HNES 472 Midterm

Physical activity is defined as

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

Which is considered a “useful, convenient, and standardized method” for quantifying absolute intensity of different physical activities?

Metabolic equivalents (METs)

Which is the most accurate definition of “light” activity based on MET values?

1.6–2.9 METs

According to the 2018 Physical Activity Guidelines Advisory Committee Scientific Report,

Exercise bouts of <10 min in duration are associated with favorable outcomes for a variety of health-related indicators.

Which is the most correct definition of sedentary behavior?

Any behavior resulting in an energy expenditure of ≤1.5 METs while in a sitting, reclining, or lying posture

Benefits attributed to resistance training may include all except

• improved management of Type 2 diabetes.

• improved blood lipids for those who are overweight.

• improved body composition.

The most common exercise-related complication is

musculoskeletal injury (MSI).

There is strong evidence today for an inverse dose-response relationship between physical activity and

all-cause mortality.

According to the cited literature, what percentage of U.S. adults self-report meeting both the aerobic and muscle strengthening activity guidelines?

20.5%

Which of the following is true regarding physical inactivity?

• It is a global pandemic.

• It has been identified as one of the four leading contributors to premature mortality.

• It affects 31.1% of adults worldwide.

An intervention designed to prevent an initial occurrence of a disease is known as

primary prevention.

True or False? A sedentary 35-year-old female with controlled Type 2 diabetes mellitus and no signs or symptoms should get medical clearance prior to starting a moderate-intensity exercise program.

True

Which of the following diseases is not considered during the exercise preparticipation health screening process?

Pulmonary disease

Which CVD factor is considered “negative,” meaning that it takes away from risk?

Elevated HDL cholesterol

Exercise professionals should have a thorough knowledge of factors and criteria for conducting an appropriate exercise preparticipation health screening. However, one area that is outside the scope of expectation for these professionals is

the pathologic sequencing of the disease.

Dyspnea can be defined as

abnormally labored breathing.

Which of the following is an example of a self-guided screening for physical activity?

PAR-Q+

How many risk factors does Todd have?

Todd is 33 years old; he quit smoking 8 months ago. He is 72 inches tall and weights 80 kg and currently rides his bike to work 20 minutes a day five days a week. His mother died of a heart attack at 59 years of age and father died of cancer at 62 years of age. BP = 118/76 mm HG, Total Serum Cholesterol = 202 mg dL, HDL = 62 mg dL, LDL = 90 mg dL, FBG = 76 mm dL.

One 

Which relative is not part of “family history” as it relates to CVD risk?

biological grandparents 

An individual who participates in regular vigorous intensity aerobic exercise feels discomfort in their chest and neck. That individual should

discontinue exercise and seek medical clearance.

According to the blood pressure guidelines from both the ACC/AHA (2017) and the JNC7 (2003), which statement is most true regarding “normal” blood pressure?

Any systolic blood pressure reading <120 mm Hg is considered normal.

Which is considered a CVD risk factor for BMI or waist circumference (WC)?

WC >38 in for women

True or False? An individual who has Type 2 diabetes and does not participate in regular exercise does not need medical clearance prior to engaging in moderate intensity aerobic exercise.

False

Medical clearance is defined as

approval from a health care professional to engage in exercise.

For men, at which age does age itself become a risk factor for CVD?

45

Low levels of cardiorespiratory fitness result in an increased risk of premature death more than any other risk factor. 

True

According to the report discussed in class, what was the leading cause of death in the United States in 2024?

Heart Disease

Which of the following is the second leading attributable fraction for all-cause death in Men and Women, behind Low Levels of Cardiorespiratory fitness?

Hypertension

Which RPE scale most commonly uses values of 6–20?

Borg scale

Which of the following is not a general indication to stop an exercise test?

Steady increase in systolic BP

What domain of exercise produces a stead-state in VO2 after 2-3 minutes of O2 deficit? 

Moderate

Extrinsic factors that can influence VO2max include which of the following? Choose all that apply. 

• Time of Day 

• Sleep 

• Nutritional Status 

• Humidity 

• Training Status 

Several regression equations exist for estimating CRF; however, these should only be used

when an exercise test cannot be performed.

You had a participant complete a VO2max test in your lab. They had an absolute VO2max of 4.52 L/min. What was their relative VO2max if their body mass is 80 kg?

56.5 ml/kg/min

Volitional fatigue is required of which type of test?

Any maximal test of CR fitness

What equation do we use to calculate VO2? 

Fick Equation

Which is not an assumption used when estimating maximal oxygen consumption (VO_2max) from the heart rate response to submaximal exercise?

