ACE Personal Trainer Manual Ch. 6 - Building Rapport and the Initial Investigation Stage

Decongestants

Act directly on the smooth muscles of the blood vessels to stimulate vasoconstriction

Positive Risk Factors per ACSM Risk Stratification Chart

Age, Family History, Cigarette Smoking, Sedentary Lifestyle, Obesity, Hypertension, Dyslipidemia, Prediabetes

D

"When do you experience your low-back soreness?" is an example of what type of interviewing technique? a) Reflecting b) Confronting c) Informing d) Probing

Resting Heart Rate (RHR) Categories

1) Slow = <60 2) Normal = 60-100 3) Fast = >100

a) Identifying the presence or absence of cardiovascular, pulmonary and metabolic disease or sings or symptoms of such b) Identifying individuals with medical contraindications who should be excluded from exercise or physical activity until those conditions have been corrected or are under control c) Detecting at-risk individuals who should first undergo medical evaluation and clinical exercise testing before initiating an exercise program d) Identifying those individuals with medical conditions who should participate in a medically supervised program

4 purposes of pre-participation health screening

Rapport, Investigation, Planning, Action (R.I.P.A.)

4 stages of Client-Trainer Relationship

1) Goals of the assessment 2) Physical limitations of the client 3) Testing Environment 4) Availability of Equipment 5)Age of Participant

5 components of choosing the right assessments for clients

Average RHR in males

60-70 bpm

Average RHR in females

72-80 bpm

1) Onset of angina pectoris or angina like symptoms 2) Significant drop (<10 mmHg) in SBP despite an increase in exercise intensity 3) Excessive rise in blood pressure: SBP >250 or DBP >115 4) Fatigue, shortness of breath, difficult or labored breathing, or wheezing (not heavy breathing due to intense exercise) 5) Signs of poor perfusion: lightheadedness, pale skin, cyanosis, nausea, or cold and clammy skin 6) Increased nervous system symptoms (i.e. ataxia, dizziness, confusion, syncope) 7) Leg cramping or claudication 8) Physical or verbal manifestation of severe fatigue

8 signs or symptoms that merit immediate test termination and referral to a more qualified health professional

Positive Risk Factor: Hypertension

>140/>90(or equal to) or currently on antihypertensive drugs

Passive Listening

A person gives the impression of listening by using minimal noncommittal agreements.

Indifferent Listening

A person is not really listening and is tuned out

Selective Listening

A person listens only to key words

Active Listening

A person shows empathy and listens as if he or she is in the speaker's shoes. This is key to effective listening.

A

A personal trainer could design an exercise program without requiring a physician's release prior to participation for which of the following? a) 42 year old female client with lumbar lordosis b) 54 year old male client with an abdominal hernia c) 61 year old female client who takes a calcium channel blocker d) 35 year old male client who has asthma

Antihypertensive drug effects on Kidneys

Depletes body water and decreases blood volume

Medical Release

Deviation from guidelines provided in this form must be approved by the client's personal physician

Antihistamines

Do not have a direct affect on the heart rate or blood pressure, but produce a drying effect in the upper airways and may cause drowsiness

Antihypertensive drug effects on Heart

Reduces it's force of contraction

Antihypertensive drug effects on Brain

Reduces the sympathetic nerve outflow

1) Identifying Coronary Artery Disease (CAD) risk factors 2) Performing a risk stratification based on CAD risk factors 3) Determining the need for a medical exam/clearance and medical supervision

Steps of the Risk Stratification Process (in order)

PAR-Q

The _________ is a minimal, yet safe, pre-exercise screening measure for low-to-moderate, but not vigorous, exercise training.

Health History Questionnaire

The client should list any medications or supplements being taken on this form

Exercise History and Attitude Questionnaire

The information listed on this form is especially important when developing goals and designing exercise programs with a client, and when implementing strategies for improving motivation and adherence

Overuse Injury

The most common type of injury sustained by persons participating in physical activity is the ___________

Stages of Change

The transtheoretical model of behavioral change is also called the _______ model.

Health History Questionnaire

This form collects more detailed medical and health information beyond the coronary artery disease risk factor screen

Agreement and Release of Liability Waiver

This form does not necessarily protect the trainer from being sued for negligence

Informed Consent Form

This form does not provide legal immunity

Medical Release

This form explains a client's physical activity limitations and/or guidelines as outlined by his or her physician

Exercise History and Attitude Questionnaire

This form includes a client's behavioral and adherence experience specific to physical activity

Testing Form

This form is used to record testing and measurement data during fitness assessments

Agreement and Release of Liability Waiver

This form represents the client's voluntary abandonment of the right to file a lawsuit

Cross Training

To avoid aggravating an existing injury, and to allow for healing to occur, trainers should modify the client's exercise program using a _________ strategy

Antihypertensive drug effects on Peripheral Blood Vessels

To open or dilate them to allow more room for the blood

High Density Lipoprotein Cholesterol (HDL)

To stratify a client's risk for coronary artery disease, the trainer should add up the total number of risk factors for a client, subtracting one point for higher ___________________ if appropriate.

