Client Assessments Flashcards
What kind of assessments are based on observation or a subjective, opinion-based measure?
Subjective assessments.
What kind of assessments collect repeatable, measurable data such as body composition or circumference measurement?
Objective assessments.
What is the name of the American legislation designed to protect the health care data, information, and payment details of patients?
The Health Insurance Portability and Accountability Act (HIPAA).
What is the name of the form used to assess a client’s readiness to begin a physical activity program and assess injury potential
Physical Activity Readiness Questionnaire (PAR-Q)
What is a detailed client intake form that gathers information on a client’s present and past health and medical history?
Health History Questionnaire
What is a short form that, when signed by a client, releases a fitness professional and/or their training facility from any liability should the client be injured while working with them?
Liability waiver
What is a signed letter from a client’s health care provider stating they are cleared for physical activity and exercise that should also include any restrictions or limitations they should adhere to?
Physician’s Letter of Clearance
A common fitness and nutrition intake form that allows clients to log their food consumption for three consecutive days to observe their habits is called a… (?)
Three-Day Dietary Record
The collection of a client’s health and intake forms, biometric measurements (physical measurements like weight, height, etc.), training plan, and liability waivers is called… (?)
Client Profile
Define “Contraindications”.
Factors that serve as a reason to withhold training because of harm that it may cause.
Give examples of some contraindications.
- Unstable coronary heart disease (CHD)—a condition where the heart does not get enough blood or oxygen flow.
- Decompensated heart failure—new or worsening signs and symptoms of heart failure.
- Uncontrolled heart arrhythmias—irregular heartbeat that is not controlled.
- Severe pulmonary hypertension—extremely high blood pressure.
- Severe and symptomatic aortic stenosis—narrowing of the aortic valve that causes shortness of breath or fatigue.
- Acute myocarditis, endocarditis, or pericarditis—inflammation of the heart muscle, heart chambers, or the sac that surrounds the heart respectively.
- Uncontrolled hypertension—high blood pressure that is not under control with medication or dietary interventions.
- Aortic dissection—a tear in the aorta.
- Marfan syndrome—a genetic disorder affecting connective tissue and that commonly affects the heart, eyes, blood vessels, and skeleton.
- Active proliferative retinopathy or moderate or worse non-proliferative diabetic retinopathy—damage to the blood vessels of the eyes.
What are some relative contraindications in which a person could begin a fitness program but should be required to provide a written physician’s approval?
- Risk factors for CHD—risk factors include high blood pressure, poor cholesterol, diabetes, obesity, smoking, and physical inactivity.
- Diabetes—high or uncontrolled blood sugar.
- Low functional capacity (Metabolic equivalent (METs))—the inability to exert energy and effort for activities such as dressing, eating, and moving around. Adequate functional capacity is anything over four METs and can include walking up stairs, cleaning, swimming, and jogging.
- Musculoskeletal limitations—limitations to mobility, dexterity, or general function, including injuries, post-surgery, and recovery from injury.
- Pacemaker or defibrillator—devices implanted in the body to regulate the heartbeat or return it to normal should it become irregular.
Define “Body Composition”.
The physical makeup of the body considering fat mass and lean mass.
Define “Lean Body Mass”.
The fat-free mass of the body calculated by total weight minus the weight of bodyfat.
What is Chronic Disease?
A condition lasting a year or more that limits daily activities and/or requires ongoing medical attention.
What is Amenorrhea?
The absence or cessation of a menstrual cycle in females.
Give bodyfat percentage ranges for men.
- Low/Essential: 4-6%
- Athletic: 7-10%
- Fit: 11-16%
- Average: 17-25%
- High/Overweight: 26% or higher
Give bodyfat perdentage ranges for women.
- Low/Essential: 10-12%
- Athletic: 7-10%
- Fit: 21-24%
- Average: 25-31%
- High/Overweight: 32% or higher
What is the mathematical formula for calculating BMI?
BMI = weight (kg) / height (m2)
Give BMI ranges.
- Below 18.5 = underweight
- 18.5 - 24.9 = normal
- 25.0 - 29.9 = overweight
- 30 or above = obese
What is a measurement used to predict an individual’s obesity-related heart disease risk and is easy to obtain?
