Chapter 9 - Client Consultation & Health Appraisal Flashcards
What is scope of practice for the personal training profession?
Personal trainers are trained health/fitness professionals who use an individualized approach to: 1) assess, 2) motivate, 3) educate, & 4) train clients regarding their health/fitness needs. They design safe and effective exercise programs and provide the guidance to help clients achieve their goals. In addition they respond appropriately in emergency situations. Recognizing their area of expertise, personal trainers refer clients to other healthcare professionals when appropriate.
What does personal trainers ‘MATER’ mean?
Motivate performance and compliance.
Assess clients health status.
Train clients safely and effectively to meet individual objectives.
Educate clients to become informed consumers.
Refer clients to health care professionals when necessary.
The most important principle underlying the client consultation and health appraisal process is to screen participants for risk factors and symptoms of chronic _______, _______, _______, and _______ diseases in order to optimize safety during exercise testing and participation.
- cardiovascular
- metabolic
- pulmonary
- orthopedic
Because the health and fitness industry is diverse, there is no specific standardized process for implementing the _______ and _______ mechanism.
client consultation
health appraisal
The delivery process is predicated on four factors that dictate implementation _______, _______, _______, and _______.
- credentials of the personal trainer
- site of delivery
- specific population
- legal statutes
Steps of the client consultation & health appraisal
- Schedule interview.
- Conduct interview.
- Implement and complete health appraisal forms.
- Evaluate for coronary risk factors, diagnosed disease, and lifestyle.
- Assess and interpret results.
- Refer to an allied health professional when necessary.
- Obtain medical clearance and program recommendations.
The initial interview is is a scheduled appointment intended as a mutual sharing of info with the expected outcomes of: _______, _______, and _______.
assessing client-trainer compatibility
discussing goals
developing a client-trainer agreement
As the first step in determining client trainer compatibility, the trainer provides _______.
- a detailed description of the services available.
Important information to convey to the potential client (during the initial interview) includes _______, _______, _______, _______, _______, _______, _______.
- an explanation of the personal trainers formal education
- professional experience
- certifications
- expertise/specializations
- mission statement
- success rate
- unique features of the program delivery system
_______ may affect suitability.
logistical aspects regarding where and when services are available.
The personal trainer may also need to evaluate the level of exercise readiness by assessing the _______ and _______ of the individual.
- motivation
- commitment
An attempt to predict compliance may begin with a discussion of _______, _______, _______, _______, _______ and _______.
- past experiences
- appreciation for exercise
- availability of support
- time management
- organizational skills
- potential obstacles that may affect adherence
An _______ form is available to predict levels of exercise readiness and compliance.
- Attitudinal assessment form
The last step in determining compatibility is to assess _______ and _______.
- suitability
- appropriateness
During the initial interview it is important that the personal trainer and client agree to: _______, _______, _______, _______, and _______
boundaries roles resources expectations address any concerns related to any of the issues or info discussed in the initial interview
If facts are discovered during the initial; interview that would establish incompatibility, it is important for the personal trainer to provide the person with an option to receive services through a _______.
referral process
If compatibility and suitability are established, the next step may be a discussion of _______.
- goals
The main function of identifying objectives is to provide and define _______ as it relates to purpose and motivation.
- direction
After the personal trainer and client have identified and clarified goals, the next step may be to finalize the _______.
- client-trainer agreement
Components of a contract include: _______, _______, _______, _______ , _______ and _______.
- written documentation describing the services
- parties involved
- expectations of those parties
- time line of delivery
- cost structure
- a payment process
Language of a contract should also cover: _______, _______, and _______.
the cancellation policy
termination of contract
circumstances that would render the document void
A discussion regarding the content of the _______ should be provided during the consultation.
- contract
The personal trainer should document and clarify _______ and _______ concerning the agreement before receipt of acknowledgment of acceptance.
- questions
- issues
The contract becomes valid when _______.
- signed by both parties
The purpose of the pre-participation health appraisal screening process is to _______, _______, and _______.
