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”

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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
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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

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4
Q

Old CSEP guideline:

A
  • CPAFLA

- The Canadian Physical Activity, Fitness & Lifestyle Approach

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5
Q

Most recent CSEP guideline:

A
  • CSEP - PATH

- Physical Activity Training for Health

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6
Q

2002 screening:

A

PAR - Q & you

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7
Q

2011 screening:

A

PAR - Q+

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8
Q

2017 screening:

A

Get Active Questionnaire

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9
Q

PAR - Q stands for:

A

Physical Activity Readiness Questionnaire

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10
Q

PAR - Q and you is for ages:

A

15-69 (roughly adult population)

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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
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12
Q

Describe the questions in PAR - Q & you:

A
  • questions considered broad and perhaps ambiguous

- probing conditions that might suggest a condition

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13
Q

PAR - Q & you is valid for how long?

A

only valid for 12 months

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14
Q

Yes to any question in the PAR - Q and You means…

A

you require medical clearance (PARmed-X)

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15
Q

PARmed - X aids in the identification of….

A

contraindications or special considerations if proceeding with an assessment

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16
Q

PARmed - X stands for:

A

Physical Activity Readiness Medical Examination

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17
Q

PARmed - X must be completed by …

A

a physician

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18
Q

3 stages of PARmed - X:

A
  • absolute contraindications
  • relative contraindications
  • special prescriptive conditions
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19
Q

Absolue contraindications:

A

permanent restriction or temporary restriction until condition is treated, stable, and/or past acute phase

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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
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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
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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
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23
Q

PAR - Q & you + PARmed = X =

A

PAR - Q+

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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
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25
Q

What is different in the PAR - Q+?

A
  • 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)
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26
Q

What replaces the PARmed - X in the PAR - Q+?

A
  • further questions

- additional info is obtained by the fitness assessment prior to making recommendation for medical assessment

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27
Q

Why is the PAR - Q+ potentially better than the PARmed - X?

A
  • 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
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28
Q

PAR - Q+ is based on…

A

stratification of risk

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29
Q

Who is considered apparently healthy and what is the minimum qualification needed to work with them?

A
  • all no answers on page 1 of PAR - Q+

- CSEP - CPT

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30
Q

Who is considered to have a stable health condition (low risk) and what is the minimum qualification needed to work with them?

A
  • yes answers on page 1 but no answers on pages 2-3 of PAR - Q+
  • CSEP - CPT
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31
Q

Who is considered to have a unstable health condition (moderate/high risk) and what is the minimum qualification needed to work with them?

A
  • yes answers on page 1 and pages 2-3 of PAR - Q+

- CSEP - CEP

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32
Q

CSEP - PATH must be completed by…

A

an M. D.

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33
Q

CSEP - PATH identifies ….

A

positive answer indicated on PAR - Q+ and provides physicians with more detail upon referral

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34
Q

CSEP - PATH form must be filled out with….

A
  • exercise recommendation
  • signed
  • stamped
  • returned prior to proceeding with testing or limited testing and prescription
35
Q

CSEP - PATH is valid for ___ months.

A

12

36
Q

CSEP - PATH also includes:

A
  • certification criteria of CSEP-CPTs/CSEP-CEPs

- CSEP- PATH assessment (provides a description of protocols)

37
Q

Differences in Get Active Questionnaire:

A
  • 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
Q

How long is the Get Active Questionnaire valid?

A

implies 6 months

39
Q

What happens if you answer YES to any of the questions in the Get Active Questionnaire?

A
  • 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
Q

Get Active Questionnaire includes a self assessment of _____ ____. It indicates _____ ____ ____.

A
  • PA

- current activity guidelines

41
Q

Get Active Questionnaire requires ____ ____.

A

self consent

42
Q

CSEP recommendation 1: All women without contraindication should be…

A

PA throughout pregnancy

43
Q

CSEP recommendation 2: pregnant women should accumulate at least ____ min. of moderate intensity PA each week to achieve _____ _____ health benefits and reductions in ____ ______.