Waist-to-Height Ratio.
What is the mathematical formula for calculating Waist-to-Height ratio?
Waist-to-height ratio = (waist circumference / height) × 100
Note: The same unit of measure must be used for both waist circumference and height (for example, inches or centimeters).
Imperial: (28 in. / 60 in.) × 100 = 46.7
Metric: (71.12 cm. / 152.4 cm.) = 46.7
What is Waist-to-Hip Ratio (WHR)?
A predictive health measure comparing the circumference of the waist to the circumference of the hips.
What is the mathematical formula for calculating Waist-to-Hip ratio (WHR)?
WHR = waist circumference / hip circumference
What is Body Density?
The compactness of the body determined by dividing its mass by its volume.
How many sites are tested during skinfold measurements?
Either three or seven.
What are the seven locations checked during a seven-site skinfold measurement assessment?
- Triceps
- Subscapular
- Chest (pectoral)
- Midaxillary
- Suprailiac
- Abdominal
- Thigh
What are the three sites used for a three-site skinfold measurement assessment in men?
- Chest/Pectoral
- Abdomen
- Thigh
What are the three sites used for a three-site skinfold measurement assessment in women?
- Triceps
- Suprailiac
- Thigh
What is a method for body composition measurement using a weak electrical current to measure the resistance of body tissues?
Bioelectric Impedance (BIA).
What is Hydrostatic Weighing?
A tool to measure body composition using water displacement and tissue density.
What is the most accurate bodyfat test available?
Dual Energy X-Ray Absorptiometry (DEXA)
What is Dyspnea?
Difficulty or labored breathing.
Chronically high blood pressure is called… (?)
Hypertension (blood pressure reading more than 140/90 mm Hg)
Blood pressure less than 120/80 mm Hg is considered… (?)
Normal
Blood pressure with systolic reading between 120 and 129 and diastolic less than 80 mm Hg is considered… (?)
Elevated
Blood pressure with systolic reading between 130 and 139 or diastolic between 80 and 89 mm Hg is considered… (?)
Stage 1 Hypertention
Blood pressure with systolic reading at least 140 or diastolic at least 90 mm Hg is considered… (?)
Stage 2 Hypertension
What is the general purpose of the cardiovascular assessments?
To determine a client’s VO2 max.
What is VO2 Max?
The maximum amount of oxygen an individual can use during exercise.
What is Ventilatory Threshold (VT)?
The threshold where ventilation increases faster than the volume of oxygen.
Describe the Cooper 12-Minute Run assessment.
- Suitable for most populations
- Can be modified to match the client’s fitness level
- Total distance completed (walk/run/combination) is recorded at the end of 12 minutes
- Use mathimatic equation to find approximate VO2 Max
* (35.97 x miles completed) - 11.29 = estimated VO2 Max
* (22.35 x kilometers completed) - 11.29 = estimated VO2 Max
Which VO2 Max assessment uses a metronome?
Step Test
Muscular strength and endurance assessments can be useful when training what type of client?
Intermediate or advanced.
What are Specific Warm-Ups?
Activities that prepares the body for specific exercise to follow by incorporating movements that mimic the planned activity.
What are Muscular Endurance Tests?
Assessments testing the ability of a muscle group to overcome resistance in as many repetitions as possible.
Describe the Push-Up Test.
- The client will complete as many push-ups as possible in one minute.
- Men do push-ups from plank position; hands to toes.
- Women do push-ups from plank position; hands to knees.
- Hands should be just outside the shoulders at chest height.
- The test ends at one minute or when the client can no longer complete any more push-ups.
- Push-ups can be modified if needed (i.e., knee push-ups or wall push-ups).
- Norms will not apply to modified push-ups but can act as a baseline.
- Use the same modifications for reassessment.
Define Muscular Imbalance.
When the muscle or muscles on one side of the body are stronger, weaker, or more or less active than the corresponding muscle on the other side of the body.
What is the Kinetic Chain?
A system of links—or joints—in the body that generate and transfer force from one to the other.
What are the Kinetic Chain Checkpoints?
- Foot & Ankle
- Knee
- Hips
- Spine
- Shoulders
- Head & Neck
What are Overactive Muscles?
