Pre-exercise Screening And Testing Considerations Flashcards
Pre-exercise screening
Information must be collected prior to physical activity to identify factors that increase the clients overall risk for injury or negative outcomes.
Pre-exercise screening should include:
Physical limitations
Medical conditions
Lifestyle behaviors
Provision of education for the client concerning their relative health risks based on their lifestyle, daily behaviors and history.
Identification of current health status.
Provision of data that can be used to create the needs analysis and most appropriate program for the client.
Establishments of starting points
Identification of particular interests, attitudes, or possible training limitations.
4 parts of screening
Informed consent
Par Q
Health risk appraisal
Health status questionnaire
Informed consent:
Provides the opportunity to understand the risks, benefits, rationale, and expectations associated with the program.
Should include:
Explanation of the background and purpose for the service being rendered.
The potential risks associated with exercise participation
Explanation of program and testing procedures
Normal physiological expectations
Opportunity for inquiry
Right of refusal of service
Statement of client data confidentiality
Informed consent is a ____________ _____________ document protecting against claims that the client was unaware of protocol and risks related to an exercise program or test.
Legally defensible
Informed consent does _______ prevent the client from taking legal action, but provides legal defensibility when procedures in question have been performed correctly.
Not
Par Q
Physical activity readiness questionnaire
Presents seven questions that serve as red flag indicators for clients age 15-69 who may require medical clearance before engaging in physical testing or advice.
Practical for groups, easy to interpret, minimal expertise is required.
Disadvantages to par q
Limited when evaluating risk to low, moderate level intensity exercise
Should never be used as a single clearance for for vigorous activities
Little value beyond medical referral identification
Health risk appraisal
Health tool consisting of a questionnaire, formulas for estimating health risk, advice database, and means for generating reports.
Health status questionnaire
Structures, self reported questionnaire that generates scores for physical functioning, limitations due to physical or emotional issues, bodily pain, general health perceptions, vitality, social functioning, and overall mental health
It should be used in an interview format to allow for probing questions.
Trainers should pay close attention to:
Cardiovascular and metabolic disease Smoking history Sedentary lifestyle Obesity High BP Blood Lipid profile Impaired glucose tolerance
Warning signs for client risk
Chronic pain Dizziness or breathlessness Heart plantations Edema Unusual fatigue Frequent thirst Infrequent urination
Behavior questionnaire
Recognize program obstacles and health status areas requiring improvement.
Educate clients with regards to their lifestyle behaviors and dietary practices
Implement behavioral management strategies identify factors correlating to current health status.
Basically the BQ allows the trainer to find the correlating factors related to the issues found on the health status questionnaire
If the client is cleared of red flag medical concerns, the trainer should then identify and implement:
A resting battery of tests.
RHR Resting BP Body Compostition Height/ weight and/or BMI Waist circumference
A high RHR
Is associated with cardiovascular inefficiency and an increased risk for arrhythmias.
Healthy <75 RHR
Reduce RHR by
Aerobic exercise
Weight management
General physical activity
Resting Bp
CO x PR
Cardiac output x peripheral resistance
Vascular damage
Stroke
Kidney damage
Congestive heart failure
BP ranges
Normal <120/<80
Pre-Hypertensive 120-139/80-89
Stage 1 140-159/ 90-99
Stage 2 >160/ >100 * requires MA (medical approval/release).
Mmhg
Millimeters of mercury
Obesity Percentages
Male: >25% morbidly >30%
Female: >32% morbidly >40%
BMI
Height and weight measurements to predict body density
Does not directly assess body composition
27 high risk
30 obese / disease risk
Waist circumference
Reference of sub-q and visceral fat
> 40 male
35 female
High risk👆🏻
Dyslipidemia
Poor blood lipid profile
Elevated risk for cardiovascular disease while high fasting blood glucose is a red flag indicator for diabetes
Medical Referral Criteria
LDL-C >135mg/dl HDL-C >40 mg/dl Total blood cholesterol: >240 mg/dl Cholesterol ratio > 5 Total blood triglycerides: 200mg/ ml Fasting blood glucose: 110mg /dl
Fitness test should be:
Valid, reliable, objective, and appropriate for the client.
Considerations for fitness testing:
Gender Age Training status Capabilities Experience
Assess testing space and equipment and do a dry run with client
A “valid” test and “reliable” test
High validity:
The test accurately quantifies what it is designed to measure
Reliable: testing measures can be easily reproduced, or a test can be validated during later re-testing procedures
Factors that reduce test validity:
Improper body position Inexperience Inadequate techniques Poor biomechanics Momentum Compensatory actions
Factors that reduce the test reliability
Changes in the environment
Changes in testing methods
Using a different testing instrument
Failure to implement identical testing protocol
Environmental factors influencing testing
Ambient temp Altitude Humidity Noise Toxins
Prior to test trainer should inspect:
The testing area
The equipment
Clients clothing
Clients footwear-proper
Provide clear instructions and a pre-during-post checklist
Make sure client is hydrated
-expose client to testing techniques and allow for skills acquisition prior to implementation: reduces anxiety/ boosts client performance.
