Lecture 16 - Health/Fitness Assessment Flashcards
Lecture 16:
Why is health & fitness assessment important for all populations?
- provides baseline data (comparisons with reassessments)
- acts as basis for exercise prescriptions
Lecture 16:
Why is health & fitness assessment especially important for cancer patients?
- safety
- strengths & weaknesses of patient
Lecture 16:
What is the assessment standard for cancer survivors?
No established assessment procedures right now
Lecture 16:
What institute has developed validated assessment techniques?
Based in Colorado, Rocky Mountain Cancer Rehabilitation Institute (RMCRI) have developed validated assessment techniques
*all other info is based on their findings
Lecture 16:
What are the 2 steps of Health & fitness Assessment?
Step 1 = Pre-assessment
Step 2 = Assessment
Lecture 16:
Step 1: Pre-Assessment; what is the first step (part a) & its importance?
Physician Referral:
- important for primary care physicians/oncologists to work together with specialists
- safety, limitations, & special concerns are discussed
Lecture 16:
Step 1: Pre-Assessment; what is the second step (part b) & what is included?
Pre-Assessment Mailings which include;
- cancer & medical history
- diet
- depression
- fatigue
- Quality of Life
- Lifestyle
*also blood profile from physician
Lecture 16:
Is there any normative data for Physiological outcome assessments?
No normative data available for physiological outcomes of cancer patients
- thus, we use normative data for the general population & account for some variation due to the cancer diagnosis
Lecture 16:
For step 2: Assessment; what are the 7 steps/tests for Physiological Outcomes?
1.) Preliminary Assessments
2.) Body Composition
3.) Pulmonary Function
4.) Circumference Measurements
5.) Cardiovascular Endurance
6.) Flexibility & ROM
7.) Muscular Endurance & Strength
Lecture 16:
When discussing physiological outcomes measured in step 2; What are the 6 types of Preliminary Assessments used?
1.) Resting HR
2.) Resting BP (right side, unless surgery done to that side)
3.) Pulse Oximetry
4.) Resting blood values (lab work done prior)
5.) Height & Weight
6.) Physical Examination
Lecture 16:
What is a Pulse Oximetry test?
Assesses the % of hemoglobin saturated with oxygen
- the finger monitor press
Lecture 16:
When discussing physiological outcomes measured in step 2; What are the 4 ways to measure body composition?
1.) Skin folds
2.) Hydrostatic weighing
3.) Bioelectric Impedence (BIA)
4.) DEXA machine
Lecture 16:
When measuring Body composition through skin folds, what do you need to be careful of?
Careful for sites near surgical incisions, ports, & prostheses
Lecture 16:
When measuring Body composition through hydrostatic weighing, when is it used or not?
Not really used due to risk of infection
Lecture 16:
When measuring Body composition through bioelectric Impedence, what is a limitation of it?
Lack of accuracy = limiting factor as dehydration may also be a factor so it’s not the most accurate due to varying hydration levels
Lecture 16:
When measuring Body composition through a DEXA machine, what makes this a great choice?
Excellent choice if available as it is very accurate, however it os very expensive & requires a technician to operate it
- machine quickly sweeps over body using light radiography & then gives you %BF, %FM, & %FFM
Lecture 16:
How is Pulmonary function measured in Step 2 of physiological assessment?
Measured using a dry spirometer
Lecture 16:
What 2 things are measured during Pulmonary function measurements in Step 2 of physiological assessment?
1.) Forced Expiratory Volume
2.) Forced vital capacity
- important to know these because of possible negative effects of radiation & chemotherapy on pulmonary function
Lecture 16:
What is forced expiratory volume?
The strength of the exhalation in the first second
Lecture 16:
What is Forced Vital Capacity?
The total volume of air exhaled
Lecture 16:
How are circumferences measurements taken in Step 2 of physiological assessment?
Taken using an Anthropometric tape to take measurements on both sides of body
- changes in lymphedema & general edema
Lecture 16:
When measuring Cardiovascular Endurance in step 2, what are the 4 critical things to monitor?
