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ACSM EP-C Combined

Terms in this set (1016)

Social Cognitive Theory

A comprehensive theoretical framework that has been extensively employed in understanding, describing, and changing exercise behavior; Based on the theory of triadic reciprocation, that is, the individuals (emotion, personality, cognition, biology), behavior (past and current achievement), and environment (physical, social, cultural) all interact to influence future behavior; Self-efficacy is a big factor in this theory as well

Refers to one's beliefs in her or his capability to successfully complete a course of action such as exercise

Task Self-efficacy

Refers to an individual's belief that she or he can actually do the behavior in question

Barriers Self-efficacy

Refers to whether an individual believes she or he can regularly exercise in the face of common barriers such as lack of time, poor weather, and feeling tired

Exercise Task Self-efficacy

Belief in the capability to physically complete the task; The measure must be specific to the task, for instance walking, running, weight training; Measured by asking the confidence of an individual to engage in incrementally challenging activities (i.e. confidence to walk continuously at a brisk pace for 15 minutes, 30 minutes, 45 minutes)

Exercise Barriers Self-efficacy

Belief in the capability to exercise regularly in the face of common barriers; Measured by asking the confidence of the individual to do a set amount of exercise when faced with common barriers (i.e. time, weather, fatigue)

Outcome Expectations

Another key concept of the social cognitive theory; Anticipatory results of a behavior

Transtheoretical Model

Developed as a framework for understanding behavior change; Arguably the most popular approach for promoting exercise behavior; Associated with 5 stages of change

Health Belief Model

Theory grounded in the notion that individuals are ready to act if they believe they are susceptible to the condition (perceived susceptibility), believe the condition has serious consequences (perceived severity), and believe that taking action reduces their susceptibility to the condition or its severity; Theory grounded in the notion that individuals are ready to act if they believe that costs of taking action (perceived barriers) are outweighed by the benefits, are confident in their ability to successfully perform an action (self-efficacy), and are exposed to factors that prompt action (e.g., seeing their weight on the scale or a reminder from one's physician to exercise) (cues to action)

Perceived Susceptibility

Beliefs about the chances of getting a disease/condition if do not exercise

Perceived Severity

Beliefs about the seriousness/consequences of the disease/condition as a result of inactivity

Perceived Benefits

Beliefs about the effectiveness of exercising to reduce susceptibility and/or severity

Perceived Barriers

Beliefs about the direct and the indirect costs associated with exercise

Factors that activate the change process and get someone to start exercising

Self-determination Theory

The theory that proposes that motivation exists on a continuum from amotivation to intrinsic motivation, with amotivation having the lowest levels of ____-_____________ and intrinsic motivation having the highest degree; The underlying factor of this theory is that individuals have 3 primary psychosocial needs that they are trying to satisfy (self-determination or autonomy, demonstration of competence or mastery, relatedness or ability to experience meaningful social interactions with others)

Theory of Planned Behavior

The theory that postulates that intention to perform a behavior is the primary determinant of behaviors; Intentions reflect an individual's probability that she or he will exercise

Social Ecological Models

Models that are important because they consider the impact of and connections between individuals and their environments; The explicit recognition of relations between an individual and their physical environment is a defining feature of these models; Levels include intrapersonal, social environment, physical environment, and policy

Motivational Interviewing

A technique that has gained support as a brief intervention technique that has been successfully used to promote engagement in physical activity; Varies from traditional counseling approaches by being client/patient centered so that rather than pushing individuals toward a change, the client/patient and counselor work and pull together to achieve the client's/patient's desired outcome

Address agenda, Assess, Advise, Assist, Arrange follow-up

Specific, Measurable, Action-oriented, Realistic, Timely, Self-determined

SMARTS Principle of goal setting

Self-regulatory Strategies

Part of the social cognitive theory; Ability to mobilize oneself to perform a behavior regularly in the face of various personal, situational, or social barriers

Refers to a systemic view of a behavior: specifying relationships between variables & predicting specific behaviors and situations; Three essential elements are variables that influence the behavior, the relationship between the variables, and understanding the conditions in which the relationships occur or do not occur

Defined as a hypothetical depiction of a behavior or situation

Reciprocal Determinism

The interaction between individuals and their environments; An important part of the social cognitive theory

Perceived Threat

(Perceived) Susceptibility + (Perceived) Seriousness/Severity = ?

Outcome Expectation

(Perceived) Benefits + (Perceived) Barriers = ?

Likelihood of Action

(Perceived) Threat + (Perceived) Expectations = ?

Defined as a positive or negative evaluation of physical activity

Subjective Norm

The individual's perception of social pressure to participate, or not, in physical activity

Perceived Behavioral Control

The individual's perception of the ease or difficulty for engaging in physical activity

The sense of being capable of completing an activity or mastering a task and the perception of being effective in the task

The need to be connected and involved with the social world

Characterized by maintaining a perceived internal locus of control and a sense that behaviors are freely chosen

Described as a continuum and can range from nonexistent to intrinsic

Physical Activity

Any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase in caloric requirements over resting energy expenditure; Any bodily movement produced by the contraction of skeletal muscles that substantially increases energy expenditure; Difficult to measure precisely (i.e., surveys)

A type of physical activity consisting of planned, structured, and repetitive bodily movement done to improve and/or maintain one or more components of physical fitness

The 5 Health-related Physical Fitness Components

Cardiorespiratory endurance, Body composition, Muscular strength, Muscular endurance, Flexibility

Cardiorespiratory Endurance

The ability of the circulatory and respiratory system to supply oxygen during sustained physical activity

Body Composition

The relative amounts of muscle, fat, bone, and other vital parts of the body

Muscular Strength

The ability of the muscle to exert force

Muscular Endurance

The ability of the muscle to continue to perform without fatigue

The range of motion available at a joint

The 6 Components of Skill-related Physical Fitness

Agility, Coordination, Balance, Power, Reaction time, Speed

The ability to change the position of the body in space with speed and accuracy

The ability to use the senses, such as sight and hearing, together with body parts in performing tasks smoothly and accurately

The maintenance of equilibrium while stationary or moving

The ability or rate at which one can perform work

The time elapsed between stimulation and the beginning of the reaction to it

The ability to perform a movement within a short period of time

Physical Fitness

An attained set of attributes (i.e., cardiorespiratory endurance, muscle strength, etc.) that relates to the ability to perform physical activity; Can be accurately and precisely measured; Influenced by inherited factors and volitional increases in physical activity; Not readily measurable in large epidemiologic studies; Components include cardiorespiratory endurance, muscle strength & endurance & power, flexibility, balance, reaction time, and body composition

Static/Isometric Muscle Contraction

No change in joint angle during contraction

Dynamic/Isotonic Muscle Contraction

Change in joint angle during contraction

Low Risk Classification

Asymptomatic individuals with one or no risk factors

Moderate Risk Classification

Asymptomatic individuals with two or more risk factors

High Risk Classification

Individuals with diagnosed cardiovascular, pulmonary, or metabolic disease OR signs and symptoms of cardiovascular, pulmonary, or metabolic disease

EP-C job title
-minimum education requirement
-duties
-populations
-goal for treatment
-academic preperation

-B.S. exercise science

-health screenings, physical fitness testing, interpret results, develop exercise prescription, apply behavioral+motivational strategies to

-apparent healthy individuals or individuals with medically controlled diseases or conditions

-support clients to adopt and maintain healthy lifestyle behaviors

-fitness management, administration and supervision

methods for quantifying relative intensities of physical activity

VO2R
HRR
Vo2
HR
METs

Health related components vs Skill related ( 5each)

health : cardiorespiratory endurance, muscular strength, muscular endurance, flexibility , body comp

skill: agility, balance, speed, power, coordination

individuals at risk for ACSM exercise recommendations : limitations include being ____ or older (women) , ____ or older (male), having ___ or more cardio-risk factors, and ....

age : women 55+ men 45+

-have 2+ risk factors
and......
-showing s/s of disease
-or known pulmonary,cardiac or metabolic disease

the ______ (organiztion)risk stratification scheme is used for individuals with known CVD because it covers all patient prognosis and potential for rehab

AACVPR (American association of cardiovascular and pulmonary rehabilitation)

(Health Assessments)
Prescreening procedures and tools ask patient to provide accurate information of what major six (6) categories

medical history
current conditions
risk factors
s/s of disease
current physical activity habits
medications

Major S/s of disease : pain-discomfort resulting form ischemia

- describe the key factors of this s/s, location and provoking factors that FAVOR ISCHEMIC ORIGIN

character: constricting, squeezing, burning, "heavy"

location: substernal, midthorax, anterior,arms, shoulders, neck , cheek, teeth, forarms, fingers in intern scapular region

provoked by: exercise exertion, excitement, stress, cold weather, after a meal

the sign/symptom of cvd described as
"shortness of breath at mild exertion or rest "...

main s/s : syncope is ....?

loss of consciousness

Main s/s: describe orthopnea or paroxysmal nocturnal dyspnea

ortopnea is dyspnea at rest or in recumbent position that is relieved by sitting up or standing
Paroxsymal nocturnal dysnpea occurs 2-5 hour after onset of sleep relived when pt. sits up or gets out of bed

-both symptoms of left ventricular dysfunction

Main s/s : ankle edema
-can it be in just one limb or does it have to be both?

can be unilateral or bilateral. both caused by separate causes

Main s/s : "unpleasant awareness of forceful or rapid beatings of the heart"

palpitations or tachycardia

Main s/s: explain Intermittent claudication

the pain that occurs in a muscle with an inadequate blood supply (usually result from atherosclerosis) stressed by exercise
described as a cramp disappearing within 1-2 min after exercise stops, does not occur standing sitting at rest

Two self guided methods of participation health screening

Par-Q
AHA/ASCM health fitness facility particpation health screening questionaire

Under what circumstances would you want to use AHA/ACSM modified screening questionaire instead of Par Q
(the difference in wording)

with patients with cardiac symptoms because they often "perceive chest discomfort rather than pain"

the AHA-ACSM modified screening asks about "chest discomfort" rather than "chest pain" like the PAR Q does

all risk factors should be counted as a positive if the information is unavailable EXCEPT for ??

-If criteria is not available then you should only count as this RF as positive if....
a.
b.

"prediabetes" risk factor

a. AGE 45++ and BMI of 25++
or
b. AGE <45 and BMI 25++ AND additional RF's for pre diabetes (family history of diabetes)

Self guided screenings are for ages __-___

15 - 69 years old

List the positive CVD risk factors

1.Age
2.Family History
3.Smoking
4.Sedentary lifestyle
5.Obesity
6. Hypertension
7.Dyslipidemia
8. Prediabetes

List all the negative CVD rf

1. HDL cholesterol

Positive RF counted is pt is ___yrs old (male)
or ____ yrs old (woman)

45 men
55 women

Family history risk factor : list the criteria

-father or 1st degree male before 65 or
or
-mother or 1st degree female before 55

(has had any of the following events: )
-heart attack
-coronary revascularization
-sudden death

count a positive RF for smoking if pt is current smoker or has quit within (before) last _____ (#) months

"Sedentary Lifestyle is counted as positive RF is pt does NOT participate in at least 30 min PHYSICAL ACTIVITY at least 3/days week for 3 months "

-what intensity (___v02r) is required for that activity ?

40-59% Vo2R
"moderate" intensity

criteria for hypertensive RF (3)

systolic BP 140 ++
OR
diastolic BP 90 ++
OR
on hypertensive medications

positive RF for Dyslipidemia criteria :
-
-
-
if total serum cholesterol only available then .....

-LDL >= 130
-HDL <40
-lipid lowering medication

if total serum >=200

which two tests & specific values from those tests are needed to classify a pt positive RF for Prediabetes?

Impaired Fasting GLucose (IFG) test
Oral Glucose Tolerance Test (OGTT) test

IFG: 100-125
OGTT: 140-199

negative RF counted if _____ is >/= ___

CVD Risk factor classification is important during prescreening in order to decide what 3 things?

1. level of medical clearance
2. need for exercise testing
3.level of supervision during ex. test or ex. program

ACSM recommends light to moderate exercise
(defined as __-___VO2R or __-__METs)

How can this level of exertion can be estimated withOUT exercise tests or VO2 measurement ......?

40-59%vo2R or 3-6 METs

instruct pt to use RPE (rate of perceived exertion scale)
OR
by exercising to point of moderate shortness of breath/dyspnea but still able to talk comfortably

AACVPR risk stratification : Must have ALL present AT EXERCISE to remain at LOW risk

(4)

-absence of Ventricular dysrhythmia during exercise test
-absence of angina or other significant s/s during ex. test
-presence of normal hemodynamics during exercise test and recovery (normal rise and fall in HR-BP)
-functional capacity >= 7 METs

Low risk characteristics non-exercise test related

(6)

-EF >=50%
-uncomplicated MI or revasc. procedure
-no vent. dysrhythmias at rest
-no CHF
-no S/S of post event/postprocedure Ischemia
-no clinical depression

AACVPR risk stratification : Must have ANY 1 or COMBINATION of these present AT EXERCISE to remain at MODERATE risk
(3)

-one non exercise test related characterisic

-presence of angina or other significant s/s at high levels (METS >=7)
-mild to moderate level silent ischemia during ex or recovery (ST set depression <2mm from base)
-functional capacity >= 5 METS

-resting EF 40-49%

AACVPR risk stratification : Must have ANY 1 or COMBINATION of present AT EXERCISE to remain at HIGH risk

-vent dysryhtmia during exercise test or recovery
-angina or other s/s present at low exertion (<5 METS)
-high level silent ischemia (st set depress >=2 mm)
-abnormal hemodynamics with exercise test or recovery

HIGH risk characteristics non-exercise testing related

-rest EF <40%
-history of cardiac arrest or sudden death
-dysryhtmias at rest
-MI or revascularization procedure
-CHF
-S/S of post event/procure ischemia
-clinical depression

Clinical exercise professionals should recognize that these AACVPR guidelines do NOT consider ________
which could influence/modify exercise prescription and supervision needed

patients classified as ___ risk can usually start light -moderate but should be advised by doctor before starting vigorous exercise

(High risk known diseases) Classify each disease into its correct category: CV, Pulmonary or Metabolic

(next 5 slides)

cystic fibrosis

Pulmonary disease

metabolic disease

Metabolic disease

COPD and Asthma

Pulmonary diseases

Peripheral vascular

key components of informed consent

1.Purpose & explain the test
2. Pt risk and discomforts
3.responsibilites required by pt
4. benefits to be expected
5. Inquires (encourage pt to ask questions)
6. Use of medical records
7. Freedome of consent (pt knows they can quit at anytime)

**Also signed and dated by pt, witness , and doctor

components of a health screening questionnaire pre-test
(8)

past and current medical history, family history of cardiac disease, orthopedic limitations, prescribed medications, activity patterns, nutritional habits, stress and anxiety levels, and smoking and alcohol use

Classify these Blood Pressure results in their correct stages:
-118/81
-145-80
-118/90

-prehypertension (80-89 DBP)
-stage 1 hypertension(140-159 SBP)
stage2 hypertension (90-99 DBP)

ATP cholesterol levels:
LDL- ____very high
___high
____borderline high
____ above optimal
____optimal
total cholesterol:
___high
____BH
___desirable
HDL: ____low
____high
TG: ____very high
____high
____borderline high
____ normal

LDL: >=190 VH,
160-189 H, 130-159 BH, 100-129 ,
<100 optimal

Total Chol: >=240 H,
200-239 BH,
<200 Optimal

HDL: <40Low,
>60 high

TG:>500 VH,
200-499 H, 150-199 BH,
<150Normal

Absolute Contraindications for Exercise Testing

1. recent significant change in the resting ECG
2. unstable angina
3.uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise
4. symptomatic severe aortic stenosis
5. uncontrolled symptomatic heart failure
6. acute pulmonary embolus or pulmonary infarction
7.acute myocarditis and pericarditis
8.suspected or known dissecting aneurysm
9.acute systemic infection, accompanied by fever, body aches, swollen lymph glands

