Health Appraisal and Risk Stratification Flashcards
1
Q
Clinical Guidelines for Aerobic Exercise Prescription
A
- why conduct health screen and risk classification?
- identify individuals…at increased risk who need physician evaluation and testing before undergoing vigorous activity; with clinically significant disease who should be in a professionally-supervised program
- prescribe all exercise at level appropriate for the individual
- best practice consists of two broad components: preliminary health screening and risk classification and aerobic testing of some type (submaximal test, graded exercise test)
2
Q
Preliminary Health Screening and Risk Classification
A
- important to classify client’s health status and risk classification before testing and/or exercise prescription
- allows us to identify individuals for: need for medical exam prior to testing, clinically significant disease states, best test for their needs, contraindications for testing
- its inclusion makes it more likely the exercise prescription is appropriately individualized
3
Q
Self-Guided Screening
A
- PAR-Q and you
- designed to identify adults: for whom unsupervised physical activity might be inappropriate
- who should receive medical advice regarding the most suitable exercise modes
- represents minimal standard for entry into moderate-intensity exercise program
4
Q
PAR-Q
A
- 7 questions
- identifies individuals needing medical clearance before participation
- client’s answering “yes” to any question on PAR-Q should be referred to their physician for medical clearance
- older or sedentary individuals should always check with physician beforehand
5
Q
Self-Guided Screening
A
- other types of self-guided screening
- routine paperwork completed within scope of an office visit (MD, PT, NP)
- entry procedures at health/fitness or clinical exercise facility
- promotional physical activity materials designed for and distributed to the general public
6
Q
Professionally Guided Screening
A
- professionally trained, certified, and/or licensed personnel
- provides greater detail/discrimination regarding: chronic diseases, signs and symptoms, CVD risk factors
- consists of detailed medical history and risk stratification and higher level needs assessment of: medical exam, exercise testing, physician supervision, exercise treatment
- all clients in medical environment typically require to complete medical history questionnaire
- subject history and questionnaires completed and analyzed
- all clients in medical environment minimally need prior to exercise training and prescription (identify signs and symptoms of CV disease, analyze coronary risk profile, classify disease risk of client)
7
Q
Informed Consent
A
- include questions relating to family history
- include questions relating to lifestyle
- note current meds
- make physician referral if necessary
8
Q
Risk Stratification: What’s the Goal?
A
- use client information to classify risk level
- based on: known or suspected disease state, signs and symptoms, risk factors
9
Q
Risk Stratification: Low Risk
A
- no signs/symptoms
- less than two CVD risk factors
- in this population the odds of an acute CV event is low
- medical exam and clearance is not needed prior to starting exercise and/or max testing
10
Q
Risk Stratification: Moderate Risk
A
- no signs/symptoms
- two or more CVD risk factors
- in this population increased odds of an acute CV event
- low to moderate intensity physical activity, e.g. 40-60% VO2R, medical exam and clearance not required
- vigorous intensity physical activity, e.g. >/ 60% VO2R, medical exam and exercise test recommended, exercise test not required
11
Q
Risk Stratification: High Risk
A
- known CV, pulmonary, or metabolic disease
- one or more signs/symptoms
- in this population increased odds of acute CV event
- medical exam should take place and clearance given prior to physical activity at any intensity
- exercise test recommended
- MD supervision of exercise test? submax and at max answer is yes
12
Q
VO2 Max
A
-maximum amount of oxygen can take in while exercising aka aerobic capacity
13
Q
ACSM Risk Stratification Categories
A
- cardiovascular, pulmonary and metabolic disease
- major signs and symptoms suggestive of CV, pulmonary, and metabolic disease
- atheroscleroitc cardiovascular risk factors
14
Q
Cardiovascular, Pulmonary, and Metabolic Disease
A
- a physician has diagnosed one of the following
- CVD: cardiac, peripheral artery disease, or cerebrovascular disease
- pulmonary disease: COPD, asthma, interstitial lung disease, or CF
- metabolic disorders: diabetes mellitus (I or II), thyroid disorders, or renal or liver disease
15
Q
Major Signs and Symptoms Suggestive of CV, Pulmonary, and Metabolic Disease
A
- pain or other anginal equivalent: chest, neck, jaw, arms, other; ischemic origin: character, location, provoking factors; -non-ischemic origin: character, location, provoking factors
- dizziness
- dyspnea
- orthopnea
- palpitations
- intermittent claudication
- high prevalence of CAD
- diabetes: increased risk for PAD
- known heart murmur: hypertrophic cardiomyopathy
- unusual fatigue or SOB with usual activities
