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very important information
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no exercise if
RBP >200/110
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when should you stop aerobic exercise
BP >240/115
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if during resistance exercise, blood pressure > 160/100. What should you do
no weight greater than 50% 1RM
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stop if heart rate >
85% HRMax
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true or false – if blood pressure is abnormally high compared to normal blood pressure you would not exercise even if > 200/110
true
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how many questions are on the PAR-Q
7
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what is the age range
- 50 – 69
- older than 69, always consult with a doctor
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patient can participate in activity if
answers no all questions
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if the patient answers yes to any questions, what do you do
refer to a physician
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what are the limitations
does not address cardiovascular issues, and can't assess people over 69 and inactive
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cardiovascular risk factors – page 28
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family history– men and women
- male relatives death or MI orcoronary revascularization or sudden death >55
- female relative death or MI or coronary revascularization or sudden death > 65
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cigarette smoking
smokers or have quit within the last six months or exposure to tobacco smoke
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sedentary lifestyle
inactive less than 30 min. a day moderate intensity, 3x/wk, for three months
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obesity
- BMI> 30 kgm squared
- men waist circumference >102 cm/40 inches
- women waist circumference > 88 cm/35 inches
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hypertension
>140/90 on two separate occasions
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dyslipidemia
LDL
HDL
total
- LDL>130
- HDL <40
- Total > 200
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prediabetes
- fasting glucose> 100
- 2 hour values in oral glucose tolerance test > 140 but <200 on 2 occasions
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signs and symptoms of disease
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pain and discomfort in
arms, chest, neck, or jaw
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shortness of breath at
rest or with mild exertion
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signs and symptoms of disease continued
- dizziness or syncope
- orthopnea, paroxysmal nocturnal dyspnea
- ankle edema
- palpitations or tachycardia
- intermittent claudication
- known heart murmur
- unusual fatigue or shortness of breath with usual activities
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low, moderate, high risk factors
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low risk factors
under specified age and 1 or less cardiovascular risk factor
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moderate risk factor
at risk age or 2 or more cardiovascular risk factors
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high-risk factors
known cardiovascular problem, pulmonary, or metabolic disease or 1 more signs or symptoms
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recommendations for fitness testing
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draw out the table for exercise recommendations
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remember
- for the test on the practical, a person that is low or moderate risk can do any of the test because all are sub Max, or moderate intensity
- know how to take resting and exercising heart rate, blood pressure, RPE
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skin folds and body fat analyzer
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measurements are always done what side of the body
the right side
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how many times should you measure each site
2x, rotating through and average
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what are the three sites for men
- pectoral – one half way between nipple and armpit; diagonal fold
- abdomen – 1 inch from belly button
- thigh –1/2 way between the inguinal crease and patella
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what are the three sites for women
- triceps –1/2 way between acromion and olecranon
- suprailiac– 1 inch over, diagonal fold
- abdomen;1 inch over from bellybutton (or thigh)
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name the different ways to measure body composition from least accurate to most
- Electrical Impedence > Skin Fold >Hydrostatic Weighing (best)
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what are some factors that make electrical impedance inaccurate
- caffeine, alcohol, diuretics
- eating or drinking 4 hours before
- moderate or vigorous activity 12 hours before
- not voiding prior
- no electrical impedancepacemaker
- same time a day – if doing it multiple times
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what are some of the factors that make skinfold testing inaccurate
- poor technique or inexperienced evaluator– to become a confident skinfold taker you need to do it 50 – 100 times
- extremely obese or lean subjects
- improperly calibrated caliber
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how do you calculate BMI
Kg/m2
- pounds to kilograms = #/2.2
- inches to centimeters = in x 2.54
- if you don't convert (weight in lbs x 703) / (height in in2)
- when taking height – feet against the wall and together, no shoes
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what are the values for BMI
- 18 – 24 normal
- 25 – 29 overweight
- > 30 obese
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where do you measure
narrowest part of the torso between reds and umbilicus
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what measurement for women is considered obese
>35 inches, 88 cm
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what measurement for men is considered obese
>40 inches, 102 cm
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high circumference is correlated with
cardiovascular disease
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android shape?
carry weight around abdomen – higher risk for cardiovascular problems
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gynoid shape?
pair, wait through hips and thigh
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what is a normal difference between strength in each hand
10%
25% difference between sides is significant
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how may times should grip strength be taken and measured
three times/hand, there should be averaged
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what is average for our age
male right-hand?
female right-hand?
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does grip strength represent overall strength
- no
- good for functional ability
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how long does this test last
30 seconds
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What kind of test is it?
D) endurance and strength
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who is this test for
for older adults, 60+
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demonstrate
without weights; two reps
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timed arm curls – continued
- sit in chair with back, no armrest
- encourage patient to do as many reps as they can do in 30 seconds
- start with hand in neutral – supine at full flexion
- women use 5 #weights, then use 8#
- norms: upper teens – 20s for women and men
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What does the timed sit- up test evaluate?
