CHW Midterm 5

• Heaviest resistance that can be used for 1 complete repetition of an exercise
• How to assess 1 rep max
• The subject performs a light warm-up of 5 to 10 repetitions at 40 to 60% of perceived maximum (i.e., “light” to “moderate” effort).
• Following a 1-min rest with light stretching, the subject performs 3 to 5 repetitions at 60 to 80% of perceived maximum (i.e., “moderate” to “hard” effort).
• The subject attempts a 1RM lift. If the lift is successful, a rest of 3 to 5 min is taken. The goal is to find the 1RM within 3 to 5 maximal efforts.
• The 1RM is reported as the weight of the last successfully completed lift.

•  determine Rep max and multiply by 0.6
•  If 100lbs was your rep max:   (100lb * 0.6)= 60 lbs
• FITTOPS
•  FREQUENCY – minimum of 2-3 days/week; 5-7 days/week may be better. 
•  INTENSITY – Slowly stretch warm muscles to the point of slight tension or mild discomfort.
•  TIME – Hold the stretch for 10-30 seconds; repeating 3- 5 times.  Relax and breathe.
•  TYPE – Stretch the major muscle groups exercised.  Refer to the end of the chapter for exercises.
•  Overload – a training stress or intensity greater than what a client is use to in order to see continual physiological adaptations
•  Progression – as the training status improves over time, training stress or intensity continues to increase
•  Specificity – training in a specific way for a specific result or change

Gold standard of ASCM guidelines. Modify as needed for the safety of your client. 

Denotes stages of behavioral change, acknowledges that change takes time & that not every individual is ready for change 

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance
• Termination

• unaware/unengaged w/ issue, have no urge to change behavior
• -Reluctance: not aware of effect of behavior or don’t think change will bring about positive outcome
• -Rebellion → may be b/c of fear of change or losing control, also may be due to adolescence 
• -Resignation → lack of energy to change, overwhelmed by perceived effort to change
• -Rationalization → excuses to change 

• thinking about issue
• Intent to change behavior within 6 months
•  “Do you think I can . . . ?” “I’ve always wanted to . .” “I wish I could . .”
•  Is aware of problem and benefits/barriers of change 

• deciding to act or not to act on issue
•  Gathering resources (nicotine patches, gym membership), enlisting support system 
•  Publicly stating intent to change at a certain time, maybe signing a contract

• acting 
•  Has initiated change within last 6 months, overtly changing behavior & modifying environment to support that behavioral change, change is visible & consistent

•  Recommitment to sustain behavioral change, modified behavior for 6 months or more, may last a year or more
•  Very challenging stage, high self efficacy at this stage 
•  Continue managing lifestyle habits, GIVE PRAISE, benefits need to outweigh cons

• termination/relapse 
•  Ultimate goal, behavior is so ingrained that there is little chance of relapse, very high self efficacy

• a. Precontemplation: help client identify personal lifestyle goals & priorities, establish trust & rapport for when they decide to make a change, explain health consequences in a gentle & factual manner, let them know you are there for them at any stage
• b. Contemplation: motivational messages w/ pros & cons of behavior, tie into their personal goals, help them analyze pros & cons, give them a sneak peek at a plan
• c. Preparation: provide encouragement, don’t rush them, help them establish commitment & start date, discuss resources/support & coping mechanisms, use written contract
• d. Action: provide info about social & medical resources available to support change, continue manipulating environment to facilitate change, teach self management strategies to prevent relapse
• e. Maintenance: review skills to manage situations that cause relapse, PRAISE, reinforce new lifestyle habits, benefits needs to continue to outweigh cons
• f. Termination: non provided by Bedard

• a. All PT’s should have a basic knowledge of nutritional wellness to address it during the Systems Review and analyze the results of the screens, but don’t have to be experts on nutrition
• b. Within scope of practice: Disease Obesity (ICD-9-CM 278) and the conditions excessive caloric intake, Deficient fiber intake, Deficient intake of vegetable, Excessive intake of sugars and sweets
• c. Not within scope of practice: Diabetes Disease (ICD-9-CM 250), Protein – Calorie Malnutrition (ICD-9-CM 262), Morbid Obesity (ICD-9-CM 278.01)