Preliminary Health Screening Flashcards
1
Q
The role of a fitness appraiser:
A
conducts physiological assessments as they relate to the spectrum of “health” and “performance”
2
Q
Purposes of pre-participation health screening:
A
- ID and exclude individuals with medical contraindications to exercise
- ID individuals at increased risk for disease
- ID those with clinically significant disease who should participate in medically supervised exercise program or that you are not qualified to work with
3
Q
Individuals at increased risk for disease include:
A
- because of age, symptoms, and/or other risk factors
- those who should undergo a medical prior to testing or starting an exercise program
4
Q
Old CSEP guideline:
A
- CPAFLA
- The Canadian Physical Activity, Fitness & Lifestyle Approach
5
Q
Most recent CSEP guideline:
A
- CSEP - PATH
- Physical Activity Training for Health
6
Q
2002 screening:
A
PAR - Q & you
7
Q
2011 screening:
A
PAR - Q+
8
Q
2017 screening:
A
Get Active Questionnaire
9
Q
PAR - Q stands for:
A
Physical Activity Readiness Questionnaire
10
Q
PAR - Q and you is for ages:
A
15-69 (roughly adult population)
11
Q
Describe the PAR - Q & you and its uses:
A
- self assessment
- simple 1 page
- can be used for initial self-assessment
- used world-wide
- still the pre-screening tool used by ACSM
- still highly utilized
- not a blanket clearance
12
Q
Describe the questions in PAR - Q & you:
A
- questions considered broad and perhaps ambiguous
- probing conditions that might suggest a condition
13
Q
PAR - Q & you is valid for how long?
A
only valid for 12 months
14
Q
Yes to any question in the PAR - Q and You means…
A
you require medical clearance (PARmed-X)
15
Q
PARmed - X aids in the identification of….
A
contraindications or special considerations if proceeding with an assessment
16
Q
PARmed - X stands for:
A
Physical Activity Readiness Medical Examination
17
Q
PARmed - X must be completed by …
A
a physician
18
Q
3 stages of PARmed - X:
A
- absolute contraindications
- relative contraindications
- special prescriptive conditions
19
Q
Absolue contraindications:
A
permanent restriction or temporary restriction until condition is treated, stable, and/or past acute phase
20
Q
Relative contraindications:
A
- highly variable
- value of exercise testing and/or program may exceed risk
- activity may be restricted
- desirable to maximize control of condition
- direct or indirect med. supervision of exercise programs
21
Q
Special prescriptive conditions:
A
- individualized prescriptive advice generally appropriate (limitations, special exercises)
- may require medical monitoring and/or initial supervision in exercise program
22
Q
Problem with the PARmed - X:
A
- poor uptake and utilization by physician groups
- recommendations previously based on expert opinion
- call for evidence based criteria
23
Q
PAR - Q & you + PARmed = X =
A
PAR - Q+
24
Q
PAR - Q+ is a ___ page form for pre screening prior to PA participation and includes additional questions on _____ _____ for …
A
- 4 page
- chronic conditions
- chronic conditions
- further probing by the qualified exercise professional
25
What is different in the PAR - Q+?
- based on systematic reviews of the literature (evidence based screening tool)
- removes age guidelines, inclusive of youth and elderly
- wording changed in the 7 questions to remove confusion or misunderstanding
- if client answers yes they proceed to page 2 or 3 to answer additional questions more specific to their condition
- no longer a self assessment (fill it out with a qualified professional)
26
What replaces the PARmed - X in the PAR - Q+?
- further questions
| - additional info is obtained by the fitness assessment prior to making recommendation for medical assessment
27
Why is the PAR - Q+ potentially better than the PARmed - X?
- after completing the additional questions ~85% of people are screened back in for PA
- should reduce the number of individuals referred for medical clearance
- valid for 12 months
28
PAR - Q+ is based on...
stratification of risk
29
Who is considered apparently healthy and what is the minimum qualification needed to work with them?
- all no answers on page 1 of PAR - Q+
| - CSEP - CPT
30
Who is considered to have a stable health condition (low risk) and what is the minimum qualification needed to work with them?
- yes answers on page 1 but no answers on pages 2-3 of PAR - Q+
- CSEP - CPT
31
Who is considered to have a unstable health condition (moderate/high risk) and what is the minimum qualification needed to work with them?
- yes answers on page 1 and pages 2-3 of PAR - Q+
| - CSEP - CEP
32
CSEP - PATH must be completed by...
an M. D.
33
CSEP - PATH identifies ....
positive answer indicated on PAR - Q+ and provides physicians with more detail upon referral
34
CSEP - PATH form must be filled out with....
- exercise recommendation
- signed
- stamped
- returned prior to proceeding with testing or limited testing and prescription
35
CSEP - PATH is valid for ___ months.
12
36
CSEP - PATH also includes:
- certification criteria of CSEP-CPTs/CSEP-CEPs
| - CSEP- PATH assessment (provides a description of protocols)
37
Differences in Get Active Questionnaire:
- simplified 2 page questionnaire
- returns to a self assessment
- intended for all ages
- includes parental assessment for children/minors
- includes concussion in health screening
38
How long is the Get Active Questionnaire valid?
implies 6 months
39
What happens if you answer YES to any of the questions in the Get Active Questionnaire?
- refer to accompanying reference doc.
- identifies the benefits of exercise in almost all populations
- provides advice regarding cautions and directs individuals to consult health care provider or QEP
40
Get Active Questionnaire includes a self assessment of _____ ____. It indicates _____ ____ ____.
