Chapter 1 Flashcards
Very light - light Metabolic equivalents (METs)
< 3.0 METs
Moderate Metabolic equivalents (METs)
3.0 - 5.9 METs
Vigorous equivalents (METs)
> ou égal 6.0 METs
Threshold daily dose of physical activity
30min or more of at least moderate PA on at least 3 days per week
Moderate PA %
40 to 60% of heart rate reserve HRR or maximal oxygen uptake reserve
Moderate intensity PA - RPE scale 6-20
12-13
Ischemia
Lack of oxygenated blood flow to the tissue, such as the heart
Other word chest pain
Angina
Chest pain or angina is not always located in the chest area; where else?!
Women may experience lower back pain or feelings of indigestion
Pain or discomfort in the chest, neck, jaw , arms, teeth, fingers
What is dyspnea?
Medical term for shortness of breath
Dyspnea at rest or mild exertion suggests what?
Suggest the presence of cardiopulmonary disorders, in particular left ventricular dysfunction or COPD (chronic obstructive pulmonary disease)
Syncope or fainting and dizziness during exercise may indicate what?!
It may indicate poor blood flow to the brain due to inadequate cardiac output from a number of cardiac disorders
Can also occur in healthy individuals as a result of a reduction in venous return to the heart
Orthopnea refers to what?!
Refers to trouble breathing while lying down
Ankle edema or swelling that is not due to injury is suggestive to what?
Suggestive of heart failure, blood clot, insufficiency of the veins, or a lymph system blockage
Palpitations and tachycardia both refers to what?
Refers to rapid beating or fluttering of the heart
Intermittent claudication refers to … and indicates what?
Refers to severe calf pain when walking
It indicates a lack of oxygenated blood flow to the working muscles
Heart murmurs are…
Unusual sounds caused by blood flowing through the heart
Some can be innocent but some may indicate valvular or other cardiovascular disease
CMR refers to..
Cardiovascular, Metabolic and/or Renal disease
Vigorous exercise is often defined as:
Greater than or equal to 60% of the client’s functional capacity
>= 6 METs >= 14 on 6-20 RPE scale
Another term for heart attack
Myocardial infarction
Coronary revascularization can refers to 2 serious disorders
Bypass surgery
Angioplasty
What is Coronary Bypass Surgery
It redirects blood around a section of a blocked or partially blocked artery in your heart. The procedure involves taking a healthy blood vessel from your leg, arm or chest and connecting it below and above the blocked arteries in your heart. With a new pathway, blood flow to the heart muscle improves.
It doesn’t cure the heart disease that caused the blockages, such as atherosclerosis or coronary artery disease. However, it can ease symptoms, such as chest pain and shortness of breath. For some people, this procedure can improve heart function and reduce the risk of dying of heart disease.
What is Angioplasty?
Angioplasty is a procedure to improve blood flow in coronary arteries that have become narrow or blocked. Your coronary arteries supply oxygen-rich blood to the heart. If you have coronary artery disease, a sticky material called plaque builds up in the coronary arteries. Plaque is made of cholesterol, calcium, and other substances in your blood. Over time, it can narrow your arteries or fully block them. When this happens, some parts of your heart don’t get enough blood.
Angioplasty widens the blocked part of the artery so more blood can get through. It is also called percutaneous coronary intervention (PCI).
Define sedentary lifestyle!
Not participating in a regular exercise program nor meeting the minimal recommendations of 30min or more of moderate PA on 3 days/week for at least 3 months
Obesity is defined as…
A BMI greater than or equal 30kg.m or a waist circumference of greater than 102cm for men and great than 88cm for women
Hypertension refers to…
Having a resting blood pressure equal to or above 130 mm Hg systolic
OR
Equal to or above 80 mm Hg diastolic OR if the client is taking any of the numerous antihypertensive medications
How many times resting blood pressure must have been assessed?
Resting blood pressure must have been assessed on at least two separate occasions
Dyslipidemia refers to what?
Having a LDL-C (low-density lipoprotein cholesterol) equal or above 130 mg.dL
And an HDL-C of less than 40 mg.dL
Or if the client is taking a lipid lowering medication
Diabetes can be defined as…
As having a fasting plasma glucose >= 126 mg.dL (7.0 mmol.L)
Or 2h plasma glucose values in oral glucose tolerance test >= 200 mg.dL
Or HbA1C >= 6.5%
What does a FBG (fasting blood glucose) of 126 mg.dL or greater would indicate?
It would indicate that the individual has diabetes which would automatically place him or her in the high-risk level
What level of High-serum HDL would represent a negative risk factor that would offset one positive risk factor?
High-serum HDL-C equal or greater than 60 mg.dL
In the systemic circulation (aorta to vena cava) what type of blood is being carried?
Arteries and arterioles carry oxygenated blood
In the pulmonary circulation (pulmonary artery to pulmonary vein) what type of blood is being carried?
