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EXSC 433 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Theories provide a ______ for understanding the process through which a complex behavior changes & is ______ over time.

A
  • framework

- sustained

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2
Q

3 ways exercise physiologists use theories?

A
  1. Support
  2. Intervention
  3. Evaluation
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3
Q

The stage of motivational readiness to change [SOC] model is also called what

A

the transtheoretical model [TTM]

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4
Q

What are the 3 basic concepts of the TTM ?

A
  1. People progress through 5 basic changes at varying rates
  2. people move back & forth along the continuum
  3. People use different cognitive and behavioral processes or strategies
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5
Q

Components of other theories are often used in conjunction with the SOC model. What are they ?

A
  1. Decisional balance (decision-making theory)

2. Self-efficacy (social cognitive theory) – what do you feel about yourself

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6
Q

what are the 5 stages of change?

A
  1. Pre-contemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
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7
Q

The SOC [TTM] model also states that individuals use a variety of _______ of ______ as they progress through the stages

A

processes of change

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8
Q

Five _____ and five ______ processes have been identified

A

experiential, behavioral

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9
Q

What are the 5 experiential processes

A
  1. Dramatic relief (be aware of risks)
  2. increase Consciousness (increase knowledge)
  3. Self re-evaluation (comprehend benefits)
  4. Social liberation (increase healthy opportunities)
  5. environmental re-evaluation (care about consequences to others)
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10
Q

Use of experiential processes usually peaks in which stage ?

A

preparation stage

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11
Q

What are the 5 behavioral processes?

A
  1. reinforcement management (reward yourself)
  2. Counter-conditioning (substitute alternatives)
  3. Self liberation (commit yourself)
  4. Stimulus control (remind yourself)
  5. Enlist social support
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12
Q

use of behavioral processes usually peaks in what stage

A

action stage

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13
Q

What is the goal for the individual in the pre contemplation stage ?

A

begin thinking about physical activity

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14
Q

what is the nickname for the pre contemplation phase

A

“not ready”

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15
Q

how does the individual feel when they are in the pre contemplation phase

A

cons greater than pros, low self-efficacy

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16
Q

What experiential processes are involved in the pre contemplation phase

A
  1. Dramatic relief - make them aware of risk of being unhealthy
  2. Consciousness rating - increase the knowledge
  3. Environmental re-evaluation - understand lifestyle impacts others
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17
Q

What is the nickname for the contemplation phase

A

“getting ready”

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18
Q

What is the goal for the contemplation phase

A

begin taking steps to become physically active; think about goals to set

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19
Q

how does the person feel if they are in the contemplation phase?

A

pros greater than cons
increase in self-efficacy
6 month intention

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20
Q

what experiential processes are involved in the contemplation phase

A
  1. dramatic relief
  2. consciousness rating
  3. Environmental re-evaluation
  4. self re-evaluation
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21
Q

what is the nickname for the preparation phase

A

“ready”

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22
Q

What is the goal for the preparation phase

A

increase physical activity to the recommended level

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23
Q

how does the person feel if they are in the preparation phase?

A

increased self efficacy; pros greater than cons; start within 30 days

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24
Q

what behavioral processes are involved in the preparation phase?

A

self-liberation [committed; change is possible]

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25
Q

What is the nickname for the action phase

A

“working the program”

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26
Q

What is the goal of the action phase

A

continue to make physical activity a regular part of life (habit)

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27
Q

how does the person feel if they are in the action phase?

A

probably only last 6 months [new years resolution dilemma]; pros are way greater than cons; much higher self-efficacy

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28
Q

what behavioral processes are involved in the action phase?

A
  1. stimulus control [remind yourself of the importance]
  2. reinforcement management [reward yourself]
  3. counter conditioning [substitution of healthier alternatives]
  4. Helping relationships [enlist social support]
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29
Q

What is the nickname of the maintenance phase

A

“keep it going”

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30
Q

What is the goal of the maintenance phase

A

prepare for future setbacks; continue to increase enjoyment

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31
Q

how does the person feel if they are in the maintenance phase?