Muscles that are shortened beyond the ideal length-tension relationship with high neural activation that feel tight.
What are Underactive Muscles?
Muscles that are lengthened beyond the ideal length-tension relationship and are, therefore, inhibited and less capable of producing force.
What are Muscle Synergies?
The activation of a group of muscles to generate movement around a particular joint.
What is a Muscular Force Couple?
Two or more muscles generate force in different linear directions at the same time to produce one movement.
What is the Lumbopelvic Hip Complex (LPHC)?
The musculature of the hip that attaches to the pelvis and lumbar spine and works to stabilize the trunk and lower extremities.
How many muscles are within the LPHC?
Between 29 and 35.
What can hyperextension or flattening of the lumbar spine during gait or squat assessments point to?
- Deviations from the ideal lumbar spine positioning can indicate muscular dysfunctions in the LPHC.
- Muscular dysfunction at the hips, glutes, abdominals, or upper leg.
What can rounding of the thoracic spine indicate?
Dysfunctions in the chest, upper back, and even the lumbar spine. It will also affect the neck and head movement.
What is the Shoulder Girdle?
The clavicle, scapula, and coracoid bones of the appendicular skeleton.
What is a Closed Kinetic Chain Movement?
A movement keeping the distal end of the body segment in action fixed.
What is an Open Kinetic Chain Movement?
A movement in which the distal aspect of the body segment in action is free (i.e., not fixed).
What is Static Posture and how is it typically observed?
Posture when standing upright and still. Static posture is typically observed from a standing position from the anterior, posterior, and lateral view.
What are Movement Assessments and how are they typically viewed?
Observation and critique of movement patterns or exercise form. Movement assessments are viewed from the anterior, posterior, and lateral angles in most cases.
Describe Ideal Posture.
Ideal posture is when the feet, knees, and hips are level and even and point straight ahead. The spine will have a normal S curve, the head and neck are neutral (balanced over the body and center of gravity), and the arms hang naturally and evenly at the sides.
What is Lordosis (Lower Cross Syndrome)? What possible muscle imbalances are involved?
The excessive inward curve of the lumbar spine.
Possible muscle imbalances are:
* Tight lower back (erectors) and hip flexors
* Weak abdominals (especially obliques) and hip extensors
What is Kyphosis (Upper Cross Syndrome)? What possible muscle imbalances are involved?
The exaggerated rounding of the thoracic spine.
Possible muscle imbalances are:
* Tight internal oblique, shoulder adductors (pectorals and latissimus) and intercostals
* Weak erector spinae of the thoracic spine and scapular adductors (mid and lower trapezius)
What is Flat Back posture? What possible muscle imbalances are involved?
An excessive lumbar flexion and posterior pelvic tilt.
Possible muscle imbalances are:
* Tight upper abdominals and hip extensors
* Weak lower back (erectors) and hip flexors
What is Swayback posture? What possible muscle imbalances are involved?
A posterior tilt with excessive extension of the lumbar spine that protrudes the buttocks.
Possible muscle imbalances are:
* Tight upper abdominals and hip flexors
* Weak oblique abdominals and hip extensors
What is Scoliosis?
The sideways curvature of the spine.
What possible muscle imbalances are involved in Forward Head posture?
- Possible tight cervical extensore and upper trapezius.
- Possible weak neck flexors.
What is Knee Valgus?
The position of the knee near the midline of the body (i.e., knock knees).
What is Knee Varus?
The position of the knee away from the midline of the body (i.e., bowlegged).
What is the Q Angle?
The quadriceps angle formed between the quadriceps muscle and the patellar tendon.
What is a Squat Assessment?
The movement assessment of body mechanics during a squat with the goal of identifying movement dysfunctions along the kinetic chain.
What are some of the possible deviations that can be observed during a Squat Assessment and their possible related muscle imbalances?
- Knee valgus
Possible muscle imbalances:
* Possible weak gluteus maximus, gluteus medius and vastus medialis
* Possible tight adductors, biceps femoris, TFL, and vastus lateralis - Foot turnout (eversion and external rotation)
Possible muscle imbalances:
* Possible weak gastrocnemius (medial), semitendinosus, semimembranosus, sartorius, and gracilis.
