Appraisal Risks

Negligence

• the doing of something which a reasonably prudent person would not do/the failure to do something which a reasonably prudent person would do, under circumstances similar to those shown by the evidence

• the failure to use ordinary or reasonable care

Cardiovascular concern of exercise/training

High-intensity exercise can acutely, albeit transiently, increase the risk for sudden cardiac arrest (SCA) or sudden cardiac death (SCD) in individuals with underlying cardiac disease

How does age affect cardiovascular risk and death from exercise

• young individuals (<40) die during exercise primarily from inherited/congenital cardiac conditions

• ex. hypertrophy cardiomyopathy, coronary artery anomalies, right ventricular cardiomyopathy

• older athletes (>40) primary cause of death is atherosclerotic coronary artery disease

How do we safeguard

• pre-test screening (RHR, RBP, GAQ)

Increased risk considerations

• History of fainting or chest pain during exercise (angina)

• Family history of sudden death at a young age

• Intensity and duration of exercise exceeds what has been recently experienced

• Competition, publicity or pride encourages persistent exercise in spite of warning signs (Denial)

• Exercise under time pressure or when encountering other sources of stress

• The activity involves heavy lifting often associated with isometric contractions

• Environmental conditions – hot or cold

• Individual has a viral infection, senses chest “discomfort” or feels “unwell”

• Exercising soon after waking – Chronobiology

• Someone with known cardiovascular disease exercising vigorously without medical guidance

Canadian Institute for Health Information (CIHI) states that ~20% of people do not have a regular health provider (2025)

True

Chronobiology

• the study of periodic phenomena in living organisms

• biological rhythms are found in almost all species and are believed to be evolutionary adaptations to cyclical variations of the environment

• ex. circadian rhythm

Blood pressure typically follows a weekly pattern influenced by the body’s circadian rhythm

False, daily pattern

BP when you first wake up

• natural increase in BP in early morning

• morning surge

• causes increased blood clot

Circadian rhythm

an internal, roughly 24 hour biological clock that regulates your body’s patterns of sleep, wakefulness, hormone release, and other functions

Aerobic fitness test termination criteria

• reaches ceiling HR

• asks to stop (volitional fatigue)

• shows signs of distress (nausea, pale)

• unable to maintain cadence (for cycle and mCAFT)

• completes Stage 8 of mCAFT

Ceiling HR formula

85% of 208-(0.7 x age)

Position to put dizzy client in

• lying on back on cold floor with feet elevated

• give juice box

Termination criteria

• 2 consecutive incorrect reps

• undue stress/discomfort

• equipment issues/improper use

Pre-Test Screening steps

1. GAQ

2. Consent

3. Resting HR

4. Resting BP

5. Observations - feeling well?

• Pre-meet information - Pre-Test Instructions

• Client Goals

• Explain PATH options

What to do if you need to refer to a physician

• use the Physician Physical Activity Readiness Clearance form

• form is used when clients need medical clearance before proceeding with the fitness assessment (aerobic fitness and musculoskeletal protocols) or physical activity program

• Client must take completed GAQ as well as the Physician Clearance Form to physician

  • Page 1 is to be completed and signed by the physician

  • Page 2 provides additional information about the CSEP-CPT qualifications, the CSEP-PATH, and the Canadian Physical Activity Guidelines

Informed consent for youth

• not a waiver of client rights

• does not cover negligent conduct

• witness - age of majority, independent of testing organization

What can we do if there’s a positive response on the GAQ

• body comp analysis (waist and BMI)

• complete healthy PA participation and healthy lifestyle components