Relative Contraindications for exercise testing

1.left main coronary stenosis
2. moderate stenosis valvular heart disease
3. electrolyte abnormalities (hypoalemia, hypomagnesemia)
4.severe arterial hypertension (SBP>200 or DBP>110) at rest
5.tachy or brady HR
6.hypertrophic cardiomyopathy and other forms of outflow tract obstruction
7.Nueromoto, musculoskeletal or rheumatoid disorders that are worsened by exercise
8.high degree atrioventricular block
9.ventricular aneurysm
10.uncontrolled metabolic disease (diabetes, thyrotoxicosis, myxedema)
11.chronic infectious disease (HIV)
12.mental and physical impairment leading to inability to exercise adequately

Before a client arrives to site for an exercise test, maintain room temp between ___F and ___F (__-__degree C) and a humidity of less than <__% with adequate airflow

68-72 (20-22)

60%

Pre-exercise testing measurements should include (minimum)

HR, BP, Subjective Symptoms (if present)

*others not always required= ECG, & explain RPE

True or False: there is no order for testing health related components

If patient is using a beta blocker, it should be noted as it will lower ____ before, during , after an exercise test

_____ and _____ women have highest prevalence of obesity

black , hispanic

what is the "obesity paradox?"

patients with CHF have survived more when BMI is =>30

BMI classes -levels
underweight
normal
overweight
obese I
obese II
obese III

underwt: <18.5
normal: 18.5-24.9
overwt: 25-29.9
Obese I: 30-34.9
Obese II:35-39.9
Obese III: >=40

more fat around trunk of body is known as _____ obesity

more fat distributed around hip and thighs is known as _____obesity

Android

gynoid or gynecoid

pt have higher risk of metabolic syndome with fat where? (visceral or subcutaneous)

When taking skin fold measurements, should do them multiple times all in what order (consecutive or rotational) , with what type of measure tape and both sets of measurements should be within ___mm of each other to be used for average

rotational
spring loaded (Gulick) tape
1-2

measurement of waist circumference taken immediately above _________(NIH guidelines)

all skin fold measurements should be taken on which side of the clients body?

wait __-__s but not longer to read measurement on caliper for skin fold

caliper placed directly on skin, ~__cm away from thumb and finger, ______to the skin fold and _____between the crest and base of fold

1cm
perpendicular
halfway

general indications for STOPPING an exercise test
(4.5 pg 87)

**NOTE: these are used if test is NOT for diagnostic measures or do not require that professional administer an ECG

1.onset of angina or like symptoms
2.drop in SBP>=10 when work rate is increasing or if SBP drops below pretest resting value
3.excessive rise in BP: SBP>250 or DBP >115
4.shortness of breath,wheezing,leg cramps,claudication
5.signs of poor perfusion:light head,confusion, ataxia, pallor cyanosis, nausea, cold-clammy skin
6.failure of HR to increase with increase exercise intensity
7.noticable change in heart rhythm by palpitation or auscultation
8.subject requests to stop
9.physical or verbal manifestations of severe fatigue
10.failure of the testing equipment

***a minimum of __,__ and subjective symptoms (___,___,___) should be measured DURING exercise testing

hr, bp
angina, dyspnea, RPE

there are 3 HR measurement methods during exercise.....
Name and describe all 3 of them

1.pulse palpitation technique: place 2nd and 3rd finger over radial artery on wrist under thumb , count beat for 15s and multiple by 4
2.Auscultation method: **most accurate when pt torso is stable and heart sounds audible - place bell os stethoscope left of sternum just above nipple
3.HR monitors- Telemetry : electrical chest electrodes, sometimes in newer machines

RPE scales : ranges of both types

Borg scale: 6-20
category ratio scale: 0-10

Most clients hit max capacity RPE during exercise test at ____(very very hard on Borg) and ____ (very very strong on cat-ratio scale)

patient describes "cramp disappearing within 1-2 min after exercise stops, does not occur standing sitting at rest" ... which major sign/symptom is this?

intermittent claudication

skin fold can be SEVEN or THREE site tests... what are the 3 sites for male (2 options) and 3 sites for women??

male : Chest-Abs-Thigh or Chest-Triceps-Subscalpulr

women: Triceps-Thigh-Suprailiac

what are the 4 anthropogenic measures

WHR (waist to hip ratio)
Skinfold
BMI
Waist circumference

Warm up and cool down should be at least ___-____ minutes long of light-mod intensity

Conditioning should be at least ___-___ min long

tendinopathies, plantar fascitis (PF) and low back pain are 3 common _______ injuries

The best exercises for someone with tendinopathies are moderate reps (6-15) of RT specifically ______ contraction exercises

_______ is a common overuse injury seen early on by flat foot or high arc

-best treatment is flexibility stretching 3 times a day to what muscles?

plantar fascitis

gastrocnemius and great toe flexors (flexor halides longs)

RT training FITT-VP:
Frequency: All major muscles __-__days/week
Intensity-Volume: each muscle __-__sets with rests of __-__ minutes

Endurance: ___-___reps (<____%1RM)
Hypertrophy: ___-___reps (___-___%1RM

**deconditioned, older adults : ___-___reps (__-__%1RM or __-___RPE on 0-10 scale)

2-3days/week
each muscle 2-4 sets, rests 2-3 minutes

ENdurance: 15-25 reps (<50%)
HYPERtrophy: 8-12 reps (60-80%1rm)

older , de-conditioned: 10-15 reps, (60-70%rm or 5-6 RPE)

1RM test protocol:

1. Warm up- submit reps of same lift that client will be doing during test
2. Determine 1RM or multiple RM within FOUR(4) trials/ sets , resting 3-5 min between each set
3. Initial weight should be within subjects perceived capacity (50-70%RM)
4. Increase weight by 2-20kg (5.5-44 lb) until client cannot successfully lift one more rep with constant speed and proper technique- last weight is recorded at 1RM

Tests for muscular endurance:

# of reps at 1RM (absolute muscular endurance)
#of reps at % of 1RM (relative muscular endurance)

field tests:
curl up (crunch) test
push up
YMCA bench press test

tests for older adults: (60-94 yrs)
Senior Fitness Test

Uncontrolled HTN of 160/100 is a _______ contraindication to RT

Uncontrolled HTN of >180/110 is a ______ contraindication to RT

Other relative contraindiction to RT include :
______(what metabolic disease)
low functional capacity <___METS
pacemakers or defibrillators

diabetes
4 mets

General guidelines for RT in children in adolescents :
start with ___-___ reps, __-___sets
focusing on what muscle group?& upper and body exercises

6-15 reps, 1-3 sets
trunk

Sit and Reach Test protocol:
Describe pretest warm up-
Starting position- Canadian box and YMCA
test steps-
scoring-

W.U: stretches , no jerky risky movements, take off shoes
Start : (Box method) person sit infront of box, soles of feet within 2cm of scale - zero point of box is 26 cm mark
(YMCA) place yardstick on floor, betweeen persons legs, place tap at right angle at 15inch mark across floor touching edge of yardstick

Pt reaches as far as can, exhaling while dropping head between arms, hands together fingers may overlap- hold farthest stretch for 2 seconds- record distance

Perform 2 trials- best of 2 is taken as measurement
**If box method starts at 23 cm then subtract 3 from score

Effects of aging on physiological and health adaptations:
Everything decreases/slows except ______ , _____ and _______and ______ is unchanged

resting/exercise BP
Residual volume
%body fat

Resting HR unchanged

initial days of exercising in high altitude :
____SV
____HR
other effects could include _____ & ______

LOWER sv
HIGHER hr
weight loss, sleep disturbance

Acclimatization to high altitude:
kidneys secrete what hormone which allows body to carry more oxygen in red blood cells

Takes body up to ____ weeks to acclimate to high altitude, and ____ days straight of __-__hours to acclimate to hot environment

4 weeks

10 days, 2-4 hours (mod -vig.)

Metabolic Equation Units
speed :
work rate:
step height:
body mass:

speed- m/min
work rate- kg/m/min
(resistance in kg x distance per rev x rpm)
step - m
body mass - kg

kg/m/min --> watts
watts --> kg/m/min

x 0.164

x 6.12

distance per rev (within work rate formula) for:

Monarch leg-
Monarch arm-
tunturi - body guard=

leg=6
arm=2.4
3

[(vo2 peak or max) / (3.5 ml/kg/min)] x % target intensity

Cholesterol and Blood Glucose Conversion:
mg-dL --> mmol-L
mmol-L --> mg-dL

divide by 18

x by 18

Hydration recommendations:

Before (4 hours prior) : consume __-__ml/kg

During : fluid should contain ____,_____ and __-__% carbs

After: ___L/kg of body weight lost

5-7ml/kg

sodium, potassium, 5-10

1.5L/kg

_____ is biggest concern during exercise for people with Diabetes

Hypoglycemia is defines as blood glucose <____mg-dl

Diabetic person working out may start showing signs of shakiness , weak, abnormal sweating, nervous/anxious, mouth and finger tingling or hunger which are signs of

________

When exercising, keep blood pressure =/< ____SBP and </= ____ DBP

"postexercise hypotension"

immediate effects of aerobic activity - BP is lower

Traumatic injury to muscle or tendon

traumatic injury to ligament or tissue

Avoid explosive, high impact, dynamic, abdominals, twisting,(golf), bending, compression or over flexing the spine

TTM stages:
When moving through the stages of TTM, a person must adopt ______ processes of change before behavioral processes of change

What are they?

cognitive

1.Consciousness raising
2.Enviromental reevalutation
3.Dramatic relief
4.self reevalutation
5.social liberation

Behavioral processes of change (TTM)

1. Self liberation
2.Stimulus control
3. counterconditioning
4. reinforcement
5. helping relationships

What behavioral process of change in needed to go from Preparation stage to Action stage

self liberation

What needs to happen for a person to go from pre contemplation to contemplation?

self efficacy increasing
-pros outweigh cons

+Cognitive processes of change : Consciousness raising,Enviromental reevaluation & Dramatic relief

*******Skinfold : all measurements taken on ____ side of body, caliper on skin __cm away from thumb and finger, perpendicular to _____ and halfway between ____ & _____
When should you read the caliper?
How to duplicate measurements? criteria for accuracy?

RIGHT
1cm
skinfold
crest and base of fold
while pinching the fold, wait 1-2 sec before reading
repeat in rotational manner so skin goes back to thickness, both trials should be 1-2 cm within each other , if not take one more

greatest risk of heatstroke is when temperature (wet bulb globe) exceeds ____degrees F / ____degrees C

most individuals notice impaired performance at "moderate altitude" which is starts at ________ft ( __m)

3950 ft (1200 m)

3950-7900 ft

most common altitude caused illness- symptoms include headache, nausea, fatigue, mild sweating- occurs w/i first 24 hour of exposure

AMS- altitude mountain sickness

5 principles that improve cohesion of group exercise classes

1. Distinctiveness (group identity)
2. Positions (give roles and responsibilities)
3. Group norms (adopt common goals or all)
4. Sacrifice
5. Interaction - Communication (be social)

submax test assumptions (5)

#1 . steady HR is obtained for each exercise workrate
#2. max HR for given age is uniform (220-age)
#3. Mechanical efficiency (vo2 at given rate) is same for everyone
#4. linear relationship between HR and workload
#5. Hr will vary between subjects depending on fitness level and workload

largest amount of 02 transported and used dur. strenuous exercise until total exhaustion

Pretest :
no eating ___ hours prior
no stren. exercise ____ hours prior
no caffeine ____ hours prior
no nicotene ____ hours and alcohol ___ hours prior
consult physician / administrator

4
24
12-24
3 , 24

YMCA test : HR between ____ & < __% age pred. HR max for at least 2 consec stages

convert absolute vo2 --> relative

(absolute *1000) / body wt ( kg )

recovery data taken __-__ min post test (HR every ___min, BP every ___min)

goal HR of astrand rhyming test

HR between 125 and 170

standard error for submax vo2 max

+/- 15 % actual max

in general , subjects reach higher vo2 max in which submax style tests

age predicted heart rate can vary by +/- ____ bpm
what is formula

List 3 possible systematic errors when performing YMCA bike test.
- define systematic error

Failure to calibrate the bike caused the subject to pedal with higher resistance, underestimating VO2.
- Bike seat is too low reducing efficacy and underestimating VO2
- Measurements are taken too early not allowing steady state and over estimating VO2.
Systematic - an error that will consistently yield inaccurate, non-reliable measurements

Isometric Exercise

Same length; Muscle contraction without noticeable change in length of muscle (velocity = 0); No physical work done, but tension and force output production are high; Contraction must be held for at least 6 seconds to develop peak tension

Types of Isometrics

Muscle setting, Resisted isometrics, Stabilization exercises

Low intensity against little or not resistance; Promote muscle relaxation, mobility and circulation while decreasing pain and spasm; Does not approve muscle strength but can slow muscle atrophy

Resisted Isometrics

Performed against manual or mechanical resistance; Develop strength when pain or movement limitations exist; For strength gains, use force 60-80% of muscle's max force capacity; Amount or resistance the muscle can hold will vary based on the point in the ROM at which the exercise is completed; In order to gain strength throughout the range, isometric exercises should be performed at various positions throughout the range

Stabilization Exericses

Co-contraction of msucles surrounding a proximal joint; Isometric contraction held at mid-range against gravity; Usually performed in weight bearing positions as close-chain exercises; Body weight of patient is usally the resistance provided for exercises; Rhythmic stabilization (applying resistance manually to the same joint in opposite motions to facilitate a simultaneous contraction of muscles on both sides of the joing

Be careful to avoid Valsalva maneuver (perform rhythmic breathing)

Isometric Exercise Positives

Can use initially in rehab secondary to ROM; Maintain neural connections

Isometric Exercise Negatives

Doesn't strengthen full ROM (10 degress carryover); No functional benefits

Isometric Exercise Examples

Quad sets/ham sets; Wall push-ups; Gluteus squeezes; Ball squeezes between legs

Isotonic Exercise

Same tension; Exercise carried out against a load (constant or vaiable) while the muscle shortens or elongates through the available range (velocity = variable); Used to increase dynamic strength, muscle endurance and power; May be performed with manual or mechanical resistance

Isotonic Constant vs. Variable Load

We typically think of isotonic exercise having a fixed load. However, since force production is not the same throughout the muscle with a fixed load, a variable load can be defined as isotonic. Key Point: Load cannot be greater than what the weakest point of the muscle can lift; Variable loads allow the resistance to change throughout the full ROM in order to provide load on the muscle at multiple pints throughout the ROM

Isotonic Concentric vs. Eccentric

Should usally include a omponent of each; this most resembles functional use of muscles; Concentric; Eccentric

Isotonic Concentric

Tension develops as muscle is shortened when external force is applied

Isotonice Eccentric

Tension Develops as muscle is elongated when external force is applied; Provide shock absorption during closed-chain activites; Greater force production capabilities than concentric contraction; More efficient than concentric contraction (less effort required); May be easier to perform in acute phases of rehab than concentric exercies; Control greatest load-->maximal resistance can be used in later stages of rehab; Greater resistance to fatigue by consuming less oxygen and fewer energy stores

Isotonic Precautions

Increased stress on cardiovascular system (should teach thrymic breathing); DOMS (keep load low acutely and progressively increases)

Isotonic Force Production Variations

Max eccectric contaction produces greater force than max concentric contraction; The same force production for concentric contraction requires a greater number of motor units be recruited

Isotonic Velocity alters production of force via neuromuscular unit capacity

Slow Velocity; Higher velocity; For strength training, slow speed is utilized with heavy loads

Greater force with eccentric contraction

Higher Velocity

Eccentric contraction levels off or lsightly increases while concentric contraction decreases

Isotonic Positives

Multiple points get load; Can be open or closed chain; Easy application; Can be inexpensive; Contraction against a maximal load produces more tension than an isometric contraction

Isotonic Negatives

Only can use oad the weakest point can lift; Requires training on proper completion for safety

Isotonic Concentric Examples

Lifting weights, push-ups (lowering phase), theraband

Isotonic Eccentric Examples

Lowering weights, releasing theraband, slow stand/lowering to sit

Open Kinematic Chain

Exercise is when the distal end of the moving segment moves freely

Open Kinematic Chain Exercise

Can be performed with manual or mechanical resistance, dynamically or statically; If weight bearing is contraindicated, this will be the only type of exercise; Don't prepare patient for funtional performance of skills if not used in combination with close-chain, weight-bearing exercises

Open-Chain Kinematic Positives

Allow isolation of one joint or muscle; Can get infor about torque production with isokinetics; Decreased resitance forces

Open-Chain Kinematic Negatives

Don't help joint position sense or proprioception; Increased acceleration and joint deformation; Increased mechanoreceptor deformation

Open-Chain Kinematic Examples

SAQ/LAQ; Ankle circles; Heel slides/ abduction slides

Exercise is when the body moves over a fixed distal segment

Closed-Chain Exercise

Can be performed with manual or mechanical resistance, using the patient's body weight, and in a dynamic and static fashion; Involve concentric, eccentric and isometric contractions; Provide load for muscles, joints, bones and noncontractile tissues; Stimulate mechanoreceptors within joints-->co-contraction-->increased stability; Improve muscle power/strength/endurance, stability, balance, and coordination; Can't be performed if NWB; Goor for improving stability in shoulder and hip girdles

Closed-Chain Positives

Teach agonist/antagonist relationships; Can be multiplaner; Force begins at the ground; Each joint absorbs some of the force; Decreased shearing forces; Decreased acceleration forces; Increased joint congruency; FUNCTIONAL!!!

