Fitness Assessment Exam 1

Physical Inactivity Risk

Risk from smoking + Obesity combined

Whats the difference between exercise and physical activity?

Exercise is planned physical activity is not

How much of the population meet both aerobic AND strength guidelines

50% meet one or the other

20% meet both

What does regular physical activity guard against

Non Communicable Diseases (NCD’s)

What do inactive children tend to become?

Inactive adults

Dose-response relationship

Dose = volume of activity

Response = health benefits

Dose response relationship contd.

Some is better than none and more is better than less

Physical Activity (PA) Reccommendations for Adults

Aerobic Exercise: >150 min/week of mod intensity or >75 min/week of vigorous intensity

Strength training > 2 days/week

PA recommendations for children

Aerobic Exercise: >60 min/day of mod to vigorous intensity

> 3 days/week of vigorous intensity

Exercise Intensity

MET = Metabolic Equivalent

1 MET = energy cost at rest

1 MET =

3.5 mL/kg/min

Exercise intensity levels using METS

Light: < 3 METS

Moderate: 3-6 METS

Vigorous: > 6 METS

Examples of Mod intensity exercise

Brisk Walk (3 mph)

Water Aerobics

Slow Bicycling (< 10 mph)

Ballroom Dancing

General Gardening

Examples of Vigorous Intensity

Jogging or Running

Lap Swimming

Bicycling ( >10 mph)

Aerobic Dancing

Backpacking

Why do we need Accreditation

Ensures quality of instruction

Why do we need Certification

Acknowledgment of skill and knowledge

Why do we need Licensure

Credibility of professional

Accreditation

Issued by: independent third pary agency

Awarded to: institutions and academic programs

Certification

Issued by: professional organization

Awarded to: individual

Degree

Issued by: academic institution

Awarded to: an individual

Licensure

Issued by: State government

Awarded to: Individual

Why do we do Preliminary Health Screenings?

Determines client readiness for exercise

Detects presence of or suggestion of disease

Assess likelihood of unexpected cardiovascular event related to exercise

Protect yourself from litigation

ACSM guidelines for medical clearance (KNOW THIS)

Does the client exercise? If they say “yes” a client must perform

PLANNED physical activity

At least moderate intensity (>3 METs)

At least 30 minutes for at least 3 days/week

Does the client have known diseases

Cardiovascular: Heart Disease, Peripheral Vascular Disease, Cerebrovascular disease

Metabolic: Diabetes Type 1 and 2

Renal: Kidney disease

Signs or symptoms at rest or during exertion of CVD

Discomfort in cheek, jaw, neck, arms, back due to ischemia

Shortness of Breath

Dizziness or Syncope

Orthopnea or Paroxysmal Nocturnal Dyspnea

Edema in Ankles

Heart palpitations or Tachycardia

Intermittent claudication

Known heart murmur

Unusual fatigue

Which clients can start at vigorous intensity for exercise?

Only clients who currently exercise and have no known disease or symptoms

What is considered vigourous exercise

6+ METS

Who usually starts with light to moderate intensity for exercise?

Someone who doesn’t currently exercise

What is the definition of light or moderate intensity

2-5.9 METs

When do you know if someone needs medical clearance to exercise?

Anyone who has a known disease or any signs or symptoms need medical clearance first!

What are the questionares that must be administered

PAR-Q

Informed Consent

Lifestyle Questionnaire

Medical History

Coronary Disease Risk Factors

Determination of Medical Clearance Requirement

What is on a PAR-Q 

Seven yes/no health questions

If answered yes to any of the questions it is followed by a followup question

If a followup question is answered with a yes then professional consultation is needed

What phrase do we always need to state?

You can stop this test at any place at any time for any reason

Are signatures required on an informed consent?

Yes

Informed Consent Describes the following

• Procedures

• Risks

• Benefits

• Confidentiality

• Voluntary participation (this must always happen)

Lifestyle Evaluation Contains

Clients living habits

Daily behavior patterns 

Barriers to physical activity

This helps answer the exercise question for medical clearance

What are the 2 most common barriers to physical activity

Not enough time and Money

Coronary Risk Factors: Modifiable

Cigarette smoking

Hypertension

Diabetes

Dyslipidemia (imbalance in blood lipids can deal with cholestorol)

Obesity

Sedentary lifestyle

Coronary Risk Factors: Unchangeable

Age and Family History

Normal Values for Blood Variables: Tryglycerides

<150 mg*dL-1

Normal Values for Blood Variables: Total Cholesterol

<200 mg*dL-1

Normal Values for Blood Variables: LDL Cholesterol

<100 mg*dL-1

Normal Values for Blood Variables: HDL Cholesterol

>= 40 mg*dL-1

Normal Values for Blood Variables: TC/HDL cholesterol

<3.5

Normal Values for Blood Variables: Blood Glucose

70-110 mg*dL-1

Normal Values for Blood Variables: Hemoglobin

14-18 g*dL -1 (men)

12-16 g*dL-1 (women)

What are some examples of Absolute Contradictions

Acute myocardial infarction (within 2 days) (heart attack)

Ongoing unstable angina (heart doesn’t get enough oxygen)

Uncontrolled cardiac arrhythmias which cause symptoms of hemodynamic compromise (heart cant maintain enough BP or blood flow)

Active endocarditis (infection of inner lining of the heart)

Aortic stenosis (narrowing of the aortic valve)