Arteries and arterioles carry deoxygenated blood
As the vasculature is more distal from the heart, arteries become what and what?!
Arteries branch into smaller arterioles, which in turn branch and merge with the capillaries
What is the smallest and most numerous of the blood vessels and is the location of gas and nutrient exchange?
The capillaries
Deoxygenated blood and metabolic byproducts move from what to what?
Move out of capillaries into venules, which consolidated into veins as they move closer to the heart
What is responsible for delivering the deoxygenated blood back to the heart? (Which side of the heart?)
Veins are responsible for delivering the deoxygenated blood back to the right side of the heart
Following order of the deoxygenated blood in the circulatory system!
Right atrium, right ventricle, pulmonary artery, lungs, pulmonary veins, left atrium, left ventricle, aorta, organs and tissues and finally the vena cava before returning back to the right atrium
What are the three primary metabolic systems to create ATP?
Creatine phosphate (CP)
Anaerobic glycolysis
Oxidative system
What is the most immediate source of ATP?
The Creatine Phosphate (CP)
For what type of efforts the Creatine Phosphate system is only used?
The CP system can provide ATP to fuel work only during short-intense bouts of exercise, owing to the limited storage capacity of CP within each cell
Primary source of ATP during very short, intense movements?
Creatine phosphate system, for efforts lasting less than approximately 10 seconds
Next most immediate ATP energy source system after the CP system?
Anaerobic glycolysis
What anaerobic glycolysis breaks down into what?
Breaks down carbohydrates (glucose or glycogen) into pyruvate
In the absence of adequate oxygen supply, pyruvate is converted to…?
Converted to lactic acid, which gradually builds up in muscle cells and the blood
When oxygen is available in the mitochondria of the cell, pyruvate continues to be broken down to… and enters the … energy system
acetyl-coenzyme A (acetyl-CoA)
aerobic energy system
What is the primary source of ATP during medium-duration, intense exercise such as the 200m and 400m or any exercise that cannot be continued for more than approximatively 90 seconds?
Anaerobic glycolysis
What energy system is being used for longer duration exercise or low-intensity exercise?
The aerobic or oxidative energy system
Which energy system is able to sustain energy production for longer durations?
Aerobic or oxidative energy system
The aerobic/oxidative includes two metabolic pathways, which ones?!
The Krebs cycle (aerobic glycolysis)
The electron transport chain
What does the oxidative system requires to produce ATP? And where?
Requires the presence of oxygen, which takes place in the mitochondria of the cell
Where is the majority of ATP generated?
In the mitochondria (the powerhouse of the cell)
What nutrients does the Krebs cycle require?
It requires the presence of carbohydrates, proteins and fats
The oxidative/aerobic system is the primary source of ATP used during low to moderate intensity lasting longer than… all the way up to long distance endurance events
Longer than 1 to 2 minutes all the way up to long distance endurance events
Oxygen is required to create ATP via which energy system?
Via the oxidative energy system
What does EPOC stand for?
Excess postexercise oxygen consumption
After cessation of exercise, VO2 remains elevated because of…?
The increased work associated with the resynthesis of ATP and CP within muscle cells
Lactate removal
Elevated body temperatures
HR…
What equation can be used to determine VO2 max?
The Fick equation
Develop the Fick equation for VO2 max:
VO2max = HRmax . SVmax . a-VO2 diff max
a-VO2 difference refers to what?
Maximal arteriovenous oxygen difference
Why is it important that women not perform any exercises in the supine position after the first trimester?
Blood flow to the heart is reduced during exercise performed in the supine position due to the weight of the fetus lying compressing the inferior vena cava.
In order to ensure that orthostatic hypotension and obstruction of venous return do not occur, exercises performed in the supine position are discouraged
Prediabetes fasting glucose level:
100 - 125 mg.dL
The a-VO2 difference reflects the difference in oxygen content between the … and the …blood taken up by the working muscles
The arterial and the venous blood
Resting oxygen content is approximately … mL.dL in arterial blood and … mL.dL in venous blood
20 mL.dL in arterial blood
15 mL.dL in venous blood
During exercise, … oxygen content decreases as a result of the increased consumption of oxygen by the working muscles
Venous oxygen content
With increasing exercise intensity, a-VO2 difference … as well
Increases as well
What is SV (stroke volume)? (p56)
Stroke volume is the volume of blood the heart ejects with each beat
Cardiac output is the product of … and … and is also a measure of blood pumped per minute
The product of HR and SV
Pulmonary ventilation is the volume of air … and … per minute
Inhaled and exhaled
Blood pressure is proportional to the product of … and …
The product of cardiac output and total peripheral resistance (TPR)
What is total peripheral resistance (TPR)?
