Exercise Testing and Prescription Test 1

Benefits of Physical Activity, Pre-exercise evaluation, and Body Composition

what is physical activity (PA)?

any bodily movement produced contracting skeletal muscles that result in substantial increase in caloric requirements over resting expenditure

what is exercise?

planned, structured, and repetitive bodily movement done to improve or maintain one or more components of physical fitness

what is physical fitness?

the ability to carry out tasks with vigor and alertness, without undue fatigue and with ample energy to meet unforeseen emergencies

what are components of physical fitness?

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

what are components related to skill?

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

what are the ACSM guidelines for light to moderate PA?

150 minutes per week

what is the upper limit for moderate work according to ACSM?

300 minutes

what are the guidelines for vigorous activity according to ACSM?

75 minutes per week

what is a dose response relationship?

the more work you put in, the more you’ll get out

what is an active couch potato?

exercises once a day and sits at their desk all day

is it more important to have a higher fitness level or to be physically active?

higher fitness level

what are the guidelines for someone to qualify as physically active?

30 minutes a day, 3 days a week, for 3 months

What are the three categories of biomedical markers that can help determine health (pre-participation)?

medical clearance, risk factors, and considerations

what is the new preparticipation health screening process based on?

1. current level of structured PA

2. presence of major signs and symptoms that would suggest CV, metabolic, or renal diseases

3. desired exercise intensity

if someone has no PA history, and no CMR disease, and is not presenting with signs and symptoms, what should you do?

start at LT/Mod PA

if someone has no PA history, and no CMR disease, and is presenting with signs and symptoms, what should you do?

refer for medical clearance, then start LT/Mod PA

if someone has no PA history, and a history of CMR disease, and is not presenting with signs and symptoms, what should you do?

refer for medical clearance, then LT/Mod PA

if someone has no PA history, and CMR disease, and is presenting with signs and symptoms, what should you do?

refer for medical clearance, then LT/Mod PA

if someone has PA history, and no CMR disease, and is not presenting with signs and symptoms, what should you do?

continue to mod/vig PA

if someone has PA history, and no CMR disease, and is presenting with signs and symptoms, what should you do?

stop and refer for medical clearance

if someone has PA history, and CMR disease, and is not presenting with signs and symptoms, what should you do?

refer for medical clearance for vig activity, but can continue LT/Mod PA

what are the nine signs and symptoms of CMR?

angina

shortness of breath at rest or with mild exertion

dizziness or syncope

orthopnea or paroxysmal nocturnal dyspnea

ankle edema

palpitations or tachycardia

intermittent claudication

known heart murmur

unusual fatigue or shortness of breath with ADLs

what is angina?

pain or discomfort in the chest, neck, jaw, arms, or other areas that may result from ischemia

what is ischemia?

reduced blood flow to part of the body

what is intermittent claudication?

muscle pain or cramping, behind the knee due to inadequate blood flow. typically occurs when walking up hill or stairs

what is ankle edema a sign of?

possible heart failure

what pre-participation form should you use if you teach a big group and why?

Par-Q+

what pre-participation form should you use if you teach a smaller group and why?

HHQ - health history question

what is informed consent?

the process in which a patient is presented with a medical treatment or care plan during which they are informed of all risk factors, side effects, benefits or other

what are the 7 parts to informed consent?

1. purpose and explanation of the tests

2. risks and discomfort

3. responsibilities of the participant

4. expected benefits

5. inquires

6. use of medical records

7. freedom of consent

what are the two non-modifiable risk factors?

age and family history

what are the six modifiable risk factors?

1. cigarette smoking

2. physical inactivity

3. BMI / Waist-hip circumference

4. blood pressure

5. blood lipids

6. blood glucose

with first or second hand smoke, how much time needs to pass in order for it not to be a risk factor any more?

6 months

what age does risk factors increase for men, with no family history?

greater or equal to 45 years old

what age does risk factors increase for women, with no family history?

greater or equal to 55 years old

if a first-degree male relative has a heart attack before age 55, is it a risk factor?

yes

if a first-degree female relative has a heart attack before age 65, is it considered a risk factor?

yes

is not meeting the ACSM guidelines on physical activity, considered a risk factor?

yes

what is the minimum waist circumference for BMI to be a risk factor?

men: >102cm or 40in

women: >88cm or 35 in

what is the minimum BMI to be at risk?

