Ch 3 Flashcards
Cardiorespiratory Fitness (CRF) is the ability of the circulatory and respiratory systems to supply oxygen to the muscles to perform dynamic PA
• High CRF is associated with health benefits and reduced risk of CVD
• A ____response relationship exists between exercise and reductions in chronic disease
• The primary role of the EP-C is to provide for the development and maintenance of CRF to clientele using _____information
Goal of the Cardiovascular & Respiratory Systems
• These systems work together in synchrony to provide ____and remove ___ from the body.
• The respiratory system promotes movement of_______ and facilitates _____exchange
• The cardiovascular system is responsible for the delivery of ______ and_____ to the ____ to facilitate the development of adenosine triphosphate (ATP).
Anatomy & Physiology
• Heart Chambers:
– Atria: upper chambers (left and right)
– Ventricles: lower chambers (left and right)
– Left Ventricle—Responsible for driving blood from _____ through the _______
• Vasculature
– Veins & venules: carry deoxygenated blood
– Arteries & arterioles: carry oxygenated blood
– ______: responsible for gas & nutrient exchange
Energy Production
• ATP is a high energy molecule composed of ______, hydrogen, nitrogen, ______, and phosphorus atoms
• ATP is utilized by all metabolic processes within the body
• ATP storage is limited and located within _____
• ATP creation is facilitated by the energy we intake via foods we eat
• ATP is produced at a rate that is equal to ATP utilization by bodily processes
• ATP is produced through one of _____ metabolic pathways
.dose, evidence based, o2, waste
O2 & co2, gas, cell, oxygenated blood, nutrients
Heart, vasculature, capillaries, carbon, oxygen
Muscle, three
Energy Production Systems
• Creatine Phosphate (CP)
– Immediate source of ATP & lasts about ___seconds
• Anaerobic Glycolysis
– Fast source of ATP & lasts about __ seconds
– Breaks down glucose or glycogen into ____
• Oxidative System
– Slower source of ATP & lasts indefinitely
– Requires oxygen to facilitate the_______ and ____
Oxygen Kinetics
• Single-Intensity Exercise
– VO2 increases at the onset of exercise until achieving ____ and declines post-exercise
– Oxygen _____: slow rise in VO2 after starting exercise
– Oxygen _____: slow decrease in VO2 after stopping exercise
– Rapid achievement of______ indicates higher fitness
• Graded-Intensity Exercise
– Max VO2: highest VO2 achieved during a _____ exercise test
– Higher VO2max indicates a higher level of aerobic training and fitness
Oxygen Uptake
• _______: an equation representing the oxygen needs during exercise
• Fick Equation: allow for determination of VO2max
– VO2max = (___max)×(___max)×(____ diff max).
• VO2 = mL/kg/min
• SV = stroke volume
• a-vO2 difference = _______ oxygen difference
.10, 90, pyruvate, Krebs cycle ,
Electron transport chain,steady state, Deficit , debt
Steady state, graded, fick principle ,
HR, stroke volume, avo2 , arteriovenous
Cardiovascular Responses to GXT
• Arteriovenous Oxygen (a-vO2) Difference: ____ with workload
• Heart Rate: increases with workload until ____ is reached
• Stroke Volume: increases with workload initially (up to _____% max) with little change later in a GXT
– As SV increases with training,____decreases.