The overall resistance to blood flow by the blood vessels
Systolic blood pressure (SBP) is the pressure in the arteries during … contraction, or systole and is heavily influenced by changes in …
Ventricular contraction
Changes in cardiac output
Thus, just as cardiac output increases linearly with increasing workload, so does …
Systolic blood pressure (SBP)
… is the pressure in the arteries when the heart is relaxed, and is heavily influenced by …
Diastolic blood pressure (DBP)
Total peripheral resistance (TPR)
During graded exercise, TPR may drop slightly because of the large muscle …
Vasodilation
HR, pulmonary ventilation, a-VO2 difference, SV, cardiac output, SBP and mean arterial BP … during graded intensity exercise, whereas … remains stable or decreases slightly during aerobic type exercise
Increase
DBP remains stable
The Exercise Physiologist should assess … and … before, during and after exercise
HR and BP
HR should be assessed at least … times at each stage to ensure that it is appropriate to move to the next workload
Two times
At rest, the heart consumes approximatively …% of the oxygen delivered to the cardiac muscle
70%
SBP is the point at which the first of two or more … sounds is heard
Korotkoff
DBP is the point … the disappearance of Korotkoff sounds
Before the disappearance
BP should be measured in … arms during the first examination
In both arms
Cardiorespiratory fitness is an umbrella term that serves as an indicator of the functional capacity of ……. to work in synchrony to support dynamic, large muscle mass exercise
The heart, lungs, blood vessels, and muscles
The gold standard used to mesure Cardiorespiratory fitness (CRF) is the assessment of …
VO2 max
…… is the raw volume of oxygen consumed by the body, whereas …… is the volume of oxygen consumed relative to body weight and can serve as a useful measure of fitness between individuals
Absolute oxygen consumption
Relative oxygen consumption
One … is equal to the relative oxygen consumption at rest, which is approximately … mL.kg.min
One MET
3.5 mL.kg.min
… kcal equals 1lb of fat
3,500 Kcal
Other term for VO2 max?
Open circuit spirometry
What does the acronym FITT-VP mean?
Frequency
Intensity
Time (duration)
Type (mode)
Volume (amount of exercise)
Progression (advancement)
Frequency (how often should you perform aerobic exercise) - moderate & vigorous intensity
Moderate intensity: at least 5x/week
Vigorous intensity: at least 3x/week
Intensity of aerobic exercise for moderate and vigorous intensity
Moderate: 40-59% VO2R
Vigorous: 60-84% VO2R
Time for aerobic exercise during the week (moderate and vigorous)
At least 150 min.week of moderate intensity (at least 300min for weight/fitness goals)
75 min.week of vigorous intensity (at least 150min for weight/fitness goals)
Exercise Volume is the product of what?!
The product of FIT (frequency, intensity and time)
Weekly volume target in METs
> =500-1,000 MET min.week
equivalent to an energy expenditure of 1,000 Kcal.week
HIIT is traditionally performed at an intensity that is greater than the … threshold and is often performed at an intensity close to that which elicits >= …% peak heart rate
Anaerobic threshold
80 to 100%
Sprint interval training (SIT) is characterized by an all-out, supramaximal effort equal to or greater than the pace that elicits >= …% VO2peak
100% VO2peak
Heart Rate Reserve (HRR) or … method requires the EP-C to determine the resting HR and maximum HR of the client
Karvonen
The Heart Rate Reserve (HRR) method is the difference between … HR and … HR
Between Maximum HR and resting HR
Target HR (bpm) formula = ?!
Target HR= [(max HR - resting HR) x %intensity desired] + resting HR
Target method HR = ?!
