Ch. 2 - Health Appraisal and Fitness Assessments

What are the various documents that facilitate the screening process?

• PAR Q+

• Medical History Questionnaire

• Informed Consent form

• Medical clearance form (Parmed-X)

What is the Parmed-X?

• Allows the exercise professional, in cooperation with the medical professional, to determine what, if any, restrictions should be placed on a participant.

Should an individual with chest pain be permitted to participate in physical activity?

No, unless medical clearance has been procured. After the medical clearance, exercise is usually done in a medically supervised facility.

Are physically active clients who do not exhibit known disease or signs or symptoms of disease required to seek medical clearance? How much exercise can they do?

No, they may continue with moderate-vigorous intensity training

Are physically inactive clients who do not exhibit known disease or signs or symptoms of disease required to seek medical clearance? How much exercise can they do?

No, they may continue with light-moderate intensity training

Are physically active clients who have history of cardiovascular, metabolic, or renal disease but are asymptomatic required to receive medical clearance? How much exercise can they do?

No, they can do moderate-intensity exercise if they have received clearance in the previous 12-month period.

Are physically inactive clients who have history of cardiovascular, metabolic, or renal disease but are asymptomatic required to receive medical clearance? How much exercise can they do?

Yes, must be referred to medical professional for clearance prior to any exercise. Can only do light-moderate exercise right after clearance.

Should clients who develop new signs or symptoms of disease be referred for medical clearance regardless of training status or the presence of disease?

Yes

If a client develops new signs or symptoms of disease while being engaged in an exercise program, should it be discontinued?

Yes, and they should get medical clearance

What are the parameters for light-intensity exercise?

• 30% to <40% intensity using Karvonen

• 9-11 RPE (on 6- to 20-point Borg scale)

• intensity producing a slight increase in heart rate and respiration rate

What are the parameters for moderate-intensity exercise?

• 40% to <60 intensity using Karvonen

• 12 or 13 RPE (on 6- to 20-point Borg scale)

• intensity producing a noticeable increase in heart rate and respiration rate

What are the parameters for vigorous-intensity exercise?

• ≥60% to 90% intensity using Karvonen

• ≥14 RPE (on 6- to 20-point Borg scale)

• intensity producing a substantial increase in heart rate and respiration rate

Should professional supervision be considered during the medical clearance process? If so, how?

Yes, some hospitals have fitness supervision in their own fitness centers with medically supervised programming.

Why is fitness testing needed?

• establishing a baseline to track progress

• identifying current levels of fitness that will contribute to the exercise program

• establishing appropriate exercise selection, frequency of exercise, intensity of exercise, and volume of exercise

• developing short-, medium-, and long-term fitness goals

• identification of a client’s needs and limitations before exercise program initiation

• establishing a method of recording decisions regarding appropriate scope of practice

Why do fitness testing results be put into context?

To provide guidance for goal setting and progression