Beginning the health appraisal process & concepts of exercise programming

HW 280

Discuss health appraisals for exercise planning

Discuss risk factor evaluation Designing exercise programs Application Wrap-up

ACSM & AHA recommend pre-participation screening to:

Determine current health status Is it appropriate to undergo fitness testing

and/or begin exercise?◦ Identifying risk factors

Standard appraisal items:◦ Medical history review◦ Risk factor assessment and stratification◦ Prescribed medications◦ Level of physical activity◦ Establishing need for physician consent◦ Administration of fitness tests; evaluation results◦ Set up exercise prescription◦ Evaluation of progress

Physical Activity Readiness Questionnaire PAR-Q◦ Light to moderate activity◦ Issues

Health Status Questionnaire (HSQ)◦ More comprehensive◦ Contraindications and risk factors◦ Lifestyle/behaviors◦ Physical activity patterns◦ Current medications◦ Information release form

Privacy issues and protected information◦ Question: What steps should professionals take

to ensure HSQ information is properly protected?

Communication and trust◦ Question: Patients may feel uncomfortable

sharing detailed, personal medical histories. What are some techniques the health professional can use to build comfort?

General Medical History◦ Heart History◦ Symptoms◦ Additional Health Issues

Risk Factor* Assessment CHD◦ Establish and quantify

Low risk: men <45 and women <55 asymptomatic & no more than 1 risk factor

Moderate risk: men >45 and women >55 or people with 2 or more risk factors

High risk: Ind. w/ cardiovascular, pulmonary, metabolic or who show signs or symptoms

Prescribed medications Level of physical activity

◦ Question: What conditions constitute the risk factor of physical inactivity?

◦ Question: How would you explain what constitutes low, moderate, and strenuous physical activity to a participant?

Establishing the need for physician consent to begin exercise

Administer and evaluate standard fitness tests

Appropriate plans consider:◦ Health status◦ Personal goals◦ Fitness test results

Types of programs◦ Supervised, clinic-based◦ Prescribed exercise, professional supervision◦ Vigorous-intensity exercise◦ Any unsupervised physical activity

Timelines Variety Accommodate individual differences Maintain control Monitor progress

Understanding physical activity vs. exercise Elements of balanced work outs

◦ Cardiovascular endurance◦ Muscle strength & endurance◦ Flexibility◦ Body composition

Activity PyramidSedentary activityFlexibility (3+ wk)Muscular strength/endurance (3+ wk)Cardio (3-5 x wk)

Physical Activity - DAILY FITT Guidelines

Frequency

Intensity

Time

Type

Overload Specificity Progression Reversibility Consistency Individual differences Safety Rest

Let’s talk about designing a program for a hypothetical participant . . . ◦ The participant is a 62 year old women, post-

menopausal with high blood pressure and sedentary lifestyle. She is somewhat motivated to tend to her health but has never exercise regularly. She cannot swim and is not likely to regularly attend a gym.

◦ What steps would you take to complete a health appraisal?

◦ What basic exercise routine would you suggest? Use the FITT guidelines. Is there anything else you think is important to discuss with the participant? Why?

Discussed health appraisals for exercise planning

Discussed risk factor evaluation Talked about designing exercise programs Application Wrap-up

Questions?