Closed-Chain Negatives

Too much strain for patients with RA; Difficult to see muscle compensations

Closed-Chain Examples

Weight shifting, wall push-ups, lifting weights, standing activities

Isokinetic Exercise

Same movement speed; Movement occurring at a constant, controlled speed (velocity=constant); Resistance will vary throughout the RAM, as exercise load changes in relation to the ability of the muscle to produce force in various parts of the ROM; Allow concentric and eccentric exercise; Strength gains appear to be speed dependent: training speed=speed where the strength gains occur; Can safely perform movements at high rate that would cause damage in isontonic exercises

Isokinetic Concentric

Capacity of muscle to produce force decreases as speed increases

Isokinetic Eccentric

Capacity to produce force may increase to a point as speed increases

Isokinetic Positives

Maximum resistance through full ROM: can change at weaker points in ROM; High speed (500 degrees/sec); Provides good objective data (work comp)

Isokinetic Negatives

Expensive equipment; No interia; Requires training of staff

Isokinetic Examples

Cybex; Kincom; Cam and pulley system; Athletic Rehab

Isotonic Equipment

Free weights; Elastic resistance devices; Pulley systems; Trampoline; Variable-resistance equipment; Swiss ball; Body blade; Exercise bike; Resistive reciprocal exercise unit; Closed-chain resistance devices

Isomentric Equipment

Use isotonic equipment to hold weight that is too heavy for patient to life; Isokinetics set at 0 degrees/sec

Isokinetic Equipment

KIN/COM. Biodex, Lido, Merac, Cybex II, UBE, Orthotron II

Isometric Regimens

Breif repetitive; Multiple-angle

Breif Repetitive

Hold isometric contraction for 6 seconds; 20 second between contractions; Up to 20 contractions can be performed

Used to achieve increased strength throughout ROM, as physiological overflow occurs only in 20 degrees surrounding training angle; Resistance should be applied at last every 20 degrees to strengthen entire ROM; One regimen has 10 reps, 10 bouts, 10 second contraction every 10 degrees

What are the three cardinal planes?

a. Sagittal plane makes a division into right and left portions
b. frontal plane makes a division inoto anterior and posterior portions
c. transverse plane makes a division into upper and lower portions

What are the three axis

a. mediolateral axis lies perpendicular to the sagittal plane
b. anteroposterior axis lies perpendicular to the frontal plane
c. longitudinal axis lies perpendicular to the transverse plane

combination of flexion, extension, abduction, adn adduction. The segment moving in circumduction describes a cone.

The muscle cell contains contractile proteins. What are they?

1. Actin
2. Myosin

What is the purpose of the C-shaped cartilages of the trachea?

1. To protect, support, and maintain an open airway.
2. To prevent overexpansion of the respiratory system.
3. To allow large masses of food to pass along the esophagus.

What is the name of the central cylindrical shaft of the long bone?

What is the term used for the end of long bones?

In immature long bones, the junction between the epiphysis and diaphysis is termed and what is its function?

Epiphyseal Plate: Where growth of long bones occur.

The prime movers for extension of the knee are?

Quadriceps:
1. Rectus Femoris
2. Vastus Intermedius
3. Vastus Lateralis
4. Vastus Medialis

The prime movers for flexion of the knee are?

1. Biceps Femoris
2. Semimembranosus
3. Semitendinosus

A baseball pitcher has been complaining of weakness in the lateral rotation motions of the shoulder. What muscles would you have him working on strengthening?

1. Infraspinatus
2. Teres Minor

What category of connective tissue would cartilage be considered?

What sites are used for the measurement of skinfolds?

1. Chest/Pectoral: Diagnol fold
2. Midaxillary: Vertical fold
3. Abdominal: Vertical fold
4. Suprailiac: Diagnol fold
5. Scubscapular: Diagnol fold
6. Triceps: Vertical fold
7. Biceps: Vertical fold
8. Thigh: Vertical fold
9. Medial calf: Vertical fold

What term is used to identify the ability of a force to cause rotation of a lever?

What joints are considered ball-and-socket joints?

1. Hip joint
2. Shoulder joint

What sites are used for the measurement of circumferences?

1. Abdomen: Level of the umbilicus.
2. Calf: Between the knee and ankle, at the maximum circumference.
3. Forearm: At the maximum forearm circumference.
4. Hips: At the maximum circumference of the hips/buttocks, above the gluteal fold.
5. Arm: Midway between the acromion and olecranon process.
6. Waist: At the narrowest part of the torso, inferior to the xiphoid process and superior to the umbilicus.
7. Thigh: At the maximum circumference between the knee and ankle joint.

Arterioles connect to what part of the vascular system and why?

-Capillaries
-The exchange of nutrients and waste products occur at this level.

Define the law of inertia?

States that a body will maintain its state of rest or uniform motion in a straight line unless acted on by an external force.

Running is a locomotor activity similar to walking but with some differences. In comparison to walking, running requires greater?

-Balance: The absence of a double support period and the presence of the "flight phase" when both feet are out of contact with the supporting surface.
-Muscle strength: More muscles required to contract more rapidly and with greater force.
-Range of Motion: Because of greater joint angles at the extremes of the movement.

Center of Gravity
Line of Gravity
Base of Support

COG Is the point of exact center around which the body freely rotates. It is the point around which the weight is equal on all sides.

Line of gravity is the downward direction of the force of gravity on an object (vertically toward the center of the earth).
Base of support is the area of contact between the body and the supporting surface.

How do we increase our stability?

-The COG is closest to the BOS.
-The COG should be placed over the center of the BOS.

Which type of musculoskeletal lever is most common? There are 3.

Third-class lever

Describe the first class lever?

The axis is between the force and the resistance arm, and the force arm may be greater than, smaller than, or equal to the resistance arm.

Describe the second-class lever?

The resistance lies between the effort force and the axis of rotation, and the force arm is greater than the resistance arm.
Example: Wheel Barrel

Describe the third-class lever?

The effort force lies closer to the axis of the lever than the resistance, and the force arm is smaller than the resistance arm.
Example: Lifting something with a shovel.

Describe the sagittal plane?

Makes a division of the human body into right and left portions.

Name the two parts of a skeleton? What are they?

1. Axial skeleton
2. Appendicular skeleton

Slapping of the foot during heel strike and increased knee and hip flexion during the swing are characteristic of what?

Weakness in the dorsiflexors.
Explained: Dorsiflexor weakness leads to foot drop during heel strike and, to ensure that the toe does not catch the walking surface, increased knee and hip flexion during swing.

Abduction, eversion, and dorsiflexion of the foot is indicative of what?

Define the frontal plane?

Makes a division into anterior and posterior portions.

Define the transverse plane?

Makes a division into upper and lower portions.

Bone is an ______

supporting connective tissue composed of calcium salts and resistant to tensile and compressive forces.

Bone is covered by a ______ that isolates it from teh surrounding tissues and provdes for circulatory and nervous supply.

Types of bone include:

compact-cortical,dense
cancellous-trabecular, spongy

Phosphagen System

-composed of ATP and PCr stored in muscle fibers
-creatine kinase + PCr yields phospate group to convert ADP to ATP
-can sustain activity for <30 seconds

Nonoxidative system

-CHO --> ATP
-without oxygen, byproduct is lactic acid
-main energy source for 30 sec --> 3 minutes

Oxidative System

-CHO, Fats, Proteins --> ATP
-byproducts are water and CO2

Long-term effects of training on bioenergetics

1) increased capacity to produce ATP (inc. mitochondrial density)
2) Increased substrate storage (lipids/CHO)

Myosin Isoforms

Type I = slow twitch, high oxidative
Type IIB(X) = fast twitch, low oxidative
Type IIA = intermediate

Sliding filament Theory

1) CNS stimulates sarcolemma and Ca++ is released from the T-tubules of the SR
2) Ca++ binds to troponin causing tropomyosin to shift shape, exposing active binding sites on the actin
3) Myosin cross-bridges bind to active sites on actin
4) ATPase in cross-bridge head cleaves ATP resulting in the power stroke
5) ATP binds to cross-bridge head and calcium pump restores Ca++ to SR

Effects of training on Fiber Type

-All training (endurance or resistance) causes a conversion of Type IIB(X) (fast twitch) to Type IIA (intermediate)

-no training converts TI to TII or vice versa

Minute Ventilation (VE)

- volume of air expired or inspired over the course of 1 minute
- about 6 L/min at rest
- can increase to 20-25x at max. (result of increased tidal volume and respiratory rate)

- amount of air entering/leaving the lungs per breath
- 0.5 L at rest, 4L at max

Respiratory Rate

- 12/min at rest, 50/min at max

Energy costs of breathing

- about 3% at rest
- 3-5% with moderate ex
- 10% at max, (15% in highly trained)

Ventilatory Adaptations

- increased ex. intensity at which anaerobic threshold occurs

Anaerobic threshold

- exercise intensity at which ATP demand cannot be met solely by aerobic metabolism and anerobically produced ATP is needed to satisfy the demand

- point at which linear relationship between expired CO2 and minute ventilation

- in untrained, occurs at about 55% of VO2max
- in trained, occurs at about 80% - 85%

- volume of blood ejected from the LV with each contraction
- 70 mL at rest, 100mL during ex in untrained men, 170mL in highly trained
- increases with exercise intensity until 50% of VO2max

Cardiac Output (Q)

- amount of blood pumped each minute

Q = HR(SV)

- at rest, Q = 5L/min (72 BPM x 70 mL)
- at max, Q = 5 - 6x (25-30 L/min)

- 35-40 L/min in trained

End-diastolic volume (EDV)

- the amount of blood in each ventricle at the end of the resting phase (diastole)

- at rest, 125 mL
- at max, 160 mL

Frank-Starling Law

effect of EDV on SV; as myocardial stretch increases, so does contractile force

End-systolic volume (ESV)

- volume of blood remaining in each ventricle following its contraction

- at rest, 55 mL
- at max, ?

Ejection fraction (EF)

- % of blood in ventricle during diastole actually pumped out during systole

EF = SV/EDV

- at rest, EF = 60% but can range from 50% - 75%

Cardiac adaptations

1) no increase in HRmax
2) Significantly lower HRrest
3) increased SV (~85mL at rest)

Effects of posture

- supine SV (e.g., swimming) is greater at any given intensity and HR is lower (same Q)

Vasodilation/constriction

- occurs at level of the arterioles to meet demands for blood flow

- resistance imposed by the vessels to the flow of blood after ejection
- directly related to the compliance of the vessel

- amount of blood in ventricle immediately before contraction (i.e., EDV)

Pulse Pressure (PP)

- difference between SYS and DIA
- approx. 40 mmHg at rest

Mean arterial pressure (MAP)

- average pressure exerted across the cardiac cycle

MAP = DBP + (1/3)(PP)

- approx 93 mm Hg at rest

Rate pressure product (RPP)

- aka double product
- correlate of myocardial oxygen uptake & LV workload

RPP = SBP(HR)

- at rest, 8,640 (i.e., 120 mmHg x 72 BPM)

Acute vascular responses to exercise

1) shunting of blood from viscera to muscles (20 to 85%)
2) Vasodilation leading to decreased TPR (1/3 resting) in order to accomodate the increased Q

BP contraindications to exercise

1) sudden drop in SBP (>15 mmHg)
2) elevation of SBP > 260 mmHg

Long-term vascular adaptations to exercise

1) decreased SBP, DBP, and MAP at rest
2) improved shunting of blood to muscles
3) improved capillarity within muscle tissue (and increased mithochondrial density) --> improved oxygen extraction

Upper body exercise

- at submax, elicits higher SBP/DBP (smaller muscle mass, greater resistance to flow)

Resistance exercise

- degree of increased TPR is proportionate to the force exerted and the total muscle mass contracting

-BP amplification highest during isometric exercise

Cardiovascular drift

- movement of plasma out of the blood into the working muscles/ surrounding tissue
- serves to prevent overheating but decreases SV and leads to hemoconcentration (high RBC concentrations, inc. hematocrit)

Long-term adaptations on blood composition

1) improved production of RBCs (better O2 delivery)
2) increased plasma volume (dec. hematocrit, i.e., runner's anemia)
3) improved thermoregulation ability

Heath benefits of exercise

1) decreased health risk (e.g., CVD, hypertension, stroke)
2) elevated HDLs
3) etc.

Tissue in the body that functions to protect RBC, organs, and tissues, and provides support for the body

Type of bone that consists of central cylindrical shaft (diaphysis) and has an epiphysis at each end

Movement that decreases the joint angle and occurs in a sagittal plane around a mediolateral axis

Quadriceps femoris
1. Rectus femoris
2. Vastus lateralis
3. Vastus medialis
4. Vastus intermedius

Muscle group that acts as a prime mover for extension of the knee

Muscles that should be strengthened when there is weakness in the lateral rotation motions of the shoulder

Example of ball and socket joint

Term describing the ability of a force to cause rotation of a lever

Body at rest tends to remain at rest, whereas a body in motion tends to remain in motion with consistent speed and in the same direction unless acted upon by an outside force

More muscles contracting more rapidly and with greater force

Why does running require greater muscular strength as compared ith walking?

Type of musculoskeletal lever that is most common

Type of motion that occurs when a force is applied off center to a freely movable object

Second class lever

Lever where resistance is located between the effort force and the axis

Foot movement that is a combination of abduction, eversion, dorsiflexion

Muscle group that is most likely weak when slapping of the foot occurs during heel strike and there is increased knee and hip flexion during swing phase

Internally rotates ulna

Moving hand from palm - up to palm - down with elbow flexed at 90 degrees

Medial rotation

Rotation of anterior surface of a bone toward the midline of the body

Plane of motion in which eversion of the ankle occurs

Internal and external shoulder rotation occur in the transverse plane of motion

Eccentric muscle action involves force production and muscle lengthening

Amount of blood ejected from the heart per minute

Exchange of gases between blood and the surrounding tissue takes place at what vessels?

ATP - PC (phosphagen)

Bioenergetics pathway that is sometimes called the anaerobic pathway

Primary advantage of this bioenergetic pathway is that it can produce large amounts of ATP to sustain prolonged exercise, w/o producing fatiguing by products

Sarcoplasmic reticulum

Within skeletal muscle fiber, large amounts of calcium are stored here

Type of muscle fibers that are primarily recruited during long duration of submaximal intensity

On myosin cross bridges

ATPase that is used to produce a muscle fiber twitch by way of sliding filaments is found:

Single motor neuron and all the muscle fibers it innervates

Within the pulmonary system, where the actual exchange of gasses with the blood occurs

During maximal intensity exercise, VE can increase by:

Under resting conditions, SV in a typical male (70 kg) is about:

Frank - Starling mechanism plays a vital role in determining:

During maximal intensity aerobic exercise, cardiac output increases by how much in an untrained individual?

Increases in resting CO

This would NOT be an adaptation expected to occur as a result of long term aerobic training

Increase in EDV

This is a response that would be expected to occur while performing a running workout of submax intensity

Non - normal response to aerobic exercise (regarding BP)

Which energy system does skeletal muscle rely most heavily on in the first 2 seconds of a 100 m race?

