ACSM Exam Prep 2

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What type of stretching is most commonly used and recommended by ACSM?

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What type of stretching is most commonly used and recommended by ACSM?

Static Flexibility

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A client shouldn't perform static flexibility more than how many times?

-4 times -After the fourth time, it is not beneficial to the client

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What is the advantage of static stretching?

Involves both relaxing and concurrent elongation of the stretched muscles w/o stimulation of a stretch reflex

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Which type of stretching is no longer advocated to improve joint ROM?

Ballistic due to increased risk of injury

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Why is ballistic stretching still used by some coaches?

Increase blood flow to the muscles

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What is PNF stretching?

Techniques combining passive stretch w/ isometric and concentric muscle actions designed to utilize the autogenic and reciprocal inhibition to the GTO

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Which type of stretching is the most sport-specific?

Dynamic -Designed to increase core temp

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Name the four factors that influence ROM.

  1. Muscle Properties

  2. PA and exercise

  3. Anatomical Structures

  4. Age and Gender

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What changes in your ROM has you age?

Reduced collagen solubility which leads to increased tendon rigidity = reduction in ROM

-Further exacerbated by age-related conditions

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What is the most useful method for determining individual joint flexibility?

Goniometer: measures a joint's ROM expressed in degrees

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The sit-and-reach assessment is most useful for evaluating the ROM in which areas of the body?

Lower back and hip joint

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Which assessment examines overall movement patterns, recognize irregularities, and prescribes corrective exercises w/ the hope of reducing the chance of injury?

Functional Movement Screening

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What are the three main things that the functional movement assesment examines?

Strength Flexibility Motor Control

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What are the different factors that affect proprioception? *

-Changes in muscle tension=GTO -Changes in muscle length= muscle spindles -Pain tolerance

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In children and adolescents, overweight is defined as what percentile of BMI for age and sex?

85th to <95th

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Obesity is defined as ______ percentile for age and sex?

>/- 95th

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Central obesity (android) is linked to a greater risk of CV than gynoid obesity (hip and thigh region). T/F


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What is the key message of the 2010 Dietary Guidelines?

Energy balance

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What is Total Energy Expenditure (TEE) and plays the biggest role in it?

TEE: Total number of calories expended each day reflects the amount of energy required to carry out all metabolic processes w/in the body

-Resting Energy Expenditure: 60-70% TEE

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Regarding weight LOSS, what does ACSM recommend?

A combo of diet and MVPA >/- 150min/wk

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Exact amount of PA necessary for weight maintenance after weight loss is currently unknown. T/F


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Engaging in how many minutes/week of MVPA would result in better weight maintenance?

250 min/wk

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What is the recommended weight loss per week?

1-2lb = 500-1,000 calorie deficit

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How have the levels of childhood obesity changed over the last several decades?

Obesity rates among children have tripled since the 1980s and are now at 17%

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LDL increases with exercise. T/F


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What is HDL responsible for?

-Removal of lipids from the circulation through reverse cholesterol transport -Good cholesterol

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Beta-Blockers have what effect on the CV system?

Lower HR and myocardial contractility Increases exercise capacity by decreasing coronary ischemia

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What are CCBs used to treat? ACE inhibitors?

CCBs: HTN & angina ACE inhibitors: HTN -Increase arterial diameter --> decreasing BP and decreasing work by the heart

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What medication is commonly used in CHF?

-Digitalis Increases contractility, slows rate, and mediates arrhythmias

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How is exercise capacity limited in an ischemic person?

Max exercise capacity is limited by insufficient myocardial oxygen supply --> Oxygen delivery to target muscle is impaired

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What is hyperlipidemia?

Elevated blood cholesterol and triglyceride levels -Caused by genetic and environmental factors

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What disease is defined as a shortage of oxygenated blood flow to the heart myocardium?

Myocardial ischemia -Imbalance of oxygen supply and demand

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If a person presents with hypertension, their systolic and diastolic BP must fall above what level?

Characterized as persistent elevation in either SBP (>140mmHg) and/or DBP (>90mmHg)

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A patient has elevated glucose levels due to increasing insulin resistance. What disease does he have?

Type II Diabetes

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Type I Diabetes is characterized by?

Absolute deficiency in blood insulin release because of destruction of pancreatic insulin secreting beta cells

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Which disease if the most prevalent type of CVD and accounts for the most CV deaths?

