Midterm 1 Flashcards
What are the main objectives for the CSEP PATH?
- establish standards of competence for fitness appraisal/PT personnel and centres on a national scale
- encourage those currently working in the field to comply with these standards
- provide consumer protection by educating the public to recognize the distinction in qualifications between levels in the model
What are the 2 types of certifications in the CSEP?
- CSEP Certified Personal Trainer (CPT)
2. CSEP Clinical Exercise Physiologist (CSEP CEP)
What is a CPT supposed to aid clients with?
- overall health of the population
- health related fitness
What is a CEP supposed to aid clients with?
- health
- performance
- job related fitness (firefighter)
- can work with clinical populations
What option do both CPT’s and CEP’s have to further their certifications?
can add High Performance Specializations once certified (work with elite athletes)
____________ health and fitness practitioner ___________. Develops and implements a ____________ physical activity, fitness and lifestyle plan
introductory, certification, tailored
who can CPT’s work with
- healthy populations
- one stable health condition
is a CPT certification the minimum acceptable standard in the industry?
yes
How much education must a CPT have?
- minimum 2 years of uni/college coursework in specific core competency areas related to exercise sciences from an accredited post-secondary institution (2 years of a kinesiology degree)
__________ health and fitness practitioner _____________
advanced, certification
who can CEP’s work with?
- asymptomatic and symptomatic populations
provides appropriate advanced assessment and exercise therapy to clients including, but not limited to, those with __________, ______________ and _________ __________.
musculoskeletal, cardio-respiratory, metabolic conditions
Can CEPs accept referrals from licensed health care professionals?
yes
what certification is considered the gold standard in the industry?
CEP
what do High Performance Specialists focus on?
- performance
- occupational testing and training
Who can high performance specialists work for?
- elite athletes
- emergency services personnel
- armed forces
- high performance clients
What do you need to do in order to become a high performance specialist?
pass a theory exam
CSEP pre and postnatal exercise specialization:
focuses on safe exercise testing and prescription during _________ and the months that follwo
pregnancy
what is a scope of practice?
- who we can work with and what we can do
- concise description in broad terms of the activities and areas of practice
- doesn’t list specific tasks or procedures because they can become outdated
what happens when a person works outside of their SOP?
- Risk the safety of clients
- expose themselves to legal risk
for what reasons can a person become at legal risk when practicing outside of SOP?
- if the trainer causes injury
2. fails to refer the client to another more appropriate health care provider
What is the SOP for a cpt
- Work with healthy people or with one stable chronic condition who can exercise independently
- pre-participation screening
- gather info about PA/lifestyle
- administer fitness assessment according to goals/wishes
- develop tailored exercise prescription
- refer clients who fall outside of expertise
what is outside of the SOP for a CPT
- use of an ECG
- do anything >90% of max effort
- create diet plans
What is the SOP for a HPS?
- SOP of CPT or CEP plus….
- restrictions of max assessment are lifted
- can do max exercise
What is the SOP for a CEP?
- Work with clients with more than one medical condition or unstable medical condition
- work with youth, older people and performance testing
- accept referrals
- suggest dietary practices
- use ECG
- monitor the use of common medications in response to exercise
- take finger prick blood samples
what is outside the SOP for a CEP?
- diagnose pathology or abnormal ECG tracings
- work with acutely injured or diseased people not in their area of expertise
What are some professionalism things to consider?
- consider benefits vs. risk
- error on the side of caution if not sure
- ensure adequate PS readiness screening and monitoring of client
- avoid high risk/contraindicated exercises
which population is at the lowest risk for physical activity?
young adults
is excessive intensity, frequency or duration better than mild to moderate activity in terms of health benefits?
No
What are the 4 facility and equipment standards?
- equipment maintenance
- building maintenance
- safety and policy signs in clear view
- environmental factors
What are the two major emergency things you must have?
