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EXCI 455 > LECTURE FIVE: Pre-Exercise and health screening > Flashcards

LECTURE FIVE: Pre-Exercise and health screening Flashcards

1
Q

What types of clients will pre-exercise screening identify (4) ?

A

Clients who….

  1. have DISEASE SYMPTOMS / risk factors
  2. are at risk of CARDIAC EVENT
  3. should be EXCLUDED from participation in an exercise program
  4. should be MEDICALLY SUPERVISED due to risk
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2
Q

During pre-screening, what are some signs or symptoms of cardiovascular or pulmonary diseases that would contraindicate exercise (4) ?

A
  • [ANGINA]–> Pain or discomfort in the chest
  • [CORONARY HEART DISEASE]–> dyspnea at rest or with mild exertion
  • [SYNCOPE]–> Dizziness or fainting
  • [CONGESTIVE HEART FAILURE]–> ankle swelling
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3
Q

What happens to blood flow when the heart fails?

A

REDUCED blood flow.

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4
Q

How do the kidneys react to the reduced blood flow during heart failure?

A

The kidneys react as though there has been significant blood loss and there is not enough blood circulating which then reduces urine production, retaining fluid and Increasing the volume of blood for circulation.

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5
Q

After the kidneys help increase the blood volume for circulation, the heart has a hard time keeping up with the extra blood, and it backs up in the vessel until fluid leaks out into other parts of the body where it accumulates: What is this called?

A

CONGESTION / Fluid accumulation

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6
Q

What causes the main symptoms of heart failure?

A

CONGESTION: FLUID ACCUMULATION

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7
Q

What S&S are caused by congestion (in the cardiovascular system) (5) ?

A
  • Breathlessness
  • Tiredness
  • Swelling in ankles and legs
  • Reduced appetite (fluid retention in liver and other organs)
  • Increased weight (from all extra fluid in the body)
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8
Q

What are the 3 most common categories of RELATIVE contraindications to exercise?

(condition under control)

A
  1. Tachyarrhythmia or bradyarrhythmia
  2. Neuromuscular, musculoskeletal or rheumatoid disorders exacerbated by exercise
  3. Uncontrolled metabolic diseases such as diabetes, thyrotoxicosis (excessive thyroid hormone), myxedema (hypothyroidism characterized by relatively hard edema of subcutaneous tissue)
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9
Q

What are the 2 most common ABSOLUTE contraindications to exercise?
(Need to see Physician)

A
  • UNSTABLE ANGINA

- Uncontrolled CARDIAC ARRHYTHMIAS causing compromised cardiac function

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10
Q

What is the difference between a RELATIVE contraindication to exercise and an ABSOLUTE contraindication?

A

RELATIVE CI: condition is asymptomatic, managed and under control.

ABSOLUTE CI : symptomatic of condition and will need to SEE physician.

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11
Q

What are signs and symptoms of cardiovascular or pulmonary diseases which would be an immediate referral to their physician (Absolute contraindication)(4)?

A
  • FAST/ IRREGULAR HR (problem with hearts electric signals)
  • INTERMITTENT CLAUDICATION / PAIN in lower legs (blocked blood vessels in the legs = pain and cramps)
  • HEART MURMER (heart problem: valves fail to close completely)
  • UNDUE FATIGUE (poor blood circulation or low oxygen levels in the blood)
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12
Q

Intermittent claudication causes pain in the LOWER LEGS. Why? Where is that pain coming from?

A

When blood vessels is blocked by plaque, there is a LACK OF OXYGEN TO MUSCLES – causing pain and cramps.

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13
Q

True or False:

Intermittent claudication is usually the cause of coronary artery disease.

A

FALSE. Intermittent claudication is not the cause of a problem, but the sign of one, somewhere in the body.

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14
Q

True or False:

Long-Term benefits of PA on cardiac risk far outweigh the temporary elevation in risk during exercise.

A

TRUE

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15
Q

What is the most serious risk associated with VIGOROUS exercise?

A

SUDDEN CARDIAC DEATH is the most serious risk

primarily associated with individuals having “at risk” medical conditions

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16
Q

Considering pre-exercise screening, what is important to identify surrounding CV disease?

A

Does the participant have….?

  1. a KNOWN CV disease
  2. SYMPTOMS of CV disease
  3. RISK FACTORS associated with CV disease
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17
Q

What is the goal of the ACSM Initial Risk Stratification?

A

To determine participants level of risk of Coronary Artery Disease.

