Key Notes from Classes

Social Cognitive Theory

• 3 main factors that influence behavior and choice

  • environment

  • individual personality and characteristics

  • behavioral factors

Self-Efficacy

• One’s belief in one’s own ability specific to the behavior in question

• influenced by

  • mastery experience

  • vicarious experience

  • verbal persuasion

  • physiological or affective states

Mastery Experience

• Success or failure in completing the objective behavior

  • ex: are you able to maintain a physical activity program for 6 weeks

Vicarious Experience

looking to peers and their experiences to evaluate your own potential

Verbal Persuasion

when others express faith in one’s ability to execute the behavior

Physiological or Affective States

are you mentally and emotionally in a “good place”

Social Ecological Model

• Asserts that a persons behaviors are largely influenced by their environment

• 4 of the 6 rings are outside of personal level

• helps identify environmental factors in client’s life that may be influencing behavior

Health Belief Model

• As individuals take greater investment in their personal health, they are more likely to participate in physical activity

  • perception of susceptibility or risk to an identified health threat

  • perception of the severity of the health threat (clinical & social consequences)

  • perception of barriers & costs to taking action to reduce the health threat

  • perception of the benefits from taking action to reduce the identified health threat

Theory of Planned Behavior

• Intention (level of motivation for PA) is the primary influence of PA

  • Attitude towards PA

  • Subjective norm

    • social pressure to participate

  • Perceived behavioral control

    • ease or difficulty of engaging in PA

Self Determination Theory

• Built around the premise that three psychological needs must be met for an individual to be motivated to engage in a behavior

  • motivation affected by

    • competence

    • relatedness

    • autonomy

Locus of Control

• Internal Locus of Control

  • when behavior perceived as self-determined

• External Locus of Control

  • when behavior is perceived to be externally controlled

Hedonic Theory

• Hedonic Principle

  • emotional experience can be thought of as a gauge that ranges from bad to good & one’s primary motivation is to keep the needle on the gauge as close to good as possible

• people continue to do things that feel good and stop doing things that feel bad

Self-Monitoring

• Client/patient tracks their own physical activity

• Can

  • inform them of their current PA levels

  • help them to keep PA top of mind

  • remind them of how poorly they are doing in executing their PA goals

  • lead to compulsive over-exercising

Goal Setting (SMART Goals)

• Specific

• Measurable

• Attainable

• Relevant

• Time-Bound

Social Support for Facilitating Behavior Change

• Instrumental

  • tangible assistance

• Emotional

  • expressing encouragement, empathy, concern

• Informational

  • giving instructions, advice & feedback

• Companionship

  • providing sense of belonging & connectedness

What is a high LDL risk?

> 130 mg/dL

What is a high HDL risk?

< 40 mg/dL in men

< 50 mg/dL in women

What happens to stroke volume during exercise?

increases

What is a high risk BP?

> 140 mm Hg

> 90 mm Hg

What is a high triglyceride risk level?

> 150 mg/dL

What is a high cholesterol risk level?

> 200 mg/dL

What are CVD risk factors?

1. Age

2. Family history

3. Smoking

4. Physical inactivity

5. Obesity

6. High BP

7. Dyslipidemia

8. High fasting blood glucose

What are the medical clearance requirements?

< 2 = low risk, no medical clearance

≥ 2 = moderate risk, medical clearance recommended

high risk, medical clearance recommended

What is the correct order of exercise testing?

1. Body composition

2. Cardiorespiratory fitness

3. Muscular fitness

4. Flexibility

What are the requirements to terminate an exercise test?

1. Onset of angina or angina-like symptoms

2. Drop in SBP ≥ 10 mm Hg during the test

3. Excessive rise in BP: SBP > 250 mm Hg, DBP > 115 mm Hg

4. Failure of HR to increase during test

5. Shortness of breath, wheezing, cramping, claudication

6. Change in heart rhythm

7. Subject requests to stop

What is the timing for each vital measurement taken during a max test?

1. HR = last 5-10 sec of each min

2. BP = last 30-60 sec of each stage

3. ECG = continuously

4. VO2 = continuously

5. Signs/symptoms = continuously

6. RPE = last 10 sec of each stage

What are some indications that someone has reached their VO2 max?

1. Plateau in VO2 despite increase in O2 demand

2. RER > 1.10

3. HR within 10 bpm of age-predicted max

4. Blood lactate concentration > 8 mmol/L

Where is BP measured?

Brachial artery

What are some absolute contraindications of max exercise testing?

1. Acute myocardial infarction within 2 days

2. Unstable angina

3. Uncontrolled cardiac arrhythmia

4. Active endocarditis

5. Symptomatic aortic stenosis

6. Decompensated heart failure

7. Acute pulmonary embolism, pulmonary infarction, or deep venous thrombosis

8. Acute myocarditis or pericarditis

9. Acute aortic dissection

10. Physical disability that precludes safe testing

What are some relative contraindications of max exercise testing?