• Cardiac Output: ____ with increased workload
Pulmonary Ventilation Responses to GXT
• Pulmonary Ventilation (Ve) increases with workload through moderate intensity (up to ______% max) with more rapid increases near max exertion
– The point of rapid increases in ventilation during GXT is known as the________
– ____= respiratory rate x tidal volume
Blood Pressure Responses to GXT
• Systolic Blood Pressure (SBP): _____ with increased workload
• Diastolic Blood Pressure (DBP): _____ with increased workload
• Total Peripheral Resistance (TPR): normally ____ with increased workload
• ____Arterial Pressure (MAP): increases with increased workload
– MAP=DBP+0.33(SBP–DBP)
HR and BP Assessment
• Pre-Exercise: assessed in the exercise position
• During Exercise: HR assessed twice during each stage;
BP assessed once near the end of each stage
• Post-Exercise: assessed for a minimum of five minutes of recovery or until each become stable
• ______: an assessment of overall myocardial demand of exercise derived from HR and BP
– RPP = HR x ____
CRF Assessment: Benefits
• Regularly performed in both healthy and _____ populations
• Used in both populations to gain insight into the most appropriate exercise ______
• Also used in clinical populations for screening, diagnosis, and prognosis of medical conditions
.increases, increases
40-60, Rhr, increases, 50-80, ventilatory threshold
Ve, increases,remains relatively stable, decreases modestly,mean
Rate pressure product, SBP
Clinical,prescriptions,
CRF Assessment: Types
• Maximal VO2 Tests: measures VO2 via metabolic testing systems; may also be max exertion tests without gas exchange
• Submaximal VO2 Tests: estimate VO2max from ____responses during submaximal workloads
• Step Tests: estimate VO2max based on _____
• Field Tests: estimate VO2max based on client____
Selecting the Appropriate___Assessment
• Primary Considerations
– Intensity, length, and expense of the test
– Type and number of personnel needed
– Equipment and facilities needed
– Physician supervision needs and safety concerns
– Information required as a result of the assessment
– Required accuracy of results
– Appropriateness of mode of exercise
– Willingness of the participant to perform the test
CRF in Pregnant Women
• Appropriate and beneficial to mother and baby unless otherwise contraindicated
• Submaximal exercise testing is _____ but is not required to initiate a training program
• Maximal exercise testing is ______ unless deemed medically necessary and appropriate
• Mode of exercise testing and prescription should be selected with comfort and reduced risk of fall and injury in mind
Interpreting results of CRF Assessments
• A primary role of the EP-C is to provide an interpretation of testing results that are understandable and useful for the client
• Testing data can be compared with established standards:
– _______ - Referenced: classification based on group categories (excellent, needs improvement, etc.)
– _______: classification based on percentile rankings based on specific demographic variables
.HR, recovery HR,
Performance , CRF, allowed,
discouraged
Criterion
Normative
Metabolic Calculations: Units & ; Conversions
• Several different approaches exist for expressing energy within exercise physiology
• Oxygen Consumption: oxygen requirements of exercise
– Absolute: does not consider body weight (e.g. L/min)
– Relative: does consider body weight (e.g. mL/kg/min)
• _____ (METs): rate of VO2 scaled against resting metabolism
– 1 MET = 3.5 ml/kg/min = rest
• Energy Expenditure: caloric cost of exercise
– kcal/min = MET × kg × 3.5 / 200
Metabolic Calculations: Formulas
• Metabolic formulas represent an accessible and accurate way to estimate both VO2 and caloric expenditure
• All formulas estimate gross energy expenditure, which is the sum of both resting and exercise metabolism
– Gross VO2 = ______VO2 + ______ VO2
– Net VO2 = ______ VO2 – ______ VO2
• Formulas can be used to develop plans for weight management
FITT-VP Framework • FITT-VP provides the framework to establish an exercise prescription that can be customized to client needs • F = Frequency • I = Intensity • T = Time (or duration) • T = Type (or mode) • V = Volume (or amount) • P = Progression (or advancement)
FITT-VP: Frequency Frequency • 5+ days/week of moderate intensity OR • 3+ days/week of vigorous intensity OR • Equivalent combination of moderate and vigorous
.metabolic equivalents,
Resting, exercise
Exercise, resting
FITT-VP: Intensity
Intensity
• 40% to ____% VO2R represents moderate intensity
• 60% to ____% VO2R represents vigorous intensity
• Either level of intensity is recommended for most healthy individuals.
• Methods of prescribing exercise intensity are varied and include: HR reserve&_____, peak VO2, &; RPE
FITT-VP: Time
Time
•Substantial Benefits
– 150+ mins/week of moderate intensity OR
– 75+ mins/week of vigorous intensity OR
– Equivalent combination of moderate and vigorous
•Additional Benefits
– 300+ mins/week of moderate intensity OR
– 150+ mins/week of vigorous intensity OR
– Equivalent combination of moderate and vigorous
FITT-VP: Type
Type
•All types of physical activity are beneficial as long as they are of sufficient _____ and _____.
•______, continuous exercise that involves major muscle groups is the most typical
– Intermittent exercise such as interval training or stop-and-go sports may be used to accumulate the recommended frequency, intensity, and time needed for _______ fitness.