Which energy system is capable of using all three fuel (CHO, fats, proteins)

Regular exercise will result in what chronic adaptations in cardiac output during exercise at the same workload

Fast - twitch glycolytic

Type of muscle fibers that can produce a large amount of tension in a very short period of time, but fatigue quickly

Smallest, narrowest passage within the bronchial system

Cardiac output can be calculated by multiplying what?

This is NOT affected during maximal exercise as a result of regular exercise training

Troponin and tropomyosin

Two regulatory proteins found w/i the actin complex of skeletal muscle

All energy for muscular contraction must come from the breakdown of what chemical compound?

BMI level an adult is considered obese

Assessment that can be used to estimate body composition

>0.95 in men, >0.86 in women

Waist to hip ratio measurements in men and women that are indicators of abdominal obesity

Abdominal obesity

Metabolic syndrome includes dyslipidemia, insulin resistance, elevated BP and what other component?

1.7 g/kg body weight

Upper limit recommended for protein intake for strength athletes

Resting metabolic rate

Amount of energy required for the body's most basic vital functions is called:

Deficiency of this micronutrient can affect bone development

Glycogen and starch are examples of polysaccharides

Dietary fiber helps with digestive health but does not help with serum cholesterol

AMDR for dietary fat is what percent of total dietary fat intake?

Anorexia nervosa

Severe form of an eating disorder where the individual consumes little to no food energy each day and occasionally it is coupled with use of other methods for decreasing intake (vomiting, diuretic use, laxative use)

Form of a saccharide that is able to be absorbed by the intestines

Adult RDA for protein intake

Peripheral artery disease (PAD) refers to inhibited blood flow through noncoronary arteries such as the femoral, popliteal, tibial, iliac, abdominal aorta, renal and mesenteric arteries

In addition to beta2 - agonists, performing a warm - up and cool down, taking antioxidants and wearing a scarf in cold weather call all help reduce exercise induced symptoms

Type II diabetes

The most prevalent type of diabetes?

A sedentary African - American woman who has previously delivered a 9 lb 5oz baby and has an aunt with diabetes is at high risk for developing type II diabetes

Shortness of breath; primary symptom of heart failure

Angioplasty, stent, bypass graft

Surgical options that are used to treat atherosclerotic arterial disease

Weight reduction

Strategy used to reduce HTN that has the greatest potential impact

Medication that is used primarily to prevent blood clots from forming

What percentage of all strokes are ischemic?

O2 sats below 88

When breathing room air, when is supplemental oxygen indicated?

Criteria that indicate diagnosis of diabetes

2 hr plasma glucose >200 mg/dL during oral glucose tolerance test, symptoms of diabetes and a casual plasma glucose >200 mg/dL, fasting plasma glucose >126 mg/dL

40 in (men), 35 in (women)

National Heart Lung and Blood Institute defines a waist circumference above what values in inches for men and women as a risk factor for diabetes

Impaired fasting glucose, central obesity, lipid abnormalities and HTN

Core components of metabolic syndrome?

Depolarization of cells is normally a very orderly process

Most patients with atrial fibrillation have underlying cardiac disease

PVCs are usually wide QRS complexes and may occur singly, in groups, in runs, or even in alternating beats

Muscle endurance

Ability of a muscle group to perform repeated contractions over a period of time sufficient to cause muscular fatigue or to maintain a specific percentage of maximum voluntary contraction for a prolonged period of time

Hamstring and lower back flexibility

What does a sit and reach test measure?

Three assessments for muscular endurance

1. Bench Press
2. Push up
3. Curl-up

Transtheoretical Model - Cognitive processes (5)

1. consciousness raising
2. dramatic relief
3. environmental re-evaluation
4. self-revolution
5. social liberation

Transtheoretical Model - Behavioral processes

1. counter conditioning
2. helping relationships
3. reinforcement management
4. self-liberation
5. stimulus control

Force x Velocity

Anaerobic Glycolysis is also known as...

Lactic Acid Cycle, uses only carbohydrate, end result is lactic acid, no oxygen required. Used for events from 30 seconds to three minutes

Symptoms of hypoglycemia

tachycardia, excessive sweating (diaphoresis), light-headedness, visual disturbances

Symptoms of hyperglycemia

acetone odor on breath, confusion, slurred speech

Failure to spot or assist a client may be considered...? (legal term)

Negligence by omission

Informed Consent

Enables clients to make informed decisions. Not a legal document. Provides detailed explanation of exercise program. Does not provide legal immunity. Negligence is not covered by informed consent.

Diagonal skinfolds

Chest, suprailiac, subscapular; all other skinfolds are vertical

setting a series of intermediate goals that lead to a long-term goal

At what stage are people at most risk of relapse?

What is cardiac output?

the amount of blood ejected from the heart per minute.

What happens at the alveoli?

exchange of gasses with the blood occurs.

Karvonen Formula

Target Heart Rate = ((max HR − resting HR) × %Intensity) + resting HR

Consequences of high temperature

Dehydration, dizziness, syncope, heat exhaustion, or heat stroke

Consequences of low temperature

dehydration, reduced coordination, chills, hypothermia, potentially frost-bite

Stroke Volume and concentric phase

Stroke volume is NOT significantly elevated to more than resting during the concentric phase of resistance training.

Stroke Volume and eccentric phase

Stroke volume is significantly increased during eccentric phase

What is muscle fatigue?

The loss of force or power output in response to voluntary effort leading to reduced performance.

What is central fatigue?

The progressive reduction in voluntary drive to motor neurons during exercise

What is peripheral fatigue?

The loss of force and power that is independent of neural drive.

Determining treadmill speed formula:

Belt length (inches) x number of revolutions per minute\ 1,056 (the conversion of inches per minute to miles per hour)

Circumferences are used for...?

Circumferences are used to estimate body composition and provide specific reference to the distribution of fat in the body.

Define "push-up"

Downward phase: eccentric, flexion
Upward phase: concentric, extension

Oxidative - Aerobic

carbs and fats used to synthesize ATP; for activities lasting longer than 3 minutes

Children and sweat

Children sweat less because sweat rate and rate of sweat production for each gland are lower in children. They have same number of glands.

decrease/lower heart rate

Blood flow from periphery

superior and inferior venae cavae, right atrium, tricuspid valve, right ventricle, pulmonic semilunar valve, pulmonary arteries, and lungs

carry blood away from heart, decrease to arterioles

where the exchange of nutrients occurs between blood and tissue

carry blood toward the heart

small veins, carry blood from capillaries to veins

Blood flow from lungs

Left pulmonary vein, left artrium, bicuspid valve, left ventricle, aortic semilunar valve, ascendina aorta, systemic circulation

Type I = slow twitch and high oxidative
Type IIB = fast twitch with low oxidative
Type IIA = intermediate, with twitch and oxidative property, bridge between I and II
Type IIx to Type IIA = from endurance and resistance training

amount of air leaving or entering with each breath, ranges from .5 to 4L

is contractile heart movement, blood is leaving the heart

is relaxation or blood filling the heart

Volume of blood ejected per beat (at rest is usually around 70 ml). SV + HR = Cardiac Output

Q = HR x SV, the amount of blood ejected from the heart per minute

amount of blood in each ventricle at end of resting phase.

Frank Starling Law

Describes the relationship between end-diastolic volume and stroke volume. It states that the heart will pump out whatever volume is delivered to it. If the end-diastolic volume doubles then stroke volume will double.

is volume of blood remaining in each ventricle after contraction

Five A's of counseling`

Address agenda, assess, advise, assist, arrange follow up

rotational movement at the radioulnar joint in a transverse plane about a longitudinal axis that results in the palm facing downward.

rotational movement at the radioulnar joint in a transverse plane around a longitudinal axis that results in the palm facing upward.

Lower stroke volume due to higher heart rate; resting HR and exercise HR are higher in children; are less efficient than adults at temperature regulation; poorer tolerance for exercise in heat

Hypertension exercise guides

aerobic: 3-7 days/week; Intensity: 40 -70%; Time: 30-60 minutes; possible multiple bouts throughout the day. Avoid isometric, valsalva, and max efforts; high reps/low intensity is better; RPE = 13-15

Diabetes exercise guides

contraindicated if fasting glucose is greater than 250 mg/dL with ketones or greater than 300 mg/dL w/o ketones

BMI greater than 30; waist circumference (m) > 102 cm; (f) > 88 cm; body fat: (m) >25%; (f) > 32%

Pregnant exercise guides

avoid supine position after first tri-mester; avoid risk of abdominal trauma; consume 30-50 g of carbs before exercise; consume extra 300 kcals/day

45 - 65% of daily energy intake; 70% for athletes; 4 cal/gram

10-15% of daily intake; .8 g/kg of body wt.; athletes may need 1.2 - 1.4 for endurance and 1.6-1.7 for strength; 4 cal/gram

Capital expense

Large and extraordinary purches of durable items with an extended useful life, like exercise equipment

Non-capital expense

day-to-day operational expenses (i.e., medical and exercise supplies, stationary)

are unchanged day to day, month to month

Variable expense

based on utilization like per diem, contract labor, etc.

income that a company receives from its normal business

income minus commission, taxes, or other expenses related to income

total revenue received before any deductions

Break-even analysis

designed around function of program, such that revenue generated is sufficient to pay for expenses incurred

Profitability analysis

Attempt to forecast future profits for program based on potential revenue generation as well as predicted fixed and variable expenses

a civil wrongdoing; negligence is failure to perform in a generally accepted standard

specific type of negligence; involves claims against defined professional; usually claim a breach of professional duties and responsibilites toward a client; usually an injury has occurred and breach of duty came before injury

Name four lung compartments affected by COPD.

central airways, peripheral airways, lung parenchyma, and the pulmonary vasculature

What is emphysema?

destruction of the parenchyma

What is asthma?

Common complex chronic disorder of the airways, characterized by variable and recurring symptoms, airflow obstruction, hyperresponsiveness of the bronchioles, and underlying inflammation

What is Restrictive Lung Disease?

A large group of disorders that restrict or reduce lung volume and tidal volume. Include loss of functioning of the alveoli-capillary unit (impairment in gas exchange), altered mechanical function of the thorax and pulmonary system, and secondary cardiovascular dysfunction.

Muscle fibers that can produce a large amount of tension in a very short period of time but fatigue quickly are referred to as

Fash-twitch glycolytic

When using the Borg scale for the general public, intensity should be maintained between?

Rotation of the anterior surface of a bone toward the midline of the body is called?

Medial rotation

Calcium, phosphorus, magnesium, potassium, sulfur, sodium, and chloride are examples of?

Angina pectoris that occurs at rest without a precipitating event?

A group of pulmonary disorders characterized by limitations in airflow tha are not fully reversible?

The loss of elasticity of the arteries is known as?

arteriosclerosis

A transient deficiency of blood flow to the myocardium resulting from an imbalance between oxygen demand and oxygen supply is known as?

A drug used during acute MI to dissolve blood clots, restore blood flow, and limit myocardial necrosis?

Thrombolytic agent's therapy

What is the correct term and definition to describe a potential complication that may occur after an MI?

Aneurysm - bulging of the ventricular wall

A possible mechanism by which chronic exercise training may reduce resting blood pressure in a person with hypertension is:

A reduced heart rate

What is asthma?

Narrowing of the bronchial airways

Considered to be the 'gold standard' diagnostic technique for CHD

Coronary Angiography

Waist-to-hip ratio

Index of upper versus lower body fat dristribution. Waist circumference and hip circumference are measured then WHR is calculated using a standard nomogram.

What are class 1A drugs?

Antiarrhythmic agents: Disopyramide, Moricizine, Procainamide, Quinidine

What is perfusion?

pumping a liquid into an organ or tissue (especially by way of blood vessels).

What is ataxia?

The loss of full control of bodily movements

What is ischemia?

An inadequate blood supply to an organ or part of the body, esp. the heart muscles

What is the most accurate measurement of functional capacity?

The normal BP response to dynamic upright exercise is:

Progressive increase in SBP, no change or slight decrease in DBP, and a widening of the pulse pressure.

What are Class 1B drugs?

Lidocaine, Mexiletine, Phenytoin, Tocainide

What are Class 1C drugs?

Flecainide (Taborcor); Propafenone (Rythmol)

What is an insertion?

The point of attachment of a tendon to bone

What is Emphysema?

A pathologic or anatomic description marked by abnormal permanent enlargement of the respiratory bronchioles and alveoli accompanied by destruction of the lung parenchyma.

What is Hypercapnia?

Excess carbon dioxide in the blood

What is Hypoxemia?

Deficient oxygenation of the blood

What is Polycythemia?

Excess red blood cells often secondary to hypoxemia

Social Cognitive Theory

A comprehensive theoretical framework that has been extensively employed in understanding, describing, and changing exercise behavior; Based on the theory of triadic reciprocation, that is, the individuals (emotion, personality, cognition, biology), behavior (past and current achievement), and environment (physical, social, cultural) all interact to influence future behavior; Self-efficacy is a big factor in this theory as well

Transtheoretical Model

Developed as a framework for understanding behavior change; Arguably the most popular approach for promoting exercise behavior; Associated with 5 stages of change

Health Belief Model

Theory grounded in the notion that individuals are ready to act if they believe they are susceptible to the condition (perceived susceptibility), believe the condition has serious consequences (perceived severity), and believe that taking action reduces their susceptibility to the condition or its severity; Theory grounded in the notion that individuals are ready to act if they believe that costs of taking action (perceived barriers) are outweighed by the benefits, are confident in their ability to successfully perform an action (self-efficacy), and are exposed to factors that prompt action (e.g., seeing their weight on the scale or a reminder from one's physician to exercise) (cues to action)

Self-determination Theory

The theory that proposes that motivation exists on a continuum from amotivation to intrinsic motivation, with amotivation having the lowest levels of ____-_____________ and intrinsic motivation having the highest degree; The underlying factor of this theory is that individuals have 3 primary psychosocial needs that they are trying to satisfy (self-determination or autonomy, demonstration of competence or mastery, relatedness or ability to experience meaningful social interactions with others)

Theory of Planned Behavior

The theory that postulates that intention to perform a behavior is the primary determinant of behaviors; Intentions reflect an individual's probability that she or he will exercise

Social Ecological Models

Models that are important because they consider the impact of and connections between individuals and their environments; The explicit recognition of relations between an individual and their physical environment is a defining feature of these models; Levels include intrapersonal, social environment, physical environment, and policy

Motivational Interviewing

A technique that has gained support as a brief intervention technique that has been successfully used to promote engagement in physical activity; Varies from traditional counseling approaches by being client/patient centered so that rather than pushing individuals toward a change, the client/patient and counselor work and pull together to achieve the client's/patient's desired outcome

Self-regulatory Strategies

Part of the social cognitive theory; Ability to mobilize oneself to perform a behavior regularly in the face of various personal, situational, or social barriers

Refers to a systemic view of a behavior: specifying relationships between variables & predicting specific behaviors and situations; Three essential elements are variables that influence the behavior, the relationship between the variables, and understanding the conditions in which the relationships occur or do not occur

Defined as a hypothetical depiction of a behavior or situation

Reciprocal Determinism

The interaction between individuals and their environments; An important part of the social cognitive theory

Perceived Threat

(Perceived) Susceptibility + (Perceived) Seriousness/Severity = ?

Outcome Expectation

(Perceived) Benefits + (Perceived) Barriers = ?

Likelihood of Action

(Perceived) Threat + (Perceived) Expectations = ?

Defined as a positive or negative evaluation of physical activity

Subjective Norm

The individual's perception of social pressure to participate, or not, in physical activity

Perceived Behavioral Control

The individual's perception of the ease or difficulty for engaging in physical activity

The sense of being capable of completing an activity or mastering a task and the perception of being effective in the task

The need to be connected and involved with the social world

Characterized by maintaining a perceived internal locus of control and a sense that behaviors are freely chosen

Described as a continuum and can range from nonexistent to intrinsic

When are psychological theories useful in exercise prescription?

They are the framework for developing programs. They do not help measure or manage programs.

Safety plans for an exercise facility should include:

Annual practices of emergency situations, posted emergency plans and emergency numbers, maintenance of CPR certifications.

How do exercise pulleys act differently than weight attached to the body?

Due to changes in force application, such as direction, the amount of resistance changes throughout the motion

What can cause overuse bone injuries in children?

Increasing training intensity more than 10% per week

How long after beginning an exercise program do most sedentary individuals stop?