Target HR = maximum HR x %intensity desired
The RPE range of …-… is recommended to improve CRF
11-16
Signs for stopping an exercise test:
Onset of angina-like symptoms
Drop in SBP of >= 10mmHg with an increase
Excessive rise in BP: SBP>250mmHg and/or DBP>115mmHg
Shortness of breath, wheezing, leg cramps or claudication
Signs of poor perfusion: light-headedness, confusion, ataxia, pallor, cyanosis, nausea or cold and clammy skin
Failure of HR to increase with increased exercise intensity
Noticeable change in heart rhythm by palpation or auscultation
Participant requests to stop
Physical or verbal manifestations of severe fatigue
Failure of the testing equipment
Hot environments reduce the body’s ability to dissipate … and thus promote an … in core body temperature
Dissipate heat
An increase
In an effort to maintain a neutral body temperature when exposed to a hot environment, … and … increase to promote heat loss
Sweat rate
Skin blood flow
Exercise in a cold environment facilitates … loss produced during exercise
Heat loss
However, long duration exercise events in a cold environment increase the risk of …
Hypothermia
If core temperature is challenged, the body attempts to increase heat production and limit heat loss via … and … on blood vessels in the skin
Shivering
Vasoconstriction of blood vessels
Individuals with greater subcutaneous fat mass have an davantage at limiting … loss in cold environments
Limiting heat loss
Overall, the effect on VO2max in a cold environment is … compared with that in a hot environment
Negligible
It is a common misconception that the thin air at altitude has less oxygen than the air at sea level; the percentage of oxygen in the air … the same at all elevations in the stratosphere
Remains
It is the change in … pressure that causes the pressure of oxygen (PO2) to decrease at altitude and reduce our ability to provide oxygen to working muscles
Barometric
In response to lower pressure of oxygen at altitude … ventilation increases
Pulmonary
… is the process of physiological adaptation that occurs in response to changes in the natural environment
Acclimatization

Both acclimatization and acclamation can … exercise performance in extreme environments
Improve
In order for a complete heat adaptation to occur … to … hours of moderate to high intensity exercise in the hot environment for 10 consecutive days is suggested
2 to 4 hrs
The first few days of exercise in the hot or humid environments should be … in intensity with frequent rest periods provided
Light
Cold acclimatization causes the shivering threshold to be reset to a … mean skin temperature
Lower
The lower pressure of oxygen at altitude stimulates the production of additional … blood cells (erythropoiesis) to increased oxygen carrying capacity of the blood
Red blood cells
The body has more than … skeletal muscles
600
The smallest contractile unit within a muscle is called a … Which is made up of different …
sarcomere
proteins
A … consist of many sarcomeres
Myofibril
Groups of … make up a single muscle fiber or muscle cell
myofibrils
Different types of connective tissue called … surrounds the muscles
Fascia
The muscles that are the primary movers of a joint or called the …, And the muscles that assist in that movement are called …
Agonists
Synergists
… are muscles that oppose a movement
Antagonists
Type I fibers are also called … … fibers
slow twitch
Type one fibers or slow twitch fibers have a high oxidative capacity and a lower contractile force capability and are better for … activities
Endurance
Type II fibers are also called … fibers
fast twitch
Type II fibers or fast twitch fibers have a high … capacity and a higher contractile force capability and are better for … activities
Glycolytic
Strength/power activities
The ratio of type one and type two fibers in the body varies for each person and depends mainly on … factors
hereditary
Regular resistance training may cause a … change in fiber type composition
Small
Resistance training will … convert type one fibers to type two fibers
Will not
Muscle fibers are innervated by a motor neuron and this neuromuscular gathering is called a …
motor unit
Smaller motor units like type one fibers are recruited … and larger motor units like type two fibers are recruited later depending on the demands of the exercise
First
When a weight is lifted, the involved muscles normally shorten and this is called a … muscle contraction
Concentric
When a weight is lowered, the involved muscles lengthen and this is called an … muscle action
Eccentric
If a muscle is activated but no movement at the joint takes place the muscle action is called … or static
isometric
The highest force produced occurs during an … muscle action
eccentric
Maximal force produced during an isometric muscle action is … than that seen during a concentric contraction
Greater
As the velocity of movement increases, the amount of force that is generated … during a concentric muscle contraction and increases during an eccentric muscle action
decreases
High force development during maximal … muscle actions has been linked to muscle soreness
Eccentric
The …, which is the heaviest weight that can be lifted only once using proper technique is the standard muscular strength assessment
The 1-RM
One rep max performance is significantly … on weight machines than free weights
Greater
Assessing muscular endurance with the … test
push-up
Seven fundamental principles that determine the effectiveness of all resistance training programs are the principles of …….
progression regularity overload creativity enjoyment specificity supervision
A reasonable guideline for a beginner is to increase the training weight about … per week and decrease the repetitions by 2 to 4 when given load can be performed for the desired number of repetition with proper exercise technique
5% to 10%
The principle of specificity is often referred referred to as the SAID principle which stands for …..
specific adaptations to imposed demands
The … plane cuts the body in the right and left side
sagittal
The frontal (coronal) plane cuts or separates the body in a … and … sides
Front and back sides
The … plane separates the body on an upper and lower parts
transverse (horizontal)
… training is the most common methods of resistance training for enhancing muscular fitness
Dynamic constant external resistance
DCER
… training involves dynamic muscular actions that are performed at a constant angular limb velocity
Isokinetic
Isokinetic training requires specialized equipment and most isokinetic devices are designed to train only … movements
single-joint
Unlike other types of resistance training, the … of movement rather than the resistance is controlled during isokinetic training
speed
… kinetic chain exercises are those in which the distal joint segment is stationary like a squat
Closed
… kinetic chain exercises are those in which to terminal joint is free to move like leg extension
Open
… kinetic chain exercises more closely mimic every day activities and include more functional movement patterns
Closed
Loads of six or less reps have the greatest effect on developing muscle …
Strength
Loads of 20 or more reps have the greatest effect on developing local muscular …
Endurance
Repetitions ranging between 8 to 12 (60% to 80% 1RM) are commonly used to enhance muscular fitness in … to … people
Novice to intermediate
Using lighter weights (<50% 1RM - 15-20reps) will have less effect on muscular strength but more effect on muscular …
Endurance
Consistent training at high intensities increases the risk of …
Overtraining
If the primary goal of the program is to maximize gains in muscular …, heavier weights and longer rest intervals are required
Muscular strength
Flexibility is defined as … of a joint or group of joints, as per the skeletal muscles and not any external forces
ROM
… flexibility is the full ROM of a given joint because of external forces
Static
… flexibility is the full ROM of a given joint achieved by the voluntary use of skeletal muscle in combination with external forces
Dynamic
Freely moveable joints or …
Synovial
Because … stretching is slow and controlled, it does not provide an increase in muscle temperature and blood flow redistribution
Static
PNF stands for…
Proprioceptive Neuromuscular Facilitation
PNF is a collection of stretching techniques combining … stretch with isometric and concentric muscle actions
Passive stretch
PNF is designed to use the autogenic and reciprocal inhibition responses of the …..
