Preliminary Health Screening And Risk Classification CH2

Question 1

What are the purposes of preparticipation Health Screening?

Answer 1

Classification of an individual’s health status and lifestyle.

Identification of individuals at risk for adverse cardiovascular events (sudden cardiac death & acute myocardial infarction) related to exercise or physical activity.

Identification and exclusion of individuals with medical contraindications to exercise.

Identification of individuals with disease symptoms and risk factors.

Identification of individuals with special needs.

Identification of individuals who should undergo a medical evaluation and exercise testing before starting an exercise program.

Identification of individuals with clinically significant diseases or conditions who should participate in medically supervised exercise programs.

Question 2

What are the procedures for comprehensive pretest Health Screening?

Answer 2

Greet the client.

Explain the purpose of the health evaluation & lifestyle evaluation.

Obtain the client’s informed consent for health screening.

Administer & evaluate the PAR-Q+ or GAQ; refer client to physician for medical clearance if needed.

Administer & evaluate client’s medical history, focusing on signs, symptoms, & diseases; refer client to physician for medical clearance if needed.

Evaluate client’s lifestyle profile.

Evaluate & classify the client’s cholesterol & lipoprotein levels if test results are available.

Measure & classify the client’s resting blood pressure & heart rate.

Assess the client’s coronary risk factors & current exercise participation history.

Evaluate the client’s blood chemistry profile if test results are available.

** consent for research and health screening **

Question 3

What are the procedures for comprehensive pretest Health Screening if requested by the client’s physician?

Answer 3

Explain the purpose of and answer any questions about the 12-lead resting ECG & graded exercise test (GXT).​

Obtain the client’s informed consent for these tests.​

Prepare the client & administer the 12-lead resting ECG.​

Have a physician interpret the results of the 12-lead resting ECG.​

Assess the client’s resting blood pressure & heart rate.​

Administer the GXT.​

Assess & classify the client’s functional aerobic capacity.

• It’s always a maximal exercise test that is administered *
• BP and HR before the test and during the test *

Question 4

What are the minimum requirements for a Health Evaluation?

Answer 4

Administration of the PAR-Q+ or GAQ,​

Evaluation of the client’s participation in regular exercise in the past 3 months,
​
Identification of signs (objective and actual conditions & symptoms of diseases (more subjective + reported by the patient),​

Analysis of coronary risk factors, &​
determination of the need for medical clearance.

Question 5

What are the 6 key steps of the CSEP-PATH Sequence?

Answer 5

Step 1 (ASK) - Get to Know the Client ** if you do that properly, you can get the trust of your clients **

Step 2 (ASSESS) - Physical Activity, Fitness, & Lifestyle

Step 3 (ADVISE) - Evaluation Report & Discussion

Step 4 (AGREE) - Devise on Action Plan ** will have primary objectives and secondary objectives. ** If you want to change a behaviour - designing exercise program to get objectives **

Step 5 (ASSIST) - Increase Motivation & Overcome Barriers

Step 6 (ARRANGE) - Provide Continuing Support ** To maintain behaviour **

Question 6

What are Soap notes?

Answer 6

Specific way that medical professionals & practionners chart

Question 7

What’s the purpose of the Informed Consent Adult?

Answer 7

Ensures the client is aware of all risks and benefits of fitness assessment\exercise prescription and that personal information is being collected.

Question 8

What’s the purpose of the Informed Consent Youth?

Answer 8

Ensures the adult consenting for the youth, as well as the youth, is aware of all risks and benefits of fitness assessment/exercise prescription and that personal information is being collected

Question 9

What’s the purpose of the Get Active Questionnaire?

Answer 9

Identifies clients who may need to speak with a qualified exercise professional or health care provider before starting or resuming a physical activity program

Question 10

What’s the purpose of the Reference Document?

Answer 10

Provides guidance to clients who have one or more YES answer on the GAQ

Question 11

What’s the purpose of the CSEP-CPT Health Screening Tool for Clients with One Medical Condition?

Answer 11

Helps the CSEP-CPT determine the risk of a client’s medical condition and it the CPT can work with the client

Question 12

What’s the purpose of the Physician Guidance for Physical Activity Form?

Answer 12

Used when guidance is needed from a physician about the appropriateness of a Clint starting or resuming a physical activity program

Question 13

What’s the purpose of the GAQ for Pregnancy?

Answer 13

Identifies prenatal clients who may need to speak with their health;th care provider before starting or resuming a physical activity program

Question 14

What’s the purpose of the Health Care Provider Form for Prenatal Physical Activity ?

Answer 14

Used to facilitate the conversation between a pregnant client and their obstetric HCP about contraindications to prenatal exercise

Question 15

What’s the purpose of the Abilities for Active Living Questionnaire?

