HEP C03hPAR-Q and Screening.

Erica Eaton Quinn

2013

What should a fitness professional do before any new client is given an exercise programme?

Meet, greet and screen the client. Need to gather certain information. What would you need to know about

your client?Medical background and current lifestyle.

Consider medical background… – Need to identify signs/symptoms

of diseases– Analyse risk profile, e.g. CHD

Why is it important to find this out?

• The aim of health screening is to look for contra-indications to exercise.

• Exercise is generally marketed from a positive perspective…

• BUT it can have negative effects for certain people if the correct prescription for a certain condition is not followed.

• The aim is to enhance health not kill them!

• For example CHD can be greatly helped by exercise, but if it is set at the wrong level it can kill.

How do you gather the information?

Using a PAR-Q.Physical Activity Readiness Questionnaire.

‘To detect the presence of disease and to assess the initial disease risk classification of the clients’(Heyward 2006)

Note there are 2 parts to the statement:Detect the presence of disease.Classify the client’s risk.

What questions do you need to ask?

Task!• Consider the design of the PAR-Q document.• In small groups list the information you need to assess

medical risk.• Try to create a series of questions to gather this

information from your client.• You need to consider how each question is worded.• Note that your client may not be aware of some of the

terms.• Only ask questions that will help you to help the client.• If a specific condition/risk is identified in your client what

do you do next?• GP?

But in reality…

• It is not so simple.• GPs are already overworked,

overstressed, have very little time!

• Given 9 minutes per person!• Many now charge for forms to be

filled in?• May not want to accept liability!• Some clubs have come up with

an alternative version.

Do all medical conditions require GP clearance?

• If they have answered yes to a specific set of questions they will need to sign a second form to say their condition is under control.

• Requires some degree of responsibility for self.• Can self certificate for certain conditions.• For example:

– Pregnancy– Diabetes– Hypertension

• Other conditions may be classified as high risk…

Risk Factors for CHD. • CHD is a big killer in the developed world.• An increase in PA is known to help the condition.• BUT if it is set at the wrong level it can kill.• Need to assess risk factors for CHD…• Three levels of risk:

Low risk• Males <45 and females <55• And those showing no current symptomsModerate risk• Males >45 and females >55• Or those showing at least one pre-existing medical

condition (but not Cardiovascular). High risk • [ACSM (1995) state medical clearance needed for the

following] • Individuals who have one or more signs or symptoms of

cardiovascular, pulmonary or metabolic disease.

Task 2

• Look at the PAR-Q you have been allocated and evaluate the following:

• Content-does it cover all the important aspects?– If not what is missing?

• Coherence-is it easy to follow?

• Language-is the use of language suitable?

• Layout-is it well laid out?– Why?

If the PAR-Q does not highlight any problems...

• If your client has no medical issues you can undertake a range of anthropometric tests and basic fitness tests.

• Height and weight (BMI) • Waist to hip ratio• Body composition• Cardiovascular function – Blood Pressure, Resting Heart

Rate, V02Max (indirectly!)• Lung Function – static and dynamic lung volumes. • Strength.• Muscular endurance.• Flexibility.

BUT before carrying out fitness tests consider…

• Is fitness testing required/what does it achieve? – Motivational tool.– Set targets.– Identify whether programme is working (re-

test). • When deciding what to test consider…

– The situation you are putting your client in?– Is it beneficial to the client?– Are you forcing the client into a situation they

are unhappy with?

Obtaining the information requires a professional approach to the client…• Consider meeting your client for the first time• Remember your client could be very

nervous/out of their comfort zone.• What should the fitness professional

consider?– First impressions are very important.– The first meeting is generally more

memorable for the client than for you.– The meeting may have a strong

significance for the client.– Your responses/reactions to the client

could have a dramatic effect…do not want to put them off!

The ACSM (2007) states a personal trainer [fitness professional] should provide…

• Professionalism• Education and knowledge• Safe and effective practice (client’s needs)• Individual attention • Motivation and enthusiasm• Achieving targets• Empathic listening and communication • Human interest / respect / welfare / guidance• High quality• Good reliable service

When you carry out your client interview consider the skills you need as a fitness professional?

• Need to remember that the client must feel as though they can trust you with personal information.

• Display a good subject knowledge as the client has come to you for expert advice…

• Need good people skills.• Need to be able to actively listen.• Must be non-judgemental.• Also need to be enthusiastic as well as

caring.• Be aware of non verbal communication

and the message you give out.

Task for next session.

• Based on the PAR-Q you developed as a group devise your own individual PAR-Q form.

• Carry out a client consultation to obtain a completed PAR-Q.

• Check with your client that you can bring the PAR-Q to the next session for analysis using anonymity.

• Bring the PAR-Q to the next session.

Useful Reading.

• Heyward, V. (2006) Advanced Fitness Assessment and Exercise Prescription. Bradford, Human Kinetics.