1. Known obstructive left man coronary artery stenosis

2. Moderate to severe aortic stenosis

3. Tachyarrhythmias

   1. Tachycardia (High RHR)

4. Bradycardia

   1. Low RHR

5. Hypertrophic Obstructive Cardiomyopathy

6. Recent stroke or ischemia attack

7. Mental impairment

8. Resting hypertension w/ SBP > 200 mm Hg or DBP > 110 mm Hg

9. Uncorrected medical conditions, such as significant anemia, important electrolyte balance, and hyperthyroidism

What are the different body fat distribution types?

1. Android

   1. Fat in abdomen & trunk (visceral fat)

      1. Visceral fat surrounds organs & impairs function

   2. Associated w/ negative health outcomes

2. Gynoid

   1. Fat in hips & thighs (subcutaneous fat)

What are the high risk waist-to-hip ratios?

1. Men > 1.0

2. Women > 0.85

What is the respiratory exchange ratio (RER)?

How much O2 is being converted into CO2 (VCO2/VO2)

What energy systems are being used with different RER?

1. Lower RER = Fat for energy (0.7)

2. Higher RER = Carbs for energy (1.0)

3. RER > 1.0 = contribution of anaerobic metabolism

4. RER ≥ 1.15 is range of max effort

What are the different energy production cycles?

1. Phosphagen System (ATP-PC)

2. Anaerobic Energy System (Glycolysis)

3. Aerobic Energy System (Krebs & ETC)

What is the Phosphagen Energy System (ATP-PC)

1. Adenosine triphosphate

   1. consists of ATP stored in muscle

   2. creatine stored in muscle

2. Initial energy system used during the few seconds of exercise

What is the anaerobic energy system (glycolysis)?

1. Phosphagen system

   1. immediate source of ATP

2. Glycolysis

   1. Second anaerobic energy system

   2. Breaks down carbs into glycogen or glucose to make ATP

   3. Energy system used during 6 sec to 2 min of exercise

What is the aerobic energy system (oxidative energy system) (Krebs & ETC)?

1. Primary source of ATP at rest

2. Uses carbs & fats

3. Energy system used during exercise lasting > 3 min

What are the different fuel sources for exercise?

1. Carbs

   1. Glucose

      1. stored as glycogen

2. Fats

   1. Fatty acids

      1. stored as triglycerides

3. Proteins

   1. Not primary source during exercise

What are the recommended macronutrient percentages for main food groups?

1. 10-30% Protein

2. 45-65% Carb

3. 25-35% Fat

What are the diagnostic requirements of metabolic syndrome?

1. Large Waist Circumference

   1. ≥ 35 in (89 cm) for women

   2. ≥ 40 in (102 cm) for men

2. High Triglyceride Level

   1. ≥ 150 mg/dL

3. Reduced HDL Cholesterol

   1. < 40 mg/dL in men

   2. < 50 mg/dL in women

4. Increased BP

   1. ≥ 130/85 mm Hg

5. Elevated Fasting Blood Sugar

   1. ≥ 100 mg/dL

What are the risk factors of metabolic syndrome?

1. Age

2. Race

3. History of Diabetes

4. Other Diseases

   1. CVD, hypertension, POCS, hyperglycemia, dyslipidemia, central adiposity

What is Type I Diabetes?

1. Body is unable to produce insulin

2. Insulin-dependent

3. Typically diagnosed in children & young adults

What is Type II Diabetes?

1. Cells are unable to use insulin properly (insulin resistant)

   1. Type 2 is “2 good for insulin”

2. Non-insulin dependent

3. Insulin necessary for the body to use glucose to produce energy

What are the symptoms of Type II Diabetes (T2DM)?

1. Increased thirst & frequent urination

2. Increased hunger

3. Weight loss

4. Fatigue

5. Blurred vision

6. Slow-healing sores or frequent infections

7. Areas of darkened skin

What are the risk factors of T1DM?

1. Family history

2. Genetics

3. Geography

4. Viral exposure

5. Low vitamin D

6. Other dietary factors

What are the risk factors of T2DM?

1. People w/ impaired glucose tolerance and/or impaired fasting glucose

   1. Hyperglycemia (elevated levels of blood glucose)

      1. > 120 mg/dL

   2. Hypoglycemia (reduced levels of blood glucose)

      1. < 40 mg/dL

2. People > 45 years old

3. Family history

4. Overweight

5. Don’t regularly exercise

6. Low HDL cholesterol

7. High triglycerides

8. High BP

9. Race

10. Women w/ gestational diabetes

What is the aerobic exercise prescription training for diabetes?

1. 3-7 days/week

2. 40-89% VO2

3. 30-60 min (10 min bouts) (150 min/week)

4. Prolonged rhythmic activity

What is the resistance training exercise prescription training for diabetes?

1. 2-3 days/week

2. 50-85% 1RM

3. 1-3 sets of 10-15; progress to 8-10 reps

4. All major muscle groups (4-5 upper & 4-5 lower)

What are the long-term effects of T2DM?

1. Heart & blood vessel disease

2. Nerve damage (neuropathy)

3. Kidney damage (nephropathy)

4. Eye damage

5. Foot damage

6. Hearing impairment

7. Skin conditions

8. Alzheimer’s disease