455 Rose EXAM 1
Define the term "wellness" as defined by Hettler (1976).
"an active process through which people become aware of, and make choices towards, a more successful existence."
Provide THREE reasons why physical activity instructors of older adults do not assess their clients prior to the start of an exercise program.
(1) Lack of time, space, and budget (2) Not required to assess by management (3) Insufficient personnel (4) Lack of appropriate assessment tools (5) Lack of training
Know the senior specific exercise principles and be able to provide examples of each principle.
(1) functional relevance, (2) challenge, and (3) tailoring/adaptation Functional Relevance! · Encourages selecting exercises that simulate movements of everyday activities · Examples of appropriate activities and environments? Challenge!! · Selected activities need to challenge but not exceed an individual's intrinsic capabilities. · Level of challenge can be altered by changing task demands or environmental constraints. · Examples of this principle? Adaptation/Tailoring! · Highly individualized exercise prescriptions and solutions should be coupled with appropriate modifications to: · Session goals · Structure of class · Type of exercise
Identify the THREE main methods of defining old age.
-Chronological age -Biological age -Functional age E.g. Physically elite, physically fit, physically independent, physically frail, physically dependent
1. Identify FIVE reasons why it is important to conduct a pre-exercise screening before an older adult engages in a moderate intensity physical activity program.
-Health and disability status -Differences- disability: impacts social roles, it affects what you want to do and what you're required to do & health: chronic conditions, lifestyle -Signs and symptoms associated with certain diseases -Risk factors that predispose the client to certain diseases -Readiness for engaging in physical activity -What's their history, how physically active are they now...
Training Module 5: Program Design for Older Adults With Stable Medical Conditions
-Information on common medical conditions of older adults, signs and symptoms associated with medication-related negative interactions during activity. -Information on how to adapt exercise for clients with varying fitness levels, and stable medical conditions to help prevent injury and other emergency situations.
Training Module 8: Client Safety and First Aid
-Information on developing a risk-management plan to promote a safe exercise environment and respond to emergency situations.
Training Module 7: Leadership, Communication, and Marketing Skills
-Information on incorporating effective motivational, communication, and leadership skills related to teaching individual and group exercise classes as well as professional leadership skills. -Information on how to create effective marketing tools for program and self.
Identify THREE general categories of factors that predict whether or not an older adult will initiate and maintain an exercise program. Under each category, provide THREE specific examples of factors that influence PA participation.
-Personal characteristic: E.g. health-related factors: Older adults in poor physical condition and poor health are less active than their healthy counterparts, and illness has been shown to be a strong predictor of poor adherence to exercise programs. Arthritic pain is a significant barrier to exercise by older adults, despite the benefits of exercise for people with arthritis. E.g. The most consistent demographic factors that are negatively associated with exercise participation by older adults include being female, being in an ethnic minority group, older age (especially those 85 years old or older), rural residence, and low socioeconomic status. While exercise programs obviously cannot modify any of these factors, awareness of them can help you guide and tailor programs to address the unique barriers faced by these subgroups of older adults. E.g. Attitudes, knowledge, and beliefs as well as psychological factors also influence exercise behaviors of older adults. An individual's willingness to make changes in his or her physical activity level is typically a necessary but not sufficient factor for exercise adoption. -Program-related factors: Program-related factors include the structure, format, complexity, intensity, convenience, and financial and psychological costs associated with the activity. E.g. For example, walking and gardening are cited most often by older adults as preferred physical activities. E.g. Adherence to supervised home-based programs is typically higher than adherence to class or group programs. -Environmental factors:Social and physical environmental factors also influence exercise participation. Social support (defined as assistance received through social relationships) from friends, family, and health professionals is positively associated with exercise adoption and maintenance. E.g. Physical environmental factors such as the travel distance required for exercise, climate and weather, neighborhood safety, neighborhood walkability, availability of facilities for physical activity (e.g., parks, walking and jogging paths), and aesthetics can also affect physical activity by older adults.
Active life expectancy:
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Biological aging:
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CH 6
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CH 7
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CH 9
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CH5
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Functional aging:
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Gerokinesiology
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Pathological aging:
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Successful aging:
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4. Describe the criteria associated with each of the initial risk classifications developed by ACSM.
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Identify FIVE reasons why the Senior Fitness Test is the preferred method of testing functional fitness in the 60+ segment of the population.
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Provide FOUR reasons why older adults do not continue to participate in physical activity programs.
1 Health and Medical Factors -Illness/injury - Pain/discomfort - Lack of strength 2 Knowledge - Lack of knowledge/ability 3 Motivational or Psychological -Lack of time -Lack of self-motivation 4 Program-Related -Lack of age-appropriate classes
Identify the FOUR stages of change for exercise that are described in the transtheoretical model.