* Possible tight soleus, gasterocnemius (lateral) and biceps femoris. - Excessive forward lean
Possible muscle imbalances:
* Possible weak gluteus maximus, erector spinae, and anterior tibialis.
* Possible tight soleus, gastrocnemius, psoas, rectus femoris, rectus abdominis, and external obliques. - Lumbar extension
Possible muscle imbalances:
* Possible weak gluteus maximus, transverse abdominus, hamstring complex, and multifidus.
* Possible tight psoas, rectus femoris, TFL, erector spinae, and latissimus dorsi. - Heel elevation
Possible muscle imbalances:
* Possible weak tibialis (anterior)
* Possible tight soleus - Foot pronation (arch collapse)
Possible muscle imbalances:
* Possible weak tibialis (anterior and posterior), gluteus medius, and gastorcnemius (medial)
* Possible tight gastrocnemius (lateral), biceps femoris, TFL - Lateral weight shift
Possible muscle imbalances:
* Possible weak gluteus medius (same side of shift), tibialis (anterior), and adductors (opposite side of shift)
* Possible tight adductors, TFL (same side of shift), gastrocnemius, soleus, piriformis, gluteus medius, and biceps femoris (opposite side of shift)
Describe an Overhead Squat Assessment.
As with all other dynamic postural assessments, this overhead squat should be observed from a lateral, posterior, and anterior position. During the squat, look for the same potential deviations as for the squat as well as the movement of the arms from the starting position relating to head position, forward lean, and, specifically, flexion and extension of any part of the spine from the lateral view. This assessment is highly effective in identifying core musculature and shoulder girdle dysfunctions.
What are some of the possible deviations that can be observed during an Overhead Squat Assessment and their possible related muscle imbalances?
- Knee Valgus
> Possible muscle imbalances:
- Possible weak Gluteus maximus, Gluteus medius, and Vastus medialis
- Possible tight Adductors, Biceps Femoris, TFL and Vastus Lateralis - Forward Lean
> Possuble muscle imbalances:
- Possible weak Gluteus maximus, Erector spinae, Anterior tibialis
- Possible tight Soleus, Gastrocnemius, Psoas, Rectus femoris, Rectus abdominis, External obliques - Foot Turnout (eversion and external rotation)
> Possible muscle imbalances:
- Possible weak Gastrocnemius (medial), Semitendinosus, Semimembranosus, Sartorius, Gracilis
- Possible tight Soleus, Gastrocnemius (lateral), Biceps femoris - Heel Elevation
> Possible muscle imbalances:
- Possible weak tibialis (anterior)
- Possible tight soleus - Foot pronation (arch collapse)
> Possible muscle imbalances:
- Possible weak Tibialis (anterior and posterior), Gluteus medius, Gastrocnemius (medial)
- Possible tight Gastrocnemius (lateral), Biceps femoris, TFL - Lateral weight shift
> Possible muscle imbalances:
- Possible weak Gluteus medius (same side of shift), Tibialis (anterior), Adductors (opposite side of shift)
- Possible tight Adductors, TFL (same side of shift), Gastrocnemius, Soleus, Piriformis, Gluteus medius, Biceps femoris (opposite side of shift) - Lumbar spinal extension (arching)
> Possible muscle imbalances:
- Possible weak luteus maximus, Transverse abdominus, Hamstring complex, Multifidus
- Possible tight Psoas, Rectus femoris, TFL, Erector spinae, Latissimus dorsi - Spinal flexion (rounding)
> Possible muscle imbalances:
- Possible weak erector spinae
- Possible tight Rectus abdominus, External obliques, Pectoralis major & minor - Forward head
> Possible muscle imbalances:
- Possible weak Flexors of the cervical spine, Extensors of the thoracic spine
- Possible tight Upper trapezius, Levator scapulae, sternocleidomastoid - Arms fall forward
> Possible muscle imbalances:
- Possible weak Middle and lower trapezius, Rhomboids, Supraspinatus, Infraspinatus, Teres minor, Subscapularis
- Possible tight Latissimus dorsi, Pectoralis major & minor, Teres major - Shoulder elevation
> Possible muscle imbalances:
- Possible weak middle or lower trapezius
- Possible tight Upper trapezius, Levator scapulae, sternocleidomastoid