Albuterol, terbutaline, glucocorticosteroids, cromolyn sodium and theophylline prevent, treat and reverse which disease?

Asthma, specifically exercise induced asthma

What is the exercise prescription for aparently healthy individuals?

Intensity: 60-90% HR max
Duration: 20-60 minutes
Frequency: 3-5 days per week

Who is responsible for program design and implementation of that program for a health/fitness site?

Manager/director of that site

At what point, according to the Health Belief Model, will people engage in a new behavior (i.e. exercise)?

When there is a perceived threat of disease, a susceptibility to the disease and the threat of the disease is severe

What does informed consent do for the client and/or professional?

Informed consent is a document in which the client is explained the procedures of the test and agrees that they understand what will happen. It does not protect the facility from legal action against them if necessary.

How do over-use injuries occur?

If there are not enough rest days in between exercise or if there is not enough time for an injury to heal

Auscultation of the heart rate is when:

A stethoscope is used to hear the heart rate through the chest.

What is the most beneficial exercise for low-fit or sedentary individuals?

Multiple short-duration, low-intensity exercise sessions per day

female athlete triad

amenorrhea, osteoporosis, and eating disorders; when left untreated they damage the musculoskeletal and reproductive systems

guidelines for losing weight

500-1000 cal daily to lose 1-2 lbs. per wk; same to increase

equivalent to losing 1 lb of fat 3500cal

waist-hip ratio

Hips/Waist (ex. 45" waist and 36" hips... 36/45=.8)
ratios above .86 for women and .95 for men indicate abdominal adiposity

Principle of Adaptation/Overload Training and Progression

-greater then normal demand is placed upon muscles,
-to enhance the muscular fitness, the system must be progressively overloaded
-tension required for strength gain is about 60% - 80% of 1RM
-fleck and kraemer recommend 75 - 90%

Progression involves increasing/changing one or more of the exercise training components to promote adaptations

Principle of Specificity of Training

The body adapts to specific exercise training stimulus with specific physical and physiological adaptations.

Cardio adaptations

-resting heart rate decreases by approx 10 - 15 bpm
-SV increases both at rest and during exercise
-Resting SBP/DBP may decrease (if prev elevated)

Exercise Program Components

(FITTE) Frequency, Intensity, Time/Duration, Type/Mode, Enjoyment

Warm up Considerations

Should include appropriate cardiorespiratory and musculoskeletal activity

Cool Down Considerations

Appropriate cardiorespiratory and musculoskeletal activity serving to enhance venous return and decrease the chance of postexercise hypotension during recovery

Initial treatment for Musculoskeletal injury for the first 24-72 hrs

(RICES) rest (prevents further injury, ice (reduces pain, swelling, and initiates inflammatory response) compression (reduces swelling and bleeding) elevation (controls edema and decreases blood flow) stabilization (assists in muscle relaxation, diminishing spasm

Symptoms of Angina (chest pain) and myocardial infaction (heart attack)

a. chest pain, b. pressure discomfort in the chest, c.left jaw, neck or shoulder-may radiate distally, d. shortness of breath and lightheadedness, e. back pain, which may be experienced by some women

Treatment for chest pain and heart attack symptoms

a. stop exercise immediately and place person ina comfortable sitting or lying position, b. 911, monitor HR, and be prepared to begin CPR, c. Automated External Defibrillator AED may be used if cardiac arrest

Signals of heat exhaustion

a. cool, moist pale, ashen, or flushed skin b. headache, nausea, dizziness, c. weakness, exhaustion d. heavy sweating e. body temp will be near normal

Signals of heat stroke

1. red, hot dry skin 2. rapid weak pulse, shallow breathing 3. changes in the level of consciousness 4. vomiting 5. body temp will be very high as high as 105

Hydration recommendations according to ACSM

approx. 3-6 ounces of water every 1-2 miles of the race

ATP-PC phosphagen system (anaerobic)

25-30 seconds of high intesity work (spints, weight lifting)

Anaerobic Glycolysis/Lactic Acid System (anaerobic)

1-2 min of high intensity work 400-800m distance sprint

Oxygen System (aerobic)

fuels activities lasting more than 2-3 min. Capacity is limited only by oxygen and fuel avail. to the cell

antihypertensive meds

reduces high blood pressure

reduces angina/chest pain

relaxes bronchial passageways

reduces blood sugar

anti-arrhythmic

prevents/controls abnormal heart rhythms

affects behavior

prevents system of allergic response

widens blood vessal

reduces resting and exercise heart rate and blood pressure

may extend endurance in moderate aerobic exercise

dehydrating-may impair exercise tolerance and increase risk of heart injury

may elevate HR,BP and respiratory response

Acute-onset muscle soreness; muscle fatigue and discomfort dimininishes when exercise stops

delayed onset muscle soreness;muscle discomfort 24-36 hr after exercise

overuse/chronic muscle and joint injury

tendonitis, fasciitis, bursitis, osteoarthritis

inflammation of a tendon

inflammation of the fascia; fascia is a connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves, binding those structures together in much the same manner as plastic wrap can be used to hold the contents of sandwiches together

Bursitis is inflammation of the fluid-filled sac (bursa) that lies between a tendon and skin, or between a tendon and bone

chronic breakdown of cartilage in the joints

normal acute cardiorespiratory response to aerobic exercise

elevated HR, SV, Cardiac output, BP, Blood Flow, Arteriovenous oxygen difference, pulmonary ventilation and oxygen consumption

pulmonary ventilation

vol of air exchanged per minute

1st class lever

primarly for balance;see saw, head on cervical vertebrea

2nd class lever

primarly for power; wheel borrw, plater flexion during walking

3rd class lever

range of motion; shovel, exbow flexion; we use this the most

Social: support systems
Physical: physical/phyiological well-being
Intellectual: Open to Learn
Emotional:Coping Skills
Spiritual:living in harmony

Transtheoretical Model stages of change

Pre-contemplation: not ready to exercise
Contemplation: thinking about behavior change
Preparation:doing something related to exercise, but not meeting the guidelines
Action: meeting set criteria of at least 6 months
Maintenance: met criteria of 6 months, and continuing

sedentary individuals will demonstrate significicant improvements in fitness early in training program

regular physical activity can improve health and reduce health risks by...

reduces...
-cardiovascular disease
-risk of stroke
-reduces high blood pressure
-risk of colon cancer, lowers
-cholesterol/triglycerides,
-depression/anxiety/stress

Increases...
-lipoproteins
-self-esteem
-healthy body

benefits of flexibility training

-reduces muscle tension
-promotes relaxation
-muscle contractions become easier/smoother
-improves ease of movement

benefits of resistance training

-stress management
-MET capacity
-increased resting metabolism
-osteoporosis prevention/management
-injury prevention/rehab

consequences of physical inactivity

-heart disease
-stroke
-diabetes
-hypertension
-obesity
-depression/anxiety
-certain cancers

Mitral valve prolapse

heart problem resulting from the mitral valve not regulating the flow of blood between the left atrium and left ventricle of the heart

An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm, such as beating too fast (tachycardia), too slow (bradycardia), or irregularly.

decrease in the mass of the muscle;Muscle atrophy results from a co-morbidity of several common diseases, including cancer, AIDS, congestive heart failure, COPD (chronic obstructive pulmonary disease), renal failure, starvation

Enlargement of muscle

2 types of hypertrophy

sarcoplasmic and myofibrillar

volume of sarcoplasmic fluid in the muscle cell increases with no accompanying increase in muscular strength

actin and myosin contractile proteins increase in number and add to muscular strength as well as a small increase in the size of the muscle

order of exercise assessments

1.resting mesurements (BP/HR/Body Fat/height/weight)
2.cardio test
3.muscular endurance
4.flex

Heart rate reserve

HRR = HRmax − HRrest

Karvonen formula

aka max heart rate reserve method;
training HR = (max HR - resting HR) X target intensity (40/50-85%) + resting HR

FITTE (resistance training)

Frequency(2-3x a week),
Intensity (2 to 4 sets of 8-12 reps w/ 2-3 mins b/w sets)
Time no longer then 60 mins,
Type (various resistance equipment),
Enjoyment

social learning theory

the theory that we learn social behavior by observing and imitating and by being rewarded or punished.

Specific, Measurable, Attainable, Realistic, Timely

active listening

Empathic listening in which the listener echoes, restates, and clarifies

Macrocycle: largest cycle
Mesocycle: next largest (4 - 6 in yr)
Microcycle: smallest cycles (1 - 4 wks)

Linear v Non Linear
Linear changes intensity every 4- 6 wks
-hypertrophy (high vol,short rest)
-Strength/power (reduced vol,increase load/rest)
-Peaking (low vol/high load/rest)
-Recovery (active rest)
Non Linear changes every day within a 4- 6 wk period

60% = 17
70%=12
80%= 8
90%=5
100%=1

exercise and pregnancy

-Supine position should be avoided after 1st trimester
-low/mod intensity
-non-ballistic
-proper clothing and hydration to prevent overheating

high risk flexibility

standing toe touches, barre streches, hurdler strech, neck circles, yoga plough, knee hyperflexion

Static stretching

active: muscle is actively moved through ROM
passive:muscle is actively moved through ROM by partner/device

Ballistic Stretching

a series of quick but gentle bouncing or bobbing motions designed to stretch your muscles

Dynamic Stretching

Stretching that involves moving the joints through their full range of motion to mimic a movement used in a sport or exercise to increase joint flexibility, core temp and circulation

3 min step test

12" step
96 bpm
locate radial pulse first
client steps up up down down for 3 mins @ 96bpm with no talking
check pulse within 5 secs after test

rotator cuff muscles

SITS
Supraspinatus, Infraspinatus, Teres minor, Subscapularis

major joint action for
-pec major
-post deltoid

-shoulder horizontal adduction
-shoulder horizontal abduction

major joint action for
-mid trap
-pec minor

-scapular retraction(add)
-scapular protraction(abd)

major joint action for
-latissimus dorsi
-middle delt

-shoulder adduction
-shoulder abduction

major joint action for
-rotator cuff muscles

-shoulder abduction/ext rotation/int. rotation

major joint action for
-erector spinae
-abs

-spinal extension/flexion

major joint action for
-biceps brachii
-triceps brachii

elbow flexion
elbow extension

major joint action for
-gluteus maximus
-Ilopsoas

Hip Extension
Hip Flexion

major joint action for
-quads
-hams

knee extension
knee flexion

major joint action for
-gastrocnemius
-tibialis anterior

planter flexion
dorsiflexion

major joint action for
-obliques

spinal rotation and lateral flexion

What is the ACSM's recommended energy expenditure per day?

What medical values (BP, glucose,etc) are contraindicative of exercise training?

BP = >200/105
Glucose = >250 w/ketones or >300 w/out ketones

What is the resting absolute O2 consumption for a 70kg person? In athletes?

0.245 L/min (up to 5.5 L/min in athletes)

How many kcal are spent consuming 1L O2?

5 kcal (20.9 kJ)

How are METs calculated?

By dividing the relative O2 consumption by 3.5

How many calories are spent by running/walking 1 mile?

What is gross Vo2? Net Vo2?

O2 cost of activity plus rest;
O2 cost of activity - rest

All ACSM formulas are for gross VO2

What are the minimum caloric intakes for men and women?

Men - 1,800
Women - 1,200

What is the Harris-Benedict Equation?

calculates RMR

PA correction factors include:
1) sedentary: RMR * 1.4
2) Moderately active: RMR * 1.6
3) Highly Active: RMR * 1.8

What are the recommendations for dietary fiber?

What are the fat recommendations?

20-35% for adults, 20-35 young children (2-3)
<10% saturated
<300 cholesterol
no fat <20%

What are the post-exerices recommendations for CHO?

1.0-1.5 g CHO/kg within 30-60 min

What muscles abduct the shoulder?

Middle deltoid and supraspinatus

What muscles adduct the shoulder?

Lat. Dorsi, Pec major, Teres Major, Post. Delt

What muscles extend the shoulder?

Lat. Dorsi, Pec major, Teres Major, Post. Delt

What muscles flex the shoulder?

Ant. Delt., Pec Major

What muscles laterally rotate the shoulder?

Infraspinatus, teres minor

What muscles medially rotate the shoulder?

Lat. Dorsi, Pec Major, Teres Major, Subscapularis

What muscles protract the shoulder girdle?

Pec Minor, Serratus anterior

What muscles retract the shoulder girdle?

Rhomboids, middle trap

What muscles abduct the hip?

Glut. medius, piriformis

What muscles adduct the hip?

Adductors magnus, longus, brevis; gracialis, pectineus

What muscles extend the hip?

Hamstrings (biceps femoris, semimembranosus, semitendinosis); glut max

What muscles flex the hip?

Iliacus, pectineus, psoas major, rectus femoris

Mediolateral axis

perpendicular to sagittal plane

Anteroposterior axis

perpendicular to frontal plane

Longitudinal axis

perpendicular to transverse plane

What is an example of a condyloid joint and what is its characteristic motion?

Wrist (radiocarpal) - circumduction, abd, add, flex/ext

Describe the substrate and duration of the nonoxidative System

-CHO --> ATP
-without oxygen, byproduct is lactic acid
-main energy source for 30 sec --> 3 minutes

Describe the substrate and duration of the oxidative System

-CHO, Fats, Proteins --> ATP
-byproducts are water and CO2

How does long-term training affect bioenergetics?

increased mitochondrial density and substrate storage in the muscle cells

Name and describe the Myosin Isoforms

Type I = slow twitch, high oxidative
Type IIA = intermediate
Type IIB(X) = fast twitch, low oxidative

Describe the sliding filament theory

1) CNS stimulates sarcolemma and Ca++ is released from the T-tubules of the SR
2) Ca++ binds to troponin causing tropomyosin to shift shape, exposing active binding sites on the actin
3) Myosin cross-bridges bind to active sites on actin
4) ATPase in cross-bridge head cleaves ATP resulting in the power stroke
5) ATP binds to cross-bridge head and calcium pump restores Ca++ to SR

What are the Effects of training on Fiber Type?

-All training (endurance or resistance) causes a conversion of Type IIB(X) (fast twitch) to Type IIA (intermediate)

-no training converts TI to TII or vice versa

Describe Minute Ventilation (VE) at rest and during exercise

volume of air expired or inspired over the course of 1 minute
- about 6 L/min at rest
- can increase to 20-25x at max. (result of increased tidal volume and respiratory rate)

Describe Tidal Volume at rest and during exercise

- amount of air entering/leaving the lungs per breath
- 0.5 L at rest, 4L at max

Describe Respiratory rate at rest and during exercise

- 12/min at rest, 50/min at max

What are the energy costs of breathing at rest and during exercise?

- about 3% at rest
- 3-5% with moderate ex
- 10% at max, (15% in highly trained)

Describe the ventilatory adaptations that occur with aerobic training

- increased ex. intensity at which anaerobic threshold occurs

Describe the Anaerobic threshold

- exercise intensity at which ATP demand cannot be met solely by aerobic metabolism and anerobically produced ATP is needed to satisfy the demand

- point at which linear relationship between expired CO2 and minute ventilation

- in untrained, occurs at about 55% of VO2max
- in trained, occurs at about 80% - 85%

Describe Stroke Volume at rest and during exercise

- volume of blood ejected from the LV with each contraction
- 70 mL at rest, 100mL during ex in untrained men, 170mL in highly trained
- increases with exercise intensity until 50% of VO2max

Describe Cardiac Output (Q) at rest and during exercise

- amount of blood pumped each minute

Q = HR(SV)

- at rest, Q = 5L/min (72 BPM x 70 mL)
- at max, Q = 5 - 6x (25-30 L/min)

- 35-40 L/min in trained

Describe end-diastolic volume at rest and during exercise

- the amount of blood in each ventricle at the end of the resting phase (diastole)

- at rest, 125 mL
- at max, 160 mL

Describe End-systolic volume (ESV) at rest

- volume of blood remaining in each ventricle following its contraction

- at rest, 55 mL
- at max, ?

Describe Ejection fraction (EF) at rest and during exercise

- % of blood in ventricle during diastole actually pumped out during systole

EF = SV/EDV

- at rest, EF = 60% but can range from 50% - 75%

What are the cardiac adaptations to training?

