collection of all relevant information to identify needs - readiness to change - health history - lifestyle preferences - assessments

- implementation of program - feedback - strategies for adherence - strategies for motivation - monitor progression toward goals

Chapter 6 - PT Manual Flashcards by Sarah Durr

PAR-Q form does NOT INCLUDE (3)

current health conditions

medications

past injury

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RF: Age

men 45 yrs or older

women 55 yrs or older

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RF family history (3)

heart attack, coronary revascularization, sudden death

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Sudden death RF ages
father
mother

father - before 55 in or 1st male relative

mother - before 65 or 1st female relative

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Smoking RF (3)

current smoker
quit within the last 6 months
exposure to second hand smoke

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Sedentary lifestyle (3)

NOT doing (physical activity)
30 min
3 days/week
3 months

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Obesity RF

BMI 30 or greater
waist 40 - men
waist 35 - women

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Hypertension RF

SBP greater than 140
DBP greater than 90

OR
currently on antihypertensive medications

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Dyslipidemia RF

LDL 130 or greater
HDL less than 40
*serum cholesterol 200 or greater
only use serum if all that is available

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Pre-diabetes RF

fasting plasma glucose 100 mg/dl or greater

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Negative RF

HDL cholesterol greater than 60 mg/dl

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Basis for performing risk stratification is to determine

presence/absence of known cardiovascular, pulmonary or metabolic disease
presence/absence of cardiovascular risk factors
presence/absence of signs/symptoms of cardiovascular, pulmonary or metabolic disease

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Client can only receive _ point per risk factor

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Empathy

ability to experience another person’s world as i were your own

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Warmth

*promotes

unconditional positive regard for another person regardless of his/her individuality and uniqueness

*safety and acceptance

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Genuineness

authenticity, ability to be open/honest

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Rapport

mutual trust, ability to communicate effectively

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Investigation (4)

collection of all relevant information to identify needs

readiness to change
health history
lifestyle preferences
assessments

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Planning (3)

goal setting
programming considerations
design motivation and adherence strategies

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Action (5)

implementation of program
feedback
strategies for adherence
strategies for motivation
monitor progression toward goals

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Primary nonverbal communication skill

effective listening

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Active listening

trainer shows empathy and listens as if he/she was in the trainers shoes

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Restating essence of client’s content of his/her communication

paraphrasing

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Restating the feelings and/or content of what the speaker coveys but with different words - feelings or attitudes may be included

relfecting

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Expanding upon shared information - providing factual information

informing

Mild to strong feedback, can encourage accountability | *can be used when there's lack of motivation

confronting

key to effective listening

active listening

Cognitive messages

factual

Affective messages

feelings, emotions and behaviors | -verbal and nonverbal

Deflecting

changing the focus off one individual - only use when trainer is sharing an appropriate experience

Directing - most effective when teaching

safety and proper form

_model identifies clients readiness to change

TTM model

Stages of change

``` pre-contemplation contemplation preparation action maintenance ```

Client centered method for enhancing change in intrinsic motivation - getting client off the fence about exercise

motivational interviewing

Self-directed pre-participation screen

PAR-Q

3 steps for risk stratification

1. identify coronary artery disease risk factors 2. perform risk stratification based on risk factors 3. determine the need for medical eam/clearance

``` Low risk = asymptomatic # of risk factors medical exam, exercise test, dr supervision of exercise test ```

