Fitness orientation and health screening

Session 5

Types of Clients

• Experienced vs inexperienced

• Regular vs new

• Various ages, Children –Older clients

Types of Clients

• Active vs inactive• Varying cultures and backgrounds, are you

aware of the local cultural background that are in your area?

• Varying health status• Other factors such as drug use.

Establishing rapport

• Client comfort• Written information about facilities and

services• Non-confronting position• Friendly, courteous greetings• Introduction of self and position.

Benefits of exercise

• Reduced risk of stroke and heart disease• Reduced body fat• Reduced blood pressure and cholesterol• Prevent and control diabetes• Maintain bone density• Increased mobility and stability of joints• Social support.

Collecting information

• PAQ-important information collection• Interview- informal chat• Previous information-previouse exercise,

previouse memberships held • Liaising with other professionals-GP

approval if clients are flagged with potential pre-existing health risks

• Confidentiality-strickly

Client expectations

• Goals– What do you want to achieve through this

program?

• Availability– What time do you have available to commit?

• Cost– What is your budget?

• Expected outcomes

Client expectations

• Cost– What is your budget?

Alternatives depending on the environment available:

– Home exercise program– Park– Inexpensive equipment– Minimal equipment.

PAQ Minimal requirements

• Current and past medical conditions• Medications• Existing injuries-chronic• Current fitness levels-• Functional limitations• Lifestyle factors• Exercise history.

Collecting information

• Age• Family history• Disease/s and medical conditions• Injury and/or surgery history• Signs and symptoms• Gender• Exercise intentions.

• Expected outcomes– What do you hope to see happen?

• Discuss 3 month (8-12 weeks) window for results

– What’s happened previously?– What motivated you to continue?– How can we mirror this

Steps in client induction

Health screening

• Also known as pre-exercise screening• Collecting health-related information which

may be used for exercise prescription• Information on which to base a referral on• Helps with identifying major coronary and

other risk factors.

Risk classification

• Low• Moderate• High

Information collection forms

Fitness testing

• Starting off with a benchmark of fitness tests, is vital in order to maintain client motivation throughout a program– Provides a starting point for training– Demonstrate how gains can be made

• Validity vs Reliability• Quality control: testing environment, client

and fitness testing equipment.

• Standard measurements– Height– Weight– MHR = 220-age= MHR– RHR = radial/carotid pulse location count for

10 second x 6

Blood pressure

• Casual blood pressure is taken in a relaxed setting, usually in a fitness testing room

• If your facility doesn't’t have the right equipment for this test, clients might be able to obtain this information from their GP

• Checklist– Stethoscope– Sphygmomanometer or the blood pressure cuff

Blood pressure

• Varies even with standard resting conditions

• Best to take multiple measurements• Systolic/diastolic arterial pressure• Average healthy reading: 120/80 mmHg

• http://www.youtube.com/watch?v=Gmic13mvsgo

Resting blood pressure ratings

Health related components of fitness

• Cardiorespiratory endurance• Muscular strength• Muscular endurance• Flexibility• body composition.

Maximal vs Submaximal oxygen consumption

• VO2 max vs MHR

• Greatest amount of oxygen the body can consume in a one minute period

• Risks-can be extremely challenging for clients that are rated at risk

Maximal vs Submaximal oxygen consumption

• Depends on:- ability to take in oxygen- vascular system’s ability to deliver blood to

working muscles- working muscle’s ability to use oxygen.

Maximal aerobic testing

• Some examples• Beep test

– Completing this test under supervision, to ensure validity and reliability of results

• Max Velocity– Incrementally increasing the effort to the clients

test, until pushing exhaustion

Submaximal aerobic testing

Rockport Walk Test

• The Rockport Walk Test is a sub-maximal exercise test that can be done on a treadmill or on a track. It is used for people who are generally less fit and cannot run for very long.

• To do this test you simply walk for one mile(1.6 Kms or 4 laps of a 400m track) at a pace that you can sustain for the entire distance.

• Immediately after you complete the mile, check your heart rate and note the time it took you to complete the distance.

• You can determine your aerobic fitness by entering your heart rate, time, age and weight into a specific formula.

• Females: VO2 = 139.168 - (0.388 x age) - (0.077 x weight in lb.) - (3.265 x walk time in minutes) - (0.156 x heart rate). Males: add 6.318 to the equation for females above

Modified Balke Treadmill Test• A widely used measure of cardiovascular endurance is the Modified Balke

Treadmill Test. • You can perform this test yourself or with the assistance of a friend, coach or

trainer. – Walk for 1 minute with the speed on your treadmill set at 3.3 miles (5.3 km) per hour, and the grade

set to 0.– Walk for another minute with the grade set at 2 percent.– After the second minute, raise the grade by 1 percent per minute until you reach 25 percent (25

minutes), or can no longer continue, whichever happens first.

• Discuss your results– Eleven minutes or less indicates low cardiovascular fitness. – Average fitness enables you to continue to 15 minutes– 25 minutes indicates a superior level of cardiovascular fitness.

Muscular strength tests

• Choosing the right tests can be critical for clients to create your benchmark for testing

• Understanding which clients should be performing 1RM test vs 1RM prediction tests

• Use clients goals to determine relevence of this test

Muscular strength tests

• One repetition maximum (1RM)1. After a period of familiarization with the movement, have the client perform a light

warm-up of 5–10 reps at 40%– 60% of his or her perceived maximum resistance (light to moderate exertion).

2. After a 1-minute (min) rest with light stretching, cue the client to perform 3–5 reps at 60%–80% of perceived maximum resistance (moderate to heavy exertion).

3. Add 5–10 pounds (lb). If the client is successful at lifting that weight, allow a rest period of 3–5 min and add another 5–10 lb. Continue this process until a failed attempt occurs. Record the last successfully completed lift as the 1RM.

4. Express the results relative to the client’s body weight (dividing the 1RM by the client’s weight).

• Bench press– muscular strength chest– Supervised exercise

• Leg press– muscular strength legs– Controlled exercise

• Squat– muscular strength legs– Supervised exercise

Muscular endurance tests

Static and dynamic• Push-up test

– 60 seconds max effort

• Abdominal crunch test– 60 seconds max effort

• Single leg wall sit test– 30-60 seconds hold

Flexibility tests

• Sit and reach test– Ensure your client has warmed up

• If you don’t have a sit and reach station, this test can also be performed with a measuring tape

Body composition

• Body mass index (BMI)• Waist to hip ration (WHR)• Skin fold measurements• Bioelectrical impedance analysis (BIA)• Girth measurement• Choose the relevant testing procedure

BMI ratings

Percentage body fat ratings

• Do not perform this test if you don’t have a private room to conduct it within

• Skinfold testing sites for male and females– Chest– Tricep– Subscapular

• http://www.youtube.com/watch?v=vDPWaiLyuTU– Tricep– Abdominal– Superiliac

• http://www.youtube.com/watch?v=hvC2TDs95xY

Percentage body fat ratings

Girth Measurement

• This type of test is most successful when used on persons who have average or above average body fat percentages.

• Waist to Hip ration– the purpose of this test is to determine the ratio

of waist girth to the hip girth, as this has been shown to be related to the risk of coronary heart disease

WHR ratings

• Additional key station that can be measured– Chest

• Placing the measuring tape under the arms

– Upper arm• Largest visual point

– Thigh• Largest visual point

Ongoing Counselling

SMART goal setting• Specific• Measureable• Achievable• Reliable• Timely.

Organisational policies and procedures

• Record management• Privacy• Screening of clients• Referral requirements• Monitoring and re-evaluation.