Client Instruction Sheets

Client Instruction Sheet (RMR) Before the Test The RMR test will require approximately 45 minutes. Dress comfortably in loose fitting clothing Fast overnight. Don’t eat or drink (except water) for at least 12 hours. Don’t engage in any strenuous exercise the day before the test (don’t work out for more than 60 minutes) and avoid physical activity, as much is possible on the morning of the test (don’t work out at all) If you take insulin, do not take your morning dose until after your test. Take all your medication as usual. Bring your medication with you to the test. You will be asked to read and sign an inform consent that explain the purpose, benefits and risk associated with the test. The fitness professional will measure your height, weight and waist circumference. The fitness professional administering the test will explain the test procedures to you in detail and you may ask questions. You will place the breathing mask over your nose and mouth and breath normally for few minutes to become familiar with the process. It is recommended to breath only through your mouth during the test. During the Test The test is conducted in a quiet, dimly light room. You will lie down or recline in a comfortable position for about 30 minutes. You will wear the breathing mask and breath normally. The air you breath will be the air present in the room you are in. Tubes from the facemask are connected to an air sensor device, which will analyze the air that is exhaled. Try to relax as much is possible, but don’t fall asleep. Lie still and don’t fidget or look around. Don’t sit up and don’t talk unless you are experiencing problems. After the Test You will remove the mask. Your mask becomes your personal propriety and can be used again for repeat RMR test. You should plan to have a snack or breakfast after the test. You will schedule a follow up session in within the next week to pick up the results and have a consultation with a fitness professional. Informed Consent for Resting Metabolic Rate Test Purpose and Explanation of the Test Your resting metabolic rate (RMR) is the number of calories you burn while you are resting and not exerting yourself in any way. Because RMR typically accounts for 60 to 70 percent of a person’s total daily energy expenditure, knowing your RMR can be useful when formulating an individualized nutrition and weight management plan. Before your RMR test, you must not participate in any strenuous exercise for 24 hours and must fast overnight for about 12 hours. The test is typically done in the morning. You will lie quietly at rest in a dimly lit room for about 30 minutes. A breathing mask will be placed over your mouth and nose and you will breathe in room air as normal. Tubes from the breathing mask are connected to a computerized device that analyzes the air you exhale. Attendant Risks and Discomforts Rarely, people feel claustrophobic and cannot tolerate wearing the breathing mask. To the best of our knowledge there are no known health risks associated with an RMR evaluation. However, it is conceivable that you could acquire an infection by breathing through a breathing mask that is not clean. To minimize the possibility of this extremely remote risk, you will be provided with your own breathing mask, which you should keep for future tests. There may be risks associated with making the dietary changes outlined in your report including, but not limited to, an increased risk for gallstones and, for persons with certain chronic illnesses, a worsening of your medical condition. Responsibilities of the Participant The results of your RMR test may not be accurate if you did not follow the instructions for preparing for the test. The accuracy of your results can also be affected by certain medications, medical conditions, acute infections and, for females, pregnancy, breast feeding and menstruation. You should notify the testing staff if you feel that any of these conditions apply to you. You should try not to fall asleep, but should be comfortable and relaxed as possible. You should try to lie as still as possible in one position while breathing normally throughout the test. You should immediately report any unusual feelings that are of concern to the test staff. Benefits to be Expected Your RMR test results will be used to help formulate an individualized nutrition plan for you. A great deal is known about the topic of RMR and its role in nutrition and weight management. However, much remains to be learned. You will be provided with recommendations based on our interpretation of the existing knowledge at this time. If your doctor or registered dietitian has provided you with nutrition and/or physical activity guidelines different than what is provided in the report you receive after your RMR test, discuss the report with your doctor or registered dietitian before implementing our recommendations. Inquiries Any questions about the procedures used in RMR test or the results of your test are encouraged. If you have any concerns or questions, please ask us for further explanations. Use of Test Results The information that is obtained during RMR testing will be treated as privileged and confidential. It is not to be released or revealed to any person except your referring physician without your written consent. The information obtained, however, may be used for statistical analysis or scientific purpose with your right to privacy retained. Freedom of Consent I hereby consent to voluntarily engage in an RMR test to help formulate an individualized nutrition and/or weight management plan for me. My permission to perform this RMR test is given voluntarily. I do hereby waive, release and forever discharge New Leaf Health , Fitness Products/Angeion Corporation and Mike George Fitness System and its officers, agents, employees, representatives, executors, and all others from any and all responsibilities or liability for injuries or damages resulting from my participation in any activities recommended or supervised by New Leaf Health, Fitness Products/Angeion Corporation and Mike George Fitness System. I do also hereby release all of those mentioned and any others acting upon their behalf form any responsibility or liability for any injury or damage to myself, including those caused by the negligent act of omission of any of those mentioned or others acting on their behalf or in any way arising out of or connected with my participation in any activities of New Leaf Health , Fitness Products/Angeion Corporation and Mike George Fitness System. Date Signature of Client ___________ _____________________________________________ Client Instruction Sheet (CMT) Before the test The CMT test will require approximately 45 minutes. If you are taking beta-blockers you should schedule the test at the time of day that you typically exercise if possible. Wear comfortable walking or running shoes and loose-fitting shirt that allows for a blood pressure cuff to be placed on your upper arm. A heart monitor (chest strap type) and or EKG electrodes may be used for monitoring purposes. Don’t eat or drink (except water) or use tobacco for at list three hours prior to test. If you take insulin and you fitness test is scheduled in the morning after 12-hour fast, wait after the fitness test to take your insulin. Take all other medicine as usual. Bring all your medication with you at the test. Avoid physical activity as much is possible on the day of the test (don’t work out before the test). You will be asked to read and sign an informed consent that explain the test purpose, benefits, and risks associated with this test. You will be given an opportunity to ask questions. You will complete a brief health history survey to help determine if is acceptably safe for you to be tested. The fitness professional who is administrating your test will explain the test procedures to you in detail including how to communicate during the test. Your heart rate and blood pressure will be measured at rest. Your height and weight may be measured. During the Test A comfortable breathing will be placed over your mouth and nose. The air you breathe will be the air present in the room. It is advised to breathe through your mouth only. Tubes from your mask are connected to an air sensor device, which will analyze the air that is exhaled while you exercise. You will begin walking or pedaling at a predetermined speed. If a multiple stage test is used, the technician will monitor the time in each stage, take your heart rate and adjust the workload as you progress through the test. Your heart rate and blood pressure will be monitored during the test. You will be monitored closely during the test. You will be asked “how are you doing?” but don’t wait to be asked if you have difficulties let them know immediately. You will be asked to provide a rating of how hard the exercise feels to you using a pre-established scale. After the Test Do not get off the treadmill or cycle suddenly when the test is completed. When the test is completed you will continue walking or pedaling at an easy intensity to cool down at a period of approximately three minutes. The cool down periods allows your heart rate to gradually return to the normal range. Occasionally the fitness professional may help you of the treadmill or stationary bike immediately when you finish the test and have you lie down. You will be giving the breathing mask that was used during your test to keep for use for any repeat tests you may have in the future. You will schedule a follow up session in within the next week to pick up the results and have a consultation with a fitness professional.