Answer 15

Allows persons who live with a disability to identify accommodations that may be needed for fitness assessment or supervised exercise session

Question 16

What can CEP and CPTS can deal with?

Answer 16

A patient who has a stable medical condition as long as they have knowledge of the condition. They cannot take on a patient with an unstable medical condition

Question 17

What are the components of a Comprehensive Health Evaluation?

Answer 17

Questionnaires/ Screening Forms and Clinical Tests

Question 18

What’s PAR-Q+ purpose?

Answer 18

To determine the client’s readiness for physical activity.

Question 19

What’s signs & Symptoms of Disease & Medical Clearance’s purpose
?

Answer 19

To identify clients in need of medical referral & to obtain evidence of physician approval for exercise testing & participation.

Question 20

What’s Coronary Risk Factor Analysis’s purpose ?

Answer 20

To determine the client’s number of CHD (CAD) risk factors.

Question 21

What’s medical history’s purpose ?

Answer 21

To review the client’s past & present personal & family health history, focusing on conditions requiring medical referral & clearance.

Question 22

What’s Lifestyle Evaluation’s purpose ?

Answer 22

To obtain information about the client’s living habits.

Question 23

What’s informed consent’s purpose ?

Answer 23

To explain the purpose, risks & benefits of physical fitness tests or participation in an exercise program & to obtain the client’s consent for participation in these tests or in an exercise program.

Question 24

What’s informed consent?

Answer 24

• is another important step in the process of a health-related physical fitness assessment.
• is not a form but a process that must be performed for several reasons.
• is an important ethical & legal consideration.
• is not a waiver form.
• does not absolve the qualified exercise professional administering the assessment protocols of negligence in the administration of the assessment.
• should be completed before:
  the collection of any personal & confidential information.
  any form of fitness testing.
  exercise participation.

Question 25

What are the 2 essential parts of informed consent?

Answer 25

Benefits of the particular assessment

Risks of the particular assessment

Question 26

What are the 3 important things to make a client aware of before the assessment?

Answer 26

The client is volunteering.

The client has certain responsibilities as far as informing us of any problems they may be experiencing.

The client is free to withdraw from participation at any time with no consequences.

Question 27

What is the pre-participation Health Screening ?

Answer 27

Using an evidence-informed questionnaire, helps to identify those who may be at increased risk during exercise due to medical history and remains a cornerstone of many personal training certifications.

Question 28

What are the evidence-informed questionnaires?

Answer 28

American College of Sports Medicine/American Heart Association Pre-Participation Questionnaire (AAPQ)

Adult Pre-Exercise Screening System (APSS) used in Australia

The 2023 Physical Activity Readiness Questionnaire Plus (PAR-Q+)

The Get Active Questionnaire (GAQ).

Question 29

What is the CSEP Get Active Questionnaire?

Answer 29

• was developed by CSEP to replace the PAR-Q+.
• is a required element for the CSEP-CPT*.
• is an evidence-based (evidence-informed), self-administered, two-page, pre-participation screening tool.
• is used to determine a client’s readiness for physical activity.
• identifies clients who may need to speak with a qualified exercise professional (QEP) or health care provider (HCP) before starting or resuming a physical activity program.
• is a user-friendly tool.

Question 30

For CSEP GAQ, client should be instructed to do what?

Answer 30

Complete pages 1-2 completely and honestly.

Answer YES to any question on page 1 if unsure.

Review the CSEP GAQ Reference Document, if a YES response is indicated on page 1.

Sign and date the declaration.

Bring the completed CSEP GAQ to the initial appointment with the CSEP Certified Member.

** Is valid for 12 months or until health changes **

Question 31

Answering no to all questions to GAQ, should do what?

Answer 31

Clears you automatically

Question 32

Answering yes to all questions of the GAQ requires what?

Answer 32

Requires you to go to GAQ reference doc.

Question 33

What is CSEP-PATH Physician Guidance for Physical Activity Form used for?

Answer 33

Used when clients need medical clearance from a physician before proceeding with the CSEP-PATH fitness assessment, or a physical activity program.

Is valid for a maximum of one year for the date it is completed or until the patient’s medical condition changes

Question 34

What is CSEP-PATH Physician Guidance for Physical Activity Form is a tool used for what?

Answer 34

Convey medical clearance for physical activity participation or make a referral to a medically-supervised exercise program

Question 35

What is the medical History Questionnaire?

Answer 35

• Some form of a Medical History Questionnaire is necessary to use with clients to establish their medical/health risks for both:
  Exercise testing &
  Participation in an exercise program
• The MHQ is generally thought of as being a fairly comprehensive assessment of a client’s medical, & personal & family health history

Question 36

When reviewing the MH, you should what?