Proper testing order
Tests should be performed on different days
Tests that challenge nervous system (or immediate energy systems) should be conducted prior to endurance tests
Non fatiguing tests can be conducted between assessments and serve as a rest period.
Resting Strength and power Muscular endurance Anaerobic capacity Aerobic
How to provide results:
Especially sub-par
Tact
Layman terms
Explain that results are starting points
Avoid negative terms
Needs analysis
Refers to the organization of gathered data to identify the needs to be addressed within the exercise program
Aka create a “to-do” list with each client
Goal setting
Daily objectives
Short term goals
Long term goals
Focusing on reaching multiple short term goals is preferred over one long term goal, be micro-ambitious.
Progress can be easily assessed.
Adjustments can be made to program design.
Most common goal setting errors:
Developing unattainable or unrealistic goals
Failing to emphasize daily objectives
Properly developed goals should:
Reflect controllable behaviors
Be specific, measurable, meaningful, and rewarding
Be Challenging but realistic
And should consider:
Clients capabilities and source of motivation
Cycle necessary to reach the target objective
Required effort on behalf of the client
______________are the most important measure of health related fitness.
Cardiorespiratory fitness
Directly related to implications on disease and lifespan & direct influences on all other components of fitness.
Vo2 max
Vo2 Max
The highest rate at which oxygen can be taken in and utilized by and individual during exercise
The lungs Reflects efficiency for delivering o2 to working muscle via the lungs, heart, and blood)
Can be estimated through predictive equations
Assessments usually measure distance, time, or HR
Submaximal testing:
Reduced risk for injury Less skill involved Easier tests Reduce stress on client Can be widely applied
Performed for a planned duration, distance, or until a given HR or intensity level has attained.
Test examples: sub maximal
Walking Running Stationary Ass bike Step Swimming test
Ml x kg/ min-1
The performance measure derived from o2 converted into an expression.
Test stop indications
Client no longer comfortable performing test
Skin becomes pale
Fails to keep cadence for 20 seconds
Inability to maintain focus.
Faintness, dizziness, light headed
Stomach pain, vomiting, chest pain, difficulty breathing
Cramp, side stitch, strain, hardcore fatigue.
Assessment of muscular fitness
Muscular strength
Muscular endurance
Trainers should utilize a minimum of 3 different exercises to incorporate the upper body, lower body, and trunk
Muscle balance
Improves joint stability
Reduces the risk for injury
Improves the transition of force through the kinetic chain
Muscle balance ratio goals
Trunk flexors/extensors: 1:1 Hip flexors/extensors 1:1 Shoulder flexors/extensors: 2:3 Knee flexors/extensors 3:2 Elbow flexors/extensors 1:1 Plantar flexor/ dorsiflexor 3:1
Potential strength testing issues include:
Risk of injury for deconditioned, unhealthy, inactive/sedentary lifestyle, unskilled lifters
Identification of maximal load
Improper movement mechanics with load
Stability requirements for form
Increased internal pressure (valsalva especially) must be correctly used
Testing novice clients:
Familiarize client with proper performance of mechanics/movements
Side with the use of tests that utilize a higher volume test. (5-10)RM
Free weights are preferred to machines:
Identify joint stability deficiencies
Measure force capacity outside of a fixed movement pattern.
Provide data that more closely transfers to free-living, everyday conditions and activities.
Examples of muscular fitness testing
Isometric: chin hang
Maximal reps in a fixed period of time: paced curl ups
Til failure: push-ups
Only count properly performed reps. Do not count falsely compensated exertion at the expense of form.
Endurance tests must be designed to use _____________ ______________ as the primary source of energy, not the phosphagen system.
Anaerobic glycolysis
Anaerobic capacity
Measures the rate of power decline; or the length of time a muscle can perform an activity using the glycolytic pathway to generate fatigue until failure.
Anaerobic capacity tests
15-90 seconds
Better predictors of functional performance than strength tests
Clients should have an appropriate baseline fitness level prior to test.
Inflexibility is linked to
Musculoskeletal injuries
Acute and chronic low back pain
Postural dysfunction
During flexibility tests the trainer should
Look for any compensatory actions and measure the terminal ROM if applicable.
Each joint should be assessed individually (bilateral)
Goniometer-document any pain, DO NOT DIAGNOSE
Skin fold measurements:
Obese clients:
Mark x’s and explain test/ make client comfortable and ask permission.
BEI test or girth measurements
SEE
Standard estimate for error. Should use tests with a see no greater than 4%