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18
Q

What are EIGHT risk factors for Coronary Artery Disease?

A
  1. AGE
    a. Men 45 + / Women 55 +
  2. Family history of CAD
    a. if parents and siblings had CAD before age 55 male / 65 female relatives = risk factor. However, after these threshold ages are NOT considered.
  3. Smoking
    a. Daily or regular basis in the last TWO years.
  4. Hypertension (High BP)
    a. Systolic: 140 mmHg +
    b. Diastolic : 90 mmHg +
  5. Cholesterol
    a. TOTAL 200 mg/dl OR HIGHER
    b. LOW levels of HDL (LESS THAN 35 mg/dl)
  6. Diabetes
    a. Type I and over 30 years old
    b. Type I for more than 15 years
    c. Type II and over the age of 35 years old
  7. Body Mass Index
    a. BMI of 30 + with a waist girth more than 102 cm males / 88 cm women
  8. Sedentary lifestyle
    a. Combination of non-participation in any regular exercise or recreational PA and having a job that does not involve PA
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19
Q

What are the 4 screening steps before beginning n exercise program?

A
  1. Informed consent
  2. The Physical Activity Readiness Questionnaire (PAR-Q(+))
  3. Physicians consent
  4. Health History and Activity Questionnaire
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20
Q

What is the first step in Participant screening?

A

Step 1: Participant Consent Form

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21
Q

What is included in the participant consent form? (5)

A
  • Purpose (objectives)
  • Procedures (PA program, Screening procedures etc.)
  • Risks
  • Benefits
  • Signature (participant)
22
Q

What is an example of the purpose stated on the participant consent form?

A

Ex: I understand that the purpose of this exercise program is to improve my physical and functional fitness.
Etc.

23
Q

What is an example of the Procedures stated on the participant consent form (2)?

A

Ex:

  • The fitness class will meet for 2 weeks, 3x week for 60 minutes…
  • I will be asked to fill out a medical and activity history questionnaire, and to participate in functional fitness tests….
24
Q

What is an example of the Summary of risks stated on the participant consent form (2)?

A

Ex:

  • The risks associated with the classes are minimal, but the exercises may cause delayed muscle soreness and physical fatigue.
  • I understand that it’s my responsibility to report any of these signs or symptoms to my instructor and doctor….
25
Q

What is an example of the Benefits stated on the participant consent form?

A

Ex:
- I understand the results of these test will help determine my fitness levels, which will be useful in developing my individualized exercise prescription

26
Q

Beyond purpose, procedures, risks, benefits and the participants signature… what else would be included on the participant consent form (3)?

A
  • Contact info
  • Statement of confidentiality (Ex: the information obtained in this program will remain confidential and will not be disclosed…. Etc.
  • Statement: “I am free to stop participation at any time” / free to withdraw.
27
Q

Which questionnaire, developed by CSEP is better suited towards the OA population?

A

The PAR-Q+ questionnaire.

28
Q

Name 3 of 7 questions asked on both the Par Q and Par Q+.

A
  1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? / Has your doctor ever said that you have a heart condition OR high blood pressure?
  2. Do you feel pain in your chest when you do physical activity? / Do you feel pain in your chest at rest, during your daily activities of living, OR when you do physical activity?
  3. In the past month, have you had chest pain when you were not doing physical activity? / Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? Please answer NO if your dizziness was associated with over breathing (including during vigorous exercise)
  4. Do you lose your balance because of dizziness or do you ever lose consciousness? / Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?
  5. Do you have a bone or joint problem (Ex: back, knee, hip) that could be made worse by a change in your physical activity? / Are you currently taking prescribed medications for a chronic medical condition
  6. Is your doctor currently prescribing drugs (ex: water pills) for blood pressure or heart condition? / Do you have a bone or joint problem that could be made worse by becoming more physically active? Please answer NO if you had a joint problem in the past, but it does not limit your current ability to be physically active. For example, knee, ankle, shoulder or other.
  7. Do you know of any other reason why you should not do physical activity? / Has your doctor ever said that you should only do medically supervised physical activity?
29
Q

What is the 2nd step in participant screening?

A

The Physical Activity Readiness Questionnaire (PAR-Q(+))

30
Q

Name one of the main differences between PAR-Q and PAR-Q+.

A

PAR-Q+ is for ALL AGES (PAR- Q is for 15-69) / Less referrals to doctor

31
Q

What are the 7 most common Chronic medical conditions checked off on the PAR-Q+?