A

6 months/change in behavior; lifestyle change

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32
Q

what behavioral processes are involved in the action phase?

A 
avoid boredom
reflect on benefits
schedule check-in appointments
plan for high-risk situations
reassess goals, etc.
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33
Q

what is the basic concept of the decision making theory?

A

people decide whether to engage in a particular behavior based on their comparison of the benefits verses the costs

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34
Q

the decision making theory is used in conjunction with the ______ model

A

SOC [TTM]

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35
Q

in later stages of the SOC people perceive more ______ for being physically active, but in early stages they perceive more ______

A

benefits; disadvantages

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36
Q

The social cognitive theory is also called what

A

reciprocal determinism

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37
Q

what is the basic concept of the social cognitive theory?

A

behavior change is influenced by interactions between the environment, personal factors and the behavior itself

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38
Q

what are 3 important components of the social cognitive theory?

A
  1. self-efficacy
  2. outcome expectations
  3. self-regulatory strategies
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39
Q

definition of self-efficacy?

A

an individuals belief & confidence about his or her ability to make specific behavior changes

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40
Q

research indicates that self-efficacy levels predict ________ in physical activity

A

participation

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41
Q

potential results that one anticipates after performing a particular behavior can be defined as

A

outcome expectations

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42
Q

3 major forms of outcome expectations

A
  1. positive & negative physical effects
  2. positive & negative social effects
  3. positive & negative self-evaluative reactions to the change in behavior
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43
Q

ability to mobilize oneself to perform a behavior regularly in the face of a variety of barriers

A

self-regulatory strategies

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44
Q

4 major processes of self-regulation

A
  1. self-monitoring
  2. proximal goal setting
  3. strategy development
  4. self-motivating incentives
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45
Q

4 practice implications for learning theory

A
  1. increase self-efficacy
  2. learn how to set goals
  3. plan for physical activity
  4. have realistic expectations
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46
Q

4 ways to improve self-efficacy?

A
  1. Mastery experiences (list of performance accomplishments)
  2. Social modeling (observe through vicarious experience)
  3. Verbal/social persuasion (communication)
  4. understand physiological states (reading articles/journals)
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47
Q

what is the basic concept of learning theory?

A

overall complex behaviors arise from many small simple behaviors

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48
Q

learning theory says it is possible to shape the desired behavior by doing what 2 things?

A
  1. reinforcing “partial behaviors”

2. modifying cues [stimuli]

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49
Q

setting a series of intermediate gold that lead to a long-term goal is known as what ?

A

shaping

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50
Q

when is shaping especially important?

A

when applied to increasing FITT; setting short term goals

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51
Q

positive or negative consequences for performing or not performing a behavior is called what ?

A

reinforcement

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52
Q

3 parts to include in reinforcement

A

verbal & material incentives & natural reinforcement

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53
Q

techniques that prompt the initiation of a behavior

A

antecedent control

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54
Q

basic concept of the health belief model

A

extent people engage in a health action is determined by their readiness to take action couples with their belief of the threat of not taking action

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55
Q

6 main component of the health belief model

A
  1. perceived susceptibility
  2. perceived severity
  3. perceived benefits
  4. perceived barriers
  5. self-efficacy
  6. cues to action
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56
Q

4 practice implications for health belief model

A
  1. educational needs
  2. interest in health matters
  3. do they feel susceptible ? what worries them?
  4. do they it could be reduced by behavior change?
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57
Q

What 3 psychosocial needs for the premise of the SDT theory ?