1 Pre-contemplation o not ready to change 2 Contemplation o thinking about changing 3 Preparation o ready to change 4 Action o making changes now · Maintenance o on-track
Describe the ABCs of behavior change and how each one influences the likelihood that an older adult will or will not engage in exercise.
1. Identify antecedents to your client's behavior. Antecedents are thoughts, emotions, perceived barriers and motivators, and aspects of the environment that set the stage for or "cue" target (exercise) versus non-target (e.g., sedentary) behavior. 2. Assess the behavior linked with the antecedents. For example, does your client skip his or her exercise session on days he or she finds stressful? What type of behavior does your client choose? Is the activity enjoyable to and realistic for your client? 3. Examine whether the immediate consequences of your client's behavior are reinforcing or punishing.
Identify FOUR characteristics of an effective exercise goal.
1. Measurable - your client should be able to determine whether or not the goal was met 2. Specific - your client should specify when he or she will perform the exercise 3. Realistic - goals that your client is sure to achieve will enhance self-efficacy 4. Behavioral - your client has more direct control over goals that are behavioral (e.g., walking 3 times per week) than goals that are outcome-oriented (e.g., lose 10 pounds)
Describe FOUR strategies that an instructor could use to increase their clients' level of self-efficacy.
1. performance experiences 2. observational learning 3. verbal reasoning 4. emotional arousal
Identify SIX risk factors that are associated with Coronary Artery Disease.
Age Family history of heart disease Smoking Hypertension High cholesterol Low levels of HDL Diabetes Obesity Sedentary lifestyle
Identify FIVE benefits that older adults will derive from engaging in regular physical activity.
Disease protection Makes activities of daily living easier Improved emotional well-being Enhanced cognitive function Higher perceived quality of life
Why are performance standards or norms associated with a physical function test believed to be helpful to physical activity instructors of older adults?
Helpful in identifying people at risk for mobility problems and/or loss of physical independence.
How should physical activity instructors of older adults handle "walk-ins" or older adults who attend a class after all initial pre-exercise screenings have already been completed?
In such cases, have the participants complete the PAR-Q+ to identify those at the greatest risk of injury. As for any client, if a walk-in answers yes to any of the questions, his or her participation should be delayed until further screening can be performed.
Training Module 6: Teaching Skills
Information about motor learning principles that guide the selection and delivery of effective individualized and group exercises and physical activities, and the construction of safe and effective practice environments.
Training Module 4: Program Design and Management
Information about using results from screening, assessment, and client goals to make appropriate decisions regarding individual and group physical activity and exercise program design and management.
Training Module 9: Ethics and Professional Conduct
Information on legal, ethical, and professional conduct.
Training module 2: psychological, sociocultural, and physiological aspects of physical activity and older adults
Information on psychological, sociocultural, and physiological aspects of physical activity in order to develop safe and effective physical activity and exercise programs for older adults
Currently, what percentage of older adults (> 75 years) currently meet the Physical Activity Guidelines for Americans (PAGA) for (a) aerobic activity and (b) aerobic activity and muscle strengthening?
Only 27.1% of adults 75 and older meet aerobic guidelines Only 8.7% in same age group meet both aerobic and muscle strengthening guidelines.
Identify FOUR predictors of "Successful Aging" identified by Strawbridge & Wallhagen (2003).
Positive outlook on life; acceptance of aging and oneself; not smoking; not being obese; feeling very satisfied with personal relationships; having little or no hearing impairments; staying physically active; and volunteering often.
5. When and under what circumstances should the pre-exercise screening information collected from older adult clients be updated?
Pre-exercise screening information should be updated whenever a client has (a) recognized decline in health or function or (b) change in care or status. All screening tests and forms should be renewed annually.
Define the term "whole-person wellness."
Text book: Simply defined, whole-person wellness is multidimensional, positive health leading to a satisfying quality of life and a sense of well-being. Lecture: An approach to living life It is not a Program, Department, or Center
Describe the FIVE steps involved in the pre-exercise screening process.
