KIN 311 Flashcards
What is fitness?
A set of attributes or characteristics individuals have or achieve that relates to their ability to perform physical activity
What is health related fitness?
is typically thought of as attributes that are related to mortality or morbidity
What is the difference between mortality and morbidity?
mortality= related to the occurrence of death
morbidity= related to the occurrence of illness
What is health
a state of complete physical, mental, and social well being, not merely the absence of disease
What are some purposes of fitness and health assessment?
- to identify an individual’s strengths and weaknesses
- Provide baseline data for an exercise/training prescription or intervention such as a rehabilitation program
- provide feedback for evaluating the effectiveness of a particular program or intervention
provide information that can be compared to norms, acceptable standards, health status or competitive standing
What are some tell tale signs of a good assessment
- safe
- reliable
- valid
- practical
- conducted in a professional manner z
What is standard deviation?
is a measure of variability within the cohort being assessed
What is standard error?
Represents the accuracy of the true mean
- used when we want to generalize our mean to other similar cohorts or the entire population
What are the factors influencing variability?
- Biological variability
- technical variability
- testing variability
- environmental variability
- unknown factors
What is biological variability?
the inherent physiological and psychological fluctuation of the individual
what is technical variability?
precision and accuracy of the instruments
What is testing variability?
Instructions and manner of administering the test
What are odds ratios
What are the odds of something happening given a particular exposure or intervention compared to control
What’s the difference between validity and reliability?
validity = accuracy, correctness
reliability = precision, repeatability
What is logical (face) validity?
Can be claimed when the measure appears to be obviously assess the target variable or performance
e.g. balance test of standing on one foot; it obviously is measuring balance
What is content validity?
- similar to logical validity and attempts to measure the desired parameter or a defined domain of content
- usually applies to written tests or questionnaires
- often no statistical verification is usually required
e.g. visual rating scale for body composition
What is construct validity?
- claimed when the measures permit inferences to be made about an underlying traits
- variable of interest is multi-factorial/multi-dimensional
e.g. sportsmanship, cardio-respiratory fitness, cardiovascular health
What is criterion validity?
The extent to which the results of a standard test can be compared to some criterion
i.e. usually another test which seeks to measure the same construct) or used to predict a practical outcome.
What is a systemic error?
- situations that result in a unidirectional change in scores on repeated testing
e.g. bias, learning, fatigue
What is random error?
- variability may, in a random manner, both increase and decrease test scores on repeated testing
e.g. imprecision, biological
What is inter-rater? (testing reliability)
- comparison of same measure between 2 (or more) testers
What is intra-rater? (testing reliability)
- comparison of 2 (or more) measures made by the same tester (tests the “measure-er”)
What is test-retest? (testing reliability)
- repeated testing on 2 or more occasions
- Used to test the reliability of the technique (repeatability)
What ensures repeatability of a test?
- same experimental tools
- the same observer
- the same measuring instrument, used under the same conditions
- the same location
- repetition over a short period of time
- same objectives
What is correlation?
- describes the strength of the relationship between 2 variables of interest
What is a regression?
- describes the numerical relationship between 2 variables
What is a Bland-Altman test
used to describe agreement between two quantitative measurements
What is a meta-analysis?
- used to get at a bigger question
- strict defined process for conducting analysis
What are some important details about informed consent?
- it is given voluntarily
- it is informed
- can be withdrawn at any time
- it should address confidentiality
- should be in writing
- signed prior to any administration
What are some important details about waivers?
- used to mitigate risks
- signed statement
- must adhere to the same issues as a consent form
- not legally binding
What are some common allegations of negligence?
- pre-existing injuries or medical conditions when developing the training
- provide appropriate types of exercises/tests
- Limit the weights lifted or length of cardiac exercises
- properly supervise the client
Important things to do as a healthcare professional regarding liability:
- be a professional
- pre-screening actions and intentions are important
- pre-screening paperwork is important
- don’t make up as you go along
Important things to do as a healthcare professional regarding mitigation:
- ask before you do
- explain before you do
- listen, answer questions
- get real acknowledgement from participants
What are some before testing considerations?
