KIN 321 Exam 1 JMU Kurti-Luden

When, where, and why do we use a Fitness Assessment?

- It is important that what we do/teach is based on research, evidence is needed for a study that it leads to (+) results

- With the rise of social media, be skeptical of sources/biases

- Approved assessment: standardized benchmark backed by science

Average life expectancy in the US

Average is 77 y.o.

Males; 73.2 y.o.

Females; 79.1 y.o.

- Largest gap in life expectancy since 1993

- A lower life expectancy is correlated with increased CV deaths

What are the PA percentages in the US based on 2019 data?

31% of adults are inactive

51% of adults meet aerobic guidelines

30% of adults meet muscle strength guidelines

20.5% of adults meet both guidelines

Physical Activity

Any unplannned/unintentional movement that causes increased energy expenditure above resting levels

Physical Fitness

Intentional movement that is working on a component of physical fitness (5 components)

- Lowers risk of arthrosclerosis (moreover that physical activity) and overall disease risk

Physical Activity and public health 1995 diagram

- Demonstrates significant correlation between increased PA and decreased disease risk (and increased health benefits)

- most benefit is observed when an individual goes from inactive to moderately active; highly active = least magnitude of change

- No overlap in health benefit; more active is better

Health related physical fitness (5) components

Muscular strength, muscular endurance, cardiovascular-respiratory endurance, flexibility and body composition

Assessments used for cardio-respiratory endurance + definition

VO2 measures (gold standard), 12 min run/walk, YMCA test, PACER, step test, etc.

- ability of the systems to supply O2 during sustained PA

Assessments used for muscular strength + definition

1 rep max, grip strength, etc.

- Ability of a muscle to exert force

Assessments used for muscle endurance + definition

Reps to failure push-ups/sit-ups, etc.

- Ability of a muscle to perform without fatigue

Assessments used for body composition + definition

DEXA, skin fold, bod-pod, etc.

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

Assessments used for flexibility + definition

Sit and reach (modified), goniometer measures (hamstring 90/90, gastroc length, soleus length), etc.

- ROM available at a joint

Benefits of movement

Physical: lowers BP and cortisol levels, improved sleep (amount and quality), reduced risk of depression

Mental: improved self esteem and self image

Social: find friends with similar interests

- To stop moving = increased risk of disease

What assessments/methods are used to predict life expectancy? (From most to least accurate)

1. Calorimetry: indirect measure of O2 consumption

2. Physiological markers, like HR

3. Mechanical and electrical motion detectors: watches, pedometers, etc.

4. Occupational and leisure time surveys: biased

How do we assess level of intensity for PA?

- METs: metabolic equivalents

- % of O2 consumption (VO2 max)

- % of max HR reserve (max HR - Resting HR)

- RPE: rating if perceived exertion

- Talk test: difficulty with talking

What is blood pressure?

force of circulating blood against arterial walls

- systolic, 1st sound around 120 mmHg

- diastolic, when sound disappears around 80 mmHg

ASCM & CDC classification of PA intensity levels

1. Light: 1.6 - 2.9 METs (slow walk)

2. Moderate: 3.0 - 5.9 METs (walking to class)

3. Vigorous: > 6.0 METs (jogging/running)

- METs are determined by collecting many physiological data entries (MET values can vary from person to person)

Recommended amount of PA for 18-65 year olds

30 minutes of moderate aerobic activity for > 3-5 days a week

- bouts need to be at least 8-10 minutes, and must be working each muscle group 1x over

- the more activity, the better

What are the risks associated with PA/exercise?

- Cardiac arrest presents the most risk to; sedentary older people performing sudden activity and younger people with cardiac conditions (hypertrophic cardiomyopathy, etc.)

- Sedentary people at at most risk for an AMI during rigorous exercises

(Acute Myocardial Infarction risk DECREASES as habitual frequency of rigorous PA INCREASES)

What is Atherosclerosis?

- The build-up of plaque (fats, cholesterol, and other substances) in and on the artery walls.

- Bending/moving of artery can cause (vulnerable) plaque to break off and form a blood clot/thrombosis (could lead to cardiac arrest due to an occlusion of blood vessel)

- Sedentary people with atherosclerosis are most at risk to cardiovascular events during sudden rigorous PA

What is the order for a pre-exercise evaluation?

