HPHP Practical

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HPHP Practical
2011-03-27 17:07:01

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  1. very important information
  2. no exercise if
    RBP >200/110
  3. when should you stop aerobic exercise
    BP >240/115
  4. if during resistance exercise, blood pressure > 160/100. What should you do
    no weight greater than 50% 1RM
  5. Stop if RPE >
    14– 15
  6. stop if heart rate >
    85% HRMax
  7. true or false – if blood pressure is abnormally high compared to normal blood pressure you would not exercise even if > 200/110
  8. PAR-Q
  9. how many questions are on the PAR-Q
  10. what is the age range
    • 50 – 69
    • older than 69, always consult with a doctor
  11. patient can participate in activity if
    answers no all questions
  12. if the patient answers yes to any questions, what do you do
    refer to a physician
  13. what are the limitations
    does not address cardiovascular issues, and can't assess people over 69 and inactive
  14. cardiovascular risk factors – page 28
  15. age
    • men> 45
    • women> 55
  16. family history– men and women
    • male relatives death or MI orcoronary revascularization or sudden death >55
    • female relative death or MI or coronary revascularization or sudden death > 65
  17. cigarette smoking
    smokers or have quit within the last six months or exposure to tobacco smoke
  18. sedentary lifestyle
    inactive less than 30 min. a day moderate intensity, 3x/wk, for three months
  19. obesity
    • BMI> 30 kgm squared
    • men waist circumference >102 cm/40 inches
    • women waist circumference > 88 cm/35 inches
  20. hypertension
    >140/90 on two separate occasions
  21. dyslipidemia
    • LDL>130
    • HDL <40
    • Total > 200
  22. prediabetes
    • fasting glucose> 100
    • 2 hour values in oral glucose tolerance test > 140 but <200 on 2 occasions
  23. signs and symptoms of disease
  24. pain and discomfort in
    arms, chest, neck, or jaw
  25. shortness of breath at
    rest or with mild exertion
  26. signs and symptoms of disease continued
    • dizziness or syncope
    • orthopnea, paroxysmal nocturnal dyspnea
    • ankle edema
    • palpitations or tachycardia
    • intermittent claudication
    • known heart murmur
    • unusual fatigue or shortness of breath with usual activities
  27. low, moderate, high risk factors
  28. low risk factors
    under specified age and 1 or less cardiovascular risk factor
  29. moderate risk factor
    at risk age or 2 or more cardiovascular risk factors
  30. high-risk factors
    known cardiovascular problem, pulmonary, or metabolic disease or 1 more signs or symptoms
  31. recommendations for fitness testing
  32. draw out the table for exercise recommendations
  33. remember
    • for the test on the practical, a person that is low or moderate risk can do any of the test because all are sub Max, or moderate intensity
    • know how to take resting and exercising heart rate, blood pressure, RPE
  34. skin folds and body fat analyzer
  35. measurements are always done what side of the body
    the right side
  36. how many times should you measure each site
    2x, rotating through and average
  37. what are the three sites for men
    • pectoral – one half way between nipple and armpit; diagonal fold
    • abdomen – 1 inch from belly button
    • thigh –1/2 way between the inguinal crease and patella
  38. what are the three sites for women
    • triceps –1/2 way between acromion and olecranon
    • suprailiac– 1 inch over, diagonal fold
    • abdomen;1 inch over from bellybutton (or thigh)
  39. name the different ways to measure body composition from least accurate to most
    • Electrical Impedence > Skin Fold >Hydrostatic Weighing (best)
  40. what are some factors that make electrical impedance inaccurate
    • caffeine, alcohol, diuretics
    • eating or drinking 4 hours before
    • moderate or vigorous activity 12 hours before
    • not voiding prior
    • no electrical impedancepacemaker
    • same time a day – if doing it multiple times
  41. what are some of the factors that make skinfold testing inaccurate
    • poor technique or inexperienced evaluator– to become a confident skinfold taker you need to do it 50 – 100 times
    • extremely obese or lean subjects
    • improperly calibrated caliber
  42. how do you calculate BMI

    • pounds to kilograms = #/2.2
    • inches to centimeters = in x 2.54
    • if you don't convert
    • (weight in lbs x 703) / (height in in2)
    • when taking height – feet against the wall and together, no shoes
  43. what are the values for BMI
    • 18 – 24 normal
    • 25 – 29 overweight
    • > 30 obese
  44. waist circumference
  45. where do you measure
    narrowest part of the torso between reds and umbilicus
  46. what measurement for women is considered obese
    >35 inches, 88 cm
  47. what measurement for men is considered obese
    >40 inches, 102 cm
  48. high circumference is correlated with
    cardiovascular disease
  49. android shape?
    carry weight around abdomen – higher risk for cardiovascular problems
  50. gynoid shape?
    pair, wait through hips and thigh
  51. Grip Strength
  52. what is a normal difference between strength in each hand