1) no increase in HRmax
2) Significantly lower HRrest
3) increased SV (~85mL at rest)

What are the effects of posture on cardiac functioning?

- supine SV (e.g., swimming) is greater at any given intensity and HR is lower (same Q)

Define pulse pressure

- difference between SYS and DIA
- approx. 40 mmHg at rest

Define Mean arterial pressure (MAP)

- average pressure exerted across the cardiac cycle

MAP = DBP + (1/3)(PP)

- approx 93 mm Hg at rest

Define Rate Pressure Product

- aka double product
- correlate of myocardial oxygen uptake & LV workload

RPP = SBP(HR)

- at rest, 8,640 (i.e., 120 mmHg x 72 BPM)

What are the BP contraindications to exercise?

1) sudden drop in SBP (>15 mmHg)
2) elevation of SBP > 260 mmHg

What are the Long-term vascular adaptations to exercise?

1) decreased SBP, DBP, and MAP at rest
2) improved shunting of blood to muscles
3) improved capillarity within muscle tissue (and increased mithochondrial density) --> improved oxygen extraction

Define Hematocrit

- % of blood volume composed of RBCs
- 45 % in men (due to inc. testosterone)
- 42 % in women

Define cardiovascular drift

- movement of plasma out of the blood into the working muscles/ surrounding tissue
- serves to prevent overheating but decreases SV and leads to hemoconcentration (high RBC concentrations, inc. hematocrit)

What are the Long-term adaptations on blood composition?

1) improved production of RBCs (better O2 delivery)
2) increased plasma volume (dec. hematocrit, i.e., runner's anemia)
3) improved thermoregulation ability

What are the ACSM developmental periods?

Neonatal: 0-3weeks
Infancy: 3 weeks - 1 year
Early Childhood: 1-6
Middle Childhood: 7-10
Prepuberty: 9-15 (girls) 12-16 (boys)
Early adulthood: 20-29
Middle adulthood: 30-44
Later adulthood: 45-64

Describe the developmental cardiopulmonary changes in children

- higher RHR and ExHR due to lower SV, hemoglobin and relative Q
- VO2 max remains relatively unchanged throughout childhood and adolescence
- lower BP
-absolute VO2max (L/min) increases substantially through childhood but relative VO2max plateaus in boys during puberty and declines in girls
-V02max is NOT related to endurance fitness in children and preadolescents

Describe Thermoregulation in children

-much lower sweating rate (rely more on convective heat loss through increased blood flow)
- same # of sweat glands, but half the production of those glands
- less acclimatization
- greater surface area to BM ratio --> inc. loss of heat (cold env) or gain of heat (hot env.)

Describe the cardiopulmonary changes that occur in older adults

-HRmax decreases 6-10bpm per decade
-RSV remains unchanged, but max SV decreases with age
- these changes likely result from dec. compliance in the LV
- capillary density decreases
- LV hypertrophy --> inc. afterload/TPR
- V02 max declines by 5-15% per decade after 25 (can be slowed by PA)
-residual volume increases and vital capacity decreases
- lung compliance increases
-early LV diastolic function decreases
-aging brings a 20% decreases in the work of respiratory muscles but a decrease in the strength of these muscles

Describe the musculoskeletal changes that occur in older adulthood

-sedentary individuals lose 20-40% of their muscle mass over the course of their life
-muscle strength declines ~15% per decade in the 5th, 6th, and 7th, and 30% thereafter

What are the key points to know about strength training in children?

-results in smaller absolute but equal relative gains
-no greater risk of injury
-focus on participation and technique rather than resistance
- muscle hypertrophy not a cause of increased strength in preadolescents

-loss of muscle tone and consciousness associated with diminished cerebral blood flow

Describe the metabolic responses to exercise in children

- 10-20% inc. submax O2 consumption compared to adults in running and walking do to dec. economy
- lower anerobic capacity
- children reach metabolic steady state quicker than adults
(less oxygen debt)
- more rapid recovery of HR and BP post-ex

Describe CV responses to exercise in children

-lower Q at a given VO2
-higher HR at submaximal loads
-lower arterial blood pressure

Describe pulmonary responses to exercise in children

-lower absolute minute ventilation
-similar relative maximal minute ventilation but lower relative submax MV
-VO2 is less trainable in children than adults

What is the minimum VO2 needed for independent living?

What are unique responses to exercise found in older adults?

- blunted HR response
- decreased blood volume, max SV and Q
- decreased EF due to reductions in LV compliance
-increased dead space in lungs (from 30% to 40-45%)
-reductions in pulmonary alveolar compliance elevates BP in the lungs during exercise
-similar or greater strength gains compared to young adults

What is the preferred walking speed of older adults relative to younger ones?

What are the 5 stages of change in the TTM?

1) Precontemplation
2) Contemplation
3) Preperation
4) Action
5) Maintenance (> 6 months)

What are the 5 cognitive processes of change?

1) Consciousness raising
2) Dramatic relief (warning of risks)
3) Environmental reevaluation
4) Self-reevaluation
5) Social liberation (increasing healthy opportunities)

What are the 5 behavioral processes of change?

1) Counter-conditioning (substituting alternatives)
2) Helping relationships (enlisting social support)
3) Reinforcement management (rewarding yourself)
4) Self-liberation (committing yourself)
5) Stimulus control (reminding yourself)

Describe the Theory of Reasoned Action

-intention is the most important determinant of behavior
-attitudes and subjective norms influence intention

Describe the Theory of Planned Behavior

extends the theory of reasoned action by incorporating perceived behavioral control, which is determined by perceived power and control beliefs

Describe Social Cognitive Theory

involves:
1) observational learning (vicarious rewards)
2) Behavioral capability (knowledge and skill)
3) outcome expectations and expectancies
4) Self-efficacy (confidence about performing a specific behavior)
5) Self-control of performance (includes self-monitoring and goal-setting)
6) Management of emotional arousal (e.g., cognitive restructuring, stress management, effective problem solving)
7) Reinforcement (direct, vicarious, self)

Name 4 ways to increase self-efficacy

1) listing performance accomplishments
2) observing through vicarious experience
3) Using verbal persuasion
4) Understanding psychological states

What is shaping?

involves setting a series of intermediate goals that lead towards a long-term goal

Define 'Antecedent control'

using techniques to prompt the initiation of the behavior (e.g. alarm reminders, packing in advance, scheduling in time, etc)

List two important cognitive restructuring techniques

1) relapse prevention strategies
2) elimination of 'all-or-none' thinking

What are the 5 A's of counseling?

1) address the agenda
2) assess
3) advise
4) Assist
5) arrange follow-up

How many days should someone with Diabetes exercise? (general FITT-VP)

If weight loss is the main goal, an individual with Diabetes should aim for more than ____ hours a week which is ~to 2,000 kcal/week

The Intensity level for exercise r/x in individuals with Diabetes ......
-same for healthy adult (___-____%vo2R which is equivalent to ___-___ on 6-20 RPE scale)

*but with diabetes, to see glucose tolerance benefit should be higher so generally aim for a goal of
_____-_____%vo2R total

40-59%Vo2R/HRR = 11-13 RPE

aim for **40-80%
(DM)

_________ is the biggest concern of Diabetic patients during exercise

-defined as <___mg-dL

Hypoglycemia

70

Overweight =/> ___ BMI
Obese =/> ____BMI
extreme obese =/> ____ BMI

bmi is in what units?

25
30
40

kg per meter squared

A healthy weightless for Overweight and Obese individuals is losing __-___% body weight in the initial 3-6 months

For weight loss, a caloric reduction of ___-___kcal per day is necessary for overweight and obese people
and dietary fat should be reduced to <____% of total daily calories

For long term weight loss management, Overweight and Obese people need to aim for >____min/week of moderate and some vigorous exercise

__________ is the abnormal blood lipid and lipoprotein concentrations - Also, this is a major modifiable risk factor for CVD

FITT-VP r/x for Dyslipidemia:

Freq: >/= ____days -week
Int: ___-____% Vo2r/hrr
Time: ___-___min a day however, for weight loss promotion and maintenance aim for ___-____min.day

*biggest concern from medications (statins, HMG-COA) is ______=muscle weakness and soreness

5days
40-75%
30-60, 50-60

myalgia

Hypertension is defined as having resting SBP ____or higher AND/OR resting DBP =___or higher
-on 2 separate occasions
-or on HTN medication

CVD risk DOUBLES with hypertension every ____increment increase of SBP and every _____increment increase of DBP

Uncontrolled HTN (SBP or __or more/DBP of ___ or more) may begin moderate-vig exercise

Severe uncontrolled (SBP or __or more/DBP of ___ or more) may begin exercise ONLY after meeting with their doctor

140/90

180/110

SBP of _____ and/or DBP of _____ is RELATIVE CONTRAINDICATION TO EXERCISE TESTING

STOP EXERCISE TEST if SBP >____ or DBP >_____

aerobic exercise decreases BP by __-___mmhg

FITT-VP r/x for HTN is same as healthy adults except what

frequency....
aim for >/= 5 days
*goal is caloric deficit/weight loss

define "postexercise hypotension"

the immediate effects of aerobic exercise on Blood pressure, normal for children and older adults

If a person has documented cases of previous ischemia, you should make their ischemic threshold during an exercise tests <____beats (HR)lower than their last event threshold

Alpha- blockers, Calcium channel blockers, and vasodilators may cause what exercise response to people with HTN

excess drop in POST exercise BP

when exercising, it is prudent to keep BP at or below _____(SBP) and/or _____(DBP)

FITT-VP for individuals at risk for osteoporosis:
F -aerobic weight bearing: __-___days/week
RT: ___-____days/week
I -aerobic :
RT:
Time: ___-____min.day
Type:

FITT-VP for individuals WITH osteoporosis:

F -aerobic weight bearing: __-___days/week
RT: ___-____days/week
I -aerobic :
RT:
Time: ___-____min.day
Type:

F- aerobic weight bearing : 3-5 days/week
RT: 2-3 days
I: aerobic- mod-vig (40-<60%) (60+%)
RT: mod (60-801RM%, 8-12 reps) AND vig (80-90%1RM, 5-6 reps)

T: 30-60min
T: wt bearing aerobic, with jumping** and RT

Same FITT-VP except
*Intensity: no vigorous RT (some may be able to)
*Type: same except without jumping

________=skeletal disease, low bone mineral density and changes in the micro arch of bone , increase risk of fracture

Osteoporosis defined as low bone mineral density (BMD) Tscore of <-2.5 of (what 3 body areas??) in postmen. women and men 50 or older

1.lumber spine
2.hip
3.femoral neck

Avoid what types of exercises when prescribing exercise to patients with osteoporosis?

high-impact, explosive
bending, twisting, spine compression

Aim to improve what skill related component when making exercise r/x for pt's with osteoporosis

Difference between rheumatoid arthritis and Osteoarthritis

Rheumatoid - chronic, systemic disease in which immune system attacking joint tissues

Osteo- local degenerative disease affecting multiple joints

FITT-VP for arthrits

F: __-___(aerobic), ___-___days/week (RT)
I: __-<__% light to moderate
some patients may need very light intensity if de-conditioned (__-__% )
RT: ___-___reps, ___-___% 1RM
Time: at least ____minutes/week or more
TYpe: what to avoid

F: 3-5(aerobic), 2-3days/week (RT)
I: 40-<60% light to moderate
some patients may need very light intensity if de-conditioned (30-39% )
RT: 10-15reps, 40-60% 1RM
Time: at least 150 minutes/week or more
TYpe: avoid high impact/ stress on joints

* aim for strength muscle around joints

What time of day should patients with arthritis workout?

whatever time of the day their joints usually are in the least amount of pain

COPD is characterized by Bronchitis and Emphysema:
-Criteria for bronchitis is a chronic cough producing mucus for ____months, for ____ years

3months
2 years

To test exercise -induced bronchoconstriction in pulmonary disease patients (asthma), the exercise test should last for ____-____ minutes, have intensity up to ____% age predicted HR max or _____% max voluntary ventilation, use 1 of which 2 machines?

**Exercise should be stopped if oxyhemoglobin saturation is at what level
** If asthma is moderate-severe, may use what other test protocol?

4-6 min
80% age predicted or 40-60% max voluntary vent.
-either motor driven treadmill or electronically braked leg cycle

</= 80%
6 min walk test

Ashtma FITT-VP

F: __-___(aerobic), RT same as healthy
I: what three measurements?

Time: at least ____minutes/day

2-3 day/week
-at ventilation anaerobic threshold
OR -at least >60% vo2 PEAK( from exercise test)
OR- at least >80% max walk speed (from walk test)

20-30min/day

When testing exercise on people with COPD, use ______ to measure ____ as an intensity indicator instead of HR. Recommended to stay at ____-____ (level)

BORG CR10 scale , dyspnea

4-6 (on a scale of 0-10)

COPD FITT-VP

Freq: ? days/week
Int: what 3 intensities beneficial?
Type:

F: 3-5 days
I: vigorous (60-80% peak) improves minute ventilation and HR
light (30-<40% pk) improves ADLs and symtoms
*Borg 10 scale for dyspnea (4-6 is goal)

T: walk or cycle

For COPD patients who experience dyspnea working their upper extremities, they should focus on resistance training targeting what area?

shoulder girdle

What form must be obtained by the patient/client prior to a test?

informed consent

A patient has auscultating lung sounds, similar to a crackle. What could this mean?

fluid in the lungs

Identify three types of metabolic diseases.

obesity, DM 1 and 2, thyroid disease, renal disease, and liver disease

Give three examples of signs or symptoms in individuals with a metabolic disease.

hyperglycemia, shakiness and disorientation (hypoglycemia), weight gain, sluggish behavior, hair loss

Signs and symptoms prompted by exercise in individuals with a neuromuscular disease.

high sensitivity to hot or cold temps, foot drop, tremors, loss of sensation and/or balance/ coordination

What is an appropriate exercise testing method for an individual with a neuromuscular disease?

low-impact machine, such as a cycle or arm ergometer

List two absolute contraindications to an exercise test.

acute MI, unstable angina, uncontrolled arrhythmias, symptomatic severe aortic stenosis, acute pulmonary embolus

List four relative contraindications to an exercise test.

electrolyte abnormalities, chronic infectious diseases, high degree AV block, mental or physical impairment, left main coronary stenosis

How is maximal oxygen uptake measured?

it is a product of maximal cardiac output and arterial-venous oxygen difference; it is measured through an open circuit spirometer

What is intensity?

level of demand that an activity places on the body

The ACSM suggest what amount of time of continuous physical activity for general health requirements?

Determine a 30 year old client's THR zone with a RHR of 65 (intensity 65-85%)

MHR: 207-(0.7*30) = 186
[(186-65) x .65] + 65 = 143.65
[(186-65) x .85] + 65 = 167.85

individual's resting metabolism or oxygen uptake, and is a way to measure intensity during a workout

T/F - ballistic stretching is a popular technique?

What is muscular endurance?

ability of a muscle or group of muscles to overcome a sub-maximal resistance several times consecutively

When the muscles are contracting concentrically an individual should (a) inhale, (b) exhale?

A lengthening of the muscle fibers is what type of action?

Define the progression principle

there is a desired level of overload that should be achieved in an optimal amount of time

what is another name for the bicuspid valve?

mitral valve - it separates the LA from the LV

trace the route of blood through the heart

(1) blood enters the RA, (2) flows through the tricuspid valve into RV, (3) pressure builds due to closing of tricuspid valve, (4) RV squeezes blood through pulmonic valve into pulmonary artery and blood is taken into the lungs (5) gases are exchanged and oxygenated blood is returned to the heart via pulmonary vein (6) blood enters LA and then (7) flows through the mitral or bicuspid valve into the LV (8) then pressure builds due to closing of mitral valve and oxygenated blood is expelled through the aortic valve into the aorta (9) oxygenated blood is distributed throughout the body

this movement increases the joint's angle and occurs in the sagittal plane (transverse axis)

Identify the six types of joints.

(1) ball and socket - shoulder and hip
(2) hinge - knee and elbow
(3) pivot - ROM of head and stability of the neck
(4) saddle - thumb
(5) gliding - ankle
(6) condyloid - wrist

Where does gas exchange take place inside the lungs?