- identify known diseases and positive risk factors associated with cad
- assess lifestyle factors that may require special considerations
- identify individuals who may require medical referral before starting an exercise program
The first step in the pre-participation health appraisal screening process is to ask the client to _______.
complete the relevant forms
The personal trainer should _______ before services are provided and any activity occurs.
- review the completed health appraisal forms
It is essential that the pre-participation health appraisal screening process be ______ and _______ in order to avoid unnecessary barriers to exercise for individuals who do not need a medical clearance to participate.
cost effective
time effecient
Health appraisal instruments are tools by which info is collected and evaluated to assess appropriateness for various levels of _______ and _______.
exercise
referral
Two health appraisal instruments that are commonly used are the _______ and _______.
- PAR-Q (physical activity readiness questionnaire)
- Health medical questionnaire
What is the PAR-Q (physical activity readiness questionnaire)?
A questionnaire that requires self-recall of observations and signs and symptoms experienced by the client, in addition to confirmation of diagnosis by a physician.
The advantages of the PAR-Q (physical activity readiness questionnaire) are that it is _______ & _______
cost-effective
easy to administer
The PAR-Q (physical activity readiness questionnaire) identifies individuals who require _______ while not excluding those who would benefit from participation in _______.
additional screening
low-intensity activity
The PAR-Q appears to have limitations in that it was designed essentially to determine the _______ and not the risk for CAD.
safety of exercise
The health/medical questionnaire can identify _______, _______, _______, _______, _______, _______, _______, _______, _______.
- positive coronary risk factors associated with CAD
- sudden cardiac death risk factors
- existing diagnosed pathologies
- orthopedic concerns
- recent operations
- personal history of suggested signs and symptoms
- medications
- supplements
- lifestyle management
The health/medical questionnaire is an effective tool for assessing the appropriateness of _______ and _______ levels of exercise.
moderate
vigorous
Lifestyle inventories consist of questions to evaluate choices and patterns related to _______, _______, and _______.
- dietary intake
- management of stress
- levels of physical activity
A personal trainer may use a _______ to augment previously gathered health/fitness related info in an attempt to clarify and confirm personal issues possibly perceived assets or obstacles to the clients success.
lifestyle inventory
Lifestyle inventories may also provide valuable info for use in developing _______.
- goals
Persons with existing health-related conditions who have been previously diagnosed by a physician may not obtain valid and reliable info from the results of the lifestyle inventories and therefore should rely on _______ for guidance.
- diagnostic info from their physician for guidance
The _______ gives clients info about the content and process of the program delivery system.
informed consent form
The essential elements of an informed consent form include: _______, _______ , _______, _______, and _______.
- a detailed description of the program
- the risk and the benefits associated with participation
- confidentiality clause
- responsibilities of the participant
- documentation of acknowledgment and acceptance of the terms described within the form
Info from the informed consent form should be conveyed both _______ and _______ to the client prior to any testing or participation to ensure that the participant knows and understands the risks and circumstances associated with the program.
verbally
in writing
An _______ is an agreement by a client, before beginning participation, to give up, relinquish, or waive the participants rights to legal remedy (damages) in the event of injury, even when such injury arises as a result of provider negligence.
release/assumption of risk agreement or waiver
A release/assumption of risk agreement needs to identify the _______ and establish that _______.
potential risks associated with participation
potential client understands those risks and voluntarily chooses to assume the responsibility
A signed _______ may limit liability.
assumption of risk may limit liability.
Acknowledgement of the content and authorization of the release/assumption of risk agreement form form does not relieve the personal trainer of the duty to perform in a _______ and _______ manner.
competent
professional
Parents should fill out a _______ for their child before he or she begins participation.
health history questionnaire
Pre-participation physical examination for children should include a pre-participation physical evaluation form that has been approved by the _______ or the _______, as well as other organizations.
