ACSM Part IV

Question 1

Endurance Exercise RX for Healthy People

Frequency

Answer 1

3 to 7 sessions per week

Question 2

Endurance Exercise RX for Healthy People

Intensity

Answer 2

70-85% peak HR(60-80%VO2max) for young
57-67% peak HR(30-45%VO2max) intially for sedentary
conversation should be possible, 12-16 on borg

Question 3

Endurance Exercise RX for Healthy People

Duration

Answer 3

20-60 min per session, average 30-40 min

Question 4

Focus of exercise RX

Answer 4

Adherence

Question 5

Initial Conditioning stage

Answer 5

May last up to 4 weeks for previously sedentary
3 days/week
40-50% HRR
15 minutes (less if very sedentary)

Question 6

Improvement/Progression Stage

Answer 6

Lasts 4 to 5 months
increase duration and frequency before intensity
3-5 days/week
increase intensity to 70-85% HRR
increase duration to at least 30 minutes

Question 7

Maintenance Stage

Answer 7

Review Goals
3-5 days/week
70-85% HRR
minimum of 30 minutes

Question 8

RX for impaired/sedentary
Frequency and Duration
Functional capacity < 3METS

Answer 8

3 sessions of 5 minutes daily

Question 9

RX for impaired/sedentary
Frequency and Duration
Functional capacity 3-5 METS

Answer 9

1-2 sessions daily

Question 10

RX for impaired/sedentary
Frequency and Duration
Functional capacity > 5 METS

Answer 10

normal Parameters

Question 11

RX for impaired/sedentary

Intensity

Answer 11

40-50% of peak VO2 initially for sedentary
progress by increasing duration and frequency before intensity
always below pain and symptom threshold

Question 12

Mechanisms by which cardiac rehab reduces morbidity and mortality

Answer 12

improved functional capacity with reduced cardiac O2 requirements
improved blood vessel function
improved coronary blood flow
improved electrical stability of the heart muscle

Question 13

Exercise RX for Cardiac Patients

Inpatient (Phase 1)

Answer 13

self care activities as precursors
resting HR + 10-30 beats/min
2-4 sessions/day for 3-10 min/session
progress by increase bout duration and then decrease number of bouts
borg scale <13
ECG and hemodynamics should be constantly monitored

Question 14

Exercise RX for Cardiac Patients
Outpatient (Phase II)
Functional Capacity < 5 METs

Answer 14

inpatient parameters

Question 15

Exercise RX for Cardiac Patients
Outpatient (Phase II)
Functional Capacity > 5 Mets

Answer 15

low end of normal parameters
progress to goal of 20-30 min, 3 times/week
progress to goal of burning 1000 Kcal/week

Question 16

Outpatient

ECG monitor required for those with:

Answer 16

LV malfunction
signs of ischemia
arrhythmias
low functional capacities

Question 17

Intensity thresholds for cardiac rehab

set intensity below:

Answer 17

onset of angina (>10 bpm below)
plateau or decrease in SBP
SBP of 240 or DBP of 110
ST segment depression of 1 mm
signs of left ventricular dysfunction
signs of incr. ventricular ectopy or arrhythmias
significant AV- block
significant supraventricular arrhythmias