Coronary Artery Disease: Narrowing of arteries due to build up and plaque

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If a pt presents w/ build-up of atherosclerosis plaque, vascular remodeling, luminal stenosis, & inflammation, they most likely have which disease?


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Injury to the muscle or tendon is called what? And where is it most common?

Strain Muscles of the calf & thigh

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Injury to the ligament?

Sprain (Ankle sprain is most common)

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What is Rheumatoid Arthritis? What does it affect?

Autoimmune, chronic inflammatory disease -Affecting the synovial lining of the joints and other CT

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A pt who is suffering from RA would present with?

-Severe joint pain and inflammation -Reduced muscle mass -Decreased muscular strength and endurance -Decreased mobility -Impaired PA

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A common chronic degenerative joint disease that is more prevalent w/ age and first presents as deficits in the articular cartilage of synovial joints:


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What occurs in a pt with osteoarthritis?

Bone remodeling and overgrowth at the joint margins Results of mechanical injury due to excessive loading

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What is tendinopathy?

Pathological change in the tendon because of repeated stress or microtraumas -Occur as a result from overload injuries that disrupt the MTU

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What are the two most common types of tendinopathy?

Tendinitis: Acute inflammatory tendinopathy Tendinosis: A tendon w/ significant degenerative changes in the absence of an inflammatory response

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Which is more common: Tendinosis or tendinitis?


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How long might it take for tendinopathy symptoms to subside?

6 months

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How often should a pt w/ osteoporosis complete weight-bearing aerobic exercise?

3-5 dy/wk 40-60% of HRR or VO2 max

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What is the total exercise time of a pt with osteoporosis?

30-60 min total

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How often should a client w/ osteoporosis perform balance/posture/fall prevention?


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In children, the ability to produce sweat is lower/higher than adults? The temperature at which sweating starts is higher/lower in adults compared with children?

-Lower -Higher -Limits ability of child to produce sweat --> limiting thermoregulation

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Children can't sustain exercise for as long when temps exceed what level?

40 degress C or 100 degrees F

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How does thermoregulation differ in older adults compared to adults?

-Thermoregulatory ability declines w/ age: # and activity of sweat glands decrease and the capillary density also decreases -Results in lower ability of the body to benefit from evaporative or radiant cooling -Can't withstand cold because of reduced ability to divert BF to deeper tissues

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Why do CV changes in the body occur while pregnant?

Occur as a result of increased blood volume

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For a mother during pregnancy, what may increase at rest? What decreases?

-SV, CO, and HR -Vascular resistance decreases

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Why does a heart increase in size while pregnant?

Higher HR and SV

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During the 3rd trimester, the uterus does what which reduces venous or less blood back to the heart?

Uterus compresses on the inferior vena cava -Supine exercises should be avoided

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Resting oxygen uptake increases by what percentage due to fetal growth?


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If a pt has significant or physiological limitations that affect physical movements or capacity, what age would they be classified as an OA?

50-64 years old

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At birth, children have higher HR and respiration rates. T/F


100-110 bpm @ rest

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A child's max HR is higher than an adults. T/F


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Pertaining to cardio-physiology in children, what is lower in children when comparing to adults?

-SV -CO -BP -Peak VO2

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Why do children recover from bouts of exercise faster than adults?

HR, oxygen consumption, and minute ventilation return to resting values quicker

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Which theory incorporates both cognitive and behavioral processes to understand PA behavior and create PA interventions?

Transtheoretical Model

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The TTM proposes that individuals move through a series of stages during PA adoption: What are they?

  1. Precontemplation: No intention of taking action-more than 6 mo out

  2. Contemplation: Intentions to alter behavior- w/in 6 mo

  3. Preparation: Intentions to increase PA-w/in 1 mo

  4. Adoption: Have made measurable changes-Now

  5. Maintenance: Maintaining the changes-6 months in

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Explain the social cognitive theory:

States that when people observe a model performing a behavior, and the potential consequence of that behavior, they remember the sequence of events & use this info to guide subsequent behaviors

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Which theory is one of the most popular for understanding PA adoption?

Social Cognitive theory

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Social Cognitive theory emphasizes Reciprocal Determinism. What is that?

Interaction b/w individuals and their environment

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What is the key concept of the Social Cognitive Theory?


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There are three main factors in the SCT that influence behavior and behavioral choices. What are they?

  1. The environment

  2. Individual personality characteristics and/or experience

  3. Behavioral factors

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Which theory involves layers including intrapersonal and interpersonal factors, community and organizational factors, institutional factors, and environmental factors?