- EAP
- conduct emergency drills and practice CPR
What information should be on hand for an EAP
- ambulance phone number
- local hospital or medical clinic
- name and number of clients physician and next of kin
What to do in case of dizziness?
- lie client down in supine position and elevate legs
- monitor BP
- Keep in this position until BP returns to pre exercise level
- maybe offer juice box
What to do in case of Loss of Consciousness?
- initiate emergency procedure right away
what to do if any other serious incident occurs? (cardiac arrest)
- emergency services
- use CPR/Automated External Defibrillator
What are you supposed to do when an adverse event occurs?
complete an incident report form
What does SOAP stand for
Subjective data
objective data
assessment of problem
plan of action
what should you keep records of with your client?
- history
- assessment results
- training programs
- progress
how long do you keep records for?
10 years or 10 years after they turn 18
should you keep clients personal information in a password protected or lock cabinet
yes
what does Subjective Data consist of?
- their opinion
- likes/dislikes
- goals
what does Objective Data consist of?
- height
- V02 max
- test results
what does Assessment of Problem consist of?
- think about S + O and make a statement
- interpret the data
what does Plan of Action consist of?
- summarize what youre going to do
- key strategies
What are 2 things you can do in order to keep your professional development?
- stay current of literature
- attend conferences
what are the 6 steps to the CSEP-PATH?
- ask
- assess
- advise
- agree
- assist
- arrange
what should you do in the pre-meeting?
- orientation to process
- informed consent
- pre participation screening
what should you do in the first meeting?
- establish rapport
- gather info about goals, PA background, knowledge and interests
- confirm readiness for PA and secure informed consent
in the first step of the ASK section of getting to know your client what should you do?
- knowledge of the importance of PA to health
- primary motivation and drivers (intrinsic or extrinsic)
- level of commitment
- confidence (self-efficacy)
should you use open ended questions to engage with the client
yes
what order should you begin for the readiness screening?
- pre assessment instructions
- informed consent form
- GAQ
- observations
- collection of relevant medical history
- pre exercise HR and BP
PRE MEETING THINGS TO SAY
- welcome letter give it to them and explain it verbally
- wear light clothing
- no food 2 hours before
- no caffene 2 hours before
- no alcohol 6 hours before
- no smoking 2 hours before
- no exercise 6 hours before
what are some things you must do for the Informed consent form
- describe assessment verbally and on paper
- signed in pen
- explain its not a waiver
- if theyre younger than 18 have guardian sign
- must be witness of 3rd party that cant be affiliated with the CPT
- must be signed before collecting personal information
What is the role of a QEP in pre participation health screening
- conducts prescreening to reduce liability exposure
- works within abilities and SOP
- charts information about medical history
- considers clients risk of an adverse event
Should the CPT help interpret the answers on the GAQ for the client
no
should the GAQ be signed with ink pen and a 3rd party witness
yes
What is the main finding for the GAQ
- to see if the client falls under the CPTs SOP or if it requires clearance from the physician before doing active portions of the fitness assessment
How long is the GAQ valid for?
12 months or unless health condition changes
What does understanding the current PA levels of the client help with?
- the CV risks associated with exercise lessen as individual becomes more active
- clients who do regular PA can begin at a higher level
- clients who are inactive should begin at a lower level
- clients who have a lower risk medical condition and are interested in vigorous activity should be referred to CEP
What are the limitations of the GAQ
- its possible for clients or have a diagnosed medical condition or take medications despite answering no to all questions
- you must ask clients about medical history
What is the purpose of the CPT health screening tool?
- used if they have 1 medical condition
- helps CPT determine if medical condition is low risk
- not a substitute for GAQ
Apparently healthy clients look like:
- no diagnosed medical condition
- no overt signs and symptoms suggesting potential underlying medical conditions
- able to exercise independently
lower risk medical condition:
- condition is medically managed and client is asymptomatic
- no change in meds or treatment pan in the last 6 months
- take medication as directed
- client can exercise independently
- benefits of PA outweigh the risks
Higher risk medical condition:
- may not be medically managed
- symptomatic
- treatment recently changed
- cant exercise independently
- benefits may not outweigh the risks
what are the medical conditions included in the health screening tool?
