Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
55 Cards in this Set
- Front
- Back
|
What are general assessment guidelines
|
Health risk appraisal including health history questionnaire and resting measurements (HR and BP)
|
|
|
How to assess heart rate?
|
Palpation :Take pulse at radial (ventral/thumb side) or carotid artery (not too hard); also can use a stethoscope; EKG, telemetry
|
|
|
Classification levels of RHR
|
Bradycardia <60 bpm
Normal sinus rythym 60-100 bpm Tachycardia >100 bpm Avg 60-70 bm for males and 72-80 female (70-72 overall) |
|
|
What affects RHR?
|
RHR is affected by fitness status, fatigue, body composition, drugs/Rx, ETOH, caffeine, stress; body position when measured, digestion increases it, environment like temperature and noise
|
|
|
Procedure for measuring RHR
|
have client rest comfortably for several minutes, count beats 30-60 seconds, first pulse is measured as 0; if using a stethoscope left of sternum
|
|
|
Procedure for measuring exercise heart rate (EHR)
|
measure 10-15 seconds, first count is 0
|
|
|
How to determine exercise target heart rate?
|
Compare RHR with Maximal HR (MHR is 208-0.7 x Age)
HRR is heart rate reserve (MHR-RHR) Target THR = (HRR x % intensity) + RHR |
|
|
Cardiovascular Drift
|
as exercise duration increases, the heart rate often increases even without an increase in intensity level, probably due to increase in temperature due to dehydration, blood redistribution
|
|
|
Blood pressure
|
The outward force exerted by the blood on the vessel wall; recorded as systolic (higher) over diastolic (lower)
|
|
|
Systolic Blood Pressure
|
pressure created by the heart as it pumps blood into circulation via ventricular contraction; this represents the greatest pressure during one cardiac cycle
|
|
|
Diastolic Blood Pressure
|
pressure that is exerted on the artery walls as blood remains in the arteries during the filling phase f the cardiac cycle, or between beats when the heart relaxes; it is the minimum pressure that exists within one cardiac cycle
|
|
|
What are Korotkoff Sounds?
|
Sounds made from vibrations as blood moves along the walls of the vessel; these sounds exist when there is deformation of wall, as when cuff is on tight; when the cuff is inflated to pressures greater than the highest pressure taht exists within a cardiac cycle, the brachial artery collapses, preventing blood flow; as air is slowly released from the bladder, blood begins to flow oast compressed area
The 1st BP phase is signified by onset of tapping which is the SBP. The DBP is inficated by the 4th (muffling) and 5th (disappearing) phases |
|
|
What is BP procedure?
|
Sit with feet on floor for 5 min (if on exam table, DBP may be increased by 6mmHg); right arm is standard but left arm is closer to heart and may amplify sounds; up to 20% people have sig diff betw rt and left; wrap cuff with lower margin about 1 inch above inside of elbow (in very boese put on forearm); support arm at angle od 0-45 degrees
|
|
|
How to use cuff & stethoscope for reading BP?
|
Turn knob to close cuff valve and rapidly inflate to 160mmHg (or 20-30 above where pulse can no longer be felt); put steth flat against skin on radial artery; release pressure at rate of 2mmHg per second by slowly turning knob to left
SBP: read dial at 1st perception of sound DBP: read dial when sounds cease to be heard or muffled |
|
|
Common source of errors when measuring BP
|
cuff deflation is too rapid, inexperience of administrator, poor stethoscope placement, wrong cuff size, too loud or can't hear, have to wait 5 minutes before redoing it
|
|
|
Measuring BP during exercise
|
hard to do it; usually only if you are worried about excessive hypotension use stand and hand held gauge, if SBP drops during exercise, re do it immediately
|
|
|
Risk factors for elevated BP
|
each 20mmHg increase in SBP or each 10mmHg in DBP above normal doubles risk of cardiovascular disease and cerebral vascular disease; and 70% death
|
|
|
BP Classifications
|
Normal= <120/<80
Prehypertension= 120-139/80-89 Hypertension 1= 140-159 or 90-99 Hypertension 2= >160 or >100 |
|
|
RPE= Ratings of Perceived Exhaustion
|
used to subjectively quantify overall feelings and sensations during stress of physical activity; they can be compared with previous sessions and have been validated against HR; can be used when taking beta blockers which blunt HR response
|
|
|
Borg 6 point scale of RPE
|
Borg 6 = HR 60 bpm
Borg 12 = HR 120 bpm Borg 20 = HR 200 bpm |
|
|
Issues with RPE
|
Men underestimate and women overestimate exertion, RPE has high learning curve that demonstrates deviation to mean; very sedentary people have initial trouble with RPE; conditioned folks may underrate RPE if they focus on muscular exertion; best to use 10 point scale unless you need actual HR equivalents or if exercise HR is unreliable due to Rx
|
|
|
When to immediately terminate any cardiorespiratory fitness testing?