A nonlinear relationship exists between heart rate and work rate.

Air in the environment contains ____ % oxygen. 

21

With cardiorespiratory fitness, expect VO_2max to decline about 10-15% per decade after adulthood. Some mechanisms could include any of the following, except:

more efficient oxygen extraction

What two parameters contribute directly to cardiac output (Q)? 

Heart Rate and Stroke Volume 

Which of the following is a single-stage submaximal test that yields an estimate of VO2max exclusively?  

Åstrand-Ryhming cycle ergometer test

Which statement describes the Ebbeling single-stage treadmill walking test?  

After a 4-minute warm-up (aiming for 50-70% of APHRM), the client walks briskly for 4 minutes at 5% grade, and steady-state HR is recorded between minutes 3 and 4.

Which statement about estimating maximal heart rate is most accurate?  

220 − age has a large error (about 7-11 bpm) and was not based on original research, and the Tanaka equation (208 − 0.7 × age) is generally preferred.

During the Ebbeling single-stage treadmill walking test, the warm-up period should elicit a heart rate that reaches what percentage of the subject's age-predicted maximal HR?

50%-70%

Estimating VO2max from the heart rate response to submaximal exercise depends on several assumptions. Which of the following is NOT one of those assumptions?  

Mechanical efficiency is the same for everyone.

Which of the following is a primary reason submaximal exercise testing is often chosen over maximal testing in health/fitness settings?  

It carries a lower risk, needs less specialized equipment, and can be administered by a trained technician to many people quickly.

Which statement about the Bruce submaximal treadmill protocol is correct?  

It uses the same 3-minute stages as the maximal Bruce test and is terminated when two stages have an HR between 110 bpm and 85% of age-predicted maximal HR.

Åstrand-Ryhming cycle test (calculation). A 50-year-old man who weighs 90 kg completes the test. The nomogram gives an uncorrected VO2max of 3.6 L/min. The age correction factor for a 50-year-old is 0.75. What is his age-corrected VO2max expressed in relative terms (ml/kg/min)? Round to the nearest tenth.  

30 ± 0.1

A 68-year-old client with COPD needs a field test to assess cardiorespiratory fitness. Which test is most appropriate, and what is the goal of the test?  

6-minute walk test; cover the greatest distance possible in 6 minutes

Queens College step test (calculation). A woman completes the 3-minute Queens College step test and her post-exercise heart rate is 160 bpm. For women, VO2max (ml/kg/min) = 65.81 − (0.1847 × HR). What is her estimated VO2max? Round to the nearest tenth.  

36.3

The rating of perceived exertion scale allows a subject to

Subjectively express his or her exertion during the test

Which description matches the Åstrand-Ryhming cycle ergometer test?  

A 6-minute single-stage test at 50 rpm in which HR is recorded every minute and the average of minutes 5 and 6 is used, with a goal HR between 125 and 170 bpm.

Your new patient is 34 years old. Which of the following is their correct predicted HRmax? Remember to use Tanaka [208- (0.7x Age)]. 

184

Which of the following testing modalities are relatively inexpensive, easily transportable, and allows blood pressure and the electrocardiogram to be measured easily?

Mechanically braked cycle ergometers

Which of the following is false regarding the components of health-related physical fitness?

They can predict high levels of athletic performance.

Which of the following is a purpose of health-related fitness testing?

Educating individuals about their present health-related fitness status relative to health-related standards and age- and sex-matched norms

The information obtained from health-related physical fitness testing, in combination with the individual’s health and medical information, is used by the health and fitness professional to

enable an individual to achieve specific health/fitness goals.

An ideal health-related physical fitness test is

valid and reliable.

A minimal recommendation for pretest instructions is the completion of

the Physical Activity Readiness Questionnaire for Everyone.

It is well established that excess body fat, particularly when located _______________, is associated with hypertension, the metabolic syndrome, Type 2 diabetes, stroke, cardiovascular disease, and dyslipidemia.

centrally around the abdomen

Approximately what percentage of American adults are classified as overweight or obese?

70% and 37%, respectively

Android obesity is characterized by

more fat on the trunk (abdominal fat).

Which of the following best describes the waist-to-hip ratio?

Circumference of the waist divided by the circumference of the hips

Which of the following would not cause potential error when assessing blood pressure?

Using a cuff that encircles at least 80% of the upper arm

Which of the following blood pressure assessments would be considered stage 1 hypertension?