Golgi tendon organs (GTO’s)
There are … types of PNF stretching techniques
3 types
3 types of PNF stretching techniques:
Hold-relax (mostly used)
Hold-relax w/ antagonist contraction (mostly used)
Agonist contraction
Each PNF techniques consists of 3 phases:
1- a passive prestretch
2- passive stretch
3- contractions
… flexibility uses slow and controlled, sport-specific movements that are designed to increase core temperature and enhance activity-related flexibility and balance
Dynamic
There are … types of sensory organs that provide muscular dynamic and limb movement information to the central nervous system
Which ones are they?! …
Two types
Muscle spindles
Golgi tendon organs
… … are a collection of 3 to 10 intrafusal, specialized muscle fibers that are innervated by gamma motor neurons and provide information about the rate of change in muscle length
Muscle spindles
When muscle spindles are stimulated there is a dual response in which a rapid tension development is initiated in the stretched muscle and inhibited in the … muscle
Antagonist
The response in the stretched muscle is known as a stretch or … reflex and the response in the antagonist muscle is known as reciprocal inhibition
When talking about muscle spindles!
Myotatic
The … reflex is less likely to occur in slow and controlled movements
myotatic
… are located in the musculotendinous junction and respond to changes in muscle tension
GTO’s
The … for encapsulated in a series with 10 to 15 muscle fibers
GTO’s
When the GTO’s are …, there is a dual response in which tension development is inhibited in the contracting muscle (autogenic inhibition) and initiated in the antagonist muscles to protect the muscle tissue from damage
stimulated
A … is similar to a protractor and is used to measure a joints range of motion expressed in degrees
goniometer
Both lumbar flexion and lumbar extension are taking place in the … plane
sagittal
Define glenohumeral flexion
Lifting the arm in front of you
Define glenohumeral extension
Lifting the arm behind you
Both glenohumeral flexion and glenohumeral extension are happening in the … plane
sagittal
Both glenohumeral internal rotation and glenohumeral external rotation are happening in the … plane
transverse
Both hip flexion and hip extension are measured in the … plane
sagittal
Both hip abduction and hip adduction are being measured in the … plane
frontal
If the average range of motion is greater than 50°, the three measures should fall within … of the mean
When it comes to goniometer
+ or -10°
If the average range of motion is lesser than 50°, it is recommended that the measures fall within … of the mean
When it comes to goniometer
+ or -5°
Whereas … is the most accurate method to assess joint specific range of motion when used properly; the … test is perhaps the most commonly used assessment for flexibility in the lower back and hip joint
goniometry
sit and reach test
Flexibility gains are lost within … of ceasing flexibility exercises
4 to 8 weeks
To improve range of motion, … training sessions per week for at least 3 to 4 weeks may be required although daily stretching exercises may be more effective
2 to 3 training sessions
Flexibility training should be conducted when a muscle is … and therefore should be completed after an aerobic warm-up of at least five minutes and some general flexibility exercises
Warm
Since some researchers have demonstrated that acute pre-exercise flexibility training may have negative effects on ensuing performance, … …flexibility training may be more beneficial
post exercise
When … stretching is being used, a 20% to 75% maximum voluntary contraction should be held for 3 to 6 seconds contraction followed by a 10 to 30 seconds assisted stretch is recommended
PNF
Individuals who are using … antibiotics are at an increased risk for tendon rupture and joint and muscle damage and therefore should approach flexibility exercises with extreme caution
Fluoroquinolone
Holding a static stretch for … seconds is recommended for most adults
10 to 30 seconds
In older individuals holding a stretch for … seconds may confer greater benefit
30 to 60 seconds
… is understood to be the sense of knowing where one’s body is in space and is composed of static (joint position sense) and dynamic (kinesthetic movement sense)
Proprioception
… enables us with closed eyes to estimate the size of our feet, to describe the width of our pelvis and scratch our noses
Proprioception
Proprioceptive acuity is gathered from specialize nerve endings, termed … that are located within the skin, muscles, fascia and joints
mechanoreceptors
… is an important mediator of joint stability and mobility and ultimately the calibration of movement
Proprioception
… control is developed through enhancing proprioceptive acuity and grooving proper movement patterns through practice
Motor control
Information collected from … and … further supports proprioception and when taken together the result is precise body awareness and well adapted motor actions
visual and vestibular centers