American Academy of Pediatrics
American Academy of Family Physicians
The pre-participation physical evaluation form for children may be helpful in determining whether a child should _______ and get the _______ of a physician prior to participation in a physical activity program.
vist
permission
According to laws in many states, “children of particular ages (generally 7-14 years) are incapable of _______”.
self-negligence
A child’s _______ is not sufficient to bar or limit any award of damages.
slef-negligence
A ______ to verify the completion and receipt of forms, along with other documentation concerning the status of the client, is instrumental in allowing one to move on to the next step of the pre-participation health appraisal screening process.
record-keeping system
Once the appropriate forms are completed and the documentation is reviewed, it is necessary to evaluate the content of the info to identify any _______ associated with the client’s present health status.
potential risks
The evaluation of a clients health status helps the personal trainer _______ and _______.
stratify risk
refer clients to physicians when necessary
The key areas to evaluate (in regards to a clients health status) include positive risk factors associated with: _______, _______, and _______.
CAD
Medical conditions and diagnosed disease
current lifestyle
_______ is the leading cause of mortality in Western Society.
Coronary artery disease
_______ is a progressive degenerative process associated with CAD through which the endothelial lining of the arterial walls becomes hardened and the walls consequently lose elasticity.
Atherosclerosis
_______ causes a deposition of fat and plaque build up, which narrows the artery wall and occludes blood flow through the vascular system to the heart, causing heart tissue to die or leading to a myocardial infarction.
Atherosclerosis
It is well documented that _______ is a protective mechanism to deter atherosclerosis.
exercise
Some individuals possess existing factors that put them at greater potential risk for a coronary episode because of the increased demand that _______ imposes on an already compromised system.
exercise
Identifiable _______ are associated with the potential to acquire CAD.
positive risk factors
A _______ may be defined as “an aspect of personal behavior or lifestyle, an environmental exposure or inherited characteristic which, on the basis of epidemiological evidence, is known to be associated with health related conditions considered important to prevent”.
positive risk factor
It is necessary to
evaluate positive risk factors associated with _______ in order to Identify Individuals who may be at higher risk during exercise.
CAD
Research suggests that a persons potential risk for developing CAD is associated with the _______ the person possesses.
positive coronary risk factors
The greater the number and severity of positive risk factors, the greater the probability of _______.
CAD
The seven identifiable positive risk factors that have a significant correlation to CAD are: _______, _______, _______, _______, _______, _______, and _______.
family history smoking hypertension dyslipidemia impaired fasting glucose levels obesity sedentary lifestyle
The probability of CAD increases with _______.
age
_______ are at a greater risk of having CAD than _______ are and they tend to develop it at younger ages.
males
females
Reaching the threshold of _______ for men and _______ for women does not, by itself, move the client into the stratification of moderate risk.
> or = 45 years
> or = 55 years
_______ appears to have a predisposing genetic connection and a tendency to be familial.
coronary artery disease
People with a family history possess a coronary artery risk factor if a _______, _______, or _______ occurred before _______ years of age in their biological father or another male first-degree relative (sibling or child) or before _______ years of age in their biological mother or another female first-degree relative.
coronary infarction coronary revascularization sudden death 55 65
Overwhelming, empirical evidence identifies smoking as a major positive risk factor for _______.
CAD
A linear relationship also appears to exist between the risk for cardiovascular disease and the _______ of cigarette smoking and _______ a person smoked.
volume
number of years
Data suggest that the chemical makeup of cigarettes accentuates risk by elevating _______ and reducing _______, causing the cardiovascular system to work harder to obtain a sufficient _______ supply.
myocardial oxygen demand
oxygen transport
oxygen
Cigarette smoking lowers _______, which has an impact on the acceleration of the atherosclerotic process.
high-density lipoprotein (HDL) cholesterol
Persons who _______ smoke cigarettes, and those who _______ smoked but who have quit within the last _______ months, have a great potential for CAD.
currently
previously
6
_______ is chronic, persistent sustained elevation of blood pressures..
hypertension
Most diagnosed individuals have _______ hypertension, which by definition cannot be attributed to any specific cause.
essential
_______ hypertension refers to elevated blood pressures caused by specific factors such as kidney disease and obesity.
secondary
Hypertension causes increased _______ which dramatically increases the _______ of the heart in pumping the extra blood required to overcome _______.
wall stress workload
peripheral vascular resistance
The _______ the blood pressure, the greater the risk for CAD.
higher
_______ is a fat like substance found in the tissues of the body that performs specific metabolic functions in the human organism.
cholesterol
Cholesterol is carried throughout the body by molecular proteins know as _______ and _______.
high-density lipoproteins (HDL’s)
low-density lipoproteins (LDL’s)
_______ molecules release cholesterol, which penetrates the endothelial lining of the arterial wall and in turn contributes to the atherosclerotic plaque build up that eventually leads to vascular occlusion and heart attacks.