- asthma
- heart disease
- hypertension
- osteoarthritis
- osteoporosis
- type 2 diabetes
when should the assessment be cancelled or postponed?
- demonstrates difficulty breathing at rest
- cough persistently
- ill or have fever
- lower extremity swelling
- have ignored preliminary instructions
- predisposed to unnecessary risk
- if they may be pregnant
what are the cutoffs for an adverse event during exercise?
HR over 100bpm
SBP over 160 mmHg
DPB over 90 mmHg
What are some optional questionnaires
- abilities for active living
- PASB-Q
- healthy sleep assessment
- stages of change questionnaire
- inventory of lifestyle needs and activity preferences (agree section)
AAL-Q
- used to identify a disability that may require accommodation
PASB-Q
- provides an approximation of clients physical activity behaviour for a typical week
- use in conjunction with health benefit ratings
Healthy Sleep Assessment
- provide indication of whether the client is good or poor in sleeping habits in general
SOC-Q
- identify a clients stage of motivational readiness for change
- knowing this allows you to decide appropriate strategies for enhancing their commitment to change
in the assess section what is the main objective?
- to choose an appropriate fitness assessment given clients goals and history
before each assessment test what should you communicate to the client?
- purpose of test
- relate it to clients goals and health
What tools should you use in assess section?
- aerobic assessment data collection sheets
- health benefit ratings
What considerations should you take in for gender?
- women carry more fat in lower extremities
- men carry more fat in their abdomen
What considerations should you take in for aging?
- people over 30 get more fat and drop in muscle mass
What considerations should you take in for body image and eating disorders?
- scales vs. other signs of progress
what are the two types of fat
subcutaneous and visceral
Males are more _____ shaped women are more _________ shaped but can still be ______ shaped
apple, pear, apple
What are the 3 types of direct methods of body composition measures?
MRI, CT, DEXA
What are the types of indirect methods of body composition measures in the lab?
hydrostatic weighing and bodpod
What are the types of indirect methods of body composition measures in the field?
skin folds, BIA, BMI, waist circumference
Explain how an MRI works
- body is place in strong magnetic field
- hydrogen protons are realigned
- when magnet is turned off the protons lose alignment and release energy
- energy release is dependent on tissue type
What are the pros and cons of MRIs
Pro: accurate
con: expensive and difficult to assess
Explain how a CT scan works
- uses x-rays passed through the body to monitor radiation
- rotates 360 degrees around body
- gives more accurate determination of visceral adipose tissue over MRI
what are the pros and cons of a CT
Pro: accurate
con: expensive, difficult to assess and exposed to radiation
Explain how a DEXA scan works
- x-rays with 2 energy peaks one peak is absorbed by soft tissue and the other by bone
- estimates bone mineral, fat and lean soft tissue mass
What does DEXA tell you
% BF
What are some pros of DEXA
- not as much radiation as CT
what are the components of fat free mass
residual chemicals, bone, muscle, water, organs/tissues
what does the two-component model entail?
- uses a measure of body density to estimate %BF through predictive equations
what are the assumptions of the two component model
- density of fat is 0.901g/cc
- density of FFB is 1.1g/cc
- no individual variations in density
- density of FFB are constant and proportions are constant
- individuals only differ from reference body in amount of fat: 73.8% water, 19.4 protein, 6.8% mineral
what is the equation for total body density?
Db = BM/BV
What is the equation for body volume?
BV = ((BM-net UWW/density of water)-(RV + GV)
What is hydrostatic weighing measuring?