Which bioenergetic pathway is sometimes called the "aerobic" pathway?

oxidative pathway

What is the sliding filament theory?

process by which the muscles are believed to contract, relax and.or produce force.

Which large protein (thick filament) is involved with muscle contraction?

During short duration and high intensity exercises (e.g. sprinting) which type of muscle fiber is primarily recruited?

Type IIB fibers are fast twitch fibers that can produce bursts of power but fatigue quickly

Describe Type I muscle fibers.

slow twitch fibers, resistant to fatigue, produce large amounts of ATP through the oxidative system, found in postural muscles and can be developed through training

Describe Type II muscle fibers.

fast twitch fibers, produce bursts of power but fatigue quickly, ATP is produced in the nonoxidative system (broken down rapidly)

What is stroke volume?

volume of blood that is ejected out of the left ventricle per contraction

What is cardiac output?

amount of blood ejected every minute from the left ventricle

What is shunting?

blood is pulled away from all the vital organs of the body to the exercising muscles

Intervertebral disks are composed of what type of tissue?

fibrocartilaginous

What is kyphosis?

hunchback due to excessive outward curving of the spinal column

What tissue holds bones together?

How many calories are in one pound?

3,500 calories per pound

What are the three most common types of eating disorders?

anorexia nervosa, bulimia nervosa, binge-eating disorder

What is the most abundant compound of the human body besides fat?

convert 150 lbs to kilograms

150/2.2 = 68 kg

Convert 30 cm into inches

30/2.54 = 11.8 in.

Define Waist-to-Hip Ratio

fraction that represents the circumference of the waist divided by the circumference of the hip

What are the three types of macronutrients?

Carbs, proteins, lipids

What is a negligence tort?

an act leading to injury that is neither expected nor intended

The Health Insurance Portability and Accountability Act was created to protect patients. It prevents clinical settings, facilities, health plans and health care providers from sharing patient info with anyone besides the patient

What are the four basic duties of a health fitness professional?

Inform, Instruct, Monitor and Supervise

What is a PAR-Q form used for?

self-screening tool used to determine the safety or possible risk of exercising for an individual based upon their answers to specific health questions

T/F: Hyperglycemia is low blood sugar

T/F: Blurred vision is a symptom of hyperglycemia

T/F: Type I diabetes occurs when the body is insulin resistant

T/F: If a client shows symptoms of hypoglycemia, they can resume activity once their blood glucose level reaches 100 mg/dL

T/F: Elevating a person's legs when they go into shock helps to keep their blood circulating

How much space should be maintained between exercise equipment in a fitness facility?

(check with professor?

What is the purpose of a cool down?

To transition the body from activity back to a resting state

Define the SMART system of goal-setting?

Specific, Measureable, Attainable, Realistic, Time-oriented

What are the five cogniitive processes of change used in the trans-theoretical model?

(1)consciousness raising, (2)dramatic relief, (3)environmental reevaluation, (4)self-reevaluation, (5)social liberation

What are the five behavioral processes of change used in the trans-theoretical model?

(1) counterconditioning (2)helping relationships, (3)reinforcement management, (4) self-liberation, (5) stimulus control

What are the five stages of the trans-theoretical model?

Precontemplation, Contemplation, Preparation, Action, Maintenance

Which of the wave forms on an ECG will yield info about atrial enlargement? What should you look for?

P waves - look for tall, peaked P waves

What are some RELATIVE indications that require concern, not necessarily immediate termination of, during an exercise test?

Increasing chest pain, wheezing, leg cramps, hypertensive response

What are some ABSOLUTE indications that require immediate termination of exercise testing?

Suspicion of MI, onset of moderate-severe angina, request by patient to stop, signs of poor perfusion

What is the formula for BMI

703 * weights(lbs)/height(in)^2

What are four ways of measuring cardiovascular endurance?

ECG, 3-min step test, Bruce Protocol, Cycle/Arm Ergometer (VO2 max)

What are two ways of measuring muscle strength?

1 RM, Handgrip dynamometer

Stable angina vs. Unstable angina

Stable: onset with exercise, goes away with rest
Unstable: occurs without exercise, prolonged - EMERGENCY

what are the four types of CV Disease?

Cerebrovascular, PAD, cardiac disease, vascular disease

What are the four types of pulmonary disease?

COPD, asthma, CF, interstitial lining disease

Compare the resting cardiac output between an untrained individual and a trained individual?

relatively the same - trained individuals HR will decrease and SV will increase; untrained individuals HR will increase and SV decrease

RER of what value indicates max Vo2?

greater than 1.14

RER of what indicates anaerobic threshold?

What happens to insulin sensitivity and glucose tolerance during exercise?

1 mph = ? m/min

1 lb fat = ? kcal

1 MET = ? mL/kg/min

1 W = ? kg/m/min

1 L O2/min = ? kcal/min

1 in = ? m, ?cm

0.0254 m, 2.54 cm

targets specific habits; example - provide the client with info about how smoking endangers those around them (cognitive processes)

environmental reevaluation

using strategies such as psychodrama, grieving losses, and role playing in order to experience and express feelings about a problem preventing exercise (cognitive processes)

dramatic relief

marketing strategies such as special offers for gym memberships (cognitive processes)

consciousness raising

removing anything that supports the occurrence of a bad habit (behavioral processes)

stimulus control

rewards for good behavior

reinforcement management

people discover a love for a particular exercise or activity and then make it a permanent part of their routine

self-liberation

promote supportive social bonds (behavioral processes)

helping relationships

replacement of an unwanted habitual behavior with a healthier alternative

counterconditioning.

most critical stage of change, in which people begin activities and programs - less than 6 months

first stage of TMC; person is not open to making lifestyle changes and is possibly in denial of the fact that any modifications are needed

Pre-Contemplation

people begin to consider making healthy changes, but haven't taken the steps to making the change

People make an effort to put a fitness plan in motion - signing up for a class, joining a gym

people are active for more than 6 months

day-to-day operational expenses (medical and exercise supplies, stationary)

non-capital expenses

large purchase orders (exercise equipment)

capital expenses

what % of daily intake should involve carbs?

What is the primary goal of a commercial fitness facility?

to generate a profit for the owners

What is the goal of corporate fitness facilities?

Increase employee productivity, morale, and retention

What is the goal of clinical and medical fitness facilities?

to fill beds and generate higher occupancy

What is the primary goal of a community fitness facility?

to serve the recreation and fitness needs of the community

Hypertension exercise guidelines

aerobic: 3-7 days/week; Intensity: 40 -70%; Time: 30-60 minutes; possible multiple bouts throughout the day. Avoid isometric, valsalva, and max efforts; high reps/low intensity is better; RPE = 13-15; SWIMMING

Diabetes exercise guidelines

no more than 2 consecutive days of rest allowed. weight management factors may need to be taken into consideration

Pregnancy Exercise Guidelines

avoid supine position after first tri-mester; avoid over the head exercises - no isometric contractions, avoid risk of abdominal trauma; consume 30-50 g of carbs before exercise; consume extra 300 kcals/day

What is revenue?

Income that a company receives from its normal business

Income minus commission, taxes or other related expenses

Total revenue received before deductions

What are four primary management functions?

Planning, Organization Alignment, Leading and Coaching, Monitoring

what are three key factors related to fitness participation?

Education, Income, and previous sports participation

the process of communicating your brand message to the market, and creating interest in your brand

a type of marketing; communicating your brand message through public media

outlines who you are targeting, how you will target them, and what you are offering - defines the scope of your business

Brand mission statement

What three factors interact in the social cognitive theory?

Person, Environment, Behaviors

What are five movements that occur in the sagittal plane?

Flexion, extension, hyperextension, plantar flexion and dorsi flexion

What are four movements that occur in the frontal (coronal ) plane?

Abduction, Adduction, lateral flexion and radial/ulnar deviation

what are some movements that occur in the transverse plane?

Horizontal abduction, horizontal adduction, supination, pronation, any kind of rotation (medial and lateral)

Metoprolol is a ____, and works to ___ the HR

Beta-blocker, blunt

Name 3 absolute contraindications to exercise and exercise testing for pregnancy

1. restrictive lung disease, 2. incompetent cervix 3. hemodynamically significant heart disease

A common issue faced when working with patients taking a lipid lowering medication is:

muscle and joint pain

What is the # 1 drug for hypertension?

what 2 muscles are involved in hip extension?

Gluteus Maximus, Hamstrings

What muscle is involved in knee extension?

What muscle is involved in knee flexion?

What 2 muscles are involved in hip flexion?

Rectus femoris, Iliopsoas

What 2 muscles are involved in plantar flexion?

gastrocnemius, soleus

What muscle is involved in ankle dorsi flexion?

Tibialis Anterior

What 3 muscles are involved in elbow flexion?

Biceps, brachialis and brachioradialis

What muslce is involved in elbow extension?

What 2 muscles are involved in shoulder flexion?

Anterior Deltoid, Pec. Major

What 2 muscles are involved in external shoulder rotation?

Infraspinatus, Teres Minor

What 2 muscles are involved in internal shoulder rotation?

Subscapularis, Teres Major

What is the prime mover for shoulder abduction?

What 2 muscles are involved in horizontal shoulder adduction?

Pec. major, anterior deltoid

What 2 muscles are involved in horizontal shoulder abduction?

Serratus Anterior and Pec. Minor

What 3 muscles are involved in shoulder abduction?

Medial deltoid, anterior deltoid, supraspinatus

What 3 muscles are involved in scapular elevation?

Upper traps, rhomboids, and levator scapulae

What 2 muscles are involved in scapular retraction?

Middle traps, rhomboids

What 3 muscles are involved in shoulder adduction?

Latissimus dorsi, teres major, and pec major

What 4 muscles are involved in shoulder extension?

lats, teres major, pec major, posterior deltoid

What 2 muscles are involved in scapular depression?

Lower traps, pec. minor

What muscle is involved in lumbar spinal flexion and posterior pelvic tilt?

Rectus abdominus

What 2 muscles are involved in spinal flexion and rotation?

internal and external obliques

What muscle is involved in spinal extension?

For individuals age 60-69, the WHR cutoff values are ___ for men and ___ for women

men: >1.03
women: >0.90

What are four types of Beta blockers?

Coreg, Corgard, Inderal and Lopressor (Metoporol)

What is one adverse side effect of taking beta blockers?

What are three types of antilipemic drugs (statins)?

Lipitor, Crestor, Zocor

What are two types of ACE-inhibitors?

Zestril, Prinivil

What major muscle is used to flex the hip joint

What is the function of hamstring muscles

knee flexion and hip extention

What is the equation for finding weight for fat percentage

100 - 30 = 70
200 x .70 = 140
100- 25 = 75
140 / 75 = 187

100% - current fat = lean body
WT * Lean Body = LBW
100 - Desired fat = Desired Lean Body
LBW / desired lean body weight = Desired lean body weight

What is the action of the trapezoids muscle in the lifting phase of standing lateral dumbbell raise

Concentric Upward Rotation of scapula

What is the recommended intensity range of aerobic exercise for low risk adults who meet minimal exercise requirements

What is ACSM strength training recommendation for metepausal

10 to 15 reps moderate, vigerous 8 to 10 major muscle groups

What stratagie would you use when helping a friend plan a exercise program during a vacation

Relapse prevention

What muscle is the major agonist for hip abdduction

frequency, intensity, time type, volume, pattern, progression

Ipsolateral is what compared to unilaterial

ipsolaterial is same side unilaterial is oneside

Pectoral major/ posterior delts

Shoulder adduction and abduction in the horizonal plane

Gluteus maxamus / Iliopsoas

Hip extention and hip flexion

Gastrocnemius / Tibialis

planter flexion (Extention) / dorsiflexion Flexion)

Gluetus medius and abbductors hip abduction
glutus maximus and hamstrings extention and hyperextention
Iliopsoas = Flexion
Rectus Femoris = Flexion

What is essential to social cognitive theory

Self efficancy and outcome expectations

Reassessment guideline

4 weeks flexability
8 week strength
12 weeks cardio
16 weeks body comp

8 to 12 power /strength
10 to 15 middle aged older starting out
15 to 25 for endurance

Variable expenses for a clinical exercise rehabilitation program

-ECG paper and electrodes
-Heat and air conditioning
-Marketing

A clinical exercise rehabilitation program's mission statement

-Is clear and understanding
-States the objectives of the organization or program
-Should be compatible with the parent organization's mission statement

A program's policy and procedures manual

-Is to be revised as the program's policies or procedures are modified
-Should be viewed as a document in progress
-Should contain program information ranging from the organizational structure to the facility's maintenance schedule

Why is a comprehensive patient care plan necessary to provide effective program maintenance?

It provides a guide for individualized care and evaluation of care

Risk stratification

-Can be modeled after AACVPR published criteria
-Is useful for participant entry criteria, exercise testing guidelines, ECG monitoring, and supervision guidelines
-Can be tied to insurance reimbursement

Statements regarding confidentiality

-All records must be kept by the program director/manager under lock and key
-Data must be available to all individuals who need to see it
-Sensitive information (e.g., participant's name) needs to be protected

Reporting an injury

-A process and form should be developed
-The process to be used and the accompanying forms must be part of the Policy and Procedure manual
-Injury reporting forms must be kept under lock and key, just as are data records

A personal trainer fails to spot a client performing heavy incline dumbbell presses and the client injures himself when the dumbbell is dropped on his face. What is the appropriate type of negligence displayed in this scenario?

An emergency plan for a clinical exercise program includes

-Telephone numbers needed to activate the emergency response system should be posted clearly on all phones
-All personnel involved in exercise supervision should be trained in CPR
-Emergency drills should be carried out on a quarterly basis and documented

What represents a fixed expense?

Continuous quality improvement (CQI) is a systematic process of program evaluation that involves

Data analysis, goals assessment, outcomes assessment

Outcome assessment

-Data that are subjective or anecdotal in nature can be used in the assessment
-Periodic progress reports are valuable and should stimulate the need to collect objective data to support any subjective findings
-Standardized tools should be used for outcome assessment

According to the AACVPR, what would be included as an element for successful adult education?

goal setting, rewards, contracts

A needs assessment

-Is a useful tool for gathering data and support for program implementation
-Often must be a creative tool developed in-house to meet the program's specific needs
-Given that the needs assessment may be developed in-house without the benefit of external validity, generalizing the results may be difficult

What is part of a comprehensive clinical exercise rehabilitation program?

The program adapts to changes in medical therapy based on clinical and scientific evaluation

Do fitness specialists need management skills?

Yes, because as instructors, they manage client programs and manage the floor with the clients

Why would a fitness facility or rehabilitation program be interested in public relations?

To increase exposure for the facility and sell its services

In what way would tort laws affect a fitness specialist or clinical exercise physiologist?

Negligence is breaking a tort law and can ruin an instructor's career

What represents the best method for an administrator to educate the fitness staff?

Joining fitness organizations and subscribing to fitness journals

What best represents the ideal manager involvement when developing fitness programs?

The manager should be active as a program developer as well as a resource, supporter, and critic for programs developed by other staff

What is the reason for designing a budget?

To determine program viability

What best describes the rules and regulations of a facility?

Policies and procedures

What best describes a request by a fitness professional for physician's clearance?

It provides a medical opinion regarding the safety of the client to exercise

Other than scheduling and implementing the policies and procedures, what best represents a duty of the supervisor of a fitness facility?

Maintaining emergency procedures and evaluations

What is the primary reason why a manager or director should conduct a needs assessment?

To determine the specific needs and interests of the target market

Why are policies and procedures important in a fitness center?

They are general guidelines for operating a fitness program or department

What are some of the common sales "rules" in promoting a fitness program?

Honesty and an understanding of the needs of the potential members important

Program description, resource availability, and client interest are examples of

Management factors

What is created or reduced by effective program administration and management?

Create successful programs and reduce problems

Why are incident reports important?

They document and give details of any incident or problem that occurs

Why are records valuable to a fitness program?

They help in evaluation of a program

What is an example of a program record?

Client progress and outcomes

Facility fitness newsletter, fitness library, and bulletin boards

Can be utilized for client and staff education

law and the legal system

The HFS must be knowledgeable about the basic concepts of ? and the ? system.

The HFS need to understand the various divisions of the law, and especially the division of _______, where tortuous and contract claims are areas withing which teh HFS is most likely to become legally embroiled.