A
  1. Self-determination
  2. Demonstration of competence
  3. Relatedness [meaningful social interaction with others]
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58
Q

Those with high levels of ________ have greater intentions to exercise, self-efficacy, & physical self-worth

A

autonomy

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59
Q

practice implications for self-determination theory

A
  1. encourage choice (ex: they decide what cardio)

2. start with a simple program to grow mastery & joy

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60
Q

explain theory of planned behavior

A

places the intention to perform a behavior as the main determinate as to whether of not an individual will exercise

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61
Q

in theory of planned behavior, intentions are often determined by what 3 things

A
  1. attitude toward behavior
  2. subjective norms [social motivation]
  3. perceived behavioral control
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62
Q

which theory says an individual intends to become physically active if they believe exercise will benefit them, make them feel good, have the approval of significant others in their life, & that they are capable of doing it

A

theory of planned behavior

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63
Q

practicer implications for theory of planned behavior

A

identify intentions & develop plan that will fit

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64
Q

basic concept of social ecological theory

A

importance of constant interaction between someone’s behavior & his or her environment

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65
Q

social ecological theory emphasizes two key influences:

A
  1. sociocultural factors
  2. quality of environment
    * best programs target both
    * important to change environment to be activity friendly
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66
Q

practice implications of social ecological theory

A

programs should combine environmental components with individual & community based physical activity promotion efforts

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67
Q

basic concept of relapse prevention

A

maintain long term behavior change by anticipating high risk situations & devising strategies

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68
Q

relapse prevention combines what 3 things

A
  1. behavioral skills training
  2. cognitive intervention
  3. lifestyle change
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69
Q

relapse prevention makes an important distinction between the terms _____ & ______.

A

lapse : brief error, slip up

re-lapse: complete return to beginning stage

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70
Q

behavior (should/should not) be viewed as a complete success or a complete failure

A

should not

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71
Q

practice applications for relapse prevention

A
  • establish collaborative relationship
  • reflect on importance of exercise
  • remind them of when they overcame physical barriers
  • teach them to identify high risk situations
  • anticipate them & problem solve
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72
Q

practitioner tries to understand the underlying meaning of what a patient is saying

A

active listening

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73
Q

understanding that is conveyed by a counselor to a patient

A

empathy

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74
Q

questions that allow the patient to provide expansive responses [beyond a simple yes or no] which they can explore their thoughts & feelings

A

open-ended questions

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75
Q

patient-centered counseling method where the patients own motivation for change is elicited & enhanced by exploring & resolving ambivalence to change

A

motivational interviewing

76
Q

counseling style that takes the patients perspective into account, features collaboration between the patient & counselor & includes genuine respect for patient opinions

A

patient-centered approach **

77
Q

positive [professional] relationship counselors establish with their patients

A

rapport

78
Q

statements that repeat back to the patient what the counselor has heard & understood the patient to say. can reflect underlying meaning/feeling of what patient is saying if done in conjunction with active listening

A

reflective statements

79
Q

approach the patient with ______ regard

A

positive

80
Q

behavior change is based on a genuine, _______ relationship

A

respectful

81
Q

_______ of the patient occurs when the practitioner seeks to enter the world of the patient to understand his or her _______

A
  • assessment

- perspective

82
Q

each contact with the patient is an opportunity to build the ________

A

relationship

83
Q

4 patient-centered techniques

A
  1. ask simple open ended questions
  2. listen & encourage verbally & non-verbally
  3. clarify & summarize
  4. Use reflective listening
84
Q

what is the 5 A’s model?

A
  • address agenda
  • assess
  • advise
  • assist
  • arrange follow-up
85
Q

4 techniques involved in the cognitive behavioral approach

A
  1. behavioral counseling
  2. goal setting
  3. self-monitoring
  4. reinforcement
86
Q

7 strategies involved in the cognitive behavioral approach

A
  1. stages of change
  2. tracking activity
  3. decisional balance
  4. problem solving
  5. goal setting
  6. confidence
  7. relapse prevention
87
Q

What are the SMART goals? (do not give up. do not give in.)

