1. Beginning the health appraisal process & concepts of exercise programming HW 280

2.  Discuss health appraisals for exercise planning  Discuss risk factor evaluation  Designing exercise programs  Application  Wrap-up Agenda

3.  ACSM & AHA recommend pre-participation screening to:  Determine current health status  Is it appropriate to undergo fitness testing and/or begin exercise? ◦ Identifying risk factors

4.  Standard appraisal items: ◦ Medical history review ◦ Risk factor assessment and stratification ◦ Prescribed medications ◦ Level of physical activity ◦ Establishing need for physician consent ◦ Administration of fitness tests; evaluation results ◦ Set up exercise prescription ◦ Evaluation of progress

5.  Physical Activity Readiness Questionnaire PAR-Q ◦ Light to moderate activity ◦ Issues  Health Status Questionnaire (HSQ) ◦ More comprehensive ◦ Contraindications and risk factors ◦ Lifestyle/behaviors ◦ Physical activity patterns ◦ Current medications ◦ Information release form

6.  Privacy issues and protected information ◦ Question: What steps should professionals take to ensure HSQ information is properly protected?  Communication and trust ◦ Question: Patients may feel uncomfortable sharing detailed, personal medical histories. What are some techniques the health professional can use to build comfort?

7.  General Medical History ◦ Heart History ◦ Symptoms ◦ Additional Health Issues  Risk Factor* Assessment CHD ◦ Establish and quantify  Low risk: men <45 and women <55 asymptomatic & no more than 1 risk factor  Moderate risk: men >45 and women >55 or people with 2 or more risk factors  High risk: Ind. w/ cardiovascular, pulmonary, metabolic or who show signs or symptoms

8.  Prescribed medications  Level of physical activity ◦ Question: What conditions constitute the risk factor of physical inactivity? ◦ Question: How would you explain what constitutes low, moderate, and strenuous physical activity to a participant?  Establishing the need for physician consent to begin exercise  Administer and evaluate standard fitness tests

10.  Appropriate plans consider: ◦ Health status ◦ Personal goals ◦ Fitness test results  Types of programs ◦ Supervised, clinic-based ◦ Prescribed exercise, professional supervision ◦ Vigorous-intensity exercise ◦ Any unsupervised physical activity

11.  Timelines  Variety  Accommodate individual differences  Maintain control  Monitor progress

12.  Understanding physical activity vs. exercise  Elements of balanced work outs ◦ Cardiovascular endurance ◦ Muscle strength & endurance ◦ Flexibility ◦ Body composition  Activity Pyramid Sedentary activity Flexibility (3+ wk) Muscular strength/ endurance (3+ wk) Cardio (3-5 x wk) Physical Activity - DAILY FITT Guidelines Frequency Intensity Time Type

13.  Overload  Specificity  Progression  Reversibility  Consistency  Individual differences  Safety  Rest

14.  Let’s talk about designing a program for a hypothetical participant... ◦ The participant is a 62 year old women, post- menopausal with high blood pressure and sedentary lifestyle. She is somewhat motivated to tend to her health but has never exercise regularly. She cannot swim and is not likely to regularly attend a gym. ◦ What steps would you take to complete a health appraisal? ◦ What basic exercise routine would you suggest? Use the FITT guidelines. Is there anything else you think is important to discuss with the participant? Why?

15.  Discussed health appraisals for exercise planning  Discussed risk factor evaluation  Talked about designing exercise programs  Application  Wrap-up  Questions?