ACSM Exam Prep 2

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

Static Flexibility

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

What is the advantage of static stretching?

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

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

Ballistic due to increased risk of injury

Why is ballistic stretching still used by some coaches?

Increase blood flow to the muscles

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

Which type of stretching is the most sport-specific?

Dynamic
-Designed to increase core temp

Name the four factors that influence ROM.

1. Muscle Properties
2. PA and exercise
3. Anatomical Structures
4. Age and Gender

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

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

Goniometer: measures a joint's ROM expressed in degrees

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

Lower back and hip joint

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

Functional Movement Screening

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

Strength
Flexibility
Motor Control

What are the different factors that affect proprioception? *

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

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

85th to

Obesity is defined as \______ percentile for age and sex?

\>/- 95th

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

TRUE

What is the key message of the 2010 Dietary Guidelines?

Energy balance

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

Regarding weight LOSS, what does ACSM recommend?

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

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

TRUE

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

250 min/wk

What is the recommended weight loss per week?

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

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%

LDL increases with exercise. T/F

FALSE

What is HDL responsible for?

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

Beta-Blockers have what effect on the CV system?

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

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

What medication is commonly used in CHF?

-Digitalis
Increases contractility, slows rate, and mediates arrhythmias

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

What is hyperlipidemia?

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

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

Myocardial ischemia
-Imbalance of oxygen supply and demand

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)

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

Type II Diabetes

Type I Diabetes is characterized by?

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

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

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

CAD

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

Strain
Muscles of the calf & thigh

Injury to the ligament?

Sprain (Ankle sprain is most common)

What is Rheumatoid Arthritis?
What does it affect?

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

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

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

Osteoarthritis

What occurs in a pt with osteoarthritis?

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

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

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

Which is more common: Tendinosis or tendinitis?

Tendinosis

How long might it take for tendinopathy symptoms to subside?

6 months

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

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

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

30-60 min total

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

Daily

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

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

40 degress C or 100 degrees F

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

Why do CV changes in the body occur while pregnant?

Occur as a result of increased blood volume

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

-SV, CO, and HR
-Vascular resistance decreases

Why does a heart increase in size while pregnant?

Higher HR and SV

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

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

20%-30%

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

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

TRUE

100-110 bpm @ rest

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

TRUE

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

-SV
-CO
-BP
-Peak VO2

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

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

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

Transtheoretical Model

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

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

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

Social Cognitive theory

Social Cognitive theory emphasizes Reciprocal Determinism. What is that?

Interaction b/w individuals and their environment

What is the key concept of the Social Cognitive Theory?

Self-efficacy

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

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

How does the Social Ecological model promote PA?

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

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

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

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

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

Theory of Planned Behavior

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

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

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

List an example of cognitive processes of change:

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

Give examples of behavioral processes of change:

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

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

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

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

List some of the common barriers to exercise?

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

What is motivational interviewing based on?

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

What is the main purpose of Motivational Interviewing?

Help individuals explore and resolve their ambivalence about the possible change

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

What is relapse prevention?

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

What is the main goal of relapse prevention?

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

Bioelectrical impedance: 2.7-6.3%

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

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

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

BOD POD

Air displacement Plethysmography:

DEXA: 1.7%

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

What percentage of weight reductions improve overall health?

5-10%

How many pounds per week for weight loss?

1-2
500-1,000 Daily calorie deficit

Management of body weight is determined by?

Energy balance

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

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%