A 
Specific
Measurable
Achievable
Realistic
Timely
88
Q

two most common risks of health & fitness testing

A

sudden cardiac events

orthopedic injury

89
Q

3 purposes of the health appraisal

A
  1. safety
  2. risk factor identification
  3. exercise prescription & programming
90
Q

identification of individuals for whom exercise requires limitations, modifications or is contraindicated falls under what category

A

safety

91
Q

identification of persons with clinically significant disease who should participate in medically supervised programs & identification of individuals with other special needs falls under what category

A

exercise prescription & programming

92
Q

most common form of a health appraisal?

A

standardized forms (aim is to ID high risk participants who should get medically advice before physical activity)

93
Q

purpose of a medical screening evaluation?

A

evaluate the risk of starting a new physical activity program

94
Q

minimal requirements of a medical screening evaluation

A

medical history; physical examination

95
Q

what does the term database refer to in this chapter?

A

body of knowledge shared between exercise physiologist & patient

96
Q

where does the database come from?

A

clinical records; patient interview for updates or missing info

97
Q

what are the components of the medical history?

A
  1. reasons for referral
  2. demographics
  3. history of present illness
  4. current medications
  5. allergies
  6. past medical history
  7. family history
  8. social history
98
Q

4 reasons for referral to health appraisal /fitness testing

A
  1. improve exercise tolerance
  2. improve muscle strength
  3. increase ROM
  4. provide relevant intervention & behavioral strategy to reduce future risk
99
Q

What is meant by demographics?

A

age, gender, ethnicity, prescription of present illness

100
Q

predictor for heart disease, osteoarthritis & virtually every cardiopulmonary condition

A

age

101
Q

influences behavioral compliance and disease management

A

gender

102
Q

socioeconomic status & access to care; some conditions are more common in certain populations

A

ethnicity

103
Q

what is meant by prescription of current illness? (don’t be brain dead. THINK. & be prepared to answer like an adult)

A

primary information related to the referral condition

104
Q

where do you incorporate reported information?

A

with medical record

105
Q

What should you include in a medical record?

A
  1. chief complaint (1 sentence)
  2. manifestations (paragraph)
  3. important elements described in patients own words (paragraph)
106
Q

Useful mnemonic to describe any symptom?

A 
O - onset {when did it start}
P - provocation & palliation {what makes it worse & better}
Q - Quality {what does it feel like}
R - region & radiation
S - Severity of pain
T - timing {when it hurts/how long}
A - associated signs & symptoms
107
Q

medications can alter what?

A

exercise responses

108
Q

What information should you include with medications

A
  1. dose
  2. frequency of dose
  3. time taken {before exercise}
109
Q

what is PMH?

A

past medical history; concise relevant list including dates

110
Q

what topics does a PMH cover?

A
  • orthopedic
  • muscular
  • neurological
  • gastrointestinal
  • immunological
  • respiratory
  • cardiovascular
111
Q

family history is limited to known relevant heritable disorders in ____ ______ family members

A

first degree

112
Q

what does family history include? (DONT GIVE UP)

A
  • cancer
  • adult onset diabetes
  • familial hypercholesterolemia
  • sudden death
  • premature coronary artery disease (CAD)
113
Q

Social history is an important component to understand, but it can be lengthy. what are the 11 points to include when gathering social history?

A
  1. significant partner status
  2. employment
  3. transportation
  4. housing
  5. diet
  6. routine/leisure
  7. alcohol smoking drugs
  8. work hours
  9. childcare
  10. family responsibilities
  11. exercise
114
Q

ADL

A

activities of daily living

115
Q

bid

A

twice a day

116
Q

HPI

A

history of present illness

117
Q

pt

A

patient

118
Q

qd

A

once daily

119
Q

qid

A

four times a day

120
Q

Rx

A

prescription

121
Q

Sx

A

signs & symptoms

122
Q

tid

A

three times a day

123
Q

A physician tackles a physical exam using a head to toe approach, but how does it differ for an exercise physiologist?