Answer 36

Focus on conditions that require medical referral : absolute contraindications to exercise testing, & relative contraindications to exercise testing

Question 37

If any of these conditions are noted, what do you do?

Answer 37

Refer your client to a physician for a physical examination & medical clearance before exercise testing and starting an exercise program

Question 38

What’s the absolute contraindications?

Answer 38

Individuals with this type of contraindication should not perform exercise tests until such conditions are stabilized or adequately treated, or unless a physician orders an exercise test.

Question 39

What’s the relative contrindications?

Answer 39

Individuals with this type of contraindication may be tested only after careful evaluation of the risk-benefit ratio.

Question 40

What’s absolute contraindications to symptom-limited maximal exercise testing?

Answer 40

Acute myocardial infarction (heart attack) within 2 days

Ongoing unstable angina

Uncontrolled cardiac arrhythmia with hemodynamic compromise

Acute endocarditis

Symptomatic severe aortic stenosis

Decompensated heart failure

Acute pulmonary embolus, pulmonary infarction, or deep venous thrombosis

Acute myocarditis or pericarditis

Acute aortic dissection

Physical disability that precludes safe & adequate testing

Question 41

What is ischemia?

Answer 41

Lack of blood flow

Question 42

What are the relative contraindications to symptom-limited maximal exercise testing?

Answer 42

Known obstructive left main coronary artery stenosis

Moderate to severe aortic stenosis with uncertain relationship to symptoms

Tachyarrhythmias with uncontrolled ventricular rates

Acquired advanced or complete heart block

Recent stroke or transient ischemic attack

Mental impairment with limited ability to cooperate

Resting hypertension: SBP > 200 mm Hg &/or DBP > 110 mm Hg

Uncorrected medical conditions, such as significant anemia, important electrolyte imbalance, and hyperthyroidism

Question 43

What’s the coronary Risk Factor Analysis?

Answer 43

The CRF Analysis is not part of the ACSM’s (2022) health screening process for exercise preparticipation,
it is still important to assess your client’s CRFs to identify factors related to disease prevention & management.

Question 44

What is the criteria for age in Atherosclerotic Cardiovascular Disease?

Answer 44

Men ≥ 45 years; Women ≥ 55 years.

Self-explanatory

Question 45

What is the criteria for family history in Atherosclerotic Cardiovascular Disease?

Answer 45

Myocardial infarction, coronary revascularization, or sudden death before 55 years of age in father or other male first-degree relative (brother or son), or before 65 years of age in mother or other female first-degree relative (sister or daughter).

**Very important eg : mother at the age has heart attack , father at the age of 50 has a heart attack. You only count family history once **

Question 46

What is the criteria for cigarette smoking in Atherosclerotic Cardiovascular Disease?

Answer 46

Current cigarette smoker, or those who quit smoking within the previous 6 months, or exposure to environmental tobacco smoke.

currently smoking or quit 6 months ago or less is a risk factor

Question 47

What is the criteria for physical inactivity in Atherosclerotic Cardiovascular Disease?

Answer 47

Not participating in at least 30 minutes of moderate intensity physical activity (40% to < 60% VO2R; 3 to < 6 METs) on at least 3 days of the week for at least the last 3 months.

in a case study, this is the definition that you use. If they meet the minimum, then they are physically active

Question 48

What is the criteria for obesity in Atherosclerotic Cardiovascular Disease?

Answer 48

BMI ≥ 30 kg·m-2, or WC > 102 cm (40 in) for men and > 88 cm (35 in) for women.

eg: client has bmi of 27 and waist circumference of 105, do you classify them as obese? Yes

Question 49

What is the criteria for hypertension in Atherosclerotic Cardiovascular Disease?

Answer 49

SBP ≥ 130 mm Hg, and/or DBP ≥ 80 mm Hg based on an average of at least 2 measurements obtained on at least 2 separate occasions, or on antihypertensive medication.

Greater or equal to 130 systolic & greater or equal to 88 diastolic on 2 separate occasions.

Question 50

What is the criteria for dyslipidemia in Atherosclerotic Cardiovascular Disease?

Answer 50

LDL-C ≥ 130 mg·dL-1, or HDL-C < 40 mg·dL-1 in men and < 50 mg·dL-1 in women , or non-HDL-C ≥ 130 mg·dL-1, or on lipid-lowering medication. If TC is all that is available, use TC ≥ 200 mg·dL-1.

Question 51

What is the criteria for impaired blood glucose in Atherosclerotic Cardiovascular Disease?