… has been defined as the state of remaining unchanged, even in the presence of forces that would normally change the state or condition
Stability
Generally speaking, … muscles are superficially located and responsible for controlling locomotion, alignment, and balancing forces imposed on the spine
mobilizing
… muscles are more centrally located and largely function to create stiffness across joints
Stabilizing
… muscles are shorter in length and respond to changes in posture and extrinsic loads
Stabilizing
Conversely, … or global muscles comprise long lever arms, allowing greater force production, torque and gross multi-planar movements
mobilizers
Mobilizer muscles are:
Fast twitch
fatigues easily
superficial
relatively small proprioceptive role
high force production
prone to hold access tension/shorten
concentric
gross movement
Stabilizer muscles are:
Slow twitch
resistant to fatigue
deep
major contributor to proprioception
low force production
prone to inhibition/weakness
isometric/eccentric
joint stabilization
The hypertonicity of the hip flexors then contributes to the progressive weakening of the gluteus maximus via … …
reciprocal inhibition
The gluteus maximus is an important hip extensors; thus, when forceful hip extension is necessary, the … (synergist of the gluteus maximus) will compensate for the weakened gluteus maximus
hamstrings
When the pelvis rotates …, it reduces the neutral curvature of the lumbar spine (flattens the low back)
posteriorly
Alterations in movement … can stem from multiple factors including obesity and overweight, sedentary behavior, poor postures, unvaried movement, join structure, propensity for certain muscles to become inhibited, and age
quality
More specifically, … position optimizes ideal muscle-length tension and force-coupling relationships, minimizes compressive and shear forces imposed on the joint, and optimizes the timing and speed of contraction of stabilizing muscles
Neutral position
Use of a … line is useful in identifying deviations from a neutral position.
Clients should be barefoot, wear form-fitting clothing that enables the assessor to identify bony landmarks, and be encouraged to assume their everyday, relaxed posture during the assessment
P.168
Plumb line
Specific stretching that targets postural corrective deviations - p169
Useful Informations
The client should be encouraged to maintain three points of contact with the dowel:
the back of the head
the upper thoracic spine
and the pelvis
Progressive six stages for neutral posture
Lying on the ground
Seated
standing
standing and adding in hip hinging
farmer carries with bilateral loading
farmer carries with unilateral loading
First, the … muscles are not only the prime muscles of respiration but they are also a vital muscle of core stabilization
diaphragm
The … assessment is a simple assessment of proper diaphragmatic control during breathing
Hi-Lo assessment
Healthy breathing patterns, or diaphragmatic breathing, involve the expansion of the rib cage and abdomen and involves proper recruitment and Endurance of the … muscles
diaphragm
Clients demonstrating improper breathing habits should be encouraged to regularly practice breathing that is focused on expansion of the rib cage and upper abdomen prior to any chest movement and to increase the length of each breast, in particular the client should be encouraged to fully …
Exhale
Define the Hi-Lo breathing assessment
Client places one hand on his sternum and one hand on his upper abdomen
The client is then instructed to perform 10 breathing cycles
The client reports which hand moved first at the beginning of the inhalation face during the majority of their assessment. In addition, the practitioner should observe the hand movements of the client
Head positioned in front of the body or tilting up or down
Lots of cervical neutral
Rounding of the thoracic spine
Loss of thoracic extension
Loss of neutral lordosis in the lumbar spine or flattening of the lumbar spine
Posterior pelvic tilt
Excessive arching of low back
Anterior pelvic tilt
Knees collapsing inward
Knee valgus
Suggested corrective exercises for common alignment faults
P176
See the table there! Good informations for bettering posture
… involves the compression of soft tissue using tools such as foam rollers, roller massagers, or tennis balls and is performed by the individual rather than by a therapist
Self myofascial release
Self myofascial release increases local … which may aid in the reduction of inflammation
bloodflow
… are a set of non-invasive, quantitative techniques for determining body size by measuring, recording, and analyzing specific dimensions of the body, such as height, weight, and body circumference
Anthropometrics
… is a measure of weight in relation to a person’s height
Body mass index
Body mass index is calculated by … body weight in kilograms by height in meters squared
dividing
Classification of individuals as underweight using the body mass index
< 18.5 kg.m-2
Normal weight Classification using the body mass index
Between 18.5 to 24.9 kg.m-2
Overweight classification using the body mass index