    25% difference between sides is significant
  53. how may times should grip strength be taken and measured
    three times/hand, there should be averaged
  54. what is average for our age
    male right-hand?
    female right-hand?
    • 120
    • 70
  55. does grip strength represent overall strength
    • no
    • good for functional ability
  56. Timed arm curls
  57. how long does this test last
    30 seconds
  58. What kind of test is it?
    A) endurance
    B) power
    C) endurance and strength
    D) strength
    C) endurance and strength
    (this multiple choice question has been scrambled)
  59. who is this test for
    for older adults, 60+
  60. demonstrate
    without weights; two reps
  61. timed arm curls – continued
    • sit in chair with back, no armrest
    • encourage patient to do as many reps as they can do in 30 seconds
    • start with hand in neutral – supine at full flexion
    • women use 5 #weights, then use 8#
    • norms: upper teens – 20s for women and men
  62. timed Sit–ups
  63. What does the timed sit- up test evaluate?
    A) Muscular endurance
    B) Stengthen
    C) Power
    D) All the above
    A) Muscular endurance
  64. Knees should be flexed to
  65. Arms should be at
  66. Shoulder blazdes should
    come completely off the ground (hands moving 10 cm) and come completely back to start position
  67. True or false - Clinician should hold the persons feet while performing this test.
  68. What is considered excellent
  69. What is considered good
  70. Needs improvement?
  71. What are the contraindications to this test
    Osteoporosis, low back pain, pregnant
  72. Back Scratch Test
  73. What does it measure?
    Flexibility and range of motion
  74. What do you as the clinician measure?
    • the distance in between middle fingertips
    • (-) for gap
    • (+) for over lap
  75. True or false - Don't use back to crawl fingers down.
  76. 90/90 Test
  77. How do you perform this test
    passively stretch hamstrings at the end range for 15-60 seconds, 3 times then assess
  78. Lacking > 25 degrees means?
    you have decreased flexibility
  79. What makes the test invalid?
    the patient can't get hips to 90
  80. Measured with a _______?
  81. Contraindications?
    THR, hip contracture
  82. Alternative way?
    if they can do passive SLR and if you get 80 hip flexion then satisfactory
  83. Chair Sit and Reach Test
  84. This test is more functional than the sit and reach test for what population?
    Older population
  85. What are the contraindication to this test?
    LBP, osteoporosis, THR, lumbar disc derangement
  86. how is a patient seated
    at the edge of the chair with the knee extended
  87. true or false – it is important to keep the spine straight, reach with overlapping hands to toe with ankle in neutral of one leg
  88. true or false – test both legs (one leg at a time), and take the measurement of the more flexible side
  89. true or false – the tests should only be administered once
    • false
    • 2 – 3 practice trials, then take measurement
    • distance = middle finger to toe
  90. how is the measurement recorded
    recorded as (–) number to the nearest .5 inches, and (+) if the overlap
  91. 3 minute steps test – YMCA step
  92. what does this test measure?
    Measures cardiovascular fitness level by looking at heart rate recovery time
  93. Who is this test for?
    A) Non - sedentary >15 y.o
    B) > 10 y.o.
    C) 15 – 69
    A) Non - sedentary >15 y.o
  94. what are the contraindications of this test
    lower extremity or balance problems
  95. how tall is the step?
    12 inches
  96. what is a cadence for this test
    96 bpm
  97. what should be done after the test is complete
    sit down after the test is over and take the patient's heart rate for full minute with stethoscope over heart
  98. quicker heart rate recovery =?
    better cardiovascular fitness level
  99. Single Stage Treadmill Test
  100. what does this test measure
    used to calculate predicted VO2 max (sub –max test)
  101. true or false – this test is for healthy sedentary men and women ages 20 – 60 years old
  102. true or false – to perform this test the clinician needs to take resting heart rate, then determine50 – 70% max heart rate (moderate intensity)
  103. how do you determine 85% of max heart rate?
    (220 – age) x .85
  104. what happens if resting blood pressure is 200/110
    no exercise should be performed
  105. during stage I the patient begins walking on treadmill at risk walking pace, how fast should that pace be?
    2.0– 4.5
  106. what is a grade during stage I
  107. once 50 – 70% heart rate mass is reached continue at this pace for ____minutes
    • 4
    • take heart rate at the end of this phase to ensure that it is not exceeding 85%
  108. true or false – during stage II, I just grade 25% and maintain current speed; walk for 4 more minutes
  109. study the rest :-)
  110. Biker Ergometer
  111. this test is used to calculate?
    predicted VO2 max
  112. This test is used for?
    A) healthy adults
    B) active adults
    C) sedentary adults
    D) all the above
    E) none of the above
    D) all the above
  113. explain how to set up bike seat
    bike seat at greater trochanter and knees flexed to 10°
  114. what things did you do before you begin the test
    measure resting heart rate, resting blood pressure, and calculate age predicted max heart rate and calculate 85% heart rate max
  115. how long should the warm up last
    2 minutes
  116. true or false – everyone starts at the same intensity

    what is the intensity?
    • true
    • 150 kgm/min or 25 W /0.5kp at 50 RPM
  117. true or false – heart rate is measured during the last 15 – 20 seconds of the second and third minute
  118. what happens if the heartbeats are not within 5 beats of each other?
    Then the patient is not at steady-state and they need to do an additional minute at the same workload
  119. true or false – if you don't reach steady-state infourth minute you would stop the test, because the test is too hard for you
  120. when do you terminate the test?
    terminate test with heart rate is between 110 – 150 for 2 separate stages
  121. how long does cool down last
    2 – 5 minutes
  122. Timed up and Go
  123. this test works best for what population?
    for elderly that may or may not have balance problems
  124. what is the purpose of this test
    to assess agility, balance, and lower extremity strength
  125. how many practice trials do they get
  126. what is the starting position
    start with back against chair and arms on armrest
  127. true or false – the patient's cannot use ambulation device in this test
    false, they can if they normally do use one
  128. how long should the distance be for adults to walk
    10 feet
  129. how long should the distance be for seniors
    8 feet
  130. what is the start and the end of the test?
    get up, walk at a comfortable pace, go around Cohen, walked back, and sit back down
  131. how fast should it be for independent healthy adults
    <13.5 seconds