Chapter 6: Building Rapport & Initial Investigation Stage Flashcards
3 Key Attributes of Rapport Building
Warmth:
This is having unconditional respect and positivity towards other people no matter who they are. This will communicate acceptance and safety.
Empathy:
The ability to understand someone else’s position as if you were in their shoes.
- Requires being able to separate the unnecessary from the meaningful.
- The ability to notice certain patterns of emotion (such as a client getting upset when you talk about their challenge with weight loss).
- The ability to be conscious of the differences between cultures while communicating.
Genuineness:
Ability to be open, honest, and authentic.
Different styles of communication:
Educating: This is a way of informing clients about information so that they can make better decisions.
Preaching: Preaching is a way of lecturing clients about what they should be doing in what they shouldn’t be doing. It comes across as judgmental and minimizes one’s chances of rapport.
Counseling: This is the most effective style out of the four listed when modifying or implementing a workout program. It is very supportive. Overall it is a collaborative effort towards helping personal training clients make better and more informed decisions.
Directing: This form is instructive. The trainer will provide directions and instructions. Can be effective. Technique and form are crucial.
Questions to ask in Investigation Stage
Ask the client about what types of physical activity/exercises they do in a typical week. This can include recreational activities, business activities, traveling, pain that they experience while moving.
You need to ask as many questions to better understand your client’s habits, history with exercise and overall lifestyle.
Health-Risk Appraisals
POSITIVE RISK FACTORS
If any of the answers are yes, one point is applied
AGE: Older than 45 years or men, Older than 55 years for women
FAMILY HISTORY: A history of sudden deaths, coronary revascularization, myocardial infarction. Before the age of 55 in the client’s father, or a male relative of the 1st degree. B for the age of 65 in the client’s mother, or a female relative that is of the 1st degree.
SMOKER: Current smokers or ones that quit within the last six months. It also includes people with high exposures to environmental/secondhand smoke.
SEDENTARY? This is for people that either do no physical activity, or less than 30 minutes of moderate intensity activity for three days a week, for at least three months.
Obesity: BMI over 30 or a waste girth of 40 inches (102 cm) for men or 35 inches (88cm) for women.
HYPERTENSION: Systolic blood pressure of more than 140 mmHg and/or a diastolic blood pressure reading of more than 90 mmHg. These readings need to be read at least two times. Or, the client is on antihypertensive medication.
DYSLIPIDEMIA: LDL cholesterol of more than 130 mg/dl or an HDL cholesterol of less than 40 mg/dl. It also applies if they are on a lipid-lowering prescription drug or if their total cholesterol serum is more than 200 mg/dl.
PREDIABETES: Pre-diabetes in your client is considered having a fasting plasma glucose of more than 100 mg/dl but less than 125 mg/dl.
NEGATIVE RISK FACTORS
If any of the answers are yes, one point is subtracted
HDL Cholesterol: Greater than 60 mg/dl
Risk Classifications
LOW RISK:
- Asymptomatic
- Having less than two risk factors.
- Medical exam before vigorous to moderate exercise
is NOT required - Exercise test is not recommended
- It is NOT needed to receive a doctor’s supervision to start exercising
MODERATE RISK:
- Asymptomatic
- Having more than (or) two risk factors
- Medical exam for moderate exercise is NOT
required - Medical exam for rigorous exercises IS
required - Exercise test before is not recommended
- It is not required to receive Dr. supervision
HIGH RISK:
- Symptomatic or you know that they have metabolic, pulmonary, renal or CV disease.
- Medical exam before moderate/rigorous exercise IS required
- Recommended to do an exercise test before a
moderate/vigorous exercise - Dr. supervision needed
Symptoms & Signs to be noted
- Tightness, pain or discomfort (angina) in the neck, chest, arms, jaw or any of the other areas that may come from ischemia.
- Difficulty breathing while at rest or a shortness of breath from minimal exertion (dyspnea)
- Paroxysmal nocturnal dyspnea or Orthopnea (Reclined position dyspnea).
[ (PND) is an attack of severe shortness of breath and coughing ] - Ankle edema (swelling)
- Tachycardia or palpations (Heart Beat over 100bpm)
- Intermittent claudication (Cramping and/or pain in lower extremities from a lack of blood supply)
- Heart murmurs
Difficulty breathing or abnormal fatigue during normal activities
- Syncope or dizziness
Atherosclerosis
When deposits from fat, cholesterol, and calcium gather in the arterial walls.
Causes the arteries to thicken
They lose their elasticity
Can lead to heart attacks, myocardial infarction’s and angina
Beta-blockers
Antihypertensive Medication
- Will block the effects of norepinephrine and epinephrine (catecholamine)
- Instead of target heart rate, use RPE if a client is using beta blockers
- Will lower the exercise, resting and maximum heart rate of client
Calcium channel blockers:
Antihypertensive Medication
- Will not significantly alter maximum heart rate
- Can both decrease, increase or have no effect on exercise or resting heart rate.
Diuretics
- Will increase the excretion of electrolytes as well as water through the kidneys.
- Can cause imbalances in electrolytes and water that lead to arrhythmias
- Has no major effect on heart rate
- Can predispose the client to dehydration
Heart Rate values
BRADYCARDIA: a slow heart rate that is less than 60 bpm
NORMAL HR: B/W 60 and 100 bpm
TACHYCARDIA: fast rate over 100 bpm
Overall averages are between 70 and 72 bpm
Males: between 60 and 70 bpm
Females between 72 and 80 bpm
- Due to smaller heart chamber for women
- Women have lower blood volume
- Women have lower hemoglobin (protein in your red blood cells that carries oxygen to your body’s organs and tissues and transports carbon dioxide from your organs and tissues back to your lungs.)
- Body position can affect resting heart rate
Digestion increases the resting heart rate
Ways of measuring heart rate
- Measuring your clients pulse for 10 seconds and then multiplying that number by 6
- Measuring your clients pulse for 15 seconds and then multiplying that number by 4