LDL
_______ act as a protective mechanism by transporting cholesterol through the bloodstream to the liver, where it is metabolized and eliminated.
HDL’s
Research has identified a strong relationship between _______ levels of total cholesterol, _______ LDL-cholesterol, and _______ HDL-cholesterol and a higher rate of CAD.
high
high
low
Individuals who have a total serum cholesterol of _______ or an HDL-cholesterol of _______ or an LDL _______ or who are on _______ have a greater risk for CAD.
> 200 mg/dl
<35 mg/dl
130 mg/dl
lipid lowering medication
_______ may provide a more predictive value for CAD than the total cholesterol.
LDL
_______ are markers to assess the body metabolic function.
fasting glucose levels
Elevated levels of circulating _______ in the bloodstream can lead to a chemical imbalance that impedes the use of fats and glucose.
glucose
Individuals who present with fasting glucose values _______
or 2-hour values in an oral glucose tolerance test _______ confirmed by measurement on at least two separate occasions, are considered to be at increased risk for CAD.
= or > 100 mg/dl
= or > 140 mg/dl
Individuals with elevated _______ levels are more susceptible to atherosclerosis and have an increased risk for CAD.
fasting glucose
Elevated _______ levels my also be early predictive values for the potential onset of diabetes.
fasting glucose
_______ by medical definition is the accumulation of excess body fat.
obesity
Obesity in and of itself may be considered an independent risk factor for _______.
CAD
Persons who store or accumulate excess body fat in the _______ or _______ area appear to be at a greater risk for CAD>
central waist
abdominal
The assessments and values associated with obesity as a positive risk factor include a body mass index (BMI) _______ or a waist girth _______ for men and _______ for women.
= or > 30 kg/m2
>40 inches
>35 inches
Physical activity or a sedentary lifestyle is recognized as a leading contributing factor to _______ and _______.
morbidity
mortality
Physical activity has many beneficial effects on other CAD risk factors, for example by _______, _______, _______, and _______
- decreases resting systolic and diastolic blood pressures
- reduces triglyceride levels
- increasing serum HDL-cholesterol level
- increases glucose tolerance and insulin sensitivity
People who do not participate in a regular _______ program or meet the minimal _______ recommendations (_______ or more of accumulated _______ intensity activity on _______, or preferably _______, days of the week to expend approximately ______ to _____ calories per day) in the U.S. Surgeon Generals report have a positive risk factor for CAD.
exercise physical activity most all 200 250
A _______ suggests a favorable influence that may contribute to the development of a protective cardiac benefit.
Negative coronary risk factor
_______ appear to provide a protective mechanism against CAD by removing cholesterol from the body and preventing plaque from forming in the arteries.
HDL’s
Increases in HDL’s are consistent with decreased risk for _______.
CAD
Persons who have a serum HDL-cholesterol of _______ improve their cholesterol profile and decrease the risk of CAD.
= or > 60 mg/dl
If HDL is high (_______), the personal trainer _______ one risk factor.
= or > 60 mg/dl
subtracts
Persons who have evidence of a known _______ , have symptoms of _______, or are _______ require special attention because of the increased potential risk.
disease
cardiovascular disease
presently on medication to control disease
People who exhibit signs and symptoms of a personal history with _______ present special safety concerns as to the appropriateness of participating in an exercise program.
