Exercise Assessment and Prescription Midterm

What is physical activity?

Any bodily movement produced by the contraction of skeletal muscle that results in a substantial increase in caloric requirements over resting energy expenditure

What is exercise?

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

What are the differences between physical activity and exercise?

Physical activity is any bodily movement using the muscles while exercise is a type of physical activity that is planned and structured. Physical activity increases caloric requirements while exercise improves or maintains components of physical fitness.

Health- and skill-related components of physical fitness

Cardiorespiratory, coordination, agility, speed, balance, power, muscular strength

What is a MET?

Metabolic equivalent of task, a unit of measurement used to quantify the energy cost and intensity of physical activities

What are the MET levels?

Light = 1.6-2.9 METs

Moderate = 3.0-5.9 METs

Vigorous = ≥ 6.0 METs

What is the difference between MET and VO2?

VO2 is the actual amount of oxygen your body uses and MET is the energy exerted during physical activity as a multiple of your resting metabolic rate

How might a MET change with the intensity of the task or exercise?

The more intense an activity is, the more energy/oxygen is required, so the MET will increase

What are the minimum recommendations of physical activity for healthy adult populations?

≥ 150 min/week moderate or ≥ 75 min/week vigorous exercise

What is the Dose-Response of physical activity?

As activity increases, risk of chronic disease decreases

What are the benefits of regular physical activity/exercise?

Improvements in cardiovascular and respiratory function, reduction in cardiovascular disease risk factors, decreased morbidity and mortality, decreased anxiety and depression, improved cognitive function, enhanced physical function, increased QoL, improved sleep quality, increased risk prevention, and increased muscular fitness

What are the risks of physical activity/exercise?

Increased risk of musculoskeletal, cardiovascular complications (sudden cardiac death or acute myocardial infarction)

What does 1 MET equal?

1 MET = 3.5 mL x kg x min

What are the components of the pre-exercise evaluation?

Informed consent, exercise prescription health screening, health history, and cardiovascular risk factor analysis o

What is the purpose of Informed Consent?

To make sure the client is properly informed of the risks and benefits and knows they can withdraw at any time.

What information is collected/communicated during Informed Consent?

Risks and benefits, research, different types of testing, and exercise prescription

What is collected during the pre-participation health screening?

Current physical activity level, signs and symptoms of any diseases, diagnosed diseases, and what type of exercise program intensity the client is looking for

When is medical clearance recommended?

When someone is experiencing chest pain, dizziness, palpitations, or shortness of breath

What are the components of medical history?

Medical diagnoses and history of medical procedures, physical examination findings, lab findings, history of symptoms, recent illnesses, procedures, or diagnoses, orthopedic problems, medication use, exercise history, work history, and family history

Positive and negative cardiovascular disease risk factors?

Positive risk factors: age, family history, smoking, hypertension, dyslipidemia, pre diabetes, obesity, sedentary lifestyle

Negative risk factors: HDL ≥ 60 mg/dL

What is the criteria for the age risk factor?

Men ≥ 45 years

Women ≥ 55 years

What is the criteria for family history risk factors?

CVD or sudden death

Before 55 years in farther or other male 1st degree

Before 65 years in mother or other female 1st degree

What is the criteria for the cigarette smoking risk factor?

Current smoker or those who quit in the last 6 months or exposure

What is the criteria for physical inactivity for risk factors?

Not meeting 75-150 minutes of moderate-to-vigorous intensity physical activity

30 minutes on 3 or more days per week during the past 3 months

What is the criteria for body mass index/waist circumference for risk factors?

≥ 30 or > 102 cm or 40 in for men, > 88 cm or 38 in for women

What is the criteria for blood pressure for risk factors?

Systolic ≥ 130 mmHg and/or ≥ diastolic 80 mmHg, or if they take antihypertensive medications (beta-blockers, ACE inhibitors, diuretics)

What is the criteria for lipids/cholesterol for risk factors?

LDL-C ≥ 130 mg/dL

HDL < 40 mg/dL for men and < 50 mg/dL for women

Total cholesterol ≥ 200 mg/dL

Or if they are on cholesterol-lowering medication (Statins, niacin)

What is the criteria for blood glucose for risk factors?

Fasting plasma glucose ≥ 100 mg/dL, it is unknown, count it as a risk factor

What is the criteria for HDL-C for the positive risk factor?

≥ 60 mg/dL

What are the purposes of health-related fitness testing?

To collect baseline data and educate individuals on their current health/fitness status relative to age- and sex-based norms. Developing an individualized exercise prescription, measuring short-term and long-term progress, motivation by establishing reasonable and attainable goals.

What are the basic principles and guidelines for pre-test fitness testing?

Ensure consent is printed and ready to read, verbalize informed consent, allow time for questions to be asked, use a PAR-Q+, medical history may be needed.

How should the fitness test be organized?

Documents should be organized in subject’s file, testing equipment should be ready, the room should be between 68-72ºF, humidity should be < 60%, there should be good air flow, emergency action plan should be in place (AED location known and emergency contacts available)

What are the components of a comprehensive health fitness evaluation?

Informed consent, health screening, pre-exercise evaluation, resting measures (BP, RHR, height, and weight), circumference and body composition measurements, measure of CRF, measure of muscular fitness, and measure of flexibility

What are the methods to assess height, weight, circumstance, and body composition? Pros and cons of each

Height - using a stadiometer, no shoes allowed, follow instructions provided

Weight - calibrated balance beam or electronic scale, minimal clothing, no shoes, empty pockets, and sinful of pre-test meals

Circumference - Using flexible but inelastic tape, place on the skin surface without compressing the surface, take duplicate measures on each site

Ideal ranges for BF%

Men: 10-22%

Women: 20-32%

What is VO2max?

