Exam 1 Exercise Testing

physical activity, health, and chronic disease; preliminary health screening; principles of assessment

Physical Fitness

ability to carry out daily tasks w/ alertness and vigor, w/o undue fatigue, and with energy reserve to meet emergencies or to enjoy leisure time pursuits

Health-Related Physical Fitness

components of PF that have a relationship w/ good health; sport-/skill-related PF (agility, balance, coordination, power)

Sedentarism

has a harmful effect on the body

• major contributor to the physical & economic burden of disease nationally & globally

• 4th leading risk factor for mortality

• causes an estimated 3.2 million deaths/year

• same level of risk as combined risk of smoking & obesity

• puts one at higher risk for CVD, musculoskeletal disorders, psyc disorders, pulmonary diseases, cancer, metabolic disorders

Physical Activity Recommendations for 3-5 year olds

active throughout the say to enhance growth and development

Physical Activity Recommendations for Children & Adolescents (6-17)

60+ min of moderate-to-vigorous activity

aerobic- most of 60 min at least 3 days/week

muscle-strengthening- part of 60 min at least 3 days/week

bone-strengthening- part of 60 min at least 3 days/week

Physical Activity Recommendations for Adults

some is better than none

150-300 min/week of moderate aerobic

or 75-150 min/week of vigorous aerobic

or an equivalent combination of moderate and vigorous aerobic activityPhysical Activity Recommendations for Children & Adolescents (6-17)

Physical Activity Recommendations for Older Adults

guidelines for adults also apply to older adults, in addition to-

multicomponent- balance, aerobic, muscle-strengthening

level of effort relative to level of fitness

pay attention to limitations due to chronic condition, be as active as their conditions allow

Physical Activity Recommendations for Pregnant & Postpartum

always under care of provider to monitor

if one was habitually physically active before pregnancy, one should be able to continue during and after

at least 150 min of moderate aerobic activity per week

Physical Activity Recommendations for Adults w/ Chronic Conditions/Disabillities

guidelines for adults also apply if able, in addition to-

muscle-strengthening of moderate-vigorous intensity 2 or more days/week

Dose-Response Relationship

improvements in health benefits depend on volume of physical activity

low level of movement is better than none

too much physical activity (5 hr, high intensity/week) may be associated with negative health consequences/overuse injuries

each 60 min increase in daily time spent being sedentary is associated with a 9% increase in the odds of satisfying criteria for metabolic syndrome

Cardiovascular Disease

one person dies every 33s in the US from CVD

risk factors: age, family history, hyperlipidemia, hypertension, tobacco, diabetes mellitus, obesity, inactivity

higher HDL lowers CVD risl

Atherosclerosis

inflammatory process involving a buildup of low-density lipoprotein, monocytes, necrotic debris, smooth myocytes, and fibrous tissue

plaques cause myocardial ischemia and produce angina pectoris, a temporary sensation of tightening and heavy pressure in the chest/shoulder

Coronary heart disease

caused by a lack of blood supply to myocardium resulting from atherosclerosis

1 in 20 adults who are 20+ have CAD

heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the US

Myocardial Infarction

when a blood clot or ruptured plaque obstructs coronary blood flow

805,000 people have had an MI in the US

1 in 5 MI’s are silent

Hypertension

leading CVD risk factor and, if not in check, becomes a risk factor for stroke, MI’s, heart, and kidney failure, dementia, and blindness

nearly ½ of adults have hypertension

primary or contributing cause of 691,095 deaths/year

Cholesterol

wacy, fatlike substance found in all animal products

1. low-density lipoprotein (LDL)- product of VLDL metabolism that serves as the primary transporter of cholesterol; CAN CAUSE PLAQUE BUILDUP

2. high-density lipoprotein (HDL)- involved in reverse transport of cholesterol to the liver for digestion; HEALTHY/GOOD CHOLESTEROL

3. very low-density lipoprotein (VLDL)- made in liver for transport of triglycerides

4. chylomicron- derived from intestinal absorption of triglycerides

LDL and HDL

LDL molecules are larger than HDL’s so they cause plaque buildup and are actively transported into vascular walls

