Week 2 Flashcards
6 Steps of the CSEP-PATH sequence
- Step 1 - ASK: get to know client
- Step 2 - ASSESS: Conduct physical activity, fitness, and/or lifestyle assessment
- Step 3 - ADVISE: Summarize results and discuss
- Step 4 - AGREE: Devise plan of action
- Step 5 - ASSIST: Increase motivation and overcome barriers
- Step 6 - ARRANGE: Provide Continuing support (follow ups)
Objectives of Step 1 - ASK
- Gain insight on client’s goals and interests
- Explain CSEP-PATH options and confirm the scope of the assessment
- Complete informed consent
- Discuss pre-meeting info
- Complete pre-participation screening process including the GAQ, RHR, RBP, and collection of relevant medical history
Def: Physical Activity
Any movement intentional or not
Def: Exercise
Intentional movement with structure
Def: Fitness
Measurement of variable related to body’s ability to preform movement
- Many different fitness variables
- Don’t always measure (can make plan based on history)
What aspects of fitness should you gain an understanding of what the client thinks about them?
- Knowledge of the importance of physical activity to health
- Primary motivation (Goals) and drivers (intrinsic or extrinsic)
- Level of commitment (readiness for change)
- Confidence that he/she can initiate and stick with physical activity plan (Self-efficacy)
Def: Self-efficacy
Own belief in how well you can do something
What are some potential questions to ask your client about motivation
- What brings you in to see me today?
- What made you sign up for the appointment
What are some potential questions for learning about a clients current activity levels
- How active are you?
- Does you job require you to sit for long periods of time?
- How about your commute?
- How do you spend your leisure time?
Potential questions to learn about clients history
- Was there a time when you were more active
- Have you ever worked with a personal trainer before? what did you like/not?
Physical activity readiness screening
- Pre-assessment instructions
- Informed consent
- Get Active Questionnaire (if applicable, physician guidance for physical activity or GAQ for pregnancy)
- Observations (Daily circumstances like sick)
- Collection of relevant medial history
- Pre-exercise heart rate and pre-exercise blood pressure
Preliminary Instructions for clients (The welcome letter)
Dress Requirements
- Light clothes and walking shoes
Food & Beverages
- No food 2 hours prior
- No caffeinated beverages 2 hours prior
- No alcohol 6 hours prior
Smoking
- No smoking 2 hours prior
Exercise
- no exercise 6 hours prior
Informed Consent
- Describe assessment (written and verbal)
- Signed in pen before anything else done
- Not a waiver form
- <18 years - youth consent form signed by guardians
- Must be witnessed at the time of signing by a 3rd party independent of the association you are working with
- Must be signed by client prior to collecting personal information
Role of QEP in pre-participation health screening
- Conducts prescreening to reduce liability and inform exercise program
- At minimum: evidence-based screening tool, medial history, RHR and RBP, assessment of current PA levels
- Works withing their knowledge skills and abilities
- Charts information about client’s medical history
- Considers client’s risk of an adverse event
Get Active Questionnaire
- Client must read and answer questions on GAQ without interpretation form CPT
- Form must be signed with ink pen and witnessed by 3rd party
- Client’s answer determine whether client falls within the CSEP-CPT scope of practice or requires clearance from a physician before either doing the active portions of the fitness assessment or starting an exercise program
- Form is valid for 12 months or unless health condition changes
What is on page 1 and 2 of the GAQ
Page 1
- 4 questions to identify clients who may need t seek advice from an appropriate health care professional before becoming more physically active
Page 2
- Assessment of current physical activity levels
- General advice for becoming more physically active
-Declaration
Why is it important to understand the client’s current PA levels
- The cardiovascular risk associated with exercise lessens as individuals become more physically active
- Clients who do regular physical activity, can usually begin at a level of physical activity that they are currently doing and progress appropriately
- Clients who are inactive should begin with light to moderate physical activity and progress gradually as tolerated
- Clients who have a lower risk medical condition and are interested in vigorous activity, should be referred to a CSEP-CEP
Limitations of the GAQ
- Possible for clients to have a diagnosed condition or take medications despite answering NO to all of the questions on page 1
MUST ASK all clients about their medical history - Any suspected or diagnosed conditions
- Taking any medications (over the counter or prescribed)
CSEP-CPT Health Screening Tool
- Used when clients identify as part of the pre-screening process that they have one medical condition
- tool helps CPT determine if client’s medical condition is low risk (stable)
- Not a substitute for the GAQ
Apparently Healthy Clients
- No diagnosed medical condition
- No overt signs and symptoms suggesting any potential underlying medical conditions
- Able to exercise independently
Low risk medical condition clients
- Condition is being medically managed and client is asymptomatic
- No change in meds or treatment plan in the past 6 months
- Client can exercise independently
- Benefits of physical activity clearly outweigh risks
Higher risk medical condition clients
Considered is meet any of follow (can’t work with)
- May not be medically managed
- May be symptomatic
- Treatment may have recently changes
- May not be able to exercise independently
- Benefits of physical activity may not outweigh risks
What medical conditions are included on the CSEP-CPT Health Screening Tool
- Asthma
- Heart Disease
- Hypertension
- Osteoarthritis
- Osteoporosis
- Type 2 diabetes
Reasons to refer a client elsewhere
- Client not able to exercise independently
- Client at risk for an adverse event or has an unstable health condition
- Client wishes to engage in maximal or near-maximal exercise
- Client has 2 or more co-morbid conditions
- Client has resting HR or BP above screening requirements
- You do not feel that you have the knowledge, skills or abilities to work with the client
What form should be used when referring a client to a physician?
Physician Guidance for physical activity form
- Pafe 1-2 is to be completed and signed by the physician
- Page 3 provides additional information about the CSEP-CPT qualifications, the PATH and the 24h movement guide
Day of observations of client that would lead to postponed assessment
- Difficult breathing at rest
- Cough persistently
- Ill or have a fever
- low extremity swelling
- clearly ignored preliminary instructions
- predisposed to unnecessary risk
- Is there any reason to believe you could be pregnant
Cut offs for pre-exercise blood pressure
SBP >160
DBP >90
* if not previously diagnosed with hypertension by SBP 140-160 you may proceed by should be encouraged to discuss their resting BP with their physician
Cut offs for pre-exercise heart rate
> 100 bpm
What optional questionnaires may be useful
- Abilities for active living questionnaire
- Physical activity & sedentary behaviour
- Healthy sleep assessment
- Stages of change
- Inventory of lifestyle needs and activity preferences
Working with clients with disabilities
- Most appropriate terminology is usually that used by the client in describing his/her disability
- Avoid using negative value judgements
- Use normal conversational phrases that refer to specific activities
- If a client is offended by the use of a particular term or phrase, ask for an alternative
Abilities for active living questionnaire
- Used to identify a disability that may require some accommodation on the part of the facility or qualified exercise professional to facilitate a successful first meeting
- Not a risk screening device
Physical activity and sedentary behaviour questionnaire
- Provides an approximation of clients’ physical activity and sedentary behaviour for a typical week
- Use in conjunction with health benefit ratings
Healthy sleep assessment
- Questions provides an indication of whether the client has good or poor sleep habits
- Question banks for age ranges (Toddler 3-4, children and youth 5-17, adults 18+)
Stages of change questionaire
- Propose is to identify a client’s stage of motivational readiness for change
- Knowing this allows you to decide appropriate strategies for enhancing their commitment to change
