EXAM 2 Flashcards
Readiness to Change Questionnaire
Motivational
Determines level or readiness to change, or current state of change
Health Risk Appraisal
Identifies
- The presence or absence of known disease
- Signs or symptoms suggestive of disease
- Medical contraindications
- At-risk individuals who should first undergo medical evaluation
- Those with medical conditions who should participate in medically supervised programs
Individuals at risk during exercise
unhealthy
existing disease
at risk for disease
Physical Activity Readiness Questionnaire (PAR-Q)
minimal, safe pre-exercise screening measure for low-to-moderate training.
- minimal health-risk appraisal prereq.
- quick, easy, non-invasive
- limits: lack of detail, may overlook health conditions, medications, or past injuries
Process of health-risk appraisal
- review clients health info., medical history, lifestyle habits
- risk stratification
- need for medical clearance
- recommendations for lifestyle modifications
- strategies for exercise testing and programming
Risk Stratification
Risk-stratification determines the presence or absence of:
- Known cardiovascular, pulmonary, and/or metabolic disease
- Cardiovascular risk factors
- Signs or symptoms suggestive of cardiovascular, pulmonary, and/or metabolic disease
CATEGORIZED AS LOW, MEDIUM, HIGH
Systolic Blood Pressure (SBP)
- the pressure created by the heart as it pumps blood into circulation via ventricular contraction
- greatest pressure during one cardiac cycle
Diastolic Blood Pressure (DBP)
- the pressure exerted on the artery walls as blood remains in the arteries during the filling phase of the cardiac cycle, or between beats when the heart relaxes
- minimum pressure that exists within one cardiac cycle
Measuring Blood Pressure
- The brachial artery is the standard site of measurement. (ARM)
- Korotkoff sounds are sounds made from vibrations as blood moves along the walls of the vessel.
- Blood pressure is measured indirectly by listening to the Korotkoff sounds, which are sounds made from vibrations as blood moves along the walls of the vessel. These sounds are only present when some degree of wall deformation exists. If the vessel has unimpeded blood flow, no vibrations are heard. However, under pressure of a blood pressure cuff, vessel deformity facilitates hearing these sounds. This deformity is created as the air bladder within the cuff is inflated, restricting the flow of blood.
Classification of Blood Pressure for Adults
Normal: SBP: < 120; DBP: < 80 Prehypertension: SBP: 120-139; DBP: 80-89 Hypertension Stage 1 SBP: 140-159; DBP: 90-99 Hypertension Stage 2 SBP: > 160; DBP: > 100
Lordosis
- Postural Deviation
- Increased anterior lumber curve (curved lower back, anterior hip tilt)
- An anterior pelvic tilt will increase lordosis in the lumbar spine, whereas a posterior pelvic tilt will reduce the amount of lordosis in the lumbar spine.
Kyphosis
- Postural Deviation
- Increased posterior thoracic curve (upper back curved back, anterior hip tilt, anterior lumber curve)
Flat Back
- Postural Deviation
- decreased anterior lumbar curve (flat spine, posterior tilt, forward hips)
Sway Back
- Postural Deviation
- decreased anterior lumbar curve and increased posterior thoracic curve (upper back curved back, flatter lower back, posterior hip tilt)
Muscle Imbalances
- Facilitated/Hypertonic (short)
- ->hamstrings, lumber extensors, neck extensors, upper fibers of posterior obliques
- Inhibited (lengthened)
- ->iliacus major, rectus femoris, external oblique, upper back extensors, neck flexors
Scoliosis
- Postural Deviation
- Lateral spinal curvature often accompanied by vertebral rotation
- CURVED SPINE
Movement efficiency pattern
muscle balance –> normal length-tension and force-coupling relationships –> proper joint mechanics –> efficient force acceptance and generation –> promotes joint stability and mobility –> movement efficiency
-When joints are correctly aligned, the length-tension relationships and force-coupling relationships function efficiently. This facilitates proper joint mechanics, allowing the body to generate and accept forces throughout the kinetic chain, and promotes joint stability and mobility and movement efficiency
Correctible Factors of Postural Deviations and Muscle Imbalances
- Repetitive movements (muscular pattern overload)
- Awkward positions and movements (habitually poor posture)
- Side dominance
- Lack of joint stability
- Lack of joint mobility
- Imbalanced strength-training programs
Non-Corrective Factors of Postural Deviations and Muscle Imbalances
- Congenital conditions (e.g., scoliosis)
- Some pathologies (e.g., rheumatoid arthritis)
- Structural deviations (e.g., tibial or femoral torsion, or femoral anteversion)
- Certain types of trauma (e.g., surgery, injury, or amputation)
Anterior Pelvic Tilting
Anterior tilting of the pelvis frequently occurs in individuals with tight hip flexors, which is generally associated with sedentary lifestyles where individuals spend countless hours in seated (i.e., shortened hip flexor) positions.
