Pre-Participation Health Screening and Exercise Guidelines

Symptomatic

Showing signs/symptoms of disease

Asymptomatic

No observable signs/symptoms

Signs

chest discomfort with exertion; unreasonable breathlessness; dizziness, fainting, blackouts; ankle swelling; unpleasant awareness of a forceful, rapid, or irregular heart rate; burning or cramping sensations in lower legs when walking short distance; known heart murmur

Diagnosis

heart attack; heart surgery, cardiac catheterization, or coronary angioplasty; pacemaker/implantable cardiac defibrillator/rhythm disturbance; heart valve disease; heart failure; heart transplantation; congenital heart disease; diabetes; renal disease

Medical Clearance

A healthcare professional's approval for exercise participation, especially for higher-risk individuals or those with medical conditions

MET values

1 MET = 3.5 mL/kg/min of O2 consumption

Light MET

<3 METs

Moderate MET

3-<6 METs

Vigorous MET

≥ 6 METs

Musculoskeletal injury factors

Caused by high intensity, unaccustomed activity, or low fitness levels

Cardiovascular disease risk goal

↑HDL, ↓LDL & triglycerides to lower CVD risk

Exercise preparticipation health screening process

Determine current PA levels, Identify known CV, renal, or metabolic diseases, Identify symptoms suggestive of these diseases, Determine if medical clearance is needed, Starting intensity and progression recommendations

Informed Consent Form

Ensure client knows and understands purposes and risks associated with exercise test or program

Legal Document

Layman's terms & can be clearly explained

Confidentiality of information

HIPAA

Purpose other than Ex.Rx

Research Benefits - adding to "Body of Knowledge"

"Emergency procedures & equipment"

Practice every 3 months

contents of IRF

Purpose and explanation

Risks/discomforts

Responsibilities of the client

Benefits

Inquiries (recorded w/responses)

Medical records

Freedom of consent

Signature (who?) & Witness (why?)

Physical Activity

Movement, Skeletal muscles, Energy expenditure

Exercise

sub-class of PA, Planned, Structured, Repetitive, Goal

Physical Fitness

Ample Energy to do daily tasks w/o undue fatigue, Enjoy leisure pursuits, Meet unforeseen emergencies

Normal blood pressure

<120/80 mm Hg

Medical clearance

A health practitioner should advise a participant to seek medical clearance prior to participating in an exercise program if there is known disease or any sign/symptom, regardless of current PA level.

Inverse dose-response relationship

The relationship where increased physical activity (↑ PA) leads to a decreased risk (↓ risk) of mortality, obesity, cardiovascular disease (CVD), and diabetes.

PAR-Q+

Physical Activity Readiness Questionnaire for Everyone, a self-guided screening form for physical activity.

Health screening for exercise

Screening potential exercise program participants for the presence and/or signs and symptoms of various cardiovascular, metabolic, and renal diseases prevents adverse events by identifying CVD, metabolic, or renal disease.

CVD risk factor analysis

Factors that may play an important role in helping patients and health practitioners optimize various parameters include age, family history, smoking, physical inactivity, obesity, dyslipidemia, hypertension, diabetes, and HDL-C.

HDL

High-density lipoprotein, which is strongly and inversely associated with the risk for cardiovascular disease.

Benefits of regular physical activity

Includes reduced risk of CVD, improved weight management, improved cholesterol values (↑HDL, ↓LDL), reduced likelihood of type 2 diabetes & some cancers, lower blood pressure, stronger bones, lower risk of falls, improved recovery, improved energy, better mood, reduced stress, and improved sleep.

Physical activity vs exercise

All exercise is physical activity (PA), but not all PA is exercise.

Validity

Measures what it claims.

Accuracy

Closeness to true value.

Reliability/Consistency

Repeatable results.

Fitness testing/assessment purposes

Conducted for baseline data, progress tracking, motivation, and exercise prescription planning.

Body composition

The ratio of fat mass to fat-free mass.

Subcutaneous fat

Fat located directly below the skin.

Visceral fat

Fat located deep around organs.

VO₂max Test

The 'gold standard' test for cardiorespiratory fitness (CRF) conducted via Graded Exercise Test (GXT).

Fick equation

VO₂ = Q × (a-vO₂ diff), where Q = HR × SV (delivery) and a-vO₂ diff = extraction (consumption).

Impact on CRF

Cardiac Output (Q) makes the largest difference in one's cardiorespiratory fitness.

RPE

Rate of Perceived Exertion, a subjective measuring tool used to gauge one's exercise intensity level.