A

the goal is to determine if it is safe to allow exercise & focuses more on complaints/symptoms, abnormal findings… not in place of physical eval

124
Q

red flags when it comes to blood pressure

A

systolic >200, 110

125
Q

8 components of the physical evaluation

A
  1. general state
  2. BP, HR, RR (respiratory rate)
  3. Obesity
  4. Pulmonary system
  5. Cardiovascular system
  6. Musculoskeletal system
  7. Nervous system
  8. Metabolic/other organ systems
126
Q

what does general state refer to?

A

patients general appearance

healthy vs. frail; well-developed or under-nourished

127
Q

normal blood pressure? high & low?

A

140 systolic, >90 diastolic

Hypotension:

128
Q

normal pulse rate? high & low?

A

60-100 BPM
tachycardia: >100 BPM
bradycardia:

129
Q

normal respiratory rate

A

12-20 breaths/min

130
Q

what is the equation for BMI?

A

kg/m squared

131
Q

In measuring waist circumference, an individual is classified as obese when:
___ inches for males; _____ inches females

A

> 40 inches

> 35 inches

132
Q

underweight BMI

A
133
Q

normal BMI

A

18.5-24.9

134
Q

overweight BMI

A

25-29.9

135
Q

Class I Obesity BMI

A

30-34.9

136
Q

Class II Obesity BMI

A

35-39.9

137
Q

Where do you place the stethoscope on your patient when checking the point of maximal cardiac impulse

A

4-5th intercostal space at the mid-clavicular line

138
Q

how do you tell if a person is well-perfused or poorly perfused

A

warm/dry vs. cold/clammy

139
Q

arterial pulse grading

A

0 - absent, non palpable
1 - reduced
2 - normal
3 - bounding

140
Q

what are bruits?

A

high velocity swooshing sounds created as blood becomes turbulent when it flows past a narrowing artery

141
Q

where are bruits commonly found?

A

carotid, abdominal & femoral arteries

142
Q

swelling of lower leg ankles or feet is known as

A

peripheral edema

143
Q

peripheral edema grading

A

1 - mild
2 - moderate
3 - severe

144
Q

what is “pitting edema”

A

when an indention remains after pressure is applied

145
Q

pitting edema is a result of what 3 things

A
  1. congestive heart failure
  2. medications
  3. chronic venous incompetence
146
Q

inflammation is associated with what 3 things

A
  1. redness
  2. swelling
  3. increased heat
147
Q

3 parts to a musculoskeletal system assessment

A

gait, joint health, muscle strength

148
Q

8 types of gait

A
  1. normal
  2. antalgic (limp)
  3. slow
  4. hemiplegic
  5. shuffling (parkinsons)
  6. wide-based (cerebellum issue)
  7. foot drop
  8. slap
    * 7&8 result in injury to dorsiflexors
149
Q

what are you looking for when you palpate a joint?

A
  1. thickening
  2. swelling/effusion
  3. tenderness
  4. redness/warmth
150
Q

muscle strength is graded on what kind of scale?

A

0-5 (note stiffness/soreness)
0 = paralysis
5 = sufficient power to overcome resistance of examiner

151
Q

what about the nervous system important to a PE ?

A

orientation, cognition, lack of understanding; disabilities of speech balance muscle tremor

152
Q

an examination of the nervous system by an exercise physiologist is done to discover what?

A
  • history of stroke
  • atrial fibrillation
  • left ventricular dysfunction
  • aneurysms
  • carotid artery stenoses
  • uncontrolled hypertension
153
Q

how do you test resting heart rate?

A

sit quietly for 5 minutes, palpate pulse 30 seconds

154
Q

how do you test resting blood pressure?