When standing, this shortened hip flexor pulls the pelvis into an anterior tilt (i.e., the superior, anterior portion of the pelvis rotates downward and forward).
Pelvic Tilting (Sagittal view) Bucket example
An anterior pelvic tilt rotates the superior, anterior portion of the pelvis forward and downward, spilling water out of the front of the bucket, whereas a posterior tilt rotates the superior, posterior portion of the pelvis backward and downward, spilling water out of the back of the bucket.
Pelvic Tilt Explained
Tight or overdominant hip flexors are generally coupled with tight erector spinae muscles, producing an anterior pelvic tilt, while tight or overdominant rectus abdominis muscles are generally coupled with tight hamstrings, producing a posterior pelvic tilt.
Scapular Protraction and Winging
You can perform a quick observational assessment to identify scapular protraction and winging. While looking at the client from the posterior view, if the vertebral (medial) and/or inferior angle of the scapulae protrude outward, this indicates an inability of the scapular stabilizers (primarily the rhomboids and serratus anterior) to hold the scapulae in place.
Noticeable protrusion of the vertebral (medial) border outward is termed “scapular protraction”, while protrusion of the inferior angle and vertebral (medial) border outward is termed “winged scapulae.
Apley’s Scratch Test
Objective: To assess simultaneous movements of the shoulder girdle (primarily the scapulothoracic and glenohumeral joints)
- Shoulder extension and flexion
- Internal and external rotation of the humerus at the shoulder
Scapular abduction and adduction
•Ability to touch the medial border of the contralateral scapula or how far down the spine the client can reach with shoulder flexion and external rotation.
•Ability to touch the opposite inferior angle of the scapula or how far up the spine the client can reach with shoulder extension and internal rotation.
•Observe any bilateral differences between the left and right arms in performing both movements.
Stork-Stand Balance Test
-timing stops when any of the following occurs:
oThe hand(s) come off the hips.
oThe stance or supporting foot inverts, everts, or moves in any direction.
oAny part of the elevated foot loses contact with the stance leg.
oThe heel of the stance leg touches the floor.
oThe client loses balance.
Males–> Excellent:>50s, Avg:31-40s, Poor: <20s
Females–> Excellent:>30s, Avg:16-24s, Poor:<10s
Fitness Testing and Measurement Termination
•Identifiable signs or symptoms that merit immediate test termination:
-Onset of angina, chest pain, or angina-like symptoms
-Significant drop (>10 mmHg) in systolic blood pressure (SBP) despite an increase in exercise intensity
-Excessive rise in blood pressure (BP): SBP reaches >250 mmHg or diastolic blood pressure (DBP) reaches >115 mmHg
-Excess fatigue, shortness of breath, or wheezing (does not include heavy breathing due to intense exercise)
-Signs of poor perfusion: lightheadedness, pallor, cyanosis, nausea, or cold and clammy skin
Pallor – pale skin
Cyanosis – bluish discoloration, especially around the mouth
-Increased nervous system symptoms (e.g., ataxia, dizziness, confusion, or syncope)
-Leg cramping or claudication
-Subject requests to stop
-Physical or verbal manifestations of severe fatigue
-Failure of testing equipment
Body Composition Measurement Techniques
- Bioelectrical impedance
- DEXA scans
- Hydrostatic (underwater) weighing
- Near-Infrared Interactance
- Skinfold measurements
- Whole body air displacement
Body Size Measurement Techniques
- Body Mass Index (BMI)
- Girth measurements (waist-to-hip ratio)
- Height
- Weight
Bioelectrical Impedance Analysis (BIA)
- body comp. assessment
- measures electrical signals as the pass through fat, lean mass, and water in the body. assess leanness. accuracy based on sophistication of machine. gyms have simpler use BIA’s. optimal hydration is necessary for accurate results
Air Displacement
- body comp. assessment
- measures the amount of air that is displaced when a person sits in a machine (egg chamber). air displacement and body weight determines body fat.
DEXA
- body comp. assessment
- dual-energy x-ray absorptiometry
- whole body scanning system that delivers low dose x-ray that reads bone and soft tissue mass. identifies body-fat distribution (regional)
