-72 BPM
60-70 BPM
72-80 BPM
Higher values in HR in females due to (3)
smaller heart chamber
lower blood volume circulating less oxygen in the body
lower levels of hemoglobin
Elevation in RHR by 5 BPM or greater over a period of days is a sign of
overtraining
5 things that can affect RHR
body position digestion absorption medications environment
Measuring resting HR (3)
client rests several minutes
place tips of middle and index finger over artery
count # of beats for 30 or 60 seconds
Measuring exercising HR (3)
10-15 second count
count the first beat at the start of the time interval
multiply count by either 6 (for a 10 second count) 4 (for a 15 second count)
Outward force exerted by blood on vessel walls is known as
blood pressure
pressure created by the heart as it pumps the blood into circulation via ventricular contraction
Systolic blood pressure
pressure that is exerted on the artery walls as blood remains in the arteries during the filling phase of the cardiac cycle
diastolic blood pressure
SBP signified by
DBP indicated by
Korotkoff sounds - first perception of sound
4th (significant muffling sound) and 5th disappearance of sound
BP monitor and cuff
arm placement
sphygmamomanometer
left - closer to heart - sounds amplified
normal BP
pre-hypertension
hypertension
stage 1
stage 2
LESS THAN 120/ LESS THAN 80
SBP 120-139 / DBP 80-89
SBP 140 - 159 / DBP 90-99
SBP GREATER THAN 160 / DBP GREATER THAN 100
btwn 40 - 70 yrs old:
20 icrease in SBP OR 10 increase in DBP
risk of cardiovascular disease doubled
BORG score: 6 =
BORG score: 12
BORG score: 20
HR of 60 BPM
HR of 120 BPM
HR of 200 BPM
Exercise induced feeling inventory should be administered
2
during initial interview - rate previous experience
directly after workout is complete
0 to 10 scale should be used when
trainer does not need to obtain HR via RPE
VT1
Fuel sources switches from
Fats to carbohydrates