A) Muscular endurance
B) Stengthen
C) Power
D) All the above
A) Muscular endurance
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Knees should be flexed to
90
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Shoulder blazdes should
come completely off the ground (hands moving 10 cm) and come completely back to start position
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True or false - Clinician should hold the persons feet while performing this test.
False
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What is considered excellent
25/1
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What is considered good
20/1
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What are the contraindications to this test
Osteoporosis, low back pain, pregnant
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What does it measure?
Flexibility and range of motion
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What do you as the clinician measure?
- the distance in between middle fingertips
- (-) for gap
- (+) for over lap
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True or false - Don't use back to crawl fingers down.
true
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How do you perform this test
passively stretch hamstrings at the end range for 15-60 seconds, 3 times then assess
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Lacking > 25 degrees means?
you have decreased flexibility
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What makes the test invalid?
the patient can't get hips to 90
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Measured with a _______?
Goni
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Contraindications?
THR, hip contracture
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Alternative way?
if they can do passive SLR and if you get 80 hip flexion then satisfactory
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This test is more functional than the sit and reach test for what population?
Older population
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What are the contraindication to this test?
LBP, osteoporosis, THR, lumbar disc derangement
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how is a patient seated
at the edge of the chair with the knee extended
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true or false – it is important to keep the spine straight, reach with overlapping hands to toe with ankle in neutral of one leg
true
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true or false – test both legs (one leg at a time), and take the measurement of the more flexible side
true
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true or false – the tests should only be administered once
- false
- 2 – 3 practice trials, then take measurement
- distance = middle finger to toe
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how is the measurement recorded
recorded as (–) number to the nearest .5 inches, and (+) if the overlap
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3 minute steps test – YMCA step
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what does this test measure?
Measures cardiovascular fitness level by looking at heart rate recovery time
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Who is this test for?
A) Non - sedentary >15 y.o
B) > 10 y.o.
C) 15 – 69
A) Non - sedentary >15 y.o
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what are the contraindications of this test
lower extremity or balance problems
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how tall is the step?
12 inches
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what is a cadence for this test
96 bpm
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what should be done after the test is complete
sit down after the test is over and take the patient's heart rate for full minute with stethoscope over heart
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quicker heart rate recovery =?
better cardiovascular fitness level
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Single Stage Treadmill Test
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what does this test measure
used to calculate predicted VO2 max (sub –max test)
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true or false – this test is for healthy sedentary men and women ages 20 – 60 years old
true
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true or false – to perform this test the clinician needs to take resting heart rate, then determine50 – 70% max heart rate (moderate intensity)
true
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how do you determine 85% of max heart rate?
(220 – age) x .85
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what happens if resting blood pressure is 200/110
no exercise should be performed
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during stage I the patient begins walking on treadmill at risk walking pace, how fast should that pace be?
2.0– 4.5
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what is a grade during stage I
zero
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once 50 – 70% heart rate mass is reached continue at this pace for ____minutes
- 4
- take heart rate at the end of this phase to ensure that it is not exceeding 85%
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true or false – during stage II, I just grade 25% and maintain current speed; walk for 4 more minutes
true
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this test is used to calculate?
predicted VO2 max
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This test is used for?
A) healthy adults
B) active adults
C) sedentary adults
D) all the above
E) none of the above
D) all the above
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explain how to set up bike seat
bike seat at greater trochanter and knees flexed to 10°
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what things did you do before you begin the test
measure resting heart rate, resting blood pressure, and calculate age predicted max heart rate and calculate 85% heart rate max
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how long should the warm up last
2 minutes
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true or false – everyone starts at the same intensity
what is the intensity?
- true
- 150 kgm/min or 25 W /0.5kp at 50 RPM
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true or false – heart rate is measured during the last 15 – 20 seconds of the second and third minute
true
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what happens if the heartbeats are not within 5 beats of each other?
Then the patient is not at steady-state and they need to do an additional minute at the same workload
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true or false – if you don't reach steady-state infourth minute you would stop the test, because the test is too hard for you
true
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when do you terminate the test?
terminate test with heart rate is between 110 – 150 for 2 separate stages
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how long does cool down last
2 – 5 minutes
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this test works best for what population?
for elderly that may or may not have balance problems
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what is the purpose of this test
to assess agility, balance, and lower extremity strength
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how many practice trials do they get
1
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what is the starting position
start with back against chair and arms on armrest
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true or false – the patient's cannot use ambulation device in this test
false, they can if they normally do use one
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how long should the distance be for adults to walk
10 feet
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how long should the distance be for seniors
8 feet
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what is the start and the end of the test?
get up, walk at a comfortable pace, go around Cohen, walked back, and sit back down
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how fast should it be for independent healthy adults
<13.5 seconds
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