CAD
The major signs or symptoms suggestive of cardiovascular and pulmonary disease are as follows: _______, _______, _______, _______, _______, _______, _______, _______
- pain, discomfort (or other anginal equivalent) in the chest, neck, jaw, arms, or other areas that may be due to ischemia (lack of blood flow)
- shortness of breath at rest or with mild exertion
-dizziness or syncope (fainting),
orthopnea (the need to sit up to breath comfortably) or paroxysmal (sudden, unexpected attack) nocturnal dyspnea (shortens of breath at night) - ankle edema (swelling, water retention)
- palpitations or tachycardia (rapid heart rate)
- intermittent claudication (calf cramping)
- known heart murmur
- unusual fatigue or shortness of breath with usual activities
if the an individual exhibits signs or symptoms of cardiovascular or pulmonary disease it is the role and the responsibility of the personal trainer to take appropriate action by _______.
referring the client to a physician for a medical exam
Various _______ diseases affect the respiratory systems ability to transport oxygen during exercise to the tissue level via the cardiovascular system.
pulmonary
Inadequate oxygen supply creates a greater than normal demand on the _______, in some cases markedly reducing exercise tolerance.
cardiorespiratory system
_______, _______, and _______, are considered to be syndromes associated with chronic obstructive pulmonary disease (COPD) and are the most common diagnosed diseases related to respiratory disfunction.
bronchitis
emphysema
asthma
Chronic _______ is an inflammatory condition caused by a persistent production of sputum due to a thickened bronchial wall, which in turn creates a reduction of airflow.
bronchitis
_______ is a disease that affects the small airways.
emphysema
_______ causes the enlargement of air spaces accompanied by the progressive destruction of alveolar-capillary units leads to elevated pulmonary vascular resistance, which in most cases can contribute to heart failure.
emphysema
_______ is mostly due to a spasmodic contraction of smooth muscle around the bronchi that produces swelling of mucosal cells lining the bronchi and an excessive secretion of mucus.
asthma
constriction of airway paths associated with asthma results in attacks that may be caused by: _______, _______, _______, and _______.
allergic reactions
exercise
air quality
stress
_______ related to exercise is caused by cardiac arrest that occurs instantaneously with an abrupt change in an individuals pre-existing clinical state or within a few minutes of that change.
sudden cardiac death
_______ does not typically provoke cardiovascular events in healthy individuals with normal cardiovascular systems.
exercise
_______ is strongly advocated by the medical community in part becasue evidence suggests that _______ delays the development of atherosclerosis and reduce the incidence of coronary heart disease events.
physical activity
physical activity
_______ physical activity can acutely and transiently increase the risk of acute myocardial infarction and sudden cardiac death in susceptible individuals.
vigorous
Both _______ and _______ populations are at risk of sudden cardiac death.
young (<35 years old)
older
Among young individuals, the most frequent cardiovascular abnormalities leading to sudden cardiac death include _______, _______, _______, _______, _______, _______, and _______.
- hypertrophic cardiomyopathy
- coronary artery anomalies
- aortic stenosis
- aortic rupture (marfan syndrome)
- mitral valve prolapse
- various heart arrhythmias
- myocarditis
In younger individuals _______ are the cause of sudden cardiac death.
ventricular arrhythmias
Older, previously asymptomatic individuals who experience sudden cardiac death often show evidence of _______ with _______.
acute coronary artery plaque disruption
acute thrombotic occlusion.
A thorough history as part of the _______ can help the personal trainer identify potential risks for sudden cardiac death.
health/medical questionnaire
Identification of one or more of the following conditions should warrant a referral for a cardiovascular examination: _______, _______, _______, _______, _______, _______.
- chest pain or discomfort with physical exertion
- unexplained dizziness or fainting, particularly when associated with physical exertion
- excessive and unexplained shortness of breath or fatigue associated with exercise
- prior recognition of a heart murmur
- elevated systemic blood pressure
- family history of sudden and unexpected death before age 50 in more than one relative
Sudden cardiac death associated with moderate to intense physical activity is more prevalent in the _______ population compared with the general population.
competitive athlete
The medical an d family history questions used to screen competitive athletes also apply to the _______, although the chance of encountering a person in the _______ with increased risk of sudden cardiac death is much smaller.
general population
general population
If an individual identifies one or risk factors associated with sudden cardiac death, it is the role and responsibility of the personal trainer to take appropriate action through the _______ process by recommending a _______ by a ________ before initiating any type of activity.
referral
medical exam
physician
For those with or at risk for coronary heart disease the benefits of regular _______ outweigh the risks of sudden cardiac death.
regular physical activity
For individuals with diagnosed or difficult-to-detect cardiac diseases, the health risks of _______ almost always exceed the benefits.
