Part 2 - Initial Consultation and Evaluation

Question 1

What is the PAR-Q?

Answer 1

Physical Activity Readiness Questionnaire

• Self recall
• Identifies individuals who will need further referral.

Should be supplemented with a health/medical questionnaire to identify positive coronary risk factors associated with coronary artery disease as well as other conditions that may limit exercise capability

Question 2

What is a very important legal factor to take into consideration before training children?

Answer 2

Parents DO NOT have the right to execute releases/assumption of risk agreements for their children. Therefore it is very hard to release trainers from liability in the case of injury.

Pre-participation physical examination form is pre-approved by American Academy of Pediatricians and should be used to determine if a child needs to see a physician before training .

Question 3

What is considered the minimum physical activity recommendation when considering coronary artery disease risk factors?

Answer 3

30 minute or more of moderate intensity (40-60% VO2) activity per day on most or all days per week.

Question 4

List the 8 positive and 1 negative risk factors for coronary artery diseasse

Answer 4

Positive

• Age
• Family history
• Cigarette smoking (within past 6 months)
• Sedentary lifestyle
• Obesity
• Hypertension
• Dyslipidemia
• Prediabetes

Negative
- High serum HDL cholesterol (over 60 mg/dl)

Question 5

List the 9 signs of cardiovascular and pulmonary disease

Answer 5

• Pain or discomfort in chest, neck, jaw, arms or other areas that may be due to ischemia (lack of blood flow)
• Shortness of breath at rest of with mild exertion
• Dizziness or syncope
• Orthopnea (need to sit up to breath)
• Ankle edema
• Palpitations or tachycardia
• Intermittent claudication (calf cramping)
• Known heart murmur
• Unusual fatigue or shortness of breath with usual activities

Question 6

List signs that identify potential risk for sudden cardiac death

Answer 6

• Chest pain or discomfort during physical exertion
• Unexplained dizziness or fainting with physical exertion
• Excessive and unexplained shortness of breath or fatigue associated with exercise
• Prior recognition of a heart murmur
• Elevated systemic blood pressure
• Family history of sudden and unexpected death before age 50 in more than one relative.
• Family history of disability from heart disease before age 50 in a close relative
• Family history of hypertrophic cardiomyopathy, long-QT syndrome, Marfan Syndrome, or hearth arrhythmias

Young individuals may exhibit these signs

Question 7

When must a trainer refer a patient to a physician before initiating training?

Answer 7

• If any question is answer yes to the PAR-Q
• If there are any positive symptoms of CAD or sudden cardiac death
• Or is stratified as moderate risk (asymptomatic, over two CAD risk factors) or high risk (known disease or symptoms of CAD/sudden cardiac death)

Question 8

According to risk stratification, when should a medical exam be conducted for

• Moderate exercise
• Vigorous exercise

MD supervision for

• Submax exercise test
• Max exercise test

Answer 8

Medical exam

• Moderate exercise (high risk)
• Vigorous exercise (moderate/high risk)

MD supervision for

• Submax exercise test (high risk)
• Max exercise test (moderate/high risk)

Question 9

True or false? Different fitness assessments should be used for males and females

Answer 9

Mostly true.

Some tests may be appropriate for males, but not females (e.g. using pull-ups as an assessment would be fine for men but problematic for women).

Question 10

What is the cutoff for waist circumference for obesity?

Answer 10

Men: 102 cm (40 in)

Women: 88 cm (35 in)

Question 11

True or false? During fitness testing shortness of breath, wheezing, leg craps, drop in systolic bp despite increased load, or claudification are indications for terminating exercise testing.

Answer 11

True

Question 12

In what order should general fitness tests (by type) be administered in? Athletic tests?

Answer 12

General Fitness

• Resting (e.g. vitals)
• Flexibility/balance
• Tests of strength
• local muscular endurance tests (e.g. YMCA bench press test)
• Submaximal aerobic capacity tests (e.g. ergometer test, 1.5-mile run, 12-minute walk/run etc.)