Answer 51

Fasting plasma glucose ≥ 100 mg·dL-1, or 2 h plasma oral glucose values in an oral glucose tolerance test ≥ 140 mg·dL-1, or HbA1C ≥ 5.7% confirmed by measurements on at least 2 separate occasions.

a recent diagnosis of diabetes

Question 52

What is the criteria for high-serum HDL-C in Atherosclerotic Cardiovascular Disease?

Answer 52

HDL-C ≥ 60 mg∙dL-1

Question 53

If a CVD risk factor is not disclosed or is not available, what should it be counted?

Answer 53

Risk factor

Question 54

What is a Non-HDL-C?

Answer 54

Total cholesterol - HDL cholesterol

Question 55

What is high HDL?

Answer 55

Considered a negative risk factor. For individuals with a high HDL cholesterol concentration (≥ 60 mg·dL-1), one positive risk factor is subtracted from the sum of positive risk factors.

Question 56

What is the ACSM’S 2022 Exercise Preparticipation Health screening process is based on?

Answer 56

• The individual’s current level of physical activity
• The presence of signs or symptoms of cardiovascular, metabolic, or renal disease
• The presence of known CV, metabolic, or renal disease, and the desired exercise intensity

Current PA level, signs or symptoms of CV-M-R disease, presence of CV-M-R disease, and desired exercise intensity are used to guide recommendations for preparticipation medical clearance.

Question 57

What are the stages of pre participation Health Screening Process Before Initiating PA or an Exercise Program?

Answer 57

The need for medical clearance before initiating or progressing exercise programming is determined using the ACSM screening algorithm, & the help of a qualified exercise or health care professional. : In the absence of professional assistance, interested individuals may use self-guided methods (e.g., PAR-Q+).

If indicated during screening, medical clearance should be sought from a physician or other qualified health care provider. : The manner of clearance should be determined by the clinical judgement & discretion of the health care provider.

Question 58

What are the major signs or symptoms at rest or during activity suggestive of cardiovascular, metabolic, or renal disease

Answer 58

Pain, discomfort (or other anginal equivalent) in the chest, neck, jaw, arms, or other areas that may result from ischemia.
Shortness of breath at rest or with mild exertion.
Dizziness or syncope.
Orthopnea or paroxysmal nocturnal dyspnea.
Ankle edema.
Palpitations or tachycardia.
Intermittent claudication.
Known heart murmur.
Unusual fatigue or shortness of breath with usual activities.

Question 59

When may a pre-exercise evaluation that includes a physical examination, an exercise test, and/or laboratory tests be warranted?

Answer 59

1) Whenever the exercise professional or health care provider has concerns about an individual’s health status, or

2) When the exercise professional or health care provider requires additional information to design an exercise prescription, or

3) When the exercise participant has concerns about starting an exercise program of any intensity without such a medical evaluation.

Question 60

What are lifestyle evaluation?

Answer 60

Used to obtain information of a client’s living habits.

Provides useful information regarding an individual’s risk factor profile.

These factors can be used to pinpoint patterns & habits that need modification & to assess the likelihood of the client’s adherence to the exercise program.

Smoking (behaviour), Drinking habits, Lack of physical activity, and Dietary habits (saturated fats, trans fats, & cholesterol).

Question 61

What is the CSEP-PATH fantastic lifestyle checklist?

Answer 61

Family Friends
Activity
Nutrition
Tobacco, Toxics
Alcohol
Sleep, Seatbelt, Stress, Safe Sex
Type of Behaviour
Insight
Career

Question 62

What is the purpose of physical examination?

Answer 62

Detect signs & symptoms of disease.

Question 63

What is the purpose of blood chemistry profile?

Answer 63

Determine if the client has normal values for selected blood values; some of these values are used in coronary risk factor analysis (CRFA).

Question 64

What is the purpose of blood pressure assessment?

Answer 64

Determine if the client is hypertensive; BP values are also used in CRFA.

Question 65

What is the purpose of 12-Lead ECG?

Answer 65

Evaluate cardiac function & detect cardiac abnormalities that are contraindications to exercise.

Question 66

What is the purpose of graded exercise test?

Answer 66

Assess functional aerobic capacity & detect cardiac abnormalities due to exercise stress.

Question 67

What is the purpose of additional laboratory tests?

Answer 67

Provide a more in-depth assessment of a client’s health status, particularly if there is known disease.

Question 68

What are the additional clinical tests that may be indicated for individuals with known or suspected CHD?

Answer 68

Resting 12-lead ECG
Angiogram
Echocardiogram
Physician-monitored GXT
Exercising 12-lead ECG
Chest X-ray
Comprehensive blood chemistry
Complete blood count