Vigorous physical activity
An absolute rate of exercise-related death among younger athletes has been estimated to be _______ per _______ men and _______ per _______ women.
1
133,000
1
769,000
The rate of sudden cardiac death during vigorous physical activity for the older population is estimate at _______ per year for every _______ to _______ people.
1
15,000
18,000
As a personal trainer, it is important to include _______ in the health/medical questionnaire in order to identify individuals who may be at risk for sudden cardiac death.
sudden cardiac death risk factors
It is important to advance all clients according to _______.
individual fitness
Sudden cardiac death at all ages is more prevalent in those who perform activity that they are _______.
not accustomed to
_______, a metabolic disease, affects the body’s ability to metabolize blood glucose properly.
diabetes mellitus
Diabetes mellitus is a metabolic disease characterized by hyperglycemia resulting from defects in _______, _______ or both.
insulin secretion (type 1) insulin action (type 2)
Persons with _______ are insulin dependent, meaning that they require insulin injections to metabolize glucose.
- type 1 diabetes
Persons with _______ in most cases are able to produce insulin, but the tissue resists it, and consequently glycemic control is inadequate.
type 2 diabetes
_______ is known to be an independent contributing factor in the development of _______ increasing the potential for _______, _______, _______, and _______.
cardiovascular disease
CAD
peripheral vascular disease
congestive heart failure
Although _______ along with _______ and _______ appear to have an impact on the regulation of glucose levels, diabetes still requires ongoing medical attention and warrants precautions.
physical activity
dietary modifications
prescribed meds
_______ limitations and disease do not appear to present the same relative risk as those associated with cardiovascular function.
orthopedic
musculoskeletal concerns may require a _______ before initiation of a a program.
physicians referral
Common musculoskeletal concerns related to _______, _______, _______, and _______ present issues and challenges that may need to be assessed on a case-by-case basis.
acute trauma
overuse
osteoporosis
lower back pain
Musculoskeletal issues related to _______, _______, _______, and _______ may require communication with a physician and in most cases medical clearance.
- orthopedic replacements
- surgical procedures
- osteoporosis,
- rheumatoid arthritis
Various meds may alter _______, _______, _______, and _______.
- heart rate
- blood pressure
- cardiac function
- exercise capacity
It is important for the personal trainer to understand the classes of commonly used _______ and their _______.
drugs
effects
_______ commonly prescribed for persons with high blood pressure may affect normal increases in heart rates during exercise, as a result people will have difficulty obtaining, and should not strive to achieve, training heart rates.
- beta blocking meds
It may be inappropriate to monitor training intensity while a client is on _______, because of the masking effect of the medications on heart rates, and therefore ratings of perceived exertion would provide a more effective mechanism to regulate intensity levels of exercise.
beta blocking meds
Evidence clearly suggests a strong relationship between lifestyle choices regarding _______, _______, and the _______ on one hand and the potential risk of CAD and other leading causes of morbidity and premature mortality on the other.
dietary intake
physical activity
management of stress
Identifying, quantifying, and assessing a persons dietary intake gives the personal trainer valuable info for assessing _______, _______, and _______ that may be contributing factors in the development of disease.
- overconsumption
- underconsumption
- caloric imbalances
There is a connection between _______ and _______ consumption and the development of atherosclerosis.
dietary saturated fat
cholesterol
Excessive _______ consumption has been associated with an increased risk for cardiovascular disease.
alcohol
Diets high in _______ can lead to chronic elevation of systolic blood pressure, or more importantly, can result in worsening of heart failure.
sodium
_______ of caloric intake may contribute to obesity and diabetes, and _______ may lead to degenerative bone diseases and psychological health issues related to disordered eating.
- over-consumption
- under-consumption
An analysis of a typical dietary intake through documentation of a _______ or _______ dietary record record may be a starting point for assessing the health-related value of the individuals eating habits.
