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Initial interview
- Questionaires
- Risk statification/classification
- Further referals (medical etc)
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Exercise testing for fitness variable
- Body composition
- Aerobic
- Muscular stength
- Muscular enderance
- Flexability
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Elements of an exercise program (6)
- 1. Initial interview
- 2. Ex testing for fitness variability
- 3. Initial exercise prescription
- 4. Modifications to --> progression
- 5. Periodic testing
- 6. Maintenance and modifications as needed
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Patrons are evaluated carefully during initial phase. This assumes...(4)
- 1. Safty of testing and program participation
- 2. Optimum choice of exercise
- 3. Optimum prescription of exercise
- 4. The need for further tests will be identified
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ACSM Risk Stratification Positive (in respect to Coronary Heart Disease) Risk Factors (7)
- 1. Family History-
- 2. Cigarette Smoking
- 3. Hylertension-
- 4. Dyslipidemia-
- 5. Impaired fasting glucose
- 6. Obeisity
- 7. Sedentary lifestyle
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Review health/medical history for known diseases, signs/symptom, and CAD risk factors... Then
- Known CV, pulmonary, medical disease?
- If Yes= High Risk
- If No then major signs of (above)?
- If Yes = High Risk
- If No then # of risk factors?
- 2 or more= Moderate Risk
- Less than 2= Low Risk
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Risk Stratification Chart
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Function measures on interest...(5)
- V02 max
- BP
- Cardiac output
- Stroke volume
- HR
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ACSM Guideline for Physical Examination Components (5)
- 1- Ausculation of the lungs w/ specific attention to: rails, weezes, and rhonci. Also uniformity of breath sounds
- 2- Palpation for carotid, femeral, and pedal pulses, also cardiac impulses and thrills
- 3- Ausculation of the heart (murmers, gallops, clicks, and rubs
- 4- Carotid, abdominal or femoral bruits
- 5- xanthoma and xanthelasma
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Contradictions to ex testing. Absolute and relative
- Absolute= risks overshadow benifits, should not be tested or programmed
- Relative= benifits outweigh the risks
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Benefits of regular exercise...
- -Improvment in CV and respiratory functions
- -reduction in coronary artery disease risk factors
- -decreases morbidity and mortality
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Degree of medical evaluation before testing and programing varies with classification into categories. Which are(4)
- 1-apparent health status
- 2-presence of major coronary risk factors
- 3-presence of disease
- 4-age
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Reasons for ex testing (4)
- 1-to aid in diagnosis of CHD
- 2-to asses safty of ex prior to program
- 3-to asses cardiopulmonary functional capacity of apparently healthy people
- 4-to follow progress of known CHD or pulmonary disease
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Characteristics of a stress test (4)
- 1-prosseses a graded series of ex intensities
- 2-prosseses an accurate ECG
- 3-prosseses an identifiable end pt
- 4-provides a measurment of work capacity
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End Points non(3)/problem related(8+)...
- Non= leg fatigue, achivement of target HR, exastion.
- Problem= chest pain(agina), shortness of breath, drastic fall in systolic BP, arithmias, light-headedness, confusion, failure of HR to rise w/ incr ex intensity, subject requests to stop, failure of testing equip
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Logic Model for Risk Stratification
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Variables of Health Fitness (5)
- Strength
- Muscle Endurance
- Aerobic Endurance
- Body Composition
- Flexibility
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