ASK

Question 1

CSEP-PATH 6 sequence

Answer 1

1. ASK: get to know client
2. ASSESS: conduct PA, fitness, and/or lifestyle assessment
3. ADVISE: summarize results and discuss
4. AGREE: devise and action plan
5. ASSIST: increase moativation and overcome barrier
6. ARRANGE: provide continuing support

Question 2

objectives of ASK

Answer 2

1. insight on client’s goals and interests
2. explain CSEP-PATH options and confirm the scope of assesment
3. complete informed consent and walk through risks and risk assessments
4. discus pre-meeting informaiton
5. complete pre-participation screening process GAQ, RHR, RBP, and relevant medical history

Question 3

ASK what should you know about your client?

Answer 3

goal is understand your clients using open ended questions and demonstrate interest in client’s responses and be non-judgemental to their:
1. knowledge of importance of PA to health
2. primary motivation (goals) and dirvers (intrinisic-internal or extrinsic-from outisde sources)
3. level of commitment, objective assessment of readiness for short term or long term change
4. confidence that they can initiate and stick with PA plan and promote confidence and commitment

Question 4

ASK: what should be compeleted during physical activity readiness screening?

Answer 4

1. pre-assessment instructions
2. informed consent
3. get active questionnaire; if applicable physician guidance for PA or PARmed-X for pregnancy
4. observations
5. collection of relevant medical history; if applicable use CSEP CPT health screening tool
6. pre-exercise HR and BP

Question 5

pre-meetiing instructions

Answer 5

as close to normal state as possible
1. light clothing you can exercise in and walking shoes for exercise
2. no food or caffeine 2 hours prior, no alcohol 6 hours prior
3. no smoking 2 hours prior
4. no exercise 6 hours prior

Question 6

informed consent

Answer 6

1. describe assessment and signed in pen before anything else to indicate that client has been walked through the assessment in case of incident put you in good legal standing; if less than 18 y/o then youth consent form is signed by guardians
2. not a waiver form, informed consent must be signed before collecting personal information
3. must be witnessed at the time of signing by 3rd party

Question 7

Purpose of pre-participation health screening

Answer 7

1. conducts presceening to reduce liabilty exposure and inform exercise program; minimum use EBP screening tool to id clients who should first seek advice from another profession, medical history, measurement of resting HR and BP, and assessment of current PA levels
2. works within knowledge, skills, and abilities and ensures this falls under SOP
3. charts information about client’s medical history and make sure it is dated and signed
4. considers client’srisk of adverse event and takes steps to mitigate risk if falls within SOP but if not then refer if needed

Question 8

GAQ requirements, purpose, and validity

Answer 8

must be completed
1. client must read and answer questions on GAQ without interpretation from CSEP CPT
2. form must be signed with pen and witnessed by 3rd party
3. client’s answers determine if they are within the SOP or require clearance from physician before fitness assessment or starting exercise
4. form is valid for 12 months unless health condition chnages

Question 9

GAQ instructions for client

Answer 9

self-administration by client, instruct to:
1. complete all pages completely and honestly
2. answer yes to any question on page 1 if you are unsure
3. review reference document if client has yes on page 1
4. sign and date declaration and bring GAQ to initial appointment with CSEP CPT

Question 10

orientation to GAQ and reference document

Answer 10

1. page 1 identifies clients who may need to seek advice from appropriate health care provider or qualified exercise professional before becoming more physically active; if yes to any question client should read the reference document before completing page 2
2. page 2 assesses current PA levels, provides general advice for becoming more physically active, and declaration

Question 11

GAQ: analysis of client’s current PA levels

Answer 11

CV risks associated with exercise decrease with increased PA
1. clients with reg PA can continue current level of PA and progress as appropriate
2. inactive clients begin with light to mod PA and progress as tolerated
3. clients who have a lower risk med condition and are interested in vigorous activity should be referred to CSEP CEP

Question 12

GAQ: orientation to reference document

Answer 12

1. give clients advice about yes responses on GAQ, allowing them to make informed decision about appropriateness of exercise, may be prompted to obtain guidance from appropriate health care provider
2. when assisting client with yes on GAQ ensure advice is within SOP and you have the knowledge, skills, and abiliites to provide such advice; refer if you do not

Question 13

limitations of the GAQ

Answer 13

possible for clients to have a medical conditions or take medicates despite no on all question on page 1, therefore must ask all clients about their medical history and chart all info:
1. suspected or diagnosed conditions, if yes symptoms
2. taking medication, if yes taking meds as directed

Question 14

CSEP CPT health screening tool
1. purpose
2. for clients with medical conditions
3. medical conditions on CSEP CPT screening tool

Answer 14

1. used when clients have one medical condition to determine if medical condition is low risk
2. check on the tool for true statement, if there are true statement refer to appropriate health care provider for clearance or recommend client get exercise advice from CSEP CEP
3. asthma, heart disease, hypertension, OA, OP, T2DM; for other medical conditions CSEP CPT must have appropriate continuing education course

Question 15

apparently healthy

Answer 15

no diagnosed medical condition, no overt signs or symptoms suggesting any potential underlying medical conditions, and able to exercise independently

Question 16

lower risk medical condition

Answer 16

diagnosed with medical condition and condition is being medically managed, client is asymptomatic, no change in meds or treatment plan in the past 6 months, client can exercise independently, and benefits of PA clearly outweigh risks

Question 17

higher risk medical condition

Answer 17

if any of the following criteria: not medically managed, symptomatic, treatment changed recently, not able to exercise independently, or benefits of PA do not outweigh risks

Question 18

interpretation of question 1A of CSEP CPT health screening tool: a diagnosis/treatment for heart disease or stroke, or pain/discomfort/pressure in your chest during activities of daily living or during PA?