3-day
7-day
A _______ or _______ may be used to evaluate a persons typical dietary intake.
dietary recall
diet history
Identifying patterns of _______ helps the personal trainer to recognize individuals with little or no history of exercise.
physical activity
An evaluation of physical activity should include: _______, _______, ______, ______ as well as _______, _______.
- identifying the specific activity
- the frequency of the activity
- the volume
- the level of intensity of that activity
- documenting signs or symptoms associated with the activity
- particularly shortness of breath or chest pains
Musculoskeletal concerns related to _______ or _______ should be identified.
joint discomfort
chronic pain
Epidemiological studies provide evidence that stress is related to the risks for _______.
CAD
Investigations have linked stress with an increase in _______ disease.
heart
_______ behavior patterns may contribute to the overall risk for developing CAD.
type A
Type A behavior pattern characteristics include: _______, _______, _______, and _______.
hostility
depression
chronic stress produced by situations involving “high demand and low control”
social isolation
Stress related characteristics can be measured _______ and _______ through _______ and _______
- psychosocially
- physiologically
- emotional stress inventories
- standard exercise testing
The _______ is to be completed during the pre-participation health screening and is used to assess a clients potential for stress and response to stressors.
health risk analysis form
Once the pre-participation health screening is complete, the personal trainer should evaluate the clients positive risk factors associated with _______, _______, and _______.
CAD
medical conditions
lifestyle
The evaluation of the results from the health appraisal screening will be used for _______.
risk stratification
Stratifying risk for potential health related concerns is a preliminary step in determining the _______ of activity and identifying clients who require _______ before beginning an exercise program.
appropriateness
referral
In order to meaningfully interpret the results obtained through the screening process, the personal trainer uses the _______ and the _______ to identify people who have a greater potential for risk and may require _______ and a _______.
- results from the PAR-Q
- initial risk stratification method
- referral
- clearance from a physician
The _______ has been shown to be useful for referring individuals who require additional medical screening while not excluding those who may benefit from exercise.
PAR-Q
After eliciting objective yes or no answers to seven questions related to signs and symptoms associated with CAD, orthopedic concerns, and diagnosis by a physician, the self-administered _______ form provides direction based on interpretation of the results and specifies recommendations as to the appropriateness of activity and the referral process.
PAR-Q
The intent of the _______ is to use age, health status, personal symptoms, and coronary risk factor info to initially classify individuals into one of three risk strata for preliminary decision making purposes.
initial risk stratification method
Using a decision-making process to evaluate the info obtained through the initial health appraisal screening process, the personal trainer should be able to classify an individual into one of the three _______.
risk categories
The personal trainer obtains relevant info through the _______.
pre-participation health appraisal screening interview
The evaluation of the following processes _______; ________, _______, and _______; and _______ are intended to help identify individuals who will need referral to a healthcare professional for medical clearance prior to participating in activity.
- pre-participation health appraisal screening
- evaluation of coronary risk factors
- disease
- lifestyle
- interpretation of the info obtained through the initial interview and client consultation process
Regular _______ to evaluate health status are normally encouraged for preventative purposes for everyone.
medical examinations
It is recommended that persons beginning a new program of activity or exercise _______ prior to participation.
consult with a physician
If a client gave yes answers to _______ questions (which are related to signs and symptoms associated with CAD, orthopedic concerns, and diagnosis by a physician) on the PAR-Q, it is recommended that the individual _______ and _______ before increasing physical activity and taking part in a fitness appraisal or assessment.
one or more
contact their physician
tell the physician which questions elicited yes answers
The client should seek recommendations from the physician regarding the _______ and _______ of activity and _______ associated with his or her specific needs.