Social Ecological model: Multi-dimensional approach that not only considers behavior change/intrapersonal factors, but also social/environmental factors

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How does the Social Ecological model promote PA?

Helps recognize the multiple variables that may influence an individual's choice

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Which theory states that the more the individual feels like he/she is engaging in self-directed behavior w/ perceived internal locus of control, the more likely they will continue the desired behavior?

Self-Determination Theory

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The Self-Determination Theory is based on 3 psychological needs that must be met in order to be motivated to engage in behavior. What are they?

  1. Competence: Sense of being capable of completing an activity

  2. Relatedness: Need to be connected

  3. Autonomy: Maintaining control and sense that behaviors are freely chosen

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What is the Theory of Planned Behavior?

An intention-based model -One's attitude, subjective norms, and perceived behavioral control influence intention which then influences behavior

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Intention directly reflects the individual's level of motivation/willingness to perform a desired behavior explains what theory?

Theory of Planned Behavior

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As individuals take greater investment in their personal health, the more likely they are to make relevant and meaningful behavior changes. This describes what theory?

Health Belief model

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There are 4 factors that influence individual health behavior choice: What are they?

  1. Perceived susceptibility or risk for the identified health threat

  2. Perceived severity of the identified health threat

  3. Perception of the benefits from taking action

  4. Perception of barriers and/or costs of taking action to reduce the identified health threat

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What is the difference between cognitive processes and behavioral process?

Cognitive: Used to change the way we THINK about activity Behavioral: Used to change/initiate the actual behavior itself

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List an example of cognitive processes of change:

-Increasing knowledge -Being aware of risks -Caring about consequences to others -Comprehending benefits -Increasing healthy opportunities

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Give examples of behavioral processes of change:

-Substituting alternatives -Enlisting social support -Rewarding yourself -Committing yourself

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What is self-efficacy and how does it differ from self-confidence?

Self-efficacy: The confidence in one's ability to successfully engage in and perform a specific behavior Self-Confidence: Indicates a belief in being able to sustain the exercise regardless of challenges faced

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What are extrinsic rewards and what happens to them over time?

Things earned in response to completing a task or accomplishing a goal. EX: Awards in competition -Decrease overtime and can reduce the value of intrinsic rewards

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What type of feedback is beneficial for someone who is trying to build self-efficacy?

-Help individuals identify ways to initiate and maintain exercise and build their confidence about their ability to succeed -Visual imagery increases self-efficacy

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List some of the common barriers to exercise?

-Lack of time -Environmental changes -Fear of injury -Lack of enjoyable activities -Social support/enjoyment

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What is motivational interviewing based on?

The premise that individuals become more committed to what they say themselves than what they hear from others

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What is the main purpose of Motivational Interviewing?

Help individuals explore and resolve their ambivalence about the possible change

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Describe the concept of visual imagery?

Process of visualizing oneself engaging in a specific behavior on route to achieving a desired outcome -Helps individuals identify and address potential barriers to achieving specific goals

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What is relapse prevention?

Ongoing process in which efforts are made to prevent a return to former, undesirable behaviors after a period of abstinence

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What is the main goal of relapse prevention?

Prevent an individual from returning to inactive lifestyle after establishing a regular exercise routine

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Bioelectrical impedance: 2.7-6.3%

Rapid, noninvasive body composition tool -Electrical current is passed through the body -% of water contained in various tissues

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Rules of Bioelectrical impedance:

-No eating/drinking wi/in 4 hurs -No exercise within 12 hours -Urinate within 30 minutes -No alc within 48 hours -No meds within 7 days

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Hydrostatic weighing:

-Calculates body density from body volume -Weighed on land and underwater -Densities of muscle and bone are higher than density of water -Fat= less dense than water

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Air displacement Plethysmography:

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DEXA: 1.7%

Low current X-rays at 2 energy levels to measure bone mineral content, Body fat, and lean soft tissue mass

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What percentage of weight reductions improve overall health?


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How many pounds per week for weight loss?

1-2 500-1,000 Daily calorie deficit

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Management of body weight is determined by?

Energy balance

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What is total energy expenditure?

The total amount of calories expended each day reflects the amount of energy required to carry out all metabolic processes within the body

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What are the three components to total energy expenditure? TEE

  1. Resting energy expenditure = 60-70% of TEE

  2. Thermic effect of food = 10% of TEE

  3. Physical activity = 20-30%

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