- PA
| - current activity guidelines
41
Get Active Questionnaire requires ____ ____.
self consent
42
CSEP recommendation 1: All women without contraindication should be...
PA throughout pregnancy
43
CSEP recommendation 2: pregnant women should accumulate at least ____ min. of moderate intensity PA each week to achieve _____ _____ health benefits and reductions in ____ ______.
- 150
- clinically meaningful
- pregnancy complications
44
CSEP recommendation 3: PA should be accumulated over a minimum of ____ days per week; however, being _____ every day is encouraged.
- 3
| - active
45
CSEP recommendation 4: pregnant women should incorporate a variety of _____ and _____ training activities to achieve greater benefits. Adding ____ and/or gentle ____ may also be beneficial.
- aerobic
- resistance
- yoga
- stretching
46
CSEP recommendation 5: _____ _____ muscle training (eg. Kegel exercises) may be performed on a ____ basis to reduce the risk of ______ _____. Instruction in proper technique is recommended to obtain optimal benefits.
- pelvic floor
- daily
- urinary incontinence
47
CSEP recommendation 6: pregnant women who experience ____ ______, _____ or feel _____ when they exercise flat on their _____ should modify their exercise position to avoid the ____ position.
- light-headedness
- nausea
- unwell
- back
- supine
48
PARmed-X for pregnancy is no longer required as part of _____ _____.
clinical guideline
49
Pregnant women are strongly encouraged to...
speak to their healthcare provider
50
Many/most practitioners (trainers, gyms etc.) require PARmed-X for pregnancy for...
liability insurance purposes
51
PARmed-X for pregnancy form must be filled out with....
- exercise recommendation
- signed
- stamped
- returned prior to proceeding with testing or limited testing and prescription
52
PARmed-X includes:
- health history questionnaire
- absolute and relative contraindications to exercise
- recommendations for aerobic and muscular activity prescription
- general advice for active living and safety considerations
53
Informed consent:
- provide info to the individual about what you are doing that day
- protocol
- risks
- meant as a discussion point
- NOT A WAIVER
- under the age of minority = parent/guardian signature
- encourage dialogue to ensure client fully understands
54
Informed consent should be...
- should be read, understood, and duly signed prior to the administration of the appraisal
- should be self explanatory, describes the nature of the appraisal items that will be undertaken and outlines client responsibilities
55
Informed consent does not...
absolve the appraiser from negligence
56
Waiver:
- assumption of risk
- signed statement relinquishing some level of right
- an attempt to cover any accidents that may occur
- must adhere to the same issues as consent for
- not legally binding, but can aid in the event of a court case
57
Waiver does not ....
excuse irresponsibility
58
3 forms that you need:
- Get Active Questionnaire
- informed consent
- waiver
59
Basic physiological assessment consists of:
- heart rate
| - blood pressure
60
HR is to identify....
cardiac irregularities
61
BP is to identify...
hypertension or hypotension
62
Preliminary instructions (CSEP-PATH) prior to physiological screening:
- abstain from smoking at least 2 hours prior to test
- abstain from alcohol at least 6 hours prior to test
- abstain from caffeine products at least 2 hours prior
- avoid a heavy meal 2 hours prior to test
- avoid vigorous exercise within 6 hours of the test
63
HR cutoff:
- if 99 bpm or less (< 100 bpm), proceed with appraisal
| - if > 99 bpm have individual sit quietly for an additional 5 min
64
If individual's HR is > 99 bpm after second reading...
physician clearance is recommended
65
Elevated HR =
tachycardia
66
BP cutoff:
- If systolic pressure is < 160 mmHg AND diastolic pressure is < 90 mmHg
proceed with appraisal
- If EITHER systolic pressure is ≥ 160 mmHg OR diastolic pressure is ≥ 90 mmHg have individual sit quietly for an addition 5 min
67
If individual’s systolic pressure is ≥ 160 mmHg OR diastolic pressure is ≥ 90 after second
reading...
physician clearance is recommended
68
Normal BP:
- Systolic: < 120 mmHg
| - Diastolic: < 80 mmHg
69
Elevated BP:
- Systolic: 120-129 mmHg
| - Diastolic: < 80 mmHg
70
Hypertension stage 1:
- Systolic: 130-139 mmHg
| - Diastolic: 80-89 mmHg
71
Hypertension stage 2:
- Systolic: > 140 mmHg
| - Diastolic: > 90 mmHg
72
When we take BP, we should be aware of ....
- white-coat hypertension (WCH)
| - aka. elevated office BP (OBP)
73
What is WCH or OBP?
- BP that is high only in a doc.'s office but otherwise a normal ambulatory BP (ABP)
- may be due to nervousness or anxiety but could signal early cardiovascular risk
- should not be ignored
74
What should we do for someone with WCH or OBP?
- check BP at rest, during and after exercise
| - stop test at any time and refer to physician with a report
75
Newborn (0-3 months old) HR:
100-150 bpm
76
Infants (3-6 months old) HR:
90-120 bpm
77
Infants (6-12 months old) HR:
80-120 bpm
78
Children 1-10 years HR:
70-130 bpm
79
Children over 10 and adults (incl. seniors) HR:
60-100 bpm
80
Well trained athletes HR:
40-60 bpm
81
ACSM pre-screening is conducted by..
a health/fitness professional
82
ACSM pre-screening is initially stratified by...
exercise status
83
ACSM pre-screening follows a ____ model for clarity.
logic
84
In ACSM pre-screening, secondary consultation is needed for the presence of...
cardio/metabolic/renal dysfunction