A
  • 150
  • clinically meaningful
  • pregnancy complications
44
Q

CSEP recommendation 3: PA should be accumulated over a minimum of ____ days per week; however, being _____ every day is encouraged.

A
  • 3

- active

45
Q

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.

A
  • aerobic
  • resistance
  • yoga
  • stretching
46
Q

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.

A
  • pelvic floor
  • daily
  • urinary incontinence
47
Q

CSEP recommendation 6: pregnant women who experience ____ ______, _____ or feel _____ when they exercise flat on their _____ should modify their exercise position to avoid the ____ position.

A
  • light-headedness
  • nausea
  • unwell
  • back
  • supine
48
Q

PARmed-X for pregnancy is no longer required as part of _____ _____.

A

clinical guideline

49
Q

Pregnant women are strongly encouraged to…

A

speak to their healthcare provider

50
Q

Many/most practitioners (trainers, gyms etc.) require PARmed-X for pregnancy for…

A

liability insurance purposes

51
Q

PARmed-X for pregnancy form must be filled out with….

A
  • exercise recommendation
  • signed
  • stamped
  • returned prior to proceeding with testing or limited testing and prescription
52
Q

PARmed-X includes:

A
  • 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
Q

Informed consent:

A
  • 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
Q

Informed consent should be…

A
  • 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
Q

Informed consent does not…

A

absolve the appraiser from negligence

56
Q

Waiver:

A
  • 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
Q

Waiver does not ….

A

excuse irresponsibility

58
Q

3 forms that you need:

A
  • Get Active Questionnaire
  • informed consent
  • waiver
59
Q

Basic physiological assessment consists of:

A
  • heart rate

- blood pressure

60
Q

HR is to identify….

A

cardiac irregularities

61
Q

BP is to identify…

A

hypertension or hypotension

62
Q

Preliminary instructions (CSEP-PATH) prior to physiological screening:

A
  • 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
Q

HR cutoff:

A
  • if 99 bpm or less (< 100 bpm), proceed with appraisal

- if > 99 bpm have individual sit quietly for an additional 5 min

64
Q

If individual’s HR is > 99 bpm after second reading…

A

physician clearance is recommended

65
Q

Elevated HR =

A

tachycardia

66
Q

BP cutoff:

A
  • 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
Q

If individual’s systolic pressure is ≥ 160 mmHg OR diastolic pressure is ≥ 90 after second
reading…

A

physician clearance is recommended

68
Q

Normal BP:

A
  • Systolic: < 120 mmHg

- Diastolic: < 80 mmHg

69
Q

Elevated BP:

A
  • Systolic: 120-129 mmHg

- Diastolic: < 80 mmHg

70
Q

Hypertension stage 1:

A
  • Systolic: 130-139 mmHg

- Diastolic: 80-89 mmHg

71
Q

Hypertension stage 2:

A
  • Systolic: > 140 mmHg

- Diastolic: > 90 mmHg

72
Q

When we take BP, we should be aware of ….

A
  • white-coat hypertension (WCH)

- aka. elevated office BP (OBP)

73
Q

What is WCH or OBP?

A
  • 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
Q

What should we do for someone with WCH or OBP?

A
  • check BP at rest, during and after exercise

- stop test at any time and refer to physician with a report

75
Q

Newborn (0-3 months old) HR:

A

100-150 bpm

76
Q

Infants (3-6 months old) HR:

A

90-120 bpm

77
Q

Infants (6-12 months old) HR:

A

80-120 bpm

78
Q

Children 1-10 years HR:

A

70-130 bpm

79
Q

Children over 10 and adults (incl. seniors) HR:

A

60-100 bpm

80
Q

Well trained athletes HR:

A

40-60 bpm

81
Q

ACSM pre-screening is conducted by..

A

a health/fitness professional

82
Q

ACSM pre-screening is initially stratified by…

A

exercise status

83
Q

ACSM pre-screening follows a ____ model for clarity.

A

logic

84
Q

In ACSM pre-screening, secondary consultation is needed for the presence of…

A

cardio/metabolic/renal dysfunction