11: Pre-Exercise Screening Recording

Exercise Guidelines and Planning for Older Adults

• Key Question: What exercise should an older adult do?

• Guidelines have been discussed; focus shifts to initiating a plan.

• Initial Step: Asking questions to learn about the individual’s:

  • Current health status

  • Health history

  • Activity levels

  • Goals and barriers

Importance of the Prescreening Process

• Objectives of Prescreening:

  • Identify health problems and assess risk levels for becoming active.

  • Discover individual goals, barriers, and motivators.

  • Design an informed assessment for effective program design.

  • Legal responsibility for exercise professionals to prescreen.

• Cognitive Capacity:

  • Important for the prescreening process; must ensure individuals can understand consent, especially among those with cognitive impairments.

Benefits and Risks of Physical Activity

• Benefits:

  • Physical, psychological, and psychosocial improvements.

  • Chronic disease prevention and improved functional independence.

• Risks:

  • Potential for musculoskeletal injuries and other serious events (e.g., heart attacks).

  • Mortality risk while exercising is low but present, particularly among previously sedentary individuals.

• Statistics on risk of cardiovascular events:

  • 0.03 per 10,000 hours for moderate to vigorous exercise.

  • 0.2 to 0.8 per 10,000 for maximal exercise testing.

When to Prescreen

• New physical activity programs, changes in health status, or after a hiatus due to injury.

• Annual re-evaluations are recommended for active individuals.

5 Steps of the Prescreening Process

1. Informed Consent:

   • Provide information about the activity, risks, benefits, confidentiality, and the voluntary nature of participation.

   • Ensure comprehension; written or verbal consent must be obtained.

   • Substitute decision-makers may be needed for individuals lacking cognitive capacity.

2. Standardized Questionnaire:

   • Utilize tools like ParQ Plus, CSEP Get Active, or ACSM checklist to assess readiness for physical activity.

   • Procedures for answering yes or no and what follow-up questions apply.

3. Medical Clearance:

   • Evaluate whether a doctor’s clearance is necessary based on health status and desired activity level.

   • Not required for most individuals who are asymptomatic.

4. Health History and Lifestyle Assessment:

   • Collect detailed lifestyle information and set goals for the program.

   • Identify barriers the individual may face.

5. Feedback and Confidentiality:

   • Two-way communication between professional and client is essential.

   • Explain and ensure patient confidentiality in all assessments and records (PHIPA in Canada).

Informed Consent Practice Exercise

• Encouragement to write an informed consent statement, taking a simple activity like pickleball as an example, to understand its components and importance in practice.

Conclusion

• Emphasis on the importance of understanding clients, the necessity of data protection, and maintaining effective communication throughout the prescreening and program design process.