A

sitting & standing; based on 2 or more measurements

155
Q

volume of air expired following a maximal inspiration

A

forced vital capacity

156
Q

proportion of the FVC expired in 1 second

A

forced expiratory capacity at 1 second

157
Q

max volume of airflow per minute possible

A

max voluntary ventilation

158
Q

4 lab tests

A

resting heart rate
resting blood pressure
lung capacity
blood tests

159
Q

types of blood tests

A
  1. total cholesterol
  2. LDL & HDL
  3. TC: HDL ratio
  4. fasting glucose
  5. homocysteine
  6. C-reactive protein
160
Q

Fitness testing order ~~~* super important

A
  1. Resting measurements
  2. Body composition
  3. Cardiorespiratory fitness
  4. Muscular fitness
  5. Flexibility
161
Q

criteria for test termination

A
  1. attainment of desired performance

2. patient/equipment complications

162
Q

3 types of tests

A

body composition
cardiorespiratory fitness
muscular fitness

163
Q

During a cardiorespiratory fitness test, how often do you check HR, BP, & RPE [rating of perceived exertion]?

A

HR: once every minute
BP: once per stage
RPE: once per stage

164
Q

what is the usual sequence for a cardiorespiratory fitness test?

A 
[3 minute stage]
minute 2:00 HR
minute 2:15 RPE
minute 2:30 BP
Minute 3:00 HR
165
Q

2 types of MAX testing

A

CAD, VO2 max

166
Q

2 types of sub MAX testing

A

fitness, estimate of VO2 max

167
Q

what is a discontinuous test?

A

a test disrupted for measurements

168
Q

what to consider when testing the elderly

A

age-related changes
difference in physiological state
prolonged warm-up

169
Q

what to consider when testing children

A

screen for cardiorespiratory disease

170
Q

what to consider when testing a person with a cardiorespiratory disorder

A

test duration 8-12 minutes; measure o2 intake, ventilation & saturation

171
Q

5 modes of testing

A
  1. field test
  2. nuclear & radionuclide testing (substance injected into bloodstream)
  3. exercise echocardiography
  4. pharmacologic testing
  5. holter ECG monitoring (ECG goes home with them)
172
Q

clinical exercise testing indications (4)

A
  1. pre discharge test following MI
  2. post discharge exercise testing following MI or cardiac surgery
  3. Diagnostic testing & disease determination
  4. functional capacity testing
173
Q

patient walks at predetermined speed & grade

A

treadmill test modality

174
Q

3 types of treadmill tests

A 
Bruce (3 MET increase every 3 minutes)
Modified Bruce (constant 1.7mph but increase grade)
ramp protocol (grade & speed increase)
175
Q

typically 2-5 minute stages with work increments of 15-50 watts

A

cycle ergometer

176
Q

when are measurements normally taken during the exercise as opposed to during the pretest or posttest?

A

12-lead ECG recorded during last 15 seconds of every state; BP during last minute of each stage; RPE if applicable at the end of each stage

177
Q

when are measurements normally taken during the post test

A
  • 12 lead ECG immediately after exercise is over then 1-2 minutes for at least 5 minutes
  • BP immediately after than 1-2 minutes until baseline
    (symptomatic ratings should be obtained as appropriate until symptoms cease)
178
Q

System designed to record subjected & objective findings and to document the immediate & future treatment plan for the patient

A

SOAP note

179
Q

what does SOAP stand for in SOAP note?

A

S: subjective
O: objective
A: Assessment
P: plan

180
Q

information that is relevant to the current visit that you obtain by talking to the patient (what the patient tells you)

A

subjective information

181
Q

What does subjective information include?

A 
patient ID
chief complaint
exercise adherence
changes in functional abilities
feedback regarding program
182
Q

these findings are a result of inspecting, palpation and assessment

A

objective findings

183
Q

what do objective findings include

A
  • vitals
  • physical exam
  • general appearance
  • lab tests
  • fitness tests
  • med changes (could also be subjective)
  • changes to exercise program
184
Q

assess the patients conditions based on subjective & objective findings–list the diagnoses

A

assessment

185
Q

what might the assessment part include?

A

noteworthy changes in performance
new info from healthcare provider
any exercise contraindications from healthcare provider

186
Q

what might the plan part include?

A
  • revisions/adjustments
  • referrals
  • anticipatory guidance
  • patient education
  • health promotion/prevention
  • follow up instructions & next appointment
  • how I will accommodate exercise contraindications

EXSC 433 (3 decks)

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