C

Your new client is a 57 year old woman who plays golf, tennis, and squash avidly. Her health-risk appraisal reveals only one positive risk factor (age) and that she has a heart murmur. According to the ACSM risk stratification, what is the client's level or risk? a) Low risk b) Moderate risk c) High risk d) Very high risk

Dyspnea

______ is defined as difficult or labored breathing

Motivational Interviewing

_____________ is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.

Risk Stratification: High Risk

a) Symptomatic, or known Cardiac, Pulmonary or Metabolic Disease b) Medical exam/Graded exercise test for Moderate exercise: recommended c) Medical exam/Graded exercise test for Vigorous exercise: recommended d) Dr supervision of exercise test for submaximal: recommended e) Dr supervision of exercise test for maximal: recommended

Risk Stratification: Low Risk

a) at least 1 risk factor b) Medical exam/Graded exercise test for Moderate exercise: not necessary c) Medical exam/Graded exercise test for Vigorous exercise: not necessary d) Dr supervision of exercise test for submaximal: not necessary e) Dr supervision of exercise test for maximal: not necessary

Risk Stratification: Moderate Risk

a) at least 2 risk factor b) Medical exam/Graded exercise test for Moderate exercise: not necessary c) Medical exam/Graded exercise test for Vigorous exercise: recommended d) Dr supervision of exercise test for submaximal: not necessary e) Dr supervision of exercise test for maximal: recommended

1

If a client answers "yes" to ______ or more questions on the PAR-Q, he or she should be referred to a healthcare professional.

Stroke

If a person's resting blood pressure is already high, it may elevate to dangerous levels during exercise, increasing the likelihood of a ________

Planning

Involves collaborative goal setting with the client after the investigation is complete to design an effective and comprehensive program.

Investigation

Involves the collection of all relevant information to identify the comprehensive needs of clients.

Rapport

Involves the personal interaction a trainer establishes and maintains with a client, as well as ability to communicate effectively with client.

Action

Involves the successful implementation of all programming components and providing the appropriate instruction, feedback, and progression as needed.

Informed Consent Form

It is recommended that the trainer also verbally review the content of this form to promote understanding

Positive Risk Factor: Dyslipidemia

LDL cholesterol >130 (or equal to) or HDL cholesterol <40 or currently on lipid-lowering drugs. (if total serum cholesterol is only available, >200)

Positive Risk Factor: Sedentary Lifestyle

Less than at least 30 minutes of moderate intensity activity on at least 3 days per week for at least 3 months

Positive Risk Factor: Age

Men greater than or equal to 45 years old Women greater than or equal to 55 years old

Positive Risk Factor: Family History

Myocardial infarction, coronary revascularization, or sudden death before 55 years of age in father or first degree male relative, or before 65 ears of age in mother or other first degree female relative

<120/<80

Normal Blood Pressure for Adults age 18 and older

Empathy, Warmth, Genuineness

3 attributes that are essential to successful relationships

1. Create a nurturing yet professional environment by meeting in a quiet comfortable location 2. Avoid high traffic areas and member distractions, do not try and build rapport with a simple facility tour or orientation 3. Do not sit behind a desk but facing the client to create a level of comfort

3 ways a trainer can attend to the environment when meeting clients.

Positive Risk Factor: Obesity

Body mass index greater than or equal to 30 kg/m or waist girth >102 cm (40 inches) for men and; >88cm (35 inches) for women

Positive Risk Factor: Cigarette Smoking

Current smoker or quit within previous 6 months, or exposure to environmental tobacco smoke (secondhand)

Diabetes

Exercise, both as a means to regulate blood glucose and to facilitate fat loss, is an important part of the lifestyle of an individual with __________

Positive Risk Factor: Prediabetes

Fasting plasma glucose >100 (or equal to)...

Diuretics

Have no primary affect on heart rate, but they can cause water and electrolyte imbalances, which may lead to dangerous cardiac arrhythmias

ACE Inhibitors

Have no primary affect on heart rate, but will cause a decrease in blood pressure at rest during exercise

4 sites affected by Antihypertensive Drugs

Heart, Peripheral blood vessels, Brain, Kidneys

Negative Risk Factors per ACSM Risk Stratification Chart

High serum HDL Cholesterol (greater than or equal to 60)

140-159/90-99

Hypertension stage I Blood Pressure for Adults age 18 and older

Greater than or equal to 160/Greater than or equal to 100

Hypertension stage II Blood Pressure for Adults age 18 and older

120-139/80-89

Prehypertension Blood Pressure for Adults age 18 and older

Beta Blockers

Using ratings of perceived exertion is especially appropriate when working with a client taking this type of medication

B

What is the name of the essential attribute of successful relationships that is described as "the ability to respect another person regardless of his or her uniqueness?" a) Empathy b) Warmth c) Genuineness d) Honesty

Informed Consent Form

When a client signs this form, he or she is acknowledging having been specifically informed about the risks associated with activity

D

Which evaluation form does a client sign to acknowledge that he or she has been educated about, and understands, the risks associated with being active? a) Agreement and release of liability waiver b) Medical release c) Exercise history and attitude questionnaire d) Informed consent