>30 kg/m²

what are the guidelines for hypertension in relation to risk factors?

systolic BP over 130 mmHg and/or diastolic BP over 80 mmHg

average of 2 readings at 2 separate times

taking any antihypertensive medication

what is considered an abnormal LDL-C

greater than or equal to 130 mg/dL

what is considered an abnormal HDL-C

less than 40 mg/dL for men

less than 50 mg/dL for women

what is number for total cholesterol to be a risk factor?

greater than or equal to 200 mg/dL

is being on a lipid-lowering medication a risk factor

yes

what is the fasting plasma glucose number in relation to risk factors?

greater than or equal to 100 mg/dL

what is the 2-hour OGTT glucose number in relation to risk factors?

greater than or equal to 140 mg/dL

greater than ____ % of HbA1c is considered a risk factor

5.7

can you use risk factors to show progress?

yes

absence of complex ventricular dysrhythmias during exercise testing and recovery

lowest risk

absence of angina or other significant symptoms (e.g shortness of breath, lightheadedness, or dizziness during exercise testing and recovery)

lowest risk

presence of normal hemodynamics during exercise testing and recovery (i.e appropriate increases and decreases in heart rate and systolic blood pressure with increasing workloads and recovery)

lowest risk

for lowest risk, what is their functional capacity in metabolic equivalents

greater than or equal to 7 METs

resting ejection fraction for lowest risk patients

greater than or equal to 50%

uncomplicated myocardial infraction or revascularization procedure

lowest risk

absence of complicated ventricular dysrhythmias at rest

lowest risk

absence of congestive heart failure

lowest risk

absence of signs or symptoms of post event/post procedure ischemia

lowest risk

absence of clinical depression

lowest risk

presence of angina or other significant symptoms (e.g. unusual shortness of breath, light-headedness, or dizziness occurring only at high levels of exertion [>7 METs])

moderate risk

mild to moderate level of silent ischemia during exercise testing or recovery (ST-segment depression <2 mm from baseline)

moderate risk

functional capacity <5 METs

moderate risk

resting ejection fraction 40% - 49%

moderate risk

presence of complex ventricular dysrhythmias during exercise testing or recovery

highest risk

presence of angina or other significant symptoms (e.g. unusual shortness of breath, light-headedness, or dizziness at low levels of exertion [<5 METs] or during recovery)

highest risk

high level of silent ischemia (ST- segment depression >2mm from baseline) during exercise testing or recovery

highest risk

presence of abnormal hemodynamics with exercise testing (i.e., chromotropic incompetence of flat or decreasing systolic BP with increasing workloads) or recovery (i.e., severe postexercise hypotension)

highest risk

resting ejection fraction <40%

highest risk

history of cardiac arrest or sudden death

highest risk

complex dysrhythmias at rest

highest risk

complicated myocardial infarction or revascularization procedure

highest risk

presence of congestive heart failure

highest risk

presence of signs or symptoms of post event / post procedure ischemia

highest risk

presence of clinical depression

highest risk

how to get BMI

dividing body weight in kilograms by height in meters squared (kg x m^-2)

inches to centimeters conversion

1 in = 2.54cm

how many centimeters are in an inch

2.54

pounds to kilograms conversion

1 kg to 2.2 Ibs

centimeters to meters conversion

1 meter = 100 centimeters

what is the range for a reasonable BMI

18 to 40

what is an underweight BMI

< 18.5

what is the normal BMI

18.5 - 24.9

what is the overweight BMI

25.0 - 29.9

waist to hip ratio for males

greater than 0.95

waist to hip ratios for females

greater than 0.86

waist to hip ratios cannot differ by more than ___ ?

5 mm

very low risk based on waist circumference for women

<70 cm

very low risk based on waist circumference for men

<80 cm

low risk based on waist circumference for women

70 - 89 cm

low risk based on waist circumference for men

80 - 99 cm

high risk based on waist circumference for women

90 - 100 cm

high risk based on waist circumference for men

100 - 120 cm

very high risk based on waist circumference for women

>110 cm

very high risk based on waist circumference for men

>120

2 compartment model

fat mass + fat free mass

3 compartment model

Fat mass + water + protein and mineral

4 compartment model

fat mass + water + protein + mineral

what does fat free mass include but fat mass doesn’t

fat free mass looks at fat, water, protein, and bone mineral density, while just looking at fat mass gives you fat and general fat free mass

what does BMI give us and what is it very inaccurate about

gives some indication of risk for disease but is very inaccurate with regards to estimating body fat percentage

what is the accuracy of skin folds

± 4-5%