Step 1: Informed Consent • Ensures participant's autonomy in deciding whether or not to participate. • Is mandated by federal law • Must be reviewed by the IRB (academic facilities), risk management team, or lawyer. • Has TWO basic components: information and consent. • Who you are what kind of background you have & obtain their consent Step Two: The Physical Activity Readiness Questionnaire (PAR-Q+) •Considered to be a minimal evaluation prior to starting a low-to-moderate intensity exercise program. PAR-Q+ is a newly developed questionnaire that can now be used with older age groups • Also a self-administered questionnaire but 4 versus 1 page. • Designed to identify small number of older adults for whom physical activity might be unsafe or need medical advice. • Instructed to contact PCP if YES to more than 1 Question. • Par q + is meant for a professional to assess an older adult • Easy tool for you is for typical older adults Step Three: Physician Consent • Recommended that physician consent be obtained to participate in physical activity. • Must inform physician about exact nature of performance testing and major components of exercise program. • Sample physician consent letter (Figure 5.4) Step Four: Health History and Activity Questionnaire • Means of identifying any contraindications to testing and exercise as well as any risks or limitations relevant to the exercise program. • Provides additional information beyond Par-Q+ that is essential for effective programming. Step Five: Feedback to Clients and Confidentiality. • Important to share results of pre-exercise screening with clients. • Important to retain client's results for later comparisons. • Information must not be shared with other clients and be stored in a secure location only accessible to program staff.
Be able to describe the recommendations outlined in the ACSM Position Stand (1998) relative to older adults and physical activity. (Grads - be able to compare and contrast the recommendations provided in the 1998 position stand and the most recent ACSM/AHA publication.)
The key message from the position stand was that regular exercise and physical activity can improve functional capacity and health and lead to greater independence and quality of life for older adults.
Identify each of the curriculum training modules that comprise the International Curriculum Guidelines for Preparing Physical Activity Instructors of Older Adults.
Training module 1: Overview of aging and physical activity Training module 2: psychological, sociocultural, and physiological aspects of physical activity and older adults Training Module 3: Screening, Assessment, and Goal Setting Training Module 4: Program Design and Management Training Module 5: Program Design for Older Adults With Stable Medical Conditions Training Module 6: Teaching Skills Training Module 7: Leadership, Communication, and Marketing Skills Training Module 8: Client Safety and First Aid Training Module 9: Ethics and Professional Conduct
Training Module 3: Screening, Assessment, and Goal Setting
o Community centers won't assess older adults because of time -Information on selection, administration, and interpretation of pre-exercise health and activity screening and fitness and mobility assessments appropriate for older adults. -Information on establishing, with client input, realistic and measurable short-term, medium-term, and long-term goals.
Provide FOUR examples of how to integrate each of the SIX dimensions of wellness into physical activity programs for older adults.
o Greeting (Emotional) o Asking and Listening (Intellectual) o Walking (Physical) o Smiling (Social) o Inspirational Messages (Spiritual) o Giving Time (Vocational)
Provide THREE reasons why it is important to assess older adult clients prior to the start of an exercise program.
o Identify and predict who is or will be at risk for mobility problems and disability o Determine if program is appropriate o Motivate client to set personal behavioral goals. o Select appropriate exercises o Provide meaningful feedback o Determine if referral is needed o Document benefits of program
In what circumstances would a physical activity instructor of older adults require medical clearance before conducting any of the Senior Fitness Test items?
o Pain or discomfort in chest o Shortness of breath o Dizziness or fainting o Swelling around ankles o Fast or irregular heartbeat o Pain in lower legs o Heart murmur o Undue Fatigue
When determining which assessment to use, what psychometric properties need to be considered?
o Reliability o Validity o Discrimination Power o Performance Standards
Identify the dimensions of functional fitness that are evaluated by the Senior Fitness Test.
o Upper and lower body strength o Upper and lower body flexibility o Dynamic balance and mobility o Aerobic endurance
According to Social Cognitive and Learning Theory, THREE factors influence human behavior. Identify the THREE factors.
personal, environmental, and behavioral factors
Training module 1: Overview of aging and physical activity:
recommended areas of study include general background information about the aging process and the benefits of an active lifestyle.
Identify the SIX steps involved in helping older adults initiate and maintain their involvement in a physical activity program.
