Chapter 7 - Resting Assessments & Anthropometric Measurements Flashcards
Traditional Physiological Assessments
- Identify areas of health/injury risk needing referral to medical professional
- Collect baseline data that can be used to create training program and for later comparison
- Educate client about their physical health in comparison to normative data.
- Motivate clients by helping them with realistic goals.
Assessments & Demotivation
Assessments may demotivate a client if they feel uncomfortable, intimidated, overwhelmed or embarrassed about their current physical condition and their inadequacies or fear of results.
Assessments to Consider
- Resting Vital Signs - HR, BP, weight, height
- Static posture and movement assessments
- Joint flexibility and muscle length
- Balance & core function
- Cardiorespiratory fitness
- Body composition & anthropometry
- Muscular fitness - endurance, strength
- Skilled related - agility, coordination, power, reactivity, speed, coordination
Conducting Assessments
- Provide instructions to client in advance - clothing, eating & hydration recommendations, avoid stimulants
- Obtain signed Informed Consent form detailing purposes, protocols, and risks. Allow client to ask questions.
- Organize all documentation for assessments, data sheets, assessment tables
- Communicate and demonstrate skills professionally, clearly, calmly, and confidently
- Exercise equipment should be calibrated and in working order
- Ensure proper environment - temperature, air flow, humidity, quiet, private
Auscultate definition
Using a stethoscope to hear the heartbeat. Stethoscope should be placed to the left of the clients sternum, just above or below the nipple
Resting Heart Rate (RHR) Factors to Consider
Fitness, fatigue, genetics, body composition, drugs, medication, alcohol, caffeine, stress. Typically fit people have lower RHR.
Heart Rate Classifications
Sinus Bradycardia (slow) - RHR <60 bpm Normal Sinus Rhythm - RHR 60-100 bpm Sinus Tachycardia (fast) - RHR >100 bpm
Average RHR for Men & Women
Men - 60-70 bpm
Women - 72-80 bpm (attributed to smaller heart chamber (less blood volume per beat) & lower hemoglobin levels (less oxygen per unit of blood)
Key Notes regarding RHR
- A rise in RHR may indicate overtraining syndrome
- Drugs & medications can affect RHR. (abstain for 12 hrs before taking RHR)
- Body position affects RHR - prone/supine better than standing or sitting
- Digestion increases RHR
- Environmental factors can affect RHR
- Psychological & emotional stress affects RHR.
- True RHR is measured in the morning before rising.
Palpation definition
Using fingers pressed on a pulse site to measure pulse
Blood Pressure Definition/Key Factors
- Outward force exerted by the blood on the vessel walls.
- Systolic (SBP) - pressure as the heart pumps blood via ventricular contraction. Larger number
- Diastolic (DBP) - pressure during the filling phase, between beats. Lower number
- BP should be measured at the same level as the heart
- Karotkoff sounds - sound that determines BP
- Clients with irregular BP should be referred to a Dr.
Blood Pressure Ranges
Normal - SPB <120mm/Hg and DBP <80mm/Hg
Elevated - SPB 120-129mm/Hg and DBP <80mm/Hg
Hypertension stage 1 - SPB 130-139mm/Hg and DBP 80-89mm/Hg
Hypertension stage 2 - SPB >=140mm/Hg and DBP >=90mm/Hg
Body Composition definition
The relative proportions of lean tissue and fat tissue.
Lean body mass - muscles, connective tissue, bones, blood, nervous tissue, skin and organs
Essential Body Fat definition
Body fat necessary for insulation, and thermoregulation, hormone production, cushioning of vital organs and maintenance of certain body functions
Men - 2-5%
Women - 10-13%
Adipose tissue definition
The remaining body fat that is not essential. Under skin is subcutaneous and inside body cavity is visceral fat
Overweight vs Overfat
Overweight - excess bodyweight relative to height
Overfat - excess amount of body fat
Body Composition Assessments
BIA - Bioelectric Impedance Analysis ADP - Air Displacement plethysmography DXA - Dual Energy X-ray Absorptiometry Hydrostatic - low margin of error MRI - Magnetic Resonance Imaging NIR - Near Infrared Interaction Skinfold - ease of administration, low cost, requires skill TOBEC - Total Body Electrical Conductivity
Standard Values for Percentage of Body Fat
Chart page 232
Men - 7.9% - 31.2% (90th percentile 20-29 yr old- 10th percentile >60 yr old
Women - 15.1% - 36.6% (90th percentile 20-29 yr old- 10th percentile >60 yr old
Expected Body Composition Changes
Body Fat - decrease 2.7-5.9% in 2-3 months
Waist Circumference 1.9-3.3 cm in 2-3 months
BMI formula
Weight(kg)/Height squared (m) or (lb)/(in)squared x 703
BMI increases risk for premature death due to:
Stroke, heart disease, some cancers, type 2 diabetes
Overweight & Obesity Statistics
Worldwide:
39% of adults have overweight (1.9 billion)
13% of adults have obesity (650million)
America:
39.8% of adults have obesity
41 million children under 5 are overweight or obese
340 million (18.5%) youth age 5-19 are overweight or obese
BMI Classifications
<18.5 - Underweight 18.5-24.9 - Normal 25.0-29.9 - Overweight 30.0-34.9 - Obesity (class 1) 35.0-39.9 - Obesity (class 2) >=40 - Extreme Obesity (class 3)
Circumference Measurement Protocols
Accuracy is important - use precise anatomical landmarks.
Measure precisely and consistently
Use a non-elastic, flexible tape
Have client wear thin, form fitting clothing
Tape should be snug against skin without pressing into subcutaneous layers
Measure all sites once and then again
Wait 20-30 seconds between measurements for tissue to return to normal
If 2nd measurement is greater than 5mm different, repeat it
Take measurements prior to exercise
Explain what will happen
Record values, evaluate and classify based on normative values
Discuss & educate client on abnormalities, strategize ways to reduce risk & improve health
Measurement Locations
Abdominal Circumference - height of iliac crest (umbilicus)
Hip Circumference - maximal circumference of the buttocks
Waist Circumference - Narrowest part of the torso
Bicep Circumference - Midway between acromion and olecranon process
Midthigh Circumference - Midway between inguinal crease (crease between torso & thigh) and the proximal border of the patella. Measured leg should be raised on a bench at 90 degree angle
Waist Circumference Risks
For every 1" of added waist circumference: Cholesterol increases by 8% BP increases by 10% HDL decreases by 15% Triglycerides increase by 18% METS risk increases by 18%
Waist Circumference Criteria
Very low <27.3” women <31.2” men
Low 27.3-34.7” 31.2-38.6”
High 35.1-42.5” 39.0-46.8”
Very high >42.9” >46.8”
Waist to Hip Ratio - WHR
Location of fat may be a better indicator of disease risk
Differentiates:
Android body-fat pattern - masculine/apple
Gynoid body-fat pattern - feminine/pear
Visceral fat is associated with insulin resistance, inflammation, production of blood lipids
Correlated with risk of Type 2 Diabetes, Hypertension and Hypercholesterolemia
Waist to Hip Ratio - WHR Criteria
Waist measurement/hip measurement
Low risks -