Rate of Perceived Exertion

Subjective tool to measure exercise intensity

Borg RPE scale

Ranges from 6-20

VO2submax

Used if VO₂max not achieved; only provides an "estimate" of VO2max based on HR response

Cardiovascular endurance

The ability of the circulatory and respiratory systems to supply oxygen during sustained physical activity

Body composition

The relative amounts of muscle, fat, bone, and other vital parts of the body

Muscular strength

The ability of the muscles to exert force

Muscular endurance

The ability of the muscles to continue to perform without fatigue

Flexibility

The range of motion available at a joint

Agility

The ability to change the position of the body in space with speed and accuracy

Coordination

The ability to use the senses, such as sight and hearing, together with body parts in performing tasks smoothly and accurately

Balance

The maintenance of equilibrium while stationary or moving

Power

The ability or rate at which one can perform work

Reaction time

The time elapsed between stimulation and the beginning of the reaction to it

Speed

The ability to perform a movement within a short period of time

1RM (One Repetition Max) test

The main test or the 'Gold Standard' test which measures the whole-body muscular fitness

Absolute number/value

Total value

Relative number/value

Adjusted for weight/body size

Absolute in Muscular Fitness

Total number of reps at given intensity

Relative in Muscular Fitness

Total number of reps at % 1RM

Gold standard test for flexibility assessment

No gold standard test

Factors affecting Agility

Strength, Power, Neuromuscular Control, Experience, Cognitive, Technique (Physical Component)

Factors affecting Balance

Vision, Inner Ear, Muscle & Joints

Vision

Focal Point

Inner Ear

Loop-shaped canals contain liquid and hair-like cells are impacted when the head and body move; Vestibular System

Muscle and Joints

Proprioceptors, perception awareness of the position and movement of body in space

Factors affecting Coordination

Vision, Experience

Vision (Coordination)

Coordinate what you see with your hands

Experience (cognitive and technique)

Especially important in fine motor skills

Improving Coordination

Eye-hand: video games, racket sports, wall ball

Factors affecting Reaction Time

Sleep deprivation, age, obesity, distraction

Factors affecting Speed

Genetics, Strength, Remember

Genetics

slow twitch/fast twitch

Power (Speed)

force of muscle contraction

Remember ___________ in agility

deceleration (strength curve)

Factors affecting Power

Speed, Strength, Genetics, Excess body fat (dead weight)

P = W/T

W = F x D

How to improve power

Strength training movements that mimic specific sport movements

Medical history, medical clearance & Consent

Necessary documentation and approval before starting a fitness program.

Assessment & Measurements

(baseline, benchmark, reference point) - measure & assess all fitness components.

Diagnosis

Analyze, identify and conclude - (musculoskeletal & cardiopulmonary).

Prescription (ExRx)

Exercise prescription for all fitness components - (Musculoskeletal & Cardiopulmonary).

Re-evaluation

Monitor progress and/or regression.

other aspects/variables are also considered

Mental & Emotional aspects; Nutritional aspects; Pharmacological Aspects (Effect of drugs/medications); Support System; Spiritualty (Faith & Believe) (Mysticism and Science)

What are the three-known disease used to determine the diagnosing outcome in the screening algorithm? (in signs and symptoms).

Cardiovascular, Metabolic (diabetes), Renal (kidney)

FITT principle

Frequency, Intensity, Time, Type - components of exercise prescription.

Components of exercise training session

Warm-up, Conditioning, Cool-down, Stretching.

Order of fitness assessment/testing

1. Resting Measurements (HR, BP, height, weight, and body composition), 2. Cardiorespiratory Fitness, 3. Muscular Fitness, 4. Flexibility.

Anthropometric measurements/tests

BMI, Waist circumference and body fat distribution, Waist-to-hip ratio (WHR), Body density (skinfold test), Hydrostatic underwater weighing.

Static strength

Strength without movement, measured through isometric contractions.

Dynanometer

Handgrip

Leg

Back

Specific to muscle group and joint angle

Passive vs. Active muscle insufficiency

Maximum Voluntary Contraction (MVC)

Peak force development

Dynamic strength

Strength involving movement, measured through isotonic strength

1RM - any muscle or muscle group

Bench Press and Leg Press: weight lifted/body weight

Multiple RM

Index of strength changes/time

Muscle Spindles

Mechanoreceptor providing feedback to CNS on muscle length and stretch, safety mechanism

muscle spindles are responsible for

stretch reflex; when activated, contraction occurs

Golgi Tendon Organs (GTOs)

Mechanoreceptor providing feedback to CNS on muscle tension, safety mechanism against excess force/tension

when GTOs activated,

muscular relaxation occurs