v Step 1: Explore Expectations and Exercise Objectives Explore the client's expectations for exercise (+ and -) & overall objectives o Will dictate type of program recommended o Can indicate how realistic exercise goals are likely to be. o Try to find the "hook" § Personally meaningful outcome(s) v Step 2: Set Goals set 2 goals for stella and henry must have an outcome to the goal · Help client set short-term & long-term goals · Good goals are: o Measurable o Specific o Realistic o Behavioral o Also, CLIENT generated v Step 3: Provide Feedback & Monitor Goals · Review goals & overall progress regularly · Successes · Struggles · Reevaluations · Encourage self-monitoring of behavior · Frequency, intensity, type, time (minutes and/or steps) Conduct a Behavioral Analysis: the ABC's of Behavior Change Encourage Social Support · Explore what type of assistance the client needs and from whom · Brainstorm how to obtain needed support · Create a supportive program environment Types of Support · Informational - advice, suggestions, exercise-specific information · Instrumental or Tangible - offering a ride to class, doing a task so wife can have free time to exercise · Emotional - expressions of love, empathy, and encouragement Use Behavioral Contracts · Outline specific goals, how they will be measured, and consequences · Rewards? · Modify regularly · Contracts: o Increase commitment o Provide concrete reminder v Step 4: Use Rewards and Incentives · Encourage self-reward · Build reinforcement into your programs § Praise § Incentives § Recognition · Schedule of rewards § Adoption vs maintenance § Intrinsic vs extrinsic motivation v Step 5: Use Problem Solving to Overcome Obstacles · Avoid the "expert trap" · Ask open-ended questions to encourage client problem solving · Recommendations are OK, but not as first response v Step 6: Promote Long-Term Adherence · Help client differentiate between a lapse and a relapse · Help prepare clients for lapses · Encourage clients to avoid "all or nothing" thinking · Consider planned relapses
How does criterion validity differ from content and predictive validity?
· Content Validity - the degree to which a test reflects a defined "domain" of interest. · Predictive Validity evidence demonstrates the degree of accuracy with which an assessment predicts how participants will perform in a future situation.
Identify the SIX dimensions of wellness and the key characteristics associated with each dimension.
· Emotional o Emphasizes Awareness and Acceptance of One's Feelings o Reflects the Degree to Which an Individual Feels Positive and Enthusiastic About One's Self and Life o Involves the Capacity to Manage Feelings and Behaviors, Accept Oneself Unconditionally and Cope With Stress · Intellectual o Promotes the Use of One's Mind to Create a Greater Understanding and Appreciation of Oneself and Others o Involves One's Ability to Think Creatively and Rationally o Encourages an Individual to Expand His Knowledge and Skill Base Through a Variety of Resources and Activities · Physical o Promotes Participation in Personal Safety & Activities for Cardiovascular Endurance, Muscular Strengthening and Flexibility o Multi-faceted Dimension is Relative to Each Person's Abilities and Disabilities o Promotes Healthy Lifestyle Habits and Discourages Negative, Excessive Behavior · Social o This Dimension is Humanistic, Emphasizing the Creation and Maintenance of Healthy Relationships o Enhances Interdependence With Others and Nature, and Encourages the Pursuit of Harmony and Feelings of Connectedness · Spiritual o Involves Seeking Meaning and Purpose in Human Existence o Developing a Strong Sense of Personal Values and Ethics · Vocational o Process of Determining and Achieving Positive Personal and Occupational Goals and Interests o Discovering an Individual's "Calling" in Life o Encourages One to be a Good Giver and Receiver of Life's Gifts
Identify FOUR major purposes of the International Curriculum Guidelines for Preparing Physical Activity Instructors of Older Adults.
· Ensure safe, effective, and accessible physical activity and fitness programs for older adults; · Develop competent physical activity instructors of older adults; · Provide more consistency among instructor training programs preparing physical activity instructors of older adults; · Inform administrators, physical activity instructors, and others about the minimum training guidelines recommended by the profession when recruiting physical activity instructors of older adults; · Clarify the definition and role of a physical activity instructor for older adults; and · Establish the level of expertise required to help protect instructors and other facility staff from litigation (lawsuits). · These curriculum guidelines were not developed to promote one certification or licensing body of physical activity instructors of older adults. · These guidelines provide nine (9) curriculum modules to encourage more consistency among instructor training programs throughout the world.
Identify FIVE factors that have been the potential to affect the reliability of a selected test.
· Instructions to the client · Expertise of tester · Clarity of published protocol · Changes in protocol · Familiarity with the test · Fatigue and pain · Fear · Motivation
What elements should be included in a behavioral contract designed to increase an older adult's participation in physical activity?
· Outline specific goals, how they will be measured, and consequences · Rewards? · Modify regularly · Contracts: o Increase commitment o Provide concrete reminder
How does inter-rater reliability differ from intra-rater reliability?
· Rater Reliability: Is especially important if measures are going to be collected on multiple occasions and/or by more than one rater. · Intrarater reliability refers to the same evaluator. · Interrater reliability refers to different (between) evaluators.
Identify FOUR factors that influence whether a selected test of physical function is practical.
· Whether medical permission or supervision is required · Time needed to administer and score test · Personnel and expertise needed · Type of equipment and space needed · Fatigue induced by test · Social acceptability and meaningfulness
Define what is meant by the term "self-efficacy"
• 'Beliefs in one's capabilities to organize and execute courses of action required to produce given attainments' (Bandura) • = Confidence to exercise - to do actual exercise - to do exercise when faced with barriers