|
onsite of anginea,. drop +10mmHg in SBP, excessive rise on SBP (SBP >250mmHg or >115mmHG); fatigues, shortness of breath, labored/ wheezing , signs of poor perfusion (lightheadedness, pallor, cyanosis, confusion, syncope); leg cramping, physical/verbal manifestations of severe fatigue, or if client requests or equipment fails
|
|
|
Why is CRF assessment useful?
|
Determine functional capacity, determine level of cardiorespiratory function/maximum oxygen uptake (VO2 max) or MET (metabolic equivalent); determine any underlying abnormalities, reassess progress
|
|
|
How to determine maximal oxygen uptake?
|
220-age for MHR; +- 12 bpm; because based on calculations usually underestimates for deconditioned and over estimate for very fit; best to use sub-maximal exercise testing because it is safer and reliable
|
|
|
MET
|
Metabolic equivalent where workload is a reflection of oxygen consumption and energy use (1 MET = O2 use at rest); most ADL are 5 MET
|
|
|
Major indicators of coronary event revealed in CRF assessment
|
Decrease or sig increase in BP with increase; inadequate HR response, if tolerate for short time higher risk of CAD, quicker HR recovery is best
|
|
|
What should be constantly assessed and recorded during exercise test?
|
HR, BP, RPE, S/S
|
|
|
Aerobic testing consists of??
|
Talk test on treadmill (ventilatory threshold test), Balke & Ware treadmill exercise test; Rockport walking Field Test
|
|
|
Ventilatory threshold test aka Talk test
|
as exercise increases ventilation increase; at 1st ventilatory threshold (VT1) blood lactate accumulates; at lower intensities fats are major fuel; the need for o2 is met mostly thru increase in tidal volume; past crossover point at VT2 a quickened expiration rate blows off more CO2 in an effort to buffer lactate; now increase in respiratory rate and rapid increase in blood lactate; talking is hard/ labored
|
|
|
How to assess ventilatory threshold?
|
Recite pledge of allegiance at last 30 seconds of each 2 minute stage on treadmill; keep increaseintensity by 5 pm per setage to gradually increaseHRss; use VT1 for de-conditioned, VT2 for advanced client; end point is when it is hard to talk
|
|
|
HRss
|
Steady state heart rate: the point during aerobic endurance exercise where the heart rate will level off (not continue to rise), assuming the work load remains constant; the point at which the demands of the active tissues can be adequately met by cardiovascular system
|
|
|
Balke and Ware Treadmill Exercise Test
|
Best for elderly/de-conditioned; terminate when reach 85%MHR, speed is held constant (increase incline every few min); assess RPE, HR and BP in last 30 sec of each stage; estimate VO2 max and max MET level
|
|
|
Field Testing Assessment: Rockport FItness Walking Test
|
estimate VO2 max from HRss response over course of 1 mile walk as fast as possible; calculate from immediate post exercise HR, RPE, and walk time; but may underestimate if person is conditioned
|
|
|
2008 Physical Activity Guidelines for Americans
|
Adults should exercise at moderate intensity 150 min/week or vigorous for 75 min/week plus strength exercise 2 days/ week; if client can't do this, plan to increase training volume 10-20% each week; if they can, then goal is to increase VO2 max so they can work harder in anerobic phase
|
|
|
Kyphosis
|
Excessive posterior curvature of the spine, esp in thoracic region
|
|
|
Lordosis
|
Excessive anterior curvature of the spine that often occurs at low back or neck; worsened by excessive abdominal fat
|
|
|
Sagittal Plane
|
Longitudinal line that divides body or its parts in to RIGHT and LEFT sections
|
|
|
Frontal Plane
|
Longitudinal line divides body into ANTERIOR and POSTERIOR parts
|
|
|
Transverse Plane
|
Horizontal line the divides body or its parts in to SUPERIOR and INFERIOR sections