Answer 18

1. collect relevant medical history and chart information
2. higher risk of adverse event during exercise if client has experienced cardiac symptoms during cardiac rehab or in the last 6 months, diagnosed or suspected aneurysm, valve disease, angina, acute MI, acute myocarditis, heart failure, or not completed a supervised cardiac rehab program
3. use professional judgement whether client falls within SOP and refer if necessary

Question 19

interpretation of question 1B of CSEP CPT health screening tool: a diagnosis/treatment for high BP or a resting BP of 160/90 mmHg?

Answer 19

1. collect relevant medical history and chart information
2. risk of adverse event during exercise higher if resting SBP/DBP is greater than 160/90; if client’s BP is over limit then refer to CSEP CEP or physician and encourage clients who does not have diagnosed hypertension but have resting BP greater than 140 mmHg to discuss with their physician
3. use professional judgement whether client falls within SOP and refer if necessary

Question 20

interpretation of question 1C of CSEP CPT health screening tool: dizziness or lightheadedness during PA?

Answer 20

recommend client speak to appropriate health care provider to id reasons and minimize risk

Question 21

interpretation of question 1D of CSEP CPT health screening tool: shortness of breath at rest

Answer 21

1. if yes to asthma and it is relieved with med, light to mod PA is safe
2. if does not get relief from med or has not been prescribed med recommend client to consult with appropriate health care provider to id reasons for shortness of breath and min risk
3. higher risk of adverse even during exercise if client has asthma and experiences chest tightness, wheeze, shortness of breath, or cough more than 2 days a week or more than 1 night per week, used rescue medication more than 2 times in the last week, or has other respiratory condition
4. use professional judgement whether client falls within SOP and refer if necessary

Question 22

interpretation of question 1E of CSEP CPT health screening tool: loss of consciousness/fainting for any reason?

Answer 22

recommend client to speak to appropriate health care provide to id reasons for loss of consciousness/fainting to min risk

Question 23

interpretation of question 1F of CSEP CPT health screening tool: concussion?

Answer 23

1. if client is still experiencing symptoms should not increase PA, if symptoms still occurring despite following advice from health care provider, client should be encouraged to consult health care provider again
2. use professional judgement whether client falls within SOP and refer if necessary

Question 24

interpretation of question 2 of CSEP CPT health screening tool: do you currently have pain or swelling in any part of your body (such as from an injury, acute flare-up of arthritis, or back pain) that affects your ability to be physically active?

Answer 24

1. If swelling or pain is new, recommend client consult appropriate health care provider to id reason
2. higher risk of adverse event during exercise if client has arthritis and has experienced joint pain, stiffness, or swealling for more than 14 days or has limited mobility in any activiites due to joint dmg
3. use professional judgement whether client falls within SOP and refer if necessary

Question 25

interpretation of question 3 of CSEP CPT health screening tool: has a health care provider told you that you should avoid or modify certain types of PA?

Answer 25

1. collect relevant medical history and chart this info 2. if deemed medical condition is still within knowledge, skills, and abilities, ensure client adheres to health care provider's advice at all exercise sessions

Question 26

interpretation of question 4 of CSEP CPT health screening tool: do you have any other medical or physical condition (such as diabetes, cancer, osteoporosis, asthma, SCI) that may affect your ability to be physically active?

Answer 26

1. collect relevant medical history and chart this info 2. use professional judgement whether client falls within SOP and refer if necessary

Question 27

other reasons to refer client after using CSEP CPT health screening tool

Answer 27

1. client cannot exercise independently 2. at risk for adverse event or has unstable health condition 3. client wishes to engage in maximal or near-max exercise, refer to CEP 4. client has 2 or more co-morbid conditions 5. resting HR above 100 bpm and resting BP above 160/90 6. feel that you do not have the knowledge, skills, or abilities to work with client

Question 28

refering client to a physician and clearing client for exercise

Answer 28

1. client must take completed GAQ and physician guidance for PA form to physician 2. page 1-2 is completed and signed by physicians 3. page 3 has additional information about CSEP CPT qualifications, CSEP PATH, and Canadian 24hr movement guidelines

Question 29

observations for cancelling or postponing client assessment

Answer 29

1. difficult breathing at rest 2. cough persistently 3. ill/fever 4. lower extremity swelling 5. clearly ignored preliminary instructions 6. predisposed to unnecessary risk 7. all female clients should be asked is there any reason to believe you could be pregnant at this time? if so complete a PAR-med X for pregnancy

Question 30

inclusivity

Answer 30

1. persons with disabilities have right to equal access to services, existence of disability not necessary equivalent to being unhealthy or at greater risk for PA 2. use the most appropriate terminology as directed by client and use normal conversational phrases to refer specific activities (client in wheelchair will go for a walk)

Question 31

abilities for active living questionnaire (AAL-Q)

Answer 31

used id disability that may req accommodation on part of the facility or QEP to facilitate a successful first meeting; send AAL-Q in welcome package; not a risk screening device, yes on AAL-Q has no bearing on client's GAQ and may not req referral

Question 32

PA and sedentary behaviour questionnaire (PASB-Q)

Answer 32

provides an approximation of client's PA and sedentary behaviour for a typical week, used in connection with health benefit ratings for aerobic PA, strength PA, perceived aerobic fitness, and sedentary behaviour

Question 33

healthy sleep assessment

Answer 33

assesses sleep hygiene to indicate whether client has good or poor sleeping habits in general with 3 short question banks for various age ranges (toddler 3-4, youth 5-17, and adults 18+)

Question 34

stages of change questionnaire (SOC-Q)

Answer 34

id client's stage of motivational readiness for change to decide appropriate strat for enhancing commitment to change