less than 2 no for all

``` Moderate risk = asymptomatic # of risk factors medical exam, exercise test, dr supervision of exercise test ```

2 or more yes- medical exam before vigorous exercise no to exercise test and dr supervised

High risk = symptomatic | medical exam, exercise test, dr supervision of exercise test- symptomatic

symptomatic or known cardiovascular, pulmonary, renal or metabolic disease yes to all

CAD signs/symptoms (9)

tightness in chest (angina) SOB orthopnea (can only breathe sitting or standing) ankle edema palpitations or tachicardyia (HR elevated 100BPM) claudication (cramps in lower extremeties) known heart murmur unusual fatigue dizziness, syncope (fainting)

Informed consent

client is informed about risks associated with activity | -not a liability waiver

Agreement and release of liability waiver

release trainer from liability

Form that collects detailed medical and health information - medications, activity history, illness, surgery

health history questionnaire

Form that provides detailed background of previous exercise history and adherence

exercise history and attitude questionaire

Questionaire safe for pre-screening for low to moderate exercise

PAR-Q

2 risks associated with regular physical activity

cardiac arrest | musculoskeletal injury - most commonly injured system

How does CAD affect exercise? can cause _ physician's release Y or N

narrowed vessels (atherosclerosis) limit oxygen to the heart heart attack Yes

Hypertension - BP can elevate during exercise and cause

stroke

Respiratory disorder requires physicians release Y/ N

Yes

Atrophy can begin after _days of inactivity

2 days

Physicians release required for any injury more severe than a strain or sprain

Yes

Diabetes and thyroid require physicians release

Yes | *especially with insulin use

Pregnancy requires physician's approval y/n

yes

Beta blockers (3)

- block the effects of epinephrine and norepinephrine - reduced resting, exercising and maximal HR - use RPE

Calcium channel blockers (2) BP HR

lower BP | -may increase, decrease, not effect HR

ACE Inhibitors (2) BP HR

- prevent blood vessels from constricting - decrease BP at rest and at exercise - no effect on HR

Diuretics

- decrease blood volume | - cause dehydration

Bronchodialators

dilate air passages - increase exercise capacity

Cold medications

raise BP b/c of vasoconstriction - increase BP abd HR rest and exercise - reduces volume of swollen tissues

Test termination signs (5)

- angina - changes in BP - signs of poor perfusion - cramps - severe fatique

Test environment temp

68 to 72

2 common pulse sites to measure pulse rate

``` carotid artery (neck) radial (wrist) ```

Sinus brachycardia Sinus tachycardia Normal sinus rhythm

slow HR: RHR less than 60 BPM fast HR: RHR greater than 100 BPM 60 -100 BPM

Average RHR men average women average

70-72 BPM 60-70 BPM 72-80 BPM

Higher values in HR in females due to (3)

smaller heart chamber lower blood volume circulating less oxygen in the body lower levels of hemoglobin

Elevation in RHR by 5 BPM or greater over a period of days is a sign of

overtraining

5 things that can affect RHR

``` body position digestion absorption medications environment ```

Measuring resting HR (3)

client rests several minutes place tips of middle and index finger over artery count # of beats for 30 or 60 seconds

Measuring exercising HR (3)

10-15 second count count the first beat at the start of the time interval multiply count by either 6 (for a 10 second count) 4 (for a 15 second count)

Outward force exerted by blood on vessel walls is known as

blood pressure

pressure created by the heart as it pumps the blood into circulation via ventricular contraction

Systolic blood pressure

pressure that is exerted on the artery walls as blood remains in the arteries during the filling phase of the cardiac cycle

diastolic blood pressure

SBP signified by DBP indicated by

Korotkoff sounds - first perception of sound 4th (significant muffling sound) and 5th disappearance of sound

BP monitor and cuff arm placement

sphygmamomanometer left - closer to heart - sounds amplified

normal BP pre-hypertension hypertension stage 1 stage 2

LESS THAN 120/ LESS THAN 80 SBP 120-139 / DBP 80-89 SBP 140 - 159 / DBP 90-99 SBP GREATER THAN 160 / DBP GREATER THAN 100

btwn 40 - 70 yrs old: 20 icrease in SBP OR 10 increase in DBP

risk of cardiovascular disease doubled

BORG score: 6 = BORG score: 12 BORG score: 20

HR of 60 BPM HR of 120 BPM HR of 200 BPM

Exercise induced feeling inventory should be administered | 2

during initial interview - rate previous experience directly after workout is complete

0 to 10 scale should be used when

trainer does not need to obtain HR via RPE

VT1 Fuel sources switches from

Fats to carbohydrates

Chapter 6 - PT Manual Flashcards

(80 cards)