FITT-VP: Volume
Volume
•______ x ______ x ______= Volume
• Recommended target volume for weekly exercise
– ____-_____ MET x min /week OR – _______kcals/week
- , 84, peak, intensity and duration
Rhythmic, cardio-respiratory,
Frequency, intensity, type,
500-1000, 1000
FITT-VP: Progression
Progression
•Rate of progression is dependent on many factors including: health status, fitness, training responses, and exercise program goals
•Any one or multiple components of FITT-VP can be increased as tolerated by the client but_____ components should be increased simultaneously
•Progression should be gradual to minimize _____
cont.)
•Progressive _______: reflects need for exercise to be greater than accustomed to induce adaptation
•________: represents the opposite of the overload principle and reflects the idea of ‘use it or lose it’
•Individual ______: recognizes that the same stimulus can produce very different responses within individuals
•_____: states that specific exercise elicits specific adaptations, creating specific training effects.
Safe &; Effective Exercises to Enhance CRF
• There is no shortage of exercise options for the EP-C to choose from.
• The ACSM has created a classification scheme in order to help the EP-C make an appropriate exercise selection.
• Weight bearing and nonweight bearing activities should be considered based on the clientele (i.e., orthopedic limitations).
Not all, risks
Overload, reversibility, differences
Specificity,
Safe &; Effective Exercises to Enhance CRF
• Categories of Cardiovascular Endurance Exercises
– Type A– endurance exercises requiring minimal skill or physical fitness to perform, such as _____ or water____
– Type B – vigorous - intensity endurance exercises requiring minimal skill, such as _____ or _____
– Type C – endurance activities requiring skill to perform, such as _______ skiing or in-line skating
– Type D – _______ sports, such as tennis or basketball.
Interval Training
• Interval training is broadly defined as when a period of intense activity is interspersed with a period of low to moderate activity
• Interval training is flexible and can be customized
• Broad Categories of Interval Training:
– ______ Interval Training (SIT)
– High-______ Interval Training (HIIT)
– Low-________Interval Training (LVIT)
• Interval training is generally safe and the EP-C should focus attention on ______ and self-______
Determining Intensity • Options range from direct measurements to more subjective approaches – Heart Rate Reserve (HRR; Karvonen) – VO2 Reserve (VO2R) – Peak Heart Rate – PeakVO2 – Peak Metabolic Equivalent (MET) – Talk Test – PerceivedExertion
Determining Intensity: HR Reserve
• Requires the EP-C to determine resting HR and maximum HR of client.
• HRR is the _____ between max HR and resting HR
• Target Heart Rate =
– [(Max HR– Rest HR) × % intensity] + Rest HR
Determining Intensity: Peak HR
• Requires the EP-C to determine ____ HR of client.
• May be accomplished from direct measurement, such as a VO2 max treadmill test, or maximum HR may be estimated from age-predicted formulas
– MHR=220-age
• Target Heart Rate =
– Max HR × % intensity
.walking, aerobics, running, spinning,
Cross country, recreational
Intensity, volume, sprint
Adherence, efficacy, difference,maximum
Determining Intensity: Peak VO2
• May be used if the EP-C has measured or estimated the _____ of the client in a laboratory or field setting.
• Caution using estimates due to the expected error in extrapolating HR.
• Target VO2 = VO2 max × % intensity
Determining Intensity: Peak MET Equivalent
• Peak MET level is determined based on measured or estimated _____
– Peak MET level – Peak VO2 / 3.5
• METs represents an absolute measure
• Target METs = (% intensity)[(VO2 max in METs) − 1] + 1
– Where 1 reflects resting metabolic rate
Determining Intensity: VO2 Reserve
• May be used when the EP-C has directly measured or estimated the client’s ____ and _____ in a laboratory setting.
• VO2R is the difference between VO2 max and resting VO2.
• Target VO2 Reserve =
– [(VO2 max – VO2 rest) × intensity] + VO2 rest.
Determining Intensity: Talk Test
• The talk test method is a ____ measure of relative intensity
• The ability to talk helps gauge exercise intensity
– Easy to talk: low intensity
– Able to talk but not sing: moderate intensity
– Difficult to talk: vigorous intensity
Determining Intensity: Perceived Exertion
• The perceived exertion method is a subjective rating of how hard one may be working.
