Transcript Exercise Science - Dixie State University

Exercise Science
Health Screening
Health Screening
Health Screening … Why?
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Determines Activity Readiness
Identifies Risk
Identifies contraindications
Identifies personal health history
Helps Identify Goals
Assists in the Prescription of Exercise
Fulfills Legal and Professional Obligations
Networking
Health Screening
Health Screening … What?
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Physical Activity Readiness
Demographics
Risk Appraisal
Medical History
Lifestyle History
Exercise History
Goals/Wants/Needs
Health Screening
Primary Risk Factors for Coronary
Heart Disease
 Smoking
 Hypertension
 Hyperlipidemia (240 mg/dl)
 Obesity
 Family History (prior to age 55)
 Diabetes
Health Screening
Secondary Risk Factors for Coronary
Heart Disease
 Sedentary Lifestyle
 Stress
 Gender
 Race
 Diet
Health Screening
Physical Activity Readiness Questionnaire
PAR-Q
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For most people physical activity should not pose any problem or hazard. PAR-Q has been designed to identify the small number of
adults for whom physical activity might be inappropriate or those who should have medical advice concerning the type of activity
most suitable for them.
Common sense is your best guide in answering these few questions. Please read them carefully and check the yes or no opposite
the question if it applies to you.
YES NO
Has your doctor ever said you have heart trouble?
Do you frequently have pains in your heart and chest?
Do you often feel faint or have spells of severe dizziness?
Has a doctor ever said your blood pressure was too high?
Has your doctor ever told you that you have a bone or joint problem such as arthritis that has been aggravated by exercise, or
might be made worse with exercise?
Is there a good physical reason not mentioned here why you should not follow an activity program even if you wanted to?
Are you over age 65 and not accustomed to vigorous exercise?
If you answered YES to one or more questions...
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if you have not recently done so, consult with your personal physician by telephone or in person before increasing your physical
activity and/or taking a fitness test.
If you answered NO to all questions...
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If you answered PAR-Q accurately, you have reasonable assurance of your present suitability for an exercise test.
Health Screening
DIXIE COLLEGE
FITNESS CENTER
Medical Questionnaire & Informed Consent
Social Security Number _______ ______ ________
Date _______ / _______ / _______
Last Name _________________________________
First Name __________________________
Address ______________________________________________________________________________
Street
City
State
Zip
Home Phone _____________________________
Business Phone __________________________
Birthdate ______/______/______
Sex (Male/ Female) _______
Course ________ Section _______
Resting Blood Pressure______/______
Resting Heart Rate_______
Height______
Weight______
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Emergency Contact Information
Name ____________________________________________
Relationship _______________________
Phone Number ________________________
_____________________________________________________________________________________
Participant Status
______ Student
______ Full Time
______ Part Time
______ Dixie College Employee
______ Dixie Center Employee
___________________________________________________________________________________
Health Screening
yes
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no
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Health Risk Appraisal
1. Has a doctor ever said you have a heart condition and recommended a medically
supervised physical activity program?
2. Do you have chest pains brought on by physical activity?
3. Have you developed chest pains within the last month?
4. Do you tend to lose consciousness or fall over as a result of dizziness?
5. Have you been diagnosed with hypertension (high blood pressure),
Systolic BP of 160mmHg or greater, or a Diastolic BP of 90mmHg or greater on
at least two (2) separate occasions?
6. Has a doctor ever recommended medication for your blood pressure or heart
condition?
7. Do you have a serum cholesterol level of 240mg/dl or greater?
8. Do you have Diabetes Mellitus? (Persons with insulin-dependent diabetes
mellitus -IDDM- who are over 30 or have had IDDM for more that 15 years
and persons with noninsulin-dependent diabetes mellitus who are over the age
of 35.)
9. Do you Smoke?
If yes, how many packs/day __________________
10. Do you have a bone or joint problem that could be aggravated by the proposed
physical activity?
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11. Do you have a family history of Coronary or other Atherosclerotic disease in
parents, grandparents, siblings at or before the age of 55?
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12. Are you over the age of 65 and not accustomed to vigorous activity?
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13. Are you aware, through your own experience or a doctors advice of any other
physical reason against your exercising without medical supervision?
If “yes”, explain: ___________________________________________________
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Instructor’s Comments:__________________________________________________________________
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Health Screening
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Medical & Lifestyle Questionnaire
yes
no
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1. Do you have Asthma?
Medication:________________________.
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2. Weight gain in the past 10 years?
How many pounds?__________________.
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3. Weight at age; 20 _______;
30 _______;
40 _______;
50_______;
60 _______?
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4. Do you have a history of Chronic Low Back pain?
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5. Have you had a recent surgery?
Please Specify _________________________.
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6. Have you had a physical from your physician in the past year? If not how long
has it been? ___________________________.
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7. Are you pregnant? Number of months along? ___________________________.