A
  1. Arthritis osteoporosis, or back problems
  2. Cancer
  3. Heart disease or CV disease (CAD, High blood pressure, heart failure etc.)
  4. Metabolic conditions (diabetes of any stage or kind)
  5. Mental Health problems / learning difficulties (Alzheimer’s/ dementia, depression, anxiety, eating disorders, etc.)
  6. Respiratory disease (COPD, asthma, pulmonary high blood pressure etc.)
  7. Stroke (avg. age of stroke = 72 years)
32
Q

The difference in the new PAR-Q + screening is massive; with a mere ________% requiring a medical referral for Physical Activity.

A

(approx.) 1%

33
Q

When answering the questions section 1 (General Health) of the PAR-Q or the PAR-Q+ form, you answered YES 2/7 times. What next for each form?

A

In the PAR-Q form, the participant would be referred to a physician for medical clearance.

Now, in the PAR-Q+ form, the participant would move to section 2 (Chronic Medical Conditions), to give information about their health condition.

34
Q

The participant has answered Yes to one or more of the follow up / sub questions in Section 2 of the PAR-Q+ form, what happens next?

A

The participant is referred to a HEALTHCARE professional OR CEP for further information

35
Q

What is the 3rd step in participant screening?

A

Physicians Consent / Medical clearance Form completed by Physician.

36
Q

What should the medical clearance form include (5)?

A

Medical clearance form should include:

  • Description of performance TESTING
  • Major components of the PROGRAM
  • Your contact info
  • Physicians consent (with /without reason) OR Denial – with reason
  • Physicians signature.
37
Q

If a participant must get clearance from physician, what is important for them to know and approve?

A

Tests and the physical parameters of those tests, and major components of the exercise program.

38
Q

To test the physical parameters of someone’s Cardiovascular system, what tests would a CEP use?

A
  • Two-minute step in place

- Six-minute walk

39
Q

To test the physical parameters of someone’s Muscular strength and endurance, what tests would a CEP use?

A
  • 30-second chair stand

- 30-second arm curl

40
Q

To test the physical parameters of someone’s Flexibility, what tests would a CEP use?

A
  • Chair Sit and reach

- Back scratch

41
Q

To test the physical parameters of someone’s balance and gait, what tests would a CEP use?

A
  • 8-foot up and go

- 50 ft. walking speed

42
Q

What is the 4th step in participant screening?

A

Health History and activity Questionnaire.

43
Q

What should the Health history and activity questionnaire include (12)?

A
  1. Demographics
  2. Existing chronic or acute diseases
  3. Assistive devices
  4. Perceived health status
  5. Family history of heart disease
  6. Medications
  7. Smoking behaviour
  8. Fall history
  9. Functional limitations an disability
  10. Current levels of PA
  11. Work history
  12. Perceived quality of life
44
Q

Should the Health history and activity questionnaire be self-administered?

A

It can be, but more information if you fill the form out with the participants…

45
Q

What questions are notable on the Physical Activity Questionnaire (Health History and Activity questionnaire (6))?

A
  • Risk Factors for CAD / family history
  • List of Medications
  • How many Falls?
  • Are you worried bout falling?
  • How often do you leave the house?
  • COMPOSITE PHYSICAL FUNCTION SCALE (Q22)
46
Q

What is the composite physical function scale found in question 22 of the health history and activity questionnaire?

A

It ascertains participants ability to perform a wide range of tasks and activities from basic ADL’s to more advanced activities.

47
Q

What is the scoring range for the Health History and Activity questionnaire?

A

Scoring range / 24

22-24. = HIGH function
16-21 = MODERATE Function
<16 = LOW function
48
Q

What is the Health History and activity questionnaire best used for (2)?

A
  1. Set goals

2. help design exercise program

49
Q

What is the Final step after pre-screening?

A

Feedback to participants and confidentiality

50
Q

What is part of the feedback that should be offered to participants (5)?

A
  • Inform your participants about their health and disability status
  • Set goals with your participant
  • Avoid technical terms
  • Explain the results in a positive manner (and give copy to participant)
  • Information must be kept secure and not left in an area with unrestricted access (should be in a locked cabinet etc.)
51
Q

When should we update pre-activity screening tests?
A. Every 4 weeks
B. Every 8 weeks
C. On a yearly basis
D. When a participant shows a decline in health or function
E. C and D

A

ANS: E – On a yearly basis and / or when a decline in health or function is apparent

EXCI 455 (13 decks)

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