• plaques block flow into CA’s, eventually causing an MI

• LDL values less than 100mg/dl-1 are optimal for reducing CVD and CHD risk

HDL molecules are suspended in plasma and protect the body by picking up excess cholesterol and delivering it to the liver

• HDL values less than 40mg/dl-1 are associated with higher risk of CHD

HIGH CHOLESTEROL HAS NO SYMPTOMS

regular physical activity has positive effects on lipid metabolism and lipid profiles

Diabetes

not making enough insulin or not using it how it should be used

when cells stop responding to insulin or there isn’t enough being made, too much glucose staying in bloodstream, which could cause heart disease, vison loss, and kidney disease

Type I: no insulin production, must take insulin everyday

Type II: doesn’t use insulin well and can’t keep blood glucose normal, can be managed with diet and exercise (90-95% of people with diabetes have Type II)

Obesity

weight that is higher than healthy for a given height

classified using BMI:

• less than 18.5 → underweight

• 18.5 to 25 → healthy weight

• 25.0 to 30 → overweight

• 30.0 or higher → obese

  • 30 to 35 → class 1

  • 35.0 to 40 → class 2

  • 40.0 or higher → class 3 (severe)

US obesity prevalence was 41.9% in 2017-March 2020

related conditions: heart disease, stroke, Type II, certain cancers

Cancers associated with Obsesity

meningioma (brain/SC)

thyroid

breast

liver

gallbladder

upper stomach

pancreas

colon/rectum

ovaries

uterus

kidneys

adenocarcinoma (esophagus)

multiple myeloma (blood cells)

Metabolic Syndrome

Musculoskeletal Disorders

osteoporosis- loss of bone mineral content and density due to aging, amenorrhea, malnutrition, menopause, inactivity

Physical Fitness Components

1. Cardiorespiratory Endurance: ability of heart, lungs, and circulatory system to supply oxygen and nutrients efficiently to working muscles

   • maximum oxygen consumption (VO2 max)- rate of O2 utilization of muscles during aerobic exercise

2. Musculoskeletal Fitness: ability of skeletal & muscular systems to perform work

   • muscular strength: maximal force pr tension level that can be produced by a muscle group'

   • muscular endurance: ability of a muscle to maintain submaximal force levels for extended periods

   • muscular power: rate of force development, how fast once can pick up a weight

   • bone strength: risk of fracture; functional of mineral content and density

3. Body Composition: body weight in terms of the absolute and relative amounts of muscle, bone, and fat tissues

4. Flexibility: ability to move a joint/series of joints fluidly through complete ROM; limited by size of muscle, connective tissue, etc.

5. Balance: keeping the body’s center of gravity within the base of support

   • functional balance- ability to perform daily movement tasks requiring balance (picking something up, dressing, looking behind you)

Validity and Reliability of Physical Fitness Testing

when you administer a complete battery of PF tests in one session, use a test sequence that minimizes the effects of previous tests on subsequent test performance

validity- ability of a test to measure, accurately w/ minimal error, a specific PF component

reliability- ability of a test to yield consistent and stable scores across trials and over time

What are the purposes of a health evaluation before a PF test?

detect presence or suggestion of disease and assess the likelihood that your client will have an unanticipated CVD situation during exercise

• administer the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+)

• evaluate client participation in regular exercise in the past 3 months

• identify signs and symptoms of diseases

• analyze coronary risk factors

• determine if medical clearance is needed

Contraindications

some individuals have medical conditions and risk factors that outweigh the potential benefits of exercise testing

absolute: you may not perform any PF test

relative: continue speaking to participant about what their condition limits them and go from there

ACSM Algorithm

1) is the client physically active?

• performs planned, structures physical activity at least 30 min at moderate intensity on at least 3 days/week for at least 3 months

2) known CV, metabolic, or renal disease?

• MI, surgery, catheterization, angioplasty, pacemaker, heart valve disease/failure, congenital heart disease, diabetes, renal failure

3) risk classification- assess client’s coronary risk

• age, family history, smoking, sedentarism, obesity, hypertension

• negative risk factor- good HDL level