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8. Circle your correct activity level:
a. Little or No exercise weekly.
b. Light, 10-20 minutes 1 to 2 times/week.
c. Moderate, 10-20 minutes 3 to 5 times/week.
d. High, 20-30 minutes 3 to 5 times/week.
e. Vigorous 30+ minutes 5 to 7 times/week.
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9. Estimate your current stress level:
a. Unhurried, generally happy, rarely tense or anxious.
b. Ambitious, generally relaxed, tense 1-3 times/week.
c. Feel tense maybe twice daily, sometimes hard driving.
d. Quite tense, usually rushed, hard driving, competitive.
e. Extremely tense, always rushed and hard driving.
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10. Do you currently take any medications?
Please list all: _____________________________________________________
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Health Screening
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Goals
Lose Weight (reduce body fat)
How many pounds? ________________.
Weight Gain
How many pounds? ________________.
Firm Up - Tone Muscles
Increase Muscular Strength
Improve Athletic Performance
How? ___________________________.
Lower Blood Pressure / Heart Rate
Lower Blood Sugar Levels
Level now? ______________________.
Lower Cholesterol Level
Level now? ______________________.
Reduce Stress
Leisure / Social Activity
Maintain Current Fitness
Health Screening
Informed Consent & Release Form
General Statement of Program Objectives & Procedures:
I __________________________, understand that this physical fitness
program may include exercises to build the cardiorespiratory system (heart
& lungs), the musculoskeletal system (muscle endurance, strength, and
flexibility) and to improve body composition. The exercises may include
aerobic activities (treadmill walking/running, rowing, cycling, or
stairclimbing, etc.), calisthenics and/or strength training (variable resistance
machines, or free weights) to assist in improving overall health and fitness
levels.
Potential Risks:
I understand that the reaction of the heart, & vascular system, lungs and
muscular system to the aforementioned exercises cannot always be
predicted with specific accuracy. I am also aware of risks that may occur
while engaged in said exercises such as; abnormalities in blood
pressure and heart rate, ineffective functioning’s of the heart, in
rare instances heart attack and stroke, muscular sprains, strains,
muscular pain, and possible broken bones.
Health Screening
Potential Benefits:
I also understand that a program of regular exercise for the heart, lungs,
muscles, and joints has many associated benefits. These may include; a
decrease in body fat, improvement in blood lipid profile, decrease
in blood pressure and resting heart rate, increases in muscular
strength, endurance, bone density and overall joint stability, as
well as improvements in ones psychological function and a
decrease risk of coronary heart disease.
Acknowledgement:
I further acknowledge the existence & purpose of certain rules and
procedures concerning the use of the equipment, facilities and activities of
the Fitness Center. I agree to abide by those rules and procedures and
shall make every effort to ensure that the equipment and facilities are kept
in a safe and useable condition.
Release:
Having read the foregoing information, I acknowledge my
understanding of the risks, benefits and rules set forth above and
knowingly agree to assume full responsibility for the same.
Health Screening
Physician Release Form
Dear Physician
Your patient_____________________________, is registered for
the Fitness Center course at Dixie College in which they will be
asked to participate in a cardiorespiratory and/or musculoskeletal
exercise program.
Through our initial screening process (we follow the American
College of Sports Medicine Guidelines) your patient has come to our
attention as an individual at Higher Risk and requires a medical
release prior to beginning their exercise program.
Please check the following activities which you feel your patient can
participate in safely with your consent. We have a well qualified
staff supervising the Fitness Center at all times so programs can be
individualized
Health Screening
Exercises (cardiorespiratory & muscular strengthening)
______ Rowing
______ Stationary Bikes (Lifecycles-upright & recumbent- & Schwinn Air
Dynes)
______ Stairclimbers (Stairmaster 4000pt, 4400pt and Crossrobics 1650LE)
______ Treadmills (Lifestride 9500)
______ Variable Resistance Strength Machines (Cybex)
______ Free Weights
______ Calisthenics Exercises
______ All of The Above
Please list below any limitations or medical considerations in which we should
be aware of:
______ No Limitations
______ Limitations:
If you have any questions or comments, please contact me at
Health Screening
Common Conditions Trainers May Encounter
– Respiratory
 Asthma, COPD
– Musculoskeletal
 Tendon/Ligament conditions
 Arthritis
 Back conditions
– Metabolic
 Diabetes
 Hypoglycemia
– Other
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Pregnancy
Hernia
Illness/Infection
Etc.
Health Screening
Common Types of Medications
– Antihypertensives:
heart
– Beta Blockers:
catecholamines
decrease contraction force of the
decreases RHR and ExHr by blocking
– Calcium Channel Blockers:
decrease contraction force of the heart
Vasodialates arteries &
– Diuretics: increase kidney function, lowers blood volume
– Bronchodilators: relaxes bronchi passages
– Cold Medication: decrease blood flow to the upper
respiratory vessels to reduce inflammation