|
|
|
Lateral view of good standing posture
|
Head suspended with ears in line with shoulders, shoulders over hips, hips over knees, knees over ankles; should have 3 natural curves of spine, soft knees
|
|
|
Anterior and posterior views of good standing posture
|
Feet shoulder width apart w/out excessive pronation or supination: arms should hang with equal spaces between arm and torso, hands hang so only thumbs and index finders visible; kneecaps forwaard
|
|
|
Stork-stand Balance Test
|
no shoes, feet together, hands on hips, raise one foot off ground anf bring it to lightly touch the inside of stance leg, just below knee; then raise heel and balance on ball of foot; allow practice, up to 3 trials, measure until loses balance or form;
Women: +30 sec excellent, 25-30 good, 16-24 avg, 10-15 fair, -10 sec poor Men: +50 sec excellent; 41-50 sec good; 31-40 sec avg, 20-30 sec fair; - 20 sec poor |
|
|
Sharpened Romberg Test
|
Assess static balance w/out visual cue; stand with one foot directly in front of other and fold arms across chest, hand on opposite shoulder; when stable ask client to close eyes and record for 1 min or loses form or opens eyes; should be able to do this for at least 30 sec
|
|
|
McGill's Torso Muscular Endurance Test Batter
|
Trunk Flexor / Lateral / Extensor Test results are taken together and the ratio between scores measures core balance
|
|
|
Trunk flexor Endurance Test
|
sit with hips and knees to 90 degrees, fold arms across chest & lean against board at 60 degree incline, press shoulders into board, keep flat back; then remove board and hold position for as long as possible
|
|
|
Trunk Lateral Endurance Test
|
Side bridge as long as possible each side; difference between L and R should be no more than .05 (balance = 1.0); ratio to extension test should be less than .75
|
|
|
Trunk extensor test
|
on stomach on bench with arms folded over chest which is off of bench; flexion to extension ratio should be less than 1.0
|
|
|
What is accurate predictor of back health?
|
Muscular endurance is more predictive than strength or ROM
|
|
|
Muscular fitness
|
Includes muscular endurance and strength; it makes ADL easier, decreases risk of injuries, enhances FFM and raises RMR; enhances glucose tolerance
|
|
|
Modified Body Weight Squat Test
|
Client does 6-10 reps of squat to depth that is tolerable: Good if knees flex 45-90 degrees, poor if less than 45;
complete max 10 or if lose form or shake before: evaluate if client felt in low back/hips then lumbar dominant squat; if felt more in thighs/knees then quad-dominant squar; best is if felt in lower posterior hips and glutes; also look at knee position |
|
|
Vulgus Strain
|
femoral adduction and tibial abduction; associated with knee pain and instability, correlated with excessive pronation; most common
|
|
|
Varus Strain
|
Femoral abduction and tibial adduction associated with excessive supination and knee pain
|
|
|
Front Plank
|
on forearms, hold 30 second; should feel it in abs; indicates poor core stability if feel in back
|
|
|
Overhead Reach
|
lie supne with knees bent, feet flat on floor about 18 inches in front of hips; hands alongside body with thumbs pointed toward ceiling; keep arms straight and low back on mat; then reach arms overhead to floor; if felt mostly in back and back arched then poor shoulder mobility/core stability; if felt mainly in shoulders but form ok then poor shoulder mobility; if felt mainly in shoulders and good form then good shoulder mobility
|
|
|
Causes of fitness testing inaccuracy
|
Client is tired, didn't eat/drink enough, on Rx; Coach is inexperienced, did test wrong, impartial, didn't motivate the client; equipment is broken, not calibrated, not matched to client; too many distractions, temperature, not private
|