- Prior activity
- nutrition
- hydration
- recent travel
- recent illness
- sleep
What is the difference between the PAR-Q & You (CSEP) and the PAR-Q+?
PAR-Q & You
- Self assessment
- for general population (not children and elderly)
PAR-Q+
- removes the age guidelines
- the wording changes for the questions
What is the Get Active Questionnaire?
- updated version of PAR-Q+
- self-assessment tool
- indented for all ages
- includes parental assessment for children/minors
What are the 2 aspects of the basic physiological assessments ?
Heart rate
- to identify cardiac irregularities
Blood pressure
- to identify hypertension (or hypotension)
What are the preliminary instructions for physiological screening?
- abstain from smoking at least 2 hours prior to the test
- abstain from alcohol at least 6 hours prior to the test
- abstain from caffeine products at least 2 hours prior
- avoid a heavy meal 2 hours prior to the test
- avoid vigorous exercise within 6 hours of the test
What are the cutoffs for heart rate?
- if 99 bpm or less (<100bpm), proceed with appraisal
- if > 99 bpm have individual sit quietly for an additional 5 minutes
- If individual’s heart rate is >99 bpm after second reading, physician clearance is recommended
- elevated HR = Tachycardia (100bpm)
What are the cutoffs for blood pressure?
- if systolic pressure is < 160 mmHg and diastolic pressure is < 90 mmHg proceed with appraisal
- If either systolic pressure is > 160 mmHg or diastolic pressure >90 mmHg have individual sit quietly for an addition 5 min
Signs of white coat hypertension:
○ When people get assessed they may become stressed out
○ May show that they are hypertensive due to the assessment
○ This is BP that is high only in a “doctor’s office”, but otherwise, a normal ambulatory BP (ABP)
○ May be due to “nervousness” or anxiety but could signal early cardiovascular risk
○ Should not be ignored
○ Check BP at rest, during and after exercise
Stop test at any time and refer to physician with a report
Explain the ACSM pre-screening
- Conducted by a health/fitness professional
- Initially stratified by exercise status
- Follows a “logic” model for clarity
- Secondary consideration is presence of cardio/metabolic/renal dysfunction
What is the purpose of a secondary risk assessment?
Provides the health/fitness, clinical exercise, and health care professionals with important information for the development of an individuals exercise prescription
What is a secondary risk assessment important for?
- Important when making decisions about:
- The level of medical clearance- The need for pre-exercise testing
- The level of supervision for exercise testing and exercise
program participation- Scope of practice
What is the difference between signs and symptoms?
signs
- something that you can measure, something that you can see
symptoms
- you have to get the information from the patients themselves
What is the new ACSM exercise pre-participation health screening process?
1) The individuals current level of physical activity
2) Presence of signs or symptoms and/or known cardiovascular, metabolic, or renal disease
3) Desired exercise intensity
What are some things that blood pressure is influenced by?
Blood volume
- contracted vs open blood vessels
- Vascular resistance (dilation vs. constriction)
- cardiac output
what does blood pressure do to the afterload?
It increases the afterload of the heart
What is afterload?
it is the pressure the heart needs to overcome to eject blood during systole
What is stroke work?
Work that the heart does in one beat
- stroke volume x mean arterial pressure
What is cardiac work?
stroke work x heart rate
What is the auscultation method of taking blood pressure?
What we use in lab
- listening to bodily sounds using a stethoscope
What are we listening for when using the auscultation method (blood pressure)
Korotkoff sounds
- vibrations of brachial artery
- not going to get a sound until you cut off blood flow
What are the 3 main steps to take blood pressure (auscultation method)
1) Pump cuff up to stop blood flow
2) Identify at what pressure blood is able to squeeze into the arm (systole)
3) Identify at what pressure the cuff no longer impeded blood flow (diastole)
What are the specific phases of Korotkoff sounds and what do they sound like
Phase 1: Clear tapping (Systolic pressure)
Phase 2: Softer tapping
Phase 3: Clear tapping (mean arterial pressure)
Phase 4: Muffled tapping
Phase 5: Tapping disappears (Diastole)
What are some problems with the indwelling arterial catheter?
- complicated
- invasive
- specialized scope of practice
- not practical in most situations