Step 4: AGREE

Question 1

What is the purpose of step 4 AGREE?

Answer 1

DEVISE AN ACTION PLAN
- guiding the client in making choices about what will work for them. Clients who have expressed a commitment to increase their physical activity levels are ready to set specific goals and develop strategies for reaching those goals. Other clients may not be ready to commit to increasing their physical activity levels at this time. Consider, instead, focusing on strategies to make daily tasks more physically active and ways to reduce sedentarily.

Question 2

What is the to-do list for step 4 agree?

Answer 2

1. SMART goal setting (Specific, Measurable, Actionable, Relevant and Timed)
2. Aerobic training prescription (Frequency, Intensity, Time, and Type)
3. Resistance training prescription (Frequency, Intensity, Time, and Type)
4. Flexibility prescription

Question 3

What documents do we use in this step?

Answer 3

1. Inventory of Lifestyle Needs and Activity Preferences
2. Goal Setting Worksheet
3. CSEP-PATH® Prescription Card

Question 4

Clients, who are ready and motivated to initiate or resume a physical activity or exercise program will benefit from what?

Answer 4

a balanced program that addresses the client’s goals, preferences, current physical activity levels, and fitness assessment results.

Question 5

What does step 4 assume?

Answer 5

the client is ready for such a program and focuses on the basic principles of exercise prescription.

Question 6

What should a balanced exercise program include?

Answer 6

1. An aerobic or endurance component to support cardiorespiratory fitness and healthy body composition.
2. A resistance component to promote the development of strong muscles and bones.
3. A stretching component to promote flexibility, good posture, or to relieve pain and/or stress.

Question 7

True or False? Effective goal setting is an essential component of physical activity and sedentary behavior prescription.

Answer 7

True.
- This is especially true for less active clients for whom habituation represents the greatest challenge. Their inexperience in knowing what is realistic is also a significant factor.

Question 8

When a client is working with a QEP what are the three main goals one would have?

Answer 8

i) improve overall health and well-being;
ii) improve fitness levels; and/or
iii) improve their performance capabilities for work or sport.

Question 9

What are the 5 prescription principles?

Answer 9

1. overload.
2. progression.
3. specificity.
4. reversibility.
5. individuality.

Question 10

What is the overload principle?

Answer 10

The training stimulus must be greater than that to which the body is accustomed. This can be achieved by changing the types of activities or by increasing the frequency, intensity, duration, or the number of repetitions and sets in a program.

Question 11

what is the progression principle?

Answer 11

As an individual’s training capacities expand, the initial intensity and volume of activities may not be sufficient to stimulate continued physiological adaptation. The initial workload must increase (progress) to ensure continued improvement.

Question 12

what is the specificity principle?

Answer 12

The demand placed on the body dictates the type of adaptation that will occur. Hence training effects are specific to the energy system used (i.e., aerobic or anaerobic), as well as the muscle groups, joint actions, and type/speed of muscle contraction.

Question 13

What is the reversibility principle?

Answer 13

Discontinuing or lowering the intensity or volume will have a detraining effect. The losses can be regained by resuming the program.

Question 14

What is the individuality principle?

Answer 14

As each individual responds uniquely to training, the program must meet the needs, interests, abilities, and goals of the client.

Question 15

What is the HRR equation? what is it used for?

Answer 15

(i. e., HRR = [(HRmax – HRrest) × intensity] + HRrest).

- calculating training zones.

Question 16

provide an example of the HRR calculation?

Answer 16

For example, a client with a HRmax of 175 bpm and resting heart rate of 65 bpm who needs to train in a target heart range of 50-60%HRR:

Target HR at 50%HRR = [(175-65) X 0.50] + 65 = 120 bpm
Target HR at 60%HRR = [(175-65) X 0.60] + 65 = 131 bpm

Question 17

What is a key goal for those who have been inactive, and hence it may be suitable to recommend daily physical activity of light-to-moderate intensity and minimum duration?

Answer 17

Habituation/ develop a routine.

Question 18

The type of exercise chosen will vary on what?

Answer 18

client’s preferences and interests, their fitness levels, and their skills and background in particular activities

Question 19

heart rate response is less variable in rhythmic activities like what? and what is the benefit?

Answer 19

• Walking and jogging.
• The low variability nature of these kinds of activities makes them ideal for maintaining the moderate-to-vigorous zone appropriate to the client’s fitness level.
• The even pace is particularly well suited for less fit clients.

Question 20

If the client’s skill level is sufficient, what activities can generate a consistent moderate-to-vigorous heart rate response?

Answer 20

skating, cross-country skiing, or swimming involve more specific skills.

Question 21

What is good for Minimal skill? Minimal fitness level?

Answer 21

Low- to moderate-intensity endurance activities of a continuous nature.

Walking, leisurely cycling, aqua-aerobics.

Question 22

What is good for Minimal skill? The baseline level of aerobic fitness?

Answer 22

Moderate- to vigorous-intensity endurance activities of a continuous nature.

Jogging, running, rowing, spinning, stepping.

Question 23

What is good for Acquired skills? The baseline level of fitness.

Answer 23

Moderate- to vigorous-intensity endurance activities that require a level of skill to achieve a constant level of intensity.

Cross-country skiing, swimming, skating.

Question 24

What is good for Acquired skills? A modest level of fitness?

Answer 24

recreational sports require modest fitness levels and skills to handle the vigorous and variable nature of the workload.

Hockey, soccer, racquet sports.

Question 25

How many days a week does the Canadian Physical Activity Guidelines recommend for muscle strengthening and bone health?

Answer 25

2.

Question 26

Why do we do flexibility training?

