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Pre-screening Procedures- What you need to know and do before testing your clients

Pre-screening Procedures- What you need to know and do before testing your clients. Before Assessing Fitness:. Reduce risk of injury or death during assessment or activity Identify lifestyle habits and health status which may prohibit assessment

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Pre-screening Procedures- What you need to know and do before testing your clients

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  1. Pre-screening Procedures-What you need to know and do before testing your clients

  2. Before Assessing Fitness: • Reduce risk of injury or death during assessment or activity • Identify lifestyle habits and health status which may prohibit assessment • Identify lifestyle habits and health status which may be risk factors for disease (risk classifications)

  3. A Comprehensive Health Evaluation Includes: • PAR-Q • Medical History • Signs and Symptoms • CHD Risk Factor Analysis • Disease Risk Classification/Initial Stratification • Physical exam or medical clearance • Lab. Tests (blood lipids, glucose) • Resting HR, BP and EKG measurement • Graded Exercise Test (GXT)

  4. Initial Procedures: • Provide pre-test instructions (p. 39 Heyward) • Greet the client • Explain the purpose of the evaluation • What you are testing • The procedures of the test

  5. Pre-test Screening Procedures • Page 20, ACSM • Administer Par-Q, Medical History and refer to Dr. if necessary • READ Screening documents and assess disease risk • Note risk factors for CAD (p. 22) • Note signs/symptoms (p. 23-4) • Stratify based on risk (p. 27)

  6. Informed Consent • Administer immediately prior to testing/training • Must ensure that participant understands the purposes and risks associated with the test or the exercise program • Must state that client was given an opportunity to ask questions and has sufficient info. to give consent • If < 18 yoa, must have parent or guardian sign

  7. Initial Risk Stratification • Risk Stratification - likelihood of an event occurring during activity (p. 27 ACSM) • Low risk = Men < 45 and women < 55 yoa who are asymptomatic and have no more than 1 risk factor • Moderate risk = Older individuals (men > or = 45 yoa and women > or = 55 yoa) or those with 2+ risk factors • High risk = Those with 1 + signs/symptoms or with known disease

  8. Is medical clearance and supervision necessary? • See Table 2-1, page 20 ACSM • Level 3

  9. Testing order • INFORMED CONSENT • Resting BP and HR • Body Composition • Cardiorespiratory Endurance • Muscular Fitness • Flexibility

  10. Testing Environment: • Professional appearance/attitude • Privacy, safe, clean • Comfortable temperature (~ 70-74 degrees) • Functional, calibrated equipment • Use of appropriate equipment (valid, reliable, objective)

  11. Test Validity • The ability of a test to ACCURATELY measure what it is supposed to measure • Direct measurement of VO2 with metabolic equipment (gold standard) compared to indirect measurements of VO2 using equations to estimate value • Validity coefficient - relation between predicted scores and criterion scores (< or = 1.0)

  12. Test Reliability • The ability of a test to yield CONSISTENT and stable scores • Reliability coefficient: the extent to which a test can reproduce the same information each time it is given. (= or < 1.0). Most fitness tests have coefficients of 0.90 or higher.

  13. Relation between Test Reliability and Validity • It is NOT possible for a test to be valid and not reliable (if it measures what it claims, it will do it consistently) • It IS possible for a test to be highly reliable without being valid (measuring what it claims to measure) • Example: body composition using home BIA scales

  14. Test Objectivity • Objective tests yield similar scores for a given individual when the same test is performed by different technicians • Calculate the correlation between pairs of scores measured on the same individual by different technicians • Objectivity coefficient: cannot exceed 1.0. Trained technicians should have 0.90 or better

  15. Test Interpretation • Classification of fitness tests results provides a context for clients –ALWAYS CLASSIFY ALL RESULTS!! • Consider the data you are using to evaluate – criterion or norm-referenced • Interpretation for clients should be simple and positive

  16. Interpretation • Criterion referenced – no comparison to others, provide a minimum acceptable level • Norm-referenced – compared to the population from which the norms were established • Interpreting percentages • Body Comp. interpretation (pp. 66-67 ACSM vs. p.162 Heyward)

  17. Female, aged 35 years • Total Cholesterol = 220 mg/dl • BP = 120/80 mm Hg • BMI = 24 kg/m2 • Non-smoker • Active • MI in mother at age 66 years • Diabetic

  18. Male, aged 46 years • No signs/symptoms • BP, CHO, Glucose, BMI all WNL • Non-smoker • Active • No family history

  19. Male, aged 27 years • BP = 138/96 mm Hg • CHOLESTEROL = 180 mg/dl • LDL = 150 mg/dl • BMI = 30 kg/m2 • Sedentary • Smoker • No family history

  20. Female, aged 53 years • Cholesterol = 210 mg/dl • HDL = 65 mg/dl • LDL = 120 mg/dl • Non-smoker • No family history • BMI = 22 kg/m2 • BP = 132/86 mm Hg • Glucose = WNL

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