Decompensated heart failure

Acute pulmonary embolism, pulmonary infarction, deep vein thrombosis

Acute myocarditis: inflammation of the myocardium

Acute pericarditis: inflammation of the pericardium

Acute aortic dissection

Physical disability that precludes safe and adequate testing

If there are any relative contradictions what should you do

Have a doctor check just incase

What are some additional clinical tests

ECG

Echocardiogram

Chest x-ray

Pulmonary function

Comprehensive blood chemistry

How to find max HR

220-age

What are some causes of HR fluctuations

Stressors

Medication

Caffeine

Tome of day

Body position

Meals

Smoking

Drinking

BP medications: Diuretics

Rid the body of excess salts and fluiid

Reduces blood volume

BP medications: Beta Blockers

Reduces HR and cardiac output

Reduces hearts oxygen demand

BP medications: Calcium Channel Blockers

Reduce heart contractility/dilate arteries

Causes relaxation of heart and lower BP

BP medications: Direct Renin Inhibitors

Blocks production of angiotensin ll (raises BP)

Relax blood vessels and reduce BP

BP medications: Potassium Channel Openers

Hyper polarize vascular smooth muscle/endothelial cells

Opening potassium causes relaxation/widening (vasodilation)

BP medications: Sympathetic Nerve Inhibitors

Prevent arteriole constriction

BP medications: Vasodilators

Relax smooth muscle of arterial walls

BP medications: Angiotensin-Converting Enzyme Inhibitors

Disrupt production of angiotension

What is considered Normal BP

Systolic: less than 120

Diastolic: less than 80

What is considered Elevated BP

Systolic: 120-129

Diastolic: less than 80

High BP hypertension (Stage 1)

Systolic: 130-139 or

Diastolic: 80-89

High BP hypertension

Systolic: 140 or higher or

Diastolic: 90 or higher 

Hypertensive Crisis (consult Dr. immediately)

Systolic: higher than 140 or higher

Diastolic: higher than 120

What does the Automated (oscillometric) blood pressure technique prevent

White coat effect (persons BP increases in places like a Dr. office)

FMS certification

Squat with bar test

Helps identify problems with mobility, stability, and movement patterns

What is somethin gyou shouldn’t ever do with FMS certifictation

Don’t add “movement” to “dysfunction”  you will only make the problem worse

What is the “light system” with FMS certification

Green light: can do all exercises

Yellow light: do both green and yellow exercises; caution w/ red

Red light: don’t do red exercises until higher score is achieved; cautious with yellow exercises

The health fitness performance continuum suggests that

Exercise programs should follow progression

What is the first component for exercise

Improved health

What is something important to think of when setting goals with cllients?

That they make realistic goals

What are some areas to set goals in?

Speed

Agility

Power

Vertical Jump

Lactate threshold

Sport specific

What percentage of improvements should occur in untrained clients over 3 months

5-10%

*What are the Basic Principles of Program Design

SPIIDOR pneumonic

Specificity

Progression

Initial values

Interindividual variability

Diminishing returns

Overload

Reversibility

Specificity of training

Def: Training targets specific muscles, movements, and energy systems

Ex: If patient has L Leg injury focus on lower body exercises not upper

Progression

Def: To continue improving, the intensity, duration, or frequency of exercise must gradually increase

Ex: progress a client who starts walking 10 mins to 20-30 mins as their endurance improves

Initial Values

Def: Starting fitness level

Ex: A more sedentary person who starts training might improve their VO2 max quickly while a trained athlete will improve slower

Interindividual Variability

Def: Due to genetic differences, age, sex, health status everyone will respond differently to the same training program

Ex;: two patients do identical strength programs one might double strength fast than the other

Diminishing returns

Def: as fitness increases the rate of improvement slows down

Ex: beginners might quickly gain muscle in first few weeks but after months of training, improvements occur more gradually

Overload

Def: to make physical improvements you must challenge body beyond normal level of activity

Ex: increasing resistance in weight training increases workload

Reversibility

Def: when training stops or load decreases, fitness levels decline

Ex: patient stops pt for a few weeks muscle strength, and ROM will decrease and it sets them back

What are the variables of exercise prescription?

FITTVP

Frequency of exercise

Intensity of exercise

Time of exercise session

Type of exercise session/program

Volume of work done day by day, week by week

Progression: through an exercise program

Physical Fitness Component: Cardio respiritory endurance

Aerobic exercise

Physical Fitness Component: Muscular Strength/Endurance

Resistance training

Physical Fitness Component: Bone strength

Weight bearing/high impact

Physical Fitness Component: Body composition

Aerobic exercise and resistance training

Physical Fitness Component: Flexibility

Stretching exercise

Physical Fitness Component: Balance

Balance training

Stages Of Program Progression

Initial Conditioning, Improvement, and Maintance

Initial conditioning

Lasts 1-6 weeks

Develops basic techniques, habit of exercising

Improvement

Aggressive Pregression toward goal

Lasts 4-8 months

Maintenance

Build on a fitness base

Desn’t mean stop improve rather keep up exercise habits

Add variety and activities of interest to the client

Program Design Concepts

Stabilization (phase 1): stabalizition endurance

Strength (phase 2): Strength endurance

Strength (phase 3): Hypertrophy

Strength (plase 4): Maximal strength

Power (phase 5): power

What does the ACE integrated fitness training model do?

Provides professionals with a systematic and comprehansive approach to exercise programming

What does the Ace IFT model training components and phases help with

Help you be able to know where to start

What are the 4 ACE training phases

Functional movement and resistance training

1. Stability and Mobility 2. Movement 3. Load 4. Performance

What are the 4 ACE training phases for cardiorespiratory training phases

1. Aerobic-base 2. Aerobic efficiency 3. anaerobic-endurance 4. Anaerobic power

What is a result for having weak core muscles

Increase injury for risk

What stage do most clients not progress to

Stage 4