Especially important to monitor survivors that are on treatment
1.) Pulse Oximeter
2.) Blood Pressure
3.) Heart Rate
4.) Rate of Perceived Exertion
Lecture 16:
During Cardiovascular Endurance measurements, What level should patients not exceed on the RPE scale?
Should not exceed 11-13 for survivors on chemotherapy for submaximal testing
Lecture 16:
During Cardiovascular Endurance measurements, What are 2 types of submaximal exercise tests?
1.) Bruce Treadmill Protocol
2.) YMCA Bicycle Protocol
Lecture 16:
During Cardiovascular Endurance measurements, What is the 6-minute walk test & who is the target audience?
Senior fitness test
- 45x5 yard area with cones to mark the track
- measure the distance they walk in the 6 minutes
**especially good for lung cancer patients
Lecture 16:
During Cardiovascular Endurance measurements,what is the 2-minute step in place test?
- target audience
Wall is parked with piece of tape halfway between knee & iliac crest
- participants march in place for 2 mins, ensuring knees reach tape height
- count # of times right knee reaches tape
*good for is 6min walk = too difficult
Lecture 16:
How do cancer treatments influence flexibility & ROM?
Alter muscle & connective tissue elasticity & compliance form scarring
Lecture 16:
What are 3 procedures used to test Flexibility & ROM in cancer patients?
1.) Modified Sit & Reach
2.) Goniometer
3.) Back Scratch Test
Lecture 16:
Why is Muscular Endurance & Strength important for cancer survivors?
Cancer survivors often report muscular weakness & fatigue
Lecture 16:
How is Muscular Endurance & Strength tested in cancer survivors?
ME = execute movemtn until tired eg; bench press, leg press, shoulder press, etc
MS = 1-RM test &/or grip strength test
Lecture 16:
What are 2 Senior Fitness Tests used to test Muscular endurance 7 strength?
1.) 30s sit to stand = # of times you stand up from seated position without using arms (cross arms)
2.) 30s arm curls = men use 8lb weights & women use 5lb weights
Lecture 16:
What are a few general contraindications to testing fitness levels of cancer patients?
- drop in systolic blood pressure (10mmHg from baseline)
- moderate to severe angina (chest pain)
- increased nervous system symptoms (ataxia, dizziness, or near syncope)
- signs of poor perfusion (cyanosis or pallor)
- ventricular tachycardia ST segment elevation
Lecture 16:
What are a few Relative contraindications with PA of cancer patients?
- drop in diastolic BP
- ST or QRS changes due to excessive ST segment depression
- Arrhythmias (other than ventricular tachycardia)
- bundle branch block or intraventricular conduction delay
- increasing chest pain
- fatigue, short breath, wheezing, leg cramps, etc
Lecture 16:
How would you assess fitness & health in patients with Hematological (blood) abnormalities?
Sometimes exercise is still acceptable but must follow guidelines based on blood work results
Lecture 16:
How would you assess fitness/which aspects would be impacted in patients withNeurological Abnormalities?
May experience balance problems due to nerve damage *eg; Peripheral Neuropathy = loss of feeling in bottoms of feet
- balance ergometer tests with extra spotters is a good assessment for this fitness component
Lecture 16:
How would you assess fitness in patients with Bone Pain?
Substitute light weights for machines for the muscular endurance component
Lecture 16:
How would you assess fitness in patients with Nausea?
Survivors told to stop immediately
Lecture 16:
How would you assess fitness in patients with Muscle Weakness?
Acknowledge they may not be able to complete tests so you should modify them
- eg 6-min walk
Lecture 16:
You should contact a physician if survivor has what symptoms during/after exercise?
- Fever, disorientation, lightheadedness, fainting
- Extreme/unusual tiredness or muscle weakness
- Irregular HR, palpitations, or chest pain
- Leg pain/cramps, joint pain, or bruising
- Sudden onset of nausea during exercise
- Rapid weight loss & severe vomiting/diarrhea
- Pallor or gray-coloured appearance