From 25.0 to 29.9 kg.m-2
Obese classification using the body mass index
Superior or equal to 30 kg.m-2
… obesity (also referred to as abdominal or android obesity) is associated with a higher risk of hypertension, metabolic syndrome, type two diabetes mellitus, dyslipidemia, CVD, and premature deaths compared with … obesity, which is characterized by a greater proportion of fat distributed on hips and thighs
Central
Gynoid
Body fat distribution can be determined using the waist-to-hip ratio
You must … the circumference of the waist by the circumference of the hips
divide
Waist circumference alone can be used as an indicator of health risk because it reflects the level of … obesity
abdominal
Health risks are high when the waist circumference is …
superior or equal to 35 inches (88 cm) for a woman
superior or equal to 40 inches (102 cm) for men
Standardized sides when measuring circumferences
Abdomen
arm
buttocks/hips
calf
forearm
hips/thigh
mid-thigh
Waist
… … is the relative proportion of fat and fat-free tissue in the body
Body composition
When it comes to body fat percentage, a range of … for men and … for woman is considered satisfactory for health
10% to 22% for men
20% to 32% for women
… measurements are used to determine the amount of subcutaneous fat, that is, the fat located directly below the skin
Skinfold
The accuracy of predicting the percentage body fat from skin folds is …
+/- 3.5%
When measuring skin folds, take all measurements on the .., side of the clients body with the client standing upright
right
Bioelectrical impedance is related to the percentage of … contained in various body tissues
water
… estimates total body water and relies on regression equation to estimate percentage body fat
Bioelectrical impedance (BIA)
The accuracy of predicting the percentage body fat from bioelectrical impedance ranges between … …
+- 2.7% and 6.3%
These guidelines will assist in obtaining an accurate prediction of percentage body fat using bioelectrical impedance:
No eating or drinking within four hours of the test
No exercise within 12 hours of the test
Completely avoid the bladder within 30 minutes of the test
No alcohol consumption within 48 hours of the test
No diuretic medication within seven days of the test (clients should not discontinue use of prescribe diuretic medication unless approved by the personal physician)
Avoid taking measurements prior to menstruation to avoid possible effects of water retention in woman
Use the same bioelectrical impedance analyzer when measuring change in a clients body composition overtime
Complete measurements in a thermoneutral environment
The technique of … … calculate body density from body volume, based on Archimedes principle, which states that the weight underwater is directly proportional to the volume of water displaced by the body volume
Hydrostatic (underwater) weighing
Densities of muscle and bone are … than the density of water, whereas fat is less dense than water
higher
A person with high levels of muscle and bone will be … in water compared with a person with high levels of fat
heavier
Hydrostatic weighing has a standard error of the estimate of …
+- 2.7% body fat
… … … also measures body volume and is an alternative to hydrostatic weighing for determining body composition
Air displacement plethysmography
Air displacement plethysmography has many advantages over … …, and that it is quick and non-invasive, does not require submersion in water, and accommodates children, adults, and older adults as well as individuals who are obese or disabled
hydrostatic weighing
… uses very low current x-rays at two energy levels to measure bone mineral content, body fat, and lean soft tissue mass
DEXA
The … method requires an individual to lie supine on a table while being scanned from head to toe
DEXA
With appropriate standards and methodology, the reproducibility of DEXA is … for percentage body fat
1.7%
New guidelines indicate that a … reduction in body weight produces health benefits
3% to 5%
Safe and effective weight loss should occur at a rate of … pound per week
1 to 2 lbs
… … … is the total number of calories expended each day and reflects the amount of energy required to carry out or metabolic processes within the body
Total energy expenditure
There are three components to determining total energy expenditure (TEE):
Resting energy expenditure or basal metabolic rate; represents about 60 to 70% of TEE
Thermic effect of food represent 10% of TEE
Physical activity expenditure represent 20 to 30% of TEE
When calculating for weight loss, the recommended rate in adults is 1 to 2 pound per week, which is equal to a daily caloric deficit of … calories
500 to 1000 calories
Following the FITT principal what is the frequency for weight loss
Superior or equal to five days a week to maximize calorie expenditure
Following the FITT principal what is the time advised for weight loss?
A minimum of 30 minutes per day (150 minute per week) progressing to 60 minutes per day or 300 minutes per week or more of moderate intensity aerobic activity
DOMS stands for?