- determines body density and percent fat
what is the equation for hydrostatic weighing
BV = BM -UWW
What is the theory behind hydrostatic weighing?
weight loss under water is proportional to volume of water displaced
what are some methodological errors in hydrostatic weighing
- fixed body density values for fat mass and ffm
- inaccurate estimation of residual volume
- failure to eliminate trapped gas
- failure to liberate air trapped in bathing suit or body hair
- failure to exhale to true residual volume
How is BODPOD different from hydrostatic weighing
it uses air displacement instead of water displacement to estimate volume
what are the effects of BODPOD
hair, thoracic gas, volume and body surface area
does bodpod use a pressure volume relationship
yes
What does the skinfold caliper measurement do?
- measures the thickness of subcutaneous adipose tissue
- uses predictive equations
who can’t you use the skinfold measurement on
- obese people
- BMI over 30
- when males WC > 102 cm and females is >88 cm
what are some assumptions of the skinfold measurement?
- good measure of subcutaneous fat
- distribution of fat subcutaneously and interally is similar for all individuals of each gender
- sum of several skinfolds can be used to estimate total body fat: theres a relationship between the sum of SKF and Db
What is the BIA technique
- low level current passes through the body and measures impedance or resistance to current
FFT provides more resistance to electrical current
false
- lower R = lower % BF
What is a methodological error of BIA
Hydration status
what does resistance (R) stand for in BIA
opposition to current flow
what does reactance (Xc) stand for in BIA
opposition to current flow caused by capacitance produced by cell membrane
is R or Xc a better predictor of FFM
R
What is the equation for BMI
BMI = Kg/m^2
what does waist circumference measure?
measure focuses on the centralized vs. a general pattern of fat distribution
what are the classifications of BMI
obese, underweight, overweight
Waist circumference implications
- visceral fat is more important determinant of health outcomes than over body fattness
- individuals with WC over specific threshold for men and women are further elevated risk of coronary event and diabetes
- higher WC is also a marker for high risk among people of normal weight
what is the lactate threshold
- 60% of V02 max
- point at which metabolic byproducts build up
what influences VO2 max
- mode of exercise (treadmill will have higher VO2 max than bike)
- hereditary (RBC, lung capacity)
- age (after 25 years VO2 max decreases by 1% per year)
- sex (males have greater than females)
- body comp (increased muscle = increased metabolic tissue)
achieving maximal aerobic power or ______
plateau
- there is no further increase in oxygen consumption with increasing workload
what is a prediction of assessment of aerobic power
that there is a linear relationship between HR/VO2 and work
direct tests for aerobic fitness include
max: VO2max test using metabolic cart
indirect tests for aerobic fitness include
submax: mCAFT, YMCA, Ebbeling
Field: Rockport 1 mile walk
theory behind submax tests
- for a given bout of exercise a person with a higher VO2max can perform the exercise with less effort (lower HR)
or - more exercise completed at a given HR
Assumptions of VO2 tests
- linear relationship between HR, VO2 and workload
- HRmax at a given age is uniform
- Mechanical efficiency of the activity is uniform
What is the error rate of VO2 tests
+- 10-20%
what are the general procedures of a vo2 test
- explain the test
- familiarize the client with the equipment
- monitor (HR, RPE, BP and signs of intolerance)
- follow post exercise recovery procedure
When to stop an aerobic test
- client asks to stop reached 85% of predicted HRmax - cant maintain cadence - HR fails to increase as intensity increases - physical or verbal manifestations of severe fatigue - onset of angina - signs of intolerance or distress - accident emergency - completes 8 stages
what are signs of intolerance
- chest pain
- facial pallor
- laboured breathing
- begins to stagger
- complains of dizziness - nausea
- extreme leg pain
Muscular strength definition
peak force or torque developed during maximal voluntary contraction
what influences muscle strength
- motivational state
- CSA of muscle
- quality of muscle (type 1 or type 2)
- type of contraction
- speed of contraction
- length of muscle
- MU recruitment
muscular power definition
rate at which mechanical work is performed
max amount of force one can exert in the least amount of time
muscular endurance definition
ability to exert submaximal force repeatedly or sustain a static contraction without fatigue
what should you keep constant when doing strength testing
- motivation, environment