- level
- progression
- restrictions
If the client gave no answers to all questions, there is reasonable assurance that it is suitable for the client to engage in a _______ and a _______
graduated exercise program
fitness appraisal/assessment
It is recommended that a client who is or may be ________ talk with her doctor before she starts becoming more active.
pregnant
Guidelines and recommendations for medical examinations and exercise testing are interfaced with the initial risk stratification classifications for _______, _______, and _______.
low
moderarte
high risk
Guidelines are consistent with the notion that as the intensity of the activity increases from _______ to _______, there is a significant increase in potential risk for the participant.
moderate (40%-60% maximal oxygen uptake)
vigorous (>60% maximal oxygen uptake)
A _______ is a non-diagnostic practical assessment, typically referred to as a _______ that is inexpensive, is easy to administer, and does not normally require maximal effort.
sub-maximal
field test
_______ are typically administered by certified personal trainers.
sub-maximal or field tests
During a field test, it may be necessary for a physician to be present at the testing if a patient is considered _______.
“high risk”
A _______ is commonly performed in a clinical setting with use of specialized diagnostic equipment to assess an individuals functional capacity through maximal effort.
maximal test
A _______ is relatively complex, and direct measurements are used to assess physiological responses.
maximal test
Because of the diagnostic capabilities and the high risk of cardiac complications, physicians often supervise the administration of _______.
maximal tests
Low risk -
- _______
- _______
- _______
- Asymptomatic, < or = 1
- it is not necessary to have a current medical exam and exercise test prior to participation in moderate and vigorous exercise.
- it is also not necessary for a physician to supervise a submaximal or maximal exercise test.
Moderate risk -
Asymptomatic, > or = 2 risk factors
it is not necessary to have a current medical exam and exercise test for moderate exercise; however, these are recommended for vigorous exercise.
it is not necessary for a physician to supervise a sub-maximal exercise test, but physician supervision is recommended for a maximal test.
High risk -
- _______
- _______
- _______
- Symptomatic, or known cardiac pulmonary, or metabolic disease
- it is recommend that a current medical exam and exercise test be performed prior to moderate or vigorous exercise.
- it is recommended that a physician supervise either a sub-maximal or a maximal exercise test.
In cases in which referral is considered necessary, it is the personal trainers responsibility to encourage _______ as a reasonable safe course of action.
medical clearance
Once medical clearance is recommended, the personal trainer should give the client a _______ in order to obtain the necessary info about health status, physical limitations, and restrictions that would be required to make future fitness program recommendations.
- physicians referral form
The physician’s referral form includes an assessment of _______, _______, _______, _______, and _______.
- the individuals functional capacity
- a classification of ability to participate
- identification of pre-exisiting conditions that may be worsened by exercise
- prescribed meds
- fitness program recommendations
The _______ provide the personal trainer with guidance and directions regarding what specific concerns and needs the individual has and which programs are appropriate on the basis of the results obtained during the diagnostic medical examination and exercise tests.
- physician recommendations
An _______ is commonly recommend for people who are apparently healthy or presumably healthy with no apparent risks. This type of program recognizes the positive health-associated benefits that regular activity provides in relation to the relatively low risk involved in participation.
unsupervised program
_______ may be designed and initiated with the support of a personal trainer, the intended long term eventual outcome being a combination of consistent weekly training sessions conducted by the personal trainer and other sessions that are self-directed.
unsupervised programs
A _______ may be recommended for people who have limitations or pre-existing conditions that would restrict involvement but not limit participation.
supervised program
_______ are usually directed by a certified fitness professional, such as a certified personal trainer, who monitors intensity and modifies activity to meet the special concerns of the participant.
supervised programs
A _______ may be recommended for individuals who present a higher potential risk due to a predisposed condition, multiple risk factors, or an uncontrolled disease.
medically supervised program
_______ are directed and monitored by allied health professionals in clinical settings with immediately accessible emergency response capabilities.
medically supervised programs
Since there is no guarantee that the initial program recommendation resulting from a physician referral will meet the clients specific goals, it is important for those involved in the referral and recommendation process to _______ and _______ the program to ensure that it will be both _______ and _______ for the client.
- monitor
- readjust
- safe
- effective
The client consultation and health appraisal process is directly in line with the scope of practice of the personal trainer to _______, _______, _______, _______, and _______.
motivate assess train educate refer when necessary
In order to develop programs of exercise that will safely and effectively see the individuals objectives, the personal trainer needs to gather _______ that will be used to assess _______ and _______.
- pertinent info and documentation
- health status
- potential for risk