Athletic

• Resting (e.g. vitals)
• Flexibility/balance
• Agility tests (e.g. t-test)
• Maximum power and strength tests (e.g. 3RM power clean, 1RM bench press)
• Sprint tests
• Local muscular endurance tests (e.g. 1-minute sit up test, push up test)
• Anaerobic capacity tests (shuttle runs)
• Maximal or Submaximal aerobic capacity tests (e.g. ergometer test, 1.5-mile run, 12-minute walk/run etc.)

MAXIMUM AEROBIC TESTS SHOULD ALWAYS BE LAST AFTER A 1-HOUR BREAK (or ideally on a separate day if possible)

Question 13

What are the two reference perspectives for comparison of fitness assessment data?

Answer 13

Norm-referenced standards (compare performance of individual against others in like category, e.g. a percentile)

Criterion-referenced standards (minimum criterion to strive for for good health, set by experts and therefore sometimes controversial)

Question 14

Define formative and summative evaluations

Answer 14

Formative: progress towards a goal

Summative: Degree of completion for a goal

Question 15

How do you measure waist and hip girth respectively?

Answer 15

Waist; tape measure around SMALLEST part of ABDOMEN

Hip: Tape measure around LARGEST part of BUTTOCKS

To determine waist to hip ratio, divide waist circumference by hip circumference (small over large)

Question 16

What assumption leads personal trainers to choose a test for measuring submaximal heart rate that is specific to the client’s existing cardiovascular exercise mode(s)?

Answer 16

Mechanical efficiency (VO2 at a given work rate) is the same for all clients.

E.g. if a client goes for lots of walks, the Rockport walking test or a submaximal treadmill walking test might be the best indicator of that client’s VO2 max

Submaximal tests are used most often to estimate VO2 max because maximal tests usually use costlier equipment, have more risk, and can require more personnel.

Question 17

What is the YMCA cycle ergometer test?

Answer 17

Provides VO2 max estimation.

The YMCA cycle ergometer test is a submaximal,
multistage exercise test for cardiovascular endurance. This popular test is designed to progress the client to 85% of his or her predicted maximal HR using 3-minute stages of increasing work rate.

Question 18

What is the Astrand-Ryhming cycle ergometer test?

Answer 18

Provides VO2 max estimation.

A single stage (unlike YMCA, which is 3 stage) test. Total duration is 6 minutes. After two minutes take heart rate to see if resistance should be increased (if HR is under 120 bpm). Take HR measurements at end of 5th and 6th minutes. Take average of two measurements to find estimated VO2 max from table of percentiles AND then multiply by age correction factor.

Question 19

What is the YMCA step test?

Answer 19

Inexpensive cardiovascular endurance test. Classifies fitness based on post-exercise HR response. Does not provide VO2 max estimation.

Client steps up and steps down to a step cadence for 3 minutes and then HR is taken.

Question 20

What are the following run and walk tests for measuring?

Answer 20

• 12-minute run/walk (distance)
• 1.5-mile run (time)
• Rockport walking test (time)
• 1-mile run (children, time)

All for measuring estimated VO2 max

Question 21

What is the YMCA bench press test?

Answer 21

The YMCA bench press test is used to measure upper body muscular endurance. This is a test of absolute muscular endurance, that is, the resistance used is the same for all members of a given gender (80 lbs for males, 35 lbs for females).

Client completes reps to a metronome (one full rep per every two seconds)

Question 22

What is the partial curl-up test?

Answer 22

The partial curl-up test measures the endurance of the abdominal muscles. It is often favored over the sit-up test because it eliminates the use of the hip flexor muscles.

Client does it to metronome, 50 beats per minute (25 reps per minute)

Question 23

What is the prone double straight-leg raise test?

Answer 23

Examines low back muscular endurance and predicts lower back pain.

Patients lies in prone position (facedown) and lifts legs so that knees come off table. The duration that client can hold this pose becomes score.

Question 24

What is the sit and reach test?

Answer 24

Measures hip and low back flexibility.

Patient sits and then it is measured how far they can reach towards or beyond their feet.

Is a meh predictor of lower back pain. But other flexibility tests are good for assessing risk for lower back pain.