Maximal rate at which O2 can be taken up, distributed, and used by the body during physical activity/exercise. Criterion measure of CRF and can be expressed as relative or absolute

What's the difference between relative and absolute VO2max?

Relative VO2max is mL/kg/min, absolute is L/min. It is better to use relative VO2max in all situations

What are some potential sources of error in blood pressure assessment?

Inaccurate sphygmomanometer, improper cuff size, auditory acuity of technician, rate of inflation or deflation of cuff pressure, experience of technician, faulty equipment, improper stethoscope placement or pressure, not having the cuff at heart level, certain physiologic abnormalities, reaction time of technician, background noise, or allowing individuals to hold treadmill handrails or flex elbow

What are the modes of testing for measuring VO2?

Field testing (12 min run/walk, 6 min walk), motor driven treadmill, mechanically breaded cycle ergometers, and step testing

What is the difference between maximal and sub maximal testing?

Maximal lasts 10-18 minutes, requires metabolic analyzers, higher risk, and often requires a physician in the room. Submax can be done in minutes, in mass numbers, uses stop watches/heart rate monitors, and has a lower risk/can be administered by technician.

Why can VO2max be predicted with sub maximal testing?

Heart rate, oxygen uptake, and work intensity share a predictable, linear relationship during aerobic exercise

What are the advantages of single stage vs multiple stage tests?

Single stage: lower risk, safer, more time efficient, minimal equipment and cost, high accessibility and feasibility

Multi-stage: safe, accessible, low cost, lower fatigue, practical design, broader applicability

What are the disadvantages of single stage vs multiple stage tests?

Single stage: Lower accuracy, lack of steady-state data, limited prescription data, external influences on heart rate

Multi-stage: estimated accuracy, vulnerability to external factors, takes more time, more staff required, lack of sport specificity

What are the advantages of field tests?

Minimal equipment required, cost-effective, can do group testing

What are the disadvantages of field tests?

Uncontrolled external variables, reduced accuracy, poor reproducibility, consent challenges

What is a maximal test?

Exercising to the point of volitional fatigue, which may require emergency equipment to be available

What is a submaximal test?

Can be done in single-stage or multi-stage tests, estimating VO2max from simple HR measurements, testing to a range below fatigue

What is a field test?

Conducted outside of a lab to predict CRF by measuring HR response, duration of test, or distance travelled, depending on protocol.

What is a single-stage test?

Yields estimates of VO2max exclusively (Astrand-Rhyming, Rockport Walk Test, or 6-min Walk Test)

What is a multi-stage test?

YMCA cycle ergometer test, Bruce sub maximal test, Chester step test

How do you convert relative VO2 to absolute VO2?

Relative x body mass / 1000

How do you convert absolute VO2 to relative VO2?

Absolute x 1,000 / body weight

What is a high VO2max, what is a low VO2max?

It depends on the age and sex of the person doing the test. A high VO2max is better than having a lower score because you have better oxygen output and CRF.

Why would a high VO2max be a concern?

It could cause reduction of movement and metabolic efficiency, or cause muscle cells to hit thresholds faster than more sustainable, balanced pathways

Why would a low VO2max be a concern?

Reflects poor cardiorespiratory fitness, elevated long-term morality risk, higher risk for heart disease and stroke, poor exercise tolerance and fatigue, underlying medical conditions

How can you use VO2max for an exercise prescription?

Someone with a higher VO2max is most likely consistently physically activity already, so they could have a more intense exercise prescription than someone with a low VO2max, who is most likely not consistently physically active

What are the benefits of improving muscular fitness?

Improves balance, coordination, strength, confidence, proprioception, performance of ADL’s, bone density, mental health, metabolism, blood sugar, injury rehab, and body composition

What are the three components of muscular fitness?

Strength, endurance, and power

What can you measure strength with?

The amount of force someone has, hand-grip strength test (static) or 1-RM and multiple RM tests (dynamic)

What can you measure endurance with?

How long someone can produce energy before fatiguing, repeated muscle contractions, push-up test, YMCA bench test, plank holds, bodyweight squats, etc. Duration oriented tests

What can you measure power with?

How fast someone can produce the force they have, countermovement vertical jump, velocity based training, 4-stair climb power test, sit-to-stand test, and 30-second chair rise test

Which factor of muscular fitness declines at the fastest rate?

Power

What is the equation for power?

Force x velocity

What is the difference between active and passive ROM?

AROM - ROM available from contraction of antagonist muscles

PROM - ROM available from force externally applied (manual resistance), typically greater than AROM

What tools are used to measure ROM?

Goniometer and technology

What are static balance tests?

Stationary time

What are dynamic balance tests?

Maintaining postural control

What is the balance error scoring system (BESS)?

3 20 second trials on 2 different surfaces, eye closed and hands on hips, 3 different stances (standing on 2 feet, standing on non-dominant foot, and standing heel to toe with non-dominant foot back), counts errors (max is 10)

What is the Y-balance test?

Tape on the floor, barefoot on center block, using one leg move the anterior box forward as far as possible, record distance from each direction and repeat 3 times on each leg, measure length

What is the purpose of functional movement screens?

To evaluate fundamental, everyday movement patterns, spot physical imbalances or asymmetries, and identify movement compensations before leading to an injury

What is the Fick equation?

VO2 = Q x (a-VO2 difference)

What is the HRmax (Tanaka) equation?

208 - (0.7 x age)