136/84 mm Hg

Which of the following in not a way to measure heart rate?

spirometer 

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 muscle to exert force

Muscular endurance:

the ability of muscle to continue to perform without fatigue

Flexibility:

the range of motion available at a joint

Agility:

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

Coordination:

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

Balance:

the maintenance of equilibrium while stationary or moving

Power:

the ability or rate at which one can perform work

Reaction time:

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

Speed:

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

Physical activity

is defined as any bodily movement produced by the contraction of skeletal muscles that results in an increase in caloric requirements over resting energy expenditure

Exercise

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

Physical fitness

described as a set of attributes or characteristics individuals have or achieve that relate to their ability to perform PA and activities of daily living

MET

are a practical, convenient, and standardized method for quantifying the intensity of various behaviors and activities

one Met equivalent

~3.5 mL · kg−1 · min−1

Light intensity MET

1.6-2.9

Moderate

3-5.9

Vigorous

>6 METS

PA Reccomendations

• All healthy adults, 18–65 years should participate in moderate-intensity aerobic PA for a minimum of 30 minutes on 5 daywk or vigorous-intensity aerobic activity for a minimum of 20 minutes on 3 day/wk

• Resistance train 2 days/week

• Moderate-intensity can be accumulated by performing bouts ≥10 minutes.

• For substantial health benefits, adults should do at least 150–300 min · wk−1 of moderate-intensity or 75–150 min · wk−1 of vigorous-intensity aerobic physical activity, or an equivalent combination

Dose response curve

• Non linear curve

• steep drop in completely sedentary individuals

How does regular physical activity improve cardiovascular and respiratory function?

• ↑ Maximal oxygen uptake (VO₂ max) through central and peripheral adaptations

• ↓ Minute ventilation at the same submaximal intensity

• ↓ Myocardial oxygen cost at the same submaximal intensity

• ↓ Heart rate and blood pressure at the same submaximal intensity

• ↑ Capillary density in skeletal muscle

• ↑ Threshold for blood lactate accumulation

• ↑ Threshold before disease signs or symptoms occur (e.g., angina, ischemic ST depression, claudication)

How does regular physical activity reduce cardiovascular disease risk factors?

• ↓ Resting systolic and diastolic blood pressure

• ↑ HDL cholesterol and ↓ triglycerides

• ↓ Total body fat and intra-abdominal fat

• ↓ Insulin needs and ↑ glucose tolerance

• ↓ Blood platelet adhesiveness and aggregation

• ↓ Inflammation

How does regular physical activity decrease morbidity and mortality through primary and secondary prevention?

- Primary prevention (preventing the initial occurrence):

• Higher activity/fitness levels are associated with ↓ death rates from coronary artery disease (CAD).

• ↓ Incidence of cardiovascular disease (CVD), CAD, stroke, type 2 diabetes, metabolic syndrome, osteoporotic fractures, cancers of the bladder, breast, colon, endometrium, and lung, and gallbladder disease.

- Secondary prevention (preventing another event after a cardiac event):

• Exercise-based cardiac rehabilitation after a myocardial infarction (MI) reduces cardiovascular and all-cause mortality, especially when combined with other risk-factor reduction strategies.

What are the other benefits of regular physical activity and exercise?

• ↓ Anxiety and depression

• ↑ Cognitive function

• ↑ Physical function and independent living in older adults

• ↑ Well-being and quality of life

• ↑ Sleep quality and efficiency

• ↑ Work, recreational, and sports performance

• ↓ Risk of falls and fall-related injuries in older adults

• Prevents or reduces functional limitations in older adults

• Effective therapy for many chronic diseases in older adults

What chest pain suggests myocardial ischemia?

Squeezing burning or heaviness triggered by exercise or stress and may spread to arms jaw neck or back

When is dyspnea abnormal?

At rest or with mild exertion and may indicate heart or lung disease

What is syncope and why is it concerning?

Loss of consciousness from reduced brain blood flow and may indicate serious heart disease during exercise

What are orthopnea and PND?

Orthopnea is shortness of breath lying flat; PND is waking from sleep short of breath; both may indicate left ventricular dysfunction

What can ankle edema indicate?

Both ankles may indicate heart failure or venous insufficiency; one limb may indicate a blood clot or lymphatic blockage

What are palpitations and what causes them?

Awareness of a rapid or forceful heartbeat caused by abnormal rhythms anxiety or illness

What is intermittent claudication?

Leg pain or cramping during exercise from poor blood flow that improves within 1–2 minutes of rest

Why is a heart murmur important before exercise?

It may indicate heart disease especially aortic stenosis or hypertrophic cardiomyopathy

What can unusual fatigue during normal activities indicate?

Possible onset or worsening of cardiovascular or metabolic disease