1. Informed consent

2. Exercise pre-evaluation health screening

3. Health history

4. CVD risk factor analysis

What is Informed Consent and why is it important?

- A written agreement to participate in a study made by an adult who has been informed of all the risks that participation may entail; done prior to exercise

- Includes purpose/explanation of study, participant responsibilities, explains use of medical records, and freedom of asking consent

- Protects vulnerable individuals/populations

What is the Participation screening and why is it important? What are the 3 variables?

- It determines if an individual needs medical clearance to participate in an exercises

- The 3 variables it focuses on;

1.) current PA levels (> 30 min, 3 days/wk, past 3 months)

2.) presence of signs/symptoms &/or known cardiovascular, metabolic, or renal diseases

3.) Desired exercise intensity (& associated risks)

Angina (s/s of disease)

chest pain

(burning/squeezing feeling)

Dyspnea (s/s of disease)

Difficulty with breathing

(Rated perception of breathlessness)

Dizziness/Syncope (s/s of disease)

Dizziness or fainting

Paroxysmal nocturnal dyspnea (s/s of disease)

Feeling breathless when lying down (often to sleep)

(Precursor to CV disease, often a sign of possible heart failure)

Ankle edema (s/s of disease)

swollen ankles

Heart palpitations/Tachycardia (s/s of disease)

fast heart rate

Intermittent claudication (s/s of disease)

leg pain as a result of plaque build-up in peripheral aa. when exercising

Known heart murmur

Usually for an adult with a CV screening (exclusions apply)

Known Metabolic Diseases

- type 1 DM; body is unable to produce insulin

- type 2 DM; body produces insufficient amounts of insulin

- hyper/hypo-thyroidism; making excess/insufficient amounts of thyroid hormone

Known Cardiovascular Diseases

- Peripheral aa. disease (PAD); narrowing/blockage of peripheral aa's.

- Coronary aa. disease (CAD); buildup of plaque in heart

- Congestive heart failure (CHF); weakened heart which causes buildup in legs, feet, arms, etc.

- Cerebrovascular disease; group of conditions affecting blood flow in the brain

How to perform a screening

- no judgement calls! Either an individual can or cannot participate

- If a participant who regularly exercises presents with s/s of the 3 known diseases (regardless of diseases status), seek medical clearance

- A participant doesn't need clearance if they; do OR don't exercise and don't present with s/s.

PAR-Q

PA readiness questionnaire; a self-guided method of screening

CVD risk factors

General term for disorders that involve the heart and blood vessels

- CVD risk factors AREN'T used for screening

- Performed AFTER a participant has received medical clearance in order to gain additional physical health info

Common locations of arthersclerosis

Internal carotid artery

Anterior descending coronary artery

Renal artery

Femoral artery

What are the 8 risk factors?

1. Age

2. Family history

3. Cigarette use

4. Hypertension

5. Elevated Cholesterol (lipids)

6. BMI/waist circumference (obesity)

7. Sedentary lifestyle

8. Glucose levels

Risk factor: age

45 y.o or greater for men

55 y.o or greater for women

Risk factor: family history

History of MCI, coronary revascularization (bypass), or heart attack in immediate family

IF occurs before 55 y.o.in Dad or before 65 y.o. in Mom

Risk factor: Cigarette use

If a current smoker, have smoked in the last 6 months, or have 2nd-hand exposure

Risk factor: Hypertension

If on medication for it

If systolic BP is > 130 mmHg

If diastolic BP is > 80 mmHg

Risk factor: Cholesterol/lipid levels

If total cholesterol is > 200 mg/dL

If LDL level is > 130 mg/dL

- LDL is atherogenic -> could lead to atherosclerosis/clots

If HDL level in MALES is < 40 mg/dL

If HDL level in FEMALES is < 50 mg/dL

- High HDL = 60 mg/dL or more (considered a (+) risk factor)

Risk factor: BMI/waist circumference (obesity)

If BMI is > 30 kg/m^2

If waist girth in MALES is > 102 cm

If waist girth in FEMALES is > 88 cm

Risk Factor: Sedentary Lifestyle

If < 30 minutes moderate intensity < 3 days/week over the past 3 months

Risk Factor: Glucose

If fasting blood sugar is > 100 mmol/L

If 2-hrs post glucose test is > 140 mmol/L

If an individual has diagnosed diabetes or is on medication for it