Answer 26

With age (and particularly inactivity), the muscles weaken and joints become less stable and mobile, often leading to stiffness and loss of flexibility. Such declines in the hip and pelvis area can reduce step length and velocity, negatively affecting a person’s mobility and increasing their susceptibility to injury.

Question 27

What does flexibility training do?

Answer 27

Flexibility training has been shown to increase joint range of motion and may be beneficial in preventing injury.

Question 28

Why are balance and stability important?

Answer 28

• Balance and stability are very important aspects of musculoskeletal health and essential to the safe and efficient execution of activities of daily living (e.g., walking, snow shoveling, lifting grocery bags, etc.) and in a wide range of recreational sports.
• balance training can also be a particularly important component for adults at risk of falling as a fall can dramatically impact the person’s health, independence, and quality of life.

Question 29

what are some examples of resistance-based balance training?

Answer 29

closed kinetic chain free weight exercises such as squats, lunges, step-ups, and deadlifts.

Question 30

Other examples of balance exercises include?

Answer 30

using an unstable device such as a ball, disc, or wobble board can be used while performing such exercises as squats, back extensions, chest presses, and a myriad of other exercises.

Question 31

what is the Inventory of Lifestyle Needs and Activity Preferences Sheet?

Answer 31

it is used as a guide to help clients identify lifestyle needs that are important to them and choose activities that will help meet these needs, have clients review the Lifestyle Needs list on their own, and check the items that apply. Have them select 3 that are the most important.

Question 32

What is the goal-setting worksheet?

Answer 32

The Goal Setting Worksheet Tool is designed to help clients in the preparation phase identify practical, short-term, and longer-term goals and specific actions for achieving them. It can be treated as a self-contract to act as a motivator for the client.

Question 33

What are the potential aerobic fitness goals of someone with a good, very good, or excellent health benefit rating?

Answer 33

1. improve general fitness and/or train for a new activity (e.g. complete a 10K run)
2. Increase power, endurance, or some other fitness component specific to the client’s sport or occupation

Question 34

what are the aerobic prescription priority for someone with a good, very good, or excellent health benefit rating?

Answer 34

1. Multicomponent program including aerobic, strength, and flexibility training
2. Encourage reductions in sedentary time
3. Include proper rest/recovery work

Question 35

What is the aerobic FITT principles for someone with a good, very good, or excellent health benefit rating?

Answer 35

Aerobic

F = At least 150 minutes/wk. More is better. Daily training possible, with proper recovery and rest between intense sessions.

I = Moderate-to-vigorous.

T= 30–45 minutes (or more) depending on intensity.

T = Continuous aerobic activity (e.g., brisk walking, jogging, swimming) and active living.

Strength & Flexibility
- 2 days/week of strength training (or more) with free weights or machine weights choosing between full-body or split routines.
Stretching after aerobic and/or strength training

Question 36

What are the potential aerobic fitness goals of someone with a poor or fair health benefit rating?

Answer 36

1. Improve health.
2. Reduce the risk of chronic diseases.
3. Lose weight.
4. Improve functional ability.

Question 37

what is the aerobic prescription priority for someone with a poor or fair health benefit rating?

Answer 37

1. Help the client get moving
2. Integrate physical activity into daily living
3. Encourage reductions in sedentary time
4. Progress towards a multicomponent exercise program including aerobic, strength, and flexibility training

Question 38

What are the aerobic FITT principles for someone with poor or fair health benefit rating?

Answer 38

Aerobic

F = Start with 1–2 days/week. Aim for 3–5 days/week.

I = Light to moderate.

T= Start with 10–20 minutes/session. Aim for 30 minutes/session.

T = Continuous aerobic activity (e.g., walking) and active living (e.g., active commute to work, taking stairs versus the elevator).

Strength & Flexibility
- Encourage some stretching after aerobic sessions.
Discuss adding resistance training such as light weights, resistance bands or bodyweight exercise after the client has done several weeks of regular aerobic activity

Question 39

What are the characteristics of the pre-contemplation stage?

Answer 39

• not intending to change.
• awareness may not be complete.
• may be demoralized.
• may not think about their habits.
• pros for not changing outweigh the cons.

Question 40

What are strategies for getting someone out of pre-contemplation?

Answer 40

• increase awareness of the importance.
  increase the pros for physical activity.
• help the client think and talk about the habit.

Question 41

What are the characteristics of the contemplation stage?

Answer 41

• intending to change in the next six months.
• maybe ambivalent. (mixed feelings).
• low self-confidence.
• more-open to consciousness-raising.

Question 42

How can we help someone in contemplation?

Answer 42

• increase attention to action by; addressing ambivalence, highlighting the benefits specific to them, and building self-efficacy.

Question 43

what are the characteristics of the preparation stage?

Answer 43

• intending to take action in the next 30 days.
• may have already been modifying their behavior.
• may have tried in the past year.

Question 44

how can we help someone in preparation?

Answer 44

• help the client plan.
• set a date.
• focus on the pros.
• provide resources that might help them.

Question 45

what are the characteristics of the action stage?

Answer 45

• have changed their behavior in the past six months.
• highest stage for a relapse.
• need support because this can be a challenging time mentally.

Question 46

how can we help someone in the action stage?

Answer 46

• support the client to prevent relapse.
• teach them how to deal with lapses.
• deal with current relapses with them.
• promote social support.

Question 47

what are the characteristics of the maintenance stage?

Answer 47

• confidence is very high.
• lasts from 6 months to termination (no risk of stopping).
• have learned strategies for dealing with relapses.
• usually do not need support with the behavior anymore.

Question 48

how can we help someone in the maintenance stage?

Answer 48

• support the person in maintaining behavior to prevent relapse.
• prepare them in case of relapse.
• add variety/refine the program.