Exercise Prescription Exam 1

class 3 obese BMI

>40

class 2 obese BMI

35-39.9

class 1 obese BMI

30-34.9

overweight BMI

25-29.9

normal weight BMI

18.5-24.9

underweight BMI

<18.5

densitometry methods of measuring body comp

hydrostatic weighing and bod pods

anthropometric methods of measuring body comp

height, weight, BMI, circumferences, skinfolds

exaggerated BP response

DBP> 115 mmHg; indication to stop

abnormal BP response

peak DBP> 90 mmHg or an >10 mmHg increase above resting value

post-exercise BP response

SBP returns to pre-exercise levels (or lower) by min-6 of recovery

blunted BP response

SBP response is slower in individual with limited ability to adjust to cardiac output

hypotensive BP response

decrease in SBP below pretest value or by >10 mmHg with increased workload

hypertensive BP response

SBP>250 mmHg

normal BP response to exercise

increase in SBP with increasing workloads at a rate of ~10 mmHg per 1 MET and typically no change or slight decrease in DBP

signs/symptoms of CVD, renal, and metabolic disease

1. pain/discomfort in chest, neck, jaw, arms, or other areas resulting from myocardial ischemia

2. dyspnea

3. dizziness or syncope

4. ankel edema

5. palpitations/tachycardia

6. intermittent claudication

7. heart murmur

8. orthopnea or paroxysmal nocturnal dyspnea

stage 2 hypertension

SBP: 140+; DBP: 90+

stage 1 hypertension

SBP: 130-139; DBP: 80-89

elevated BP

SBP: 120-129; <80

normal BP

SBP: <120; DBP: <80

HDL cholesterol criteria for CVD risk factors

negative criteria; HDL: greater or equal to 60 mg/dL

blood glucose criteria for CVD risk factors

fasting glucose: greater or equal to 100 mg/dL; 2-hr OGTT: greater or equal to 140 mg/dL; HbA1G: greater or equal to 5.7%

lipid criteria for CVD risk factors

LDL: greater or equal to 130 mmHg; non-HDL: greater or equal to 130 mmHg; total cholesterol: greater or equal to 200 mmHg; HDL: men < 40 mmHg and women < 50 mmHg

blood pressure criteria for CVD risk factors

SBP: greater or equal to 130 mmHg and/or DBP: greater or equal to 80 mmHg

BMI/waist circumference criteria for CVD risk factors

BMI greater or equal to 30 kg/m2; waist circumference: greater than 40 in (102 cm) for men and greater than 35 in (88 cm) for women

physical inactivity criteria for CVD risk factors

not meeting minimum thresholds of PA recommendations; 75-150 min/week or 500-1,000 MET-min

cigarette smoking criteria for CVD risk factors

current smoker, quit within the last 6 months, exposure to environmental tobacco smoke

family history criteria for CVD risk factors

before 55 in dad and 65 in mom; history of heart attack, coronary revascularization, or sudden cardiac death

age criteria for CVD risk factors

men 45 or older and female 55 or older

PAR-Q+

self-recall of observations and signs/symptoms of patient’s experiences; only assesses safety of exercise

typical testing organization

1. informed consent and exercise pre-participation screening

2. pre-exercise evaluation; resting measurements

3. body comp

4. CRF testing

5. strength testing

6. flexibility testing

reasons for COD for people over 35 due to exercise

heart arrhythmias from CVD

reason for COD for people under 35 due to exercise

genetic abnormalities and aneurysm

risks of PA/exercise

musculoskeletal injuries and sudden cardiac arrest

effects of PA on CVD risk factors

increases HDL cholesterol, endothelial function, and insulin sensitivity; decreases BP, LDL, total cholesterol, triglycerides, and inflammation

health risk classification

compares a person’s values against criterion reference standards established from epidemiological data on health risks; results in classification describing health risk level or disease state