The anatomy of a _______ should be understood such that the HFS can navigate the sequence of legal proceedings and requirements to successfully support or defend a neglibence claim or contract violation.

one's failure to act or one's substandard performance

How many elements of a negligence claim are there?

five-stages
STEPS

There exist a myriad of setting to be consicdered when determining one's suceptibility to a neglibence lawsuit, and these areas of vulnerability can primarily be found within the ____stages of the instructor-client relationship called ________.

Screening
Testing
Evaluation
Programming
Supervision

What are the STEPS to avoiding legal liability?

1) Constitutional Law
2) Statutory Law
3) Case Law
4) Administrative Law

4 categories that the primary sources of law can be divided into:
1)
2)
3)
4)

Good Samaritan Law

What is the immunity granted to those persons who in good faith try to protect, serve, and tend to others who are injured or ill called?

The Good Samaritan Law _______ apply to the HFS while on the job.

The federal government and all states have ________ that not only provide the authority for government, but also define hot it will function and what its responsibilities are.

Statutory Laws (Legislative Law)

enacted by mandates from federal, state, and municiple government, and this codification of law imposes duties or restrictions upon individuals

Case Law (common law)

basedon decisions of courts and adminisrative tribunals

founded on unwritten law (not codified) and is based on customs and general usages

based on reported judicial decison of selected lower and appellate courts

Administrative Law

found within specialized bodies or agencies that hve been granted law-making power to regulate specific activities

primary sources of law

official bodies with the authority to make laws that can affect the legal rights of citizens

criminal law and civil law

Our system of jurisprudence is subdivided into 2 domains of ? and ?, both of which dispose the citizenry to act in a way that benefits society.

governs the conduct of both individuals and groups toward society as a whole.
The HFS is less likely to violate this type of law

pertains to personal responsibilities that an individual or a group must observe when dealing with other individuals or groups

misdemeanors or felonies

When individuals or grops violate criminal laws, they're subject to the penalties for _______s and _________s , including fines, imprisonment, or both.

When individuals or groups violate ______ law, they're suject to the jurisprudence of civil courts that adjudicate noncriminal cases.

_____ lawsuits handle disputes between individuals, organizations, businesses, and governmental agencies wherein two parties, the plantiff (eg: the injured party or representative of an injured or deceased individual) and the defendant(eg: the HFS and/or thefacility that they represent) present their cases for litigation

criminal law
civil law

________ law requires that a prosecutor provide proof beyond a reasonable doubt to find the defendant guilty, but ______ law only requires that the plaintiff demonstrate that the preponderance of teh evidence supports his or her claim to find teh defendant liable

tort law or contract law

When considering lawsuits against instructor personnel adn fitness facilities, the plurality of such cases falls within the domain of civil law. The typical civil law violation falls under the categories of either ? or ? law.

a breach of legal duty amounting to a civil wrong or injury for which a court of law will provide compensation/damages.
Therefore, ____ law governs the legal rights and obligations between idividuals as well as betweeen collective bodies in relationsihp to inuries, deaths, or civil wrongdoings

a wrongful act, whether intentional or accidental, from which an insult, injury, or death occurs to another person or perhaps an organization that sustains pecuniary damage

individual or group that 's injured or sustains pecuniary damage

defendant (tortfeasor)

individual or group responsible for the tortuous act

*informational:
When an injury, death, or wrong is documented and attributed to the defendant, a remedy, usually in the form of a financial judgment , is then levied agaist the defenant. This levy, applied by teh civil courts, provides relief to the plaintiff.

T/F: A tort doesn't include a breach of contract that can also lead to adjudication and compensation in the form of monetary damages.

negligence
"no fault"

Torts do include all ________ cases as well as intentional wrongdoings that result in injury or death. There also exists a tort due to "______" conduct.

1) intentional misconduct
2) negligent conduct
3) "no fault" conduct

3 categories of tortuous acts

conduct that falls under the category of Strict Liability and relates to ultrahazardous activities andproduct liability

intentional tort

indicative of an act that willfully caused an injury, a death, a financial distress, or a damaged reputation

T/F: Since it's extremely difficult to document an intentional tort, courts typically give the benefit of the doubt to the defendant and presume that the tort is one of negligence.

a majority of lawsutis filed against fitness facilities and/or fitness instructors are suits allegging what?

negligence and standard of care

The definitions of "?" and "?" are similar in that they both are concerned with prudence and caution in dealing with clients

Standard of Care

refers to the application of a degree of prudence and caution required by an individual or organization that owes a duty of care

Standard of Care

the degree of care that a reasonably prudent fitness instructor or reasonably prudent facility management would utilize under similar circumstances.

1) a legal duty must be established
2) a breach of that legal duty
3) the breach of duty owed was the factual or proximate cause of the injury or death
4) the negligent act or failure to act resulted in well-documeted damages or losses to the plaintiff

For the plaintiff to prosecure a successful tort claim, what 4 basic elements of negligence must be well documented?
1) a _______ must be established
2) a _____ of that legal duty
3) the breach of duty owed was the _____ or _________cause of the injury or death
4) the negligent act or failure to act resulted in well-documented ________ or ______ to the plaintiff

3 major risk management strategies the HFS can use to lessen the chances of becoming embroiled in legal liability with a negligence tort

1) The HFS must adhere to the standard of care in the screening process, fitness profiling, evaluation, programming, and supervison of clients.
2) the HFS must use wiavers and assumption of risk forms in varried venues of the client-instructor relationship
3) the HFS must ensure that they have purchased appropriate liability insurance for the activites in which their client is engaged

The prudent and cautious HFS is unlikely to be faced with litigation because of their commitment to providing safe and effective practices. This is the ___ line of defense in risk management.

Waivers adn assumption of risk forms provide a _______ line of defense in risk management and must be understood in light of their implementations and limitations

informed consent, agreement to participate, and prospective waivers or releases

3 most common types of protective legal documents

1) Inherent
2) Negligence
3) Extreme forms of negligence

3 major causes of injury or death associated with physical activity

one of the major causes of injury or death associated with physical activity;
inuries due to accidents that are not preventable and are no one's fault

one of the major causes of injury or death associated with physical activity;
Injuries due to the fault of the defendant (sometimes the plaintiff)

Extreme forms of negligence

one of the major causes of injury or death associated with physical activity;
injuries due to the gross neglibence, willful and wonton, or reckless conduct of the defendent.

informed consent or agreement form

Utilized prior to fitness testing or exercise programming and participation.
What document provides the best type of legal protection by strengthening what is termed an assumption of risk defense?;

prospective waiver or release

When lawsuits are filed due to negligence on the part of the instructor, what type of document provides the best legal protection to thwart potential liability?.
Within this document is an "exculpatory" clause

"exculpatory" clause

Withing teh prospective waiver, there exists and "______" clause explicitly stating that the instructor is released from laibility due to any negligence.

T/F: Early stage progressive loading of tissue is imporatnat for collagen fiber aligment and muscle fiber hypertrophy, whereas later stage exercise should transition to activity-specific to prepare for return to activity

1. Warm up 5-7mins prior to vigorous exercise using large muscle groups activities
2. Stretch tight muscles after the general warm-up, holding each stretch for 15-30 sec
3. Balance regular physical activities /sports with resistance training
4. If possible, avoid exercise/sports when fatigued

4 preventative strategies to reduce strains and sprains

T/F: There's considerable evidence that supports the use of appropriatedly graded eccentric exercise as a safe and effective means of strengthening the MTU across the affected joint

"sustain talk"
"change talk"

With MI, as individuals discuss their ambivalence about behavior change, they typically produce what 2 types of talk regarding their behavior?

refers to talking about the costs of changing and the benefits of not changing;
Used as a way for the client to not feel obligated to adopt any change

refers to talk about the benefits of changing a clients behavior and the costs of not changing

change talk
open-ended questions

The goal of MI intervention is to generate ______ talk, as this indicates the client having moved to a point of readiness to adopt change.
This is accomplished by asking ___-___ questions, making summaries, and skillfully using reflective listening to express empathy and direct the conversation toward more change talk

T/F: In MI, first it's important to make observations, not evaluations. Second, is the ability to express feelings, not thoughts. Third, is to identify needs, not strategies. Lastly, making requests, not demands.

a term used to describe the process of visualizing once self engaging in a specific behavior or set of behaviors en route to achieving a desired outcome

May increase self-efficacy, help individuals identify and address potential barriers to achieving specific goals or behaviors, and also increases the likelihood that they will successfully perform specific behaviors

used to improve muscle memory for specific physical tasks that involve intricate movements or fine motor skills

imagery; (mental rehearsal or mental practice)

this process has been used to enhance physical rehabilitation after injury or trauma, such as in stroke patients.
Evidence suggests that this process (also known at ______ or _____) may strengthen cortical connections I the brain that are involved in the actual physical performance of the target task

"mind's eye"
internal or external perspective

Imagery usually entails visualizing in your "_____" a scene associate with a goal or plan and can be completed from an ? and ? perspective

perspective in which individuals imagine a scene in which they're inside their own body and thus experience it as they would in real life;
The person is going through the motions, seeing the environment form an internal perspective, and enacting or rehearsing the scene.

perspective in which individuals imagine a scene in which they are outside of their own body and thus experience it as an observer or audience might;
They are watching themselves in an out of body type experience.

T/F:internal and external imagery can be equally effective

overcoming barriers

Imagery could be helpful for ____________ that deter regular exercise participation.
Imagery can address these barriers by helping individuals anticipate and overcome these barriers by visualizing themselves overcoming the barriers prior to the barrier occurring, thus increasing their confidence that they can overcome the barrier if it should occur.

Exercise Imagery Questionaire (EIQ)

questionnaire that's guided more of the research in exercise imagery to date;
Yields 3 types/functions of exercise imagery, including energy, appearance, and technique

energy appearance, and technique

The Exercise Imagery Questionnaire (EIQ) yields what 3 types/functions of exercise imagery?
1)
2)
3)

includes mental images related to becoming more energized ore relieving stress

Appearance Imagery

involves images associated with a leaner, fitter, and healthier appearance

Technique Imagery

includes imagery related to the execution of proper body positioning and form while exercising

Appearance Imagery

most frequency used type of imagery among older adults and young adults

Maintaining behavior change over time may be _______________ that initial health behavior change, because it requires a lifelong commitment to change.

Often used as the barometer for the "maintenance phase" of behavior change, when the goal shifts from initiating to maintaining behavior change.

Relapse Prevention

an ongoing process in which efforts are made to prevent a return to former, undesirable behaviors after a period of abstinence;
the ___________'s goal is to prevent an individual from returning to an inactive lifestyle after establishing a regular exercise routine

regular check-ins

___________ with a practitioner, friend, group, or another trusted confidante are often incorporated into the relapse prevention process. *often the same techniques used in the initial behavior change process are used to a lesser degree in relapse prevention

self-regulation and anticipation
self-monitoring

Relapse prevention focuses largely on ? and ?;
Long-term exercise maintenance only involve "booster sessions" reviewing exercise adherence and may rely more on the client's own ______________.

The initial behavior change process relies heavily on the ________ between the HFS and clients.

a simple but crucial component of the relapse prevention model

T/F: The individual should be prepared to follow a specific plan of how to deal with decreasing exercise levels if a relapse occurs.

Although relapses are often spontaneous or unforeseeable, they typically result from a series of events that could've been _______ if more caution was used

community resources

Incorporating ______ resources to maintain exercise may be a helpful step in the relapse prevention stage

involves at least 2 parties: sender and receiver. The sender coveys the message and the receiver interprets and responds to it (at which point the sender and receiver roles reverse)

Effective ______ is vital in the behavior change process.

verbal communication

comprises words the speaker says aloud

includes messages that are conveyed in several ways, including hand gestures, eye contact, and posture. Often more effective than verbal communication;
Convey emotions, level of engagement and other internal processes

what is just as important at speaking in the communication process?

inspires and motivates

To facilitate behavior change, the HFS strives to convey messages in a manner that ideally ? and ? their client.

T/F: Other important components of cummnicion that facilitate exercise include conveying messages to clients and demonstrating to them that they'll be accepted regardless of their success or failure in their attempt to increase their exercise;
Clients also need to feel adequately challenged.

TRUE/FALSE: While exercise is certainly a form of PA, PA does not always include exercise.

True/False: individuals should participate in several familiarization/practice sessions before testing and adhere to a specific protocol to botain a reliabel fitness score that can be used to track fitness chagnes over time

Large amplitude dynamic movements (dynamic stretching) and test-specific activities should precede muscular fitness testing

Platlet inhibitors

aspirin, warfarin (Coumadin), clopidogrel (Plavix)

increase the anginal threshold by reducing myocardial oxygen demand at rest and during exercise; occurs through chronotropic (dec. HR) and inotropic (dec. contraction) responses

Thrombolytic therapy

administration of streptokinase or t-PA within 1-2 hours post MI

Current state of knowledge on progression/regression of atherosclerosis

regression has been observed in clinical studies, progression begins at birth

True/False:
individuals who do monderate- or vigorous-intenisty aerobic physical activity have significantly lower risk of CVD than inactive people.
A dose-response relationships exists between aerobic fitness and health outcomes

True/False:
the principle role of the HFS is to provide the development and maintenance of CRF to clientele;
The HFS needs a firm science foundation in the physiology of the CV and pulmonary systems

overload principle

the foundation of all exercise prescription;
To improve CRF, the individual must exercise at a level greater than accustomed to induce adaptation

principle of reversibilty

opposite of the overload principle;
"use it or lose it" principle;
dicates that once cardiorespiratory training is decreased or stopped for a significant period, previous improvement swill reverse and decrease, and the body will readjust to the demands of the reduced physiological stimuli

principle of individual differences

states that all individuals will not respond similarly to a given training stimulus

specificity principle

states that specific exercise elicits specific adaptations, creating specific training effects;
dependent on the type and mode of exercise;
also known as the SAID principle (specific adaptations to imposed demands)

True/False: when designing an exercise program to develop CFR, the type of exercise genereally prescribed to improve health and fitness is rhythimc and continous and used large muscle groups

1) Type A
2) Type B
3) Type C
4) Type D

4 categories of cardiovascular endurance exercises
1) ______: endurance exercised requiring minimal skill or physical fitness to perform (ie: walking or water aerobics)
2) ______: vigorous-intensity endurance exercises requiring minimal skill (ie: runing or spinning)
3) ______: endurance activites requiring skill to perform (ie: cross-country skiing or in-line skating)
4) ______:recreational sports (ie: tennis or basketball)

Accepted as the criterion measure for CRF

maximal o2 uptake

Why is vo2 normally defined as relative rather than absolute?

to allow for meaningful comparisons between differing body weight

vo2 is the product of....

maxiaml Q & arterial venious difference

cardiac output can be described using -

What will happen if the submaximal test chosen is too aggresive?

Handrails will often be utilized
VO2 will be overestimated

When is submaximal testing most accurate?

steady state hr is obtained
linear relationship between hr and work rate is seen
Diff b/w actual and predicted maximal HR is minimal
Mechanical efficiency is the same for everyone

Field tests inclue:

walking, running, cycing a predetermined amount of time or distance

Advantage of field tests

They are easy to administer to a large group quickly with little equipment

Disadvantage of field tests

May not be appropriate intensity for everyone
Person may not know how to pace self
Bp and Hr not monitered during entire test

6 MIN walk test is used for what populations

sedentary older adults or clinical pt populations

rate perceived product (RPP) equation

6 min walk test equation

VO2 = .2 x (M) distance - age - (.7 x kg) + (.09 x height (cm)) + (.26 x RPP [X 10 ^-3]) + 2.45

coefficient of determination

standard error of estimate

What is the astrand ryhming cycling ergometere test

a single stage test lasting 6 minutes demonstrating on average 50% of the maximal hr. dependent on age and gender. 125-170 bpm hr being measured during the fifth and sixth minute

What is a reason for error in a submaximal test formula?

the maximal hear rate formula, 220 - age has a standard deviation of +/- 12 bpm to only provide an estimate of hr max

What is a common error in cycling submaximal tests

if a person has an eradic cadence. These tests are designed to extrapolate steady state exercise

astrand and ryhming step test

men - 40 cm and women 33 cm at 22. 5 steps per minute requireinv a vo2 of b/w 25.8 to 29.5

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