• Primarily measured using ___ Scales
– OriginalScale:6-20
– CR-10:0-10
• Exercise Prescriptions:
– OriginalScale:11-16 – CR-10Scale:5-8
.VO2max, vo2max
VO2max, resting vo2, subjective, borg
Abnormal Responses to Exercise
• Most measureable changes that occur at the onset of or during exercise is normal and healthy
• The EP-C should be aware of abnormal responses so as to know when to terminate an exercise session and/or seek medical attention
• The ‘How To’ box provides guidelines related to stopping exercise tests
Contraindications to Cardiovascular Training
• Individuals with clinical conditions and disorders should be supervised by ____ trained personnel when beginning an exercise program.
• Preexercise screening, informed consent, and review of medical history are necessary for the EP-C to identify potential contraindications and to ensure client safety.
• Apparently healthy individual experiencing signs and symptoms should stop exercise and be referred to a professional.
Effects of Medication on CR Exercise
• It is important for the EP-C to understand the potential complex interactions of medication and exercise.
• Medications may alter HR, BP, and/or exercise capacity
– clientstakingmedicationshouldbestrongly encouraged to communicate any changes in medication to the EP-C
• Reference Chapter 7 for further information.
Musculoskeletal Injuries
• Exquisite point tenderness
• Pain that persists even when the body part is ____
• Joint____
• Pain that does not go away after warming up
• Swelling or discoloration
• Increased pain with weight-bearing activities or with active movement
• Changes in normal ____ functions
Effects of Heat, Cold, and Altitude
• Heat Stress
– Hot environments ____ the body’s ability to dissipate heat and promote_____ in core body temperature.
– Sweat rate and skin _____ increase during heat stress to promote heat loss
– Increased sweat rates can cause a _____in plasma volume and increase risk of _____.
– Increased sweat rates may lead to a _____ in SV &; _____ HR to maintain cardiac output
.clinically, at rest, pain, bodily
Reduce, increases, blood flow, Reduction,
Dehydration, decrease, increase,
• Cold Stress
– Cold environments challenges the body to increase heat production and limit heat loss via shivering and _____ of blood vessels in the skin.
– Individuals with greater subcutaneous fat mass have an advantage at ____ heat loss
– Respiratory rate is ____ at a given submaximal intensity and VO2max may be slightly ____ when compared to neutral environments
• Altitude
– High altitude environments cause the partial pressure of O2 to ____ and _____ ability to provide O2 to working muscles.
– Pulmonary ventilation _____ in response to lower PO2 at altitude.
– Initial exposure to altitude causes a _____ in SV, a large______ in HR, and a slight _____ in cardiac output
• Heat
– Benefitsofheatacclimatization:lowercorebody temperature, lower skin temperature, ____ sweat rate, ____ plasma volume, _____ HR at a specific workload, lower perception of effort, and improved conservation of ____.
– Heat acclimatization requires ____hours of moderate to high intensity exercise in a hot environment for ___consecutive days.
• Cold
– Benefits of cold acclimatization: enhanced ability to maintain ____ production through means besides shivering.
– Cold acclimatization has been show to improve maintenance of hand and feet temperatures that normally accompanies cold exposure
• Altitude
– Benefits of altitude acclimatization: the low PO2 at altitude stimulates the production of additional ____ (erythropoiesis) to increase the_____ carrying capacity of the blood.
– After the oxygen carrying capacity of the blood is restored via _____, the HR, SV, cardiac output, and pulmonary ventilation responses to exercise revert back to more typical conditions.
Summary
• There are numerous means of assessing cardiorespiratory fitness, so that the EP-C can accommodate a wide range of clientele safely.
• The FITT-VP principle provides a framework of prescribing exercise that also allows for tremendous individual variation.
• Properly assessing and prescribing exercise can play a significant role in helping individuals initiate an enjoyable exercise program.
.vasoconstriction, limiting
Higher, lower, decrease, reduces, increases,
Decrease, increase, increase,
Higher, higher, lower, sodium,
2-4, 10, heat, red blood cells, oxygen,
Erythropoiesis,