criterion reference standard

compares a person’s values against a predetermined standard, goal, or performance level’ classification such as good, average, or poor

normative classification

compares a person’s values against the normal or “norm” group usually resulting in a ranking; can be stratified by race, sex, or age

purpose of health related fitness testing

collecting baseline data, educating participant about current health/fitness status, data for development of an individual EX RX, follow-up data for progression in program, setting goals/motivating participant

skill-related components of fitness

agility, coordination, balance, power, reaction time, and speed

health-related components of fitness

cardiorespiratory endurance, muscular endurance, muscular strength, body comp, and flexibility

physical fitness

a set of attributes one has that relates to their ability to perform PA

exercise

a type of PA consisting of planned, structured, and repetitive bodily movement with the intent to improve and/or maintain one or more components of fitness

vigorous intensity PA in METs

greater than or equal to 6.0 METs

moderate intensity PA in METs

3.0-5.9 METs

physical activity

bodily movement produce by contraction of skeletal muscle that substantially increases energy expenditure

light intensity PA in METs

1.6-2.9 METs

android obesity

fat distributed in torso; apple shape; increased risk of hypertension, metabolic syndrome, T2DM, dyslipidemia, CVD, and premature death

gynoid obesity

fat distributed in the hip and thigh; pear shaped

WHR (waist-to-hip ratio)

method for assessing body fat distribution and identifying individuals with greater deposits of abdominal fat; increased WHR = increased health risk

hydrostatic weighing

densitometry; most accurate method

DEXA

measures bone and soft-tissue composition; precise and reliable but expensive and technical

limitations of hydrostatic weighing

lung air volume confounding, conversion of body density of fat percentage, and fat-free density varies among people

bod pod

densitometry technique; 3 measures: empty, calibration cylinder, and person; tight-fitting clothing and swim cap; subject displace air

skinfold

based on the principle that subcutaneous fat is proportional to total body fat; ~1/3 subcutaneous fat to total fat; most widely used technique

body comp norms

12-23% in men and 17-26% for women

cardiorespiratory fitness

ability to perform large muscle, dynamic, moderate-vigorous intensity for prolonged periods; important part of primary and secondary prevention and rehabilitory programs; very important for peoples mortality risk

assumptions of VO2max

• steady-state HR is established for each work rate/stage

• a linear relationship exists between HR and work rate/intensity

• the difference between predicted and actual HRmax is minimal

• mechanical difficulty is the same for everyone

  • the individual isn’t on any HR altering mediations or OTC products

when to stop an exercise test

• onset of angina

• drop in SBP of at least 10 mmHg

• SBP>250 mmHg and/or DBP>115 mmHg

• dyspnea, wheezing, leg cramps, or claudication

• signs of poor perfusion

• HR doesn’t increase with increasing intensity

• noticeable heart rhythm changes by palpitation/auscultation

• physical/verbal cues of severe fatigue

• failure of testing equipment

  • failure to follow protocol

components of muscular fitness

muscular strength, muscular power, and muscular endurance

muscular strength

muscle’s ability to exert force; 3 or more reps to fatigue

muscular endurance

muscle’s ability to perform successive exertions or many reps; >12 reps to fatigue

muscular power

muscle’s ability to exert force over time, or the rate of performing work

flexibilty

ability to move a joint through its complete range of motion; depends on distensibility of joint capsule, adequate warm-up, and muscle viscosity

desirable non-HDL-C level

<130

above desirable non-HDL-C level

130-159

borderline high non-HDL-C level

160-189

high non-HDL-C level

190-219

very high non-HDL-C level

220+

desirable LDL-C level

<100

above desirable LDL-C level

100-129

borderline high LDL-C level

130-159

high LDL-C level

160—189

very high LDL-C level

190+

low HDL-C level

<40

normal triglycerides level

<150

borderline high triglycerides level

150-199

high triglycerides level

200-499

very high triglycerides level

500+