Delayed onset muscle soreness
Muscle hypertrophy occurs only after … weeks of higher intensity resistance training, and therefore it is highly unlikely to see any muscle gain in the first two months of exercise
6 to 8 weeks
Appropriate weight loss methods include exercise, dietary changes, behavioral strategies, and … …
bariatric surgery
Although a safe upper limit has been established for adults and caffeine …, there is no recommendation for adolescents
(250 to 300 mg per day)
For instants, the IOM recommends at least … g of carbohydrates each day for all age groups
130g
The pregnant woman needs an additional … cal each day to ensure that enough essential nutrients are available for both mother and baby
300 calories
In addition to the increased daily need for proteins, there’s also an increased dietary needs for … and … that is provided in prenatal vitamin
Folic acid and Iron
… (a B vitamin) is important in the prevention of serious birth defects such as neural tube defect and congenital heart disease
Folic acid
Extra … is needed to help support the increased blood supply needed to carry extra oxygen throughout the pregnancy
Iron
It is also recommended that pregnant women do not take herbal or botanical … because they were not FDA regulated in terms of dosage, purity, and testing
supplements
In addition, the demand for other nutrients such as …, … and … increase during pregnancy
calcium, proteins and carbohydrates
Vitamin D recommendations for children and adolescents ages 1 to 18 years is … IU, and recommendations for adults older than 71 years is … IU
600 IU
800 IU
Also in the older adults, vitamin D is particularly important in its role of promoting the absorption of … and in maintaining serum calcium levels, which in turn protects bone strength
calcium
Current daily calcium recommendations are … mg per day for 4 to 8 years olds, with an increase of calcium for 9 to 18 years olds to 1300 mg per day
1000 mg
Adults aged 19 to 50 years need … mg of calcium per day
1000 mg
Calcium absorption … with age, thus increasing the need of this nutrient in the older adult population
declines
Post menopausal woman (51 years and older) tend to experience greater bone loss and decreased absorption of calcium, which increases the need in this population to … mg per day
1200 mg
In older adults, vitamin … supplementation can be important
B12
… … account for more American deaths than any other disease, with nearly 650,000 total deaths annually
Cardiovascular diseases (CVDs)
… … disease is one of the most prevalent types of cardiovascular disease and also accounts for the most cardiovascular deaths
Coronary artery disease (CAD)
… … … is characterized by any one of several factors, including a buildup of atherosclerotic plaques, vascular remodeling resulting in luminal stenosis, and inflammation, brought on by numerous factors, including dyslipidemia and hypertension
Coronary heart disease (CAD)
Central to coronary heart disease is the formation of atherosclerotic plaque in the elastic and smooth lining inside of …
Arteries
Plaque formations in the … arteries will obstruct blood flow to cardiac muscle tissue downstream of the obstruction resulting in reduced cardiac function and/or tissue death (necrosis)
coronary
Atherosclerosis is a process where a … … develop causing the artery wall to thicken while reducing nominal diameter
fatty streaks
A partial impairment of coronary artery blood flow and therefore oxygen delivery to cardiac tissue is referred to as … …
myocardial ischemia
The complete obstruction of blood flow to the cardiac myocardial tissue is referred to as a … … or a heart attack and results in tissue death or necrosis
myocardial infarction (MI)
… is considered the “silent killer” because this condition’s signs and symptoms often go unnoticed
Hypertension (HTN)
Hypertension is characterized as a persistent elevation in either … and …
systolic blood pressure (superior to 130 mm HG)
or
diastolic blood pressure (superior to 80 mm Hg)
Blood pressure is regulated by two factors:
cardiac output (a function of heart rate and stroke volume)
total peripheral vascular resistance
Increased … resistance is the most common characteristic of primary and secondary hypertension and is caused by chronic vasoconstriction, or narrowing of the peripheral arterioles, or by vascular plaque buildup
peripheral
When … is present, arterioles lose elasticity because of the increase the presence of fibers collagen tissue
hypertension (HTN)
Specifically, … … … is characterized by occlusion or narrowing of peripheral arteries or vessels of the upper and lower limbs as a result of the buildup of atherosclerotic plaques
peripheral artery disease (PAD)
The most common symptom of peripheral artery disease (PAD) is … … that is characterized by repeatable aching, cramping sensation, or fatigue affecting the muscles of the calf in one or both legs
intermittent claudication
The severity of peripheral artery disease (PAD) is based on the extent of … and is qualified by the use of ankle/break your systolic pressure index (ABI)
claudication
Type one and type two diabetes are defined by a decrease in the production, release and or effectiveness, and action of …
insulin
Either form of diabetes mellitus results in increased blood glucose levels, a condition referred to as …
hyperglycemia
Type … diabetes is quite uncommon found in only 5 to 10% of all patients with diabetes and is characterized by an absolute deficiency in blood insulin release because of the destruction of pancreatic insulin secreting beta cells
Type 1
The patient with type two diabetes has elevated glucose levels which is typically result of increasing insulin …
resistance
Excessive … fat is the leading cause of type two diabetes
abdominal
Type … diabetes responds well to exercise therapy and drugs that either increase insulin sensitivity or decrease blood glucose levels
two
…, defined as elevated blood cholesterol and triglyceride levels, is caused by a combination of genetic and or environmental factors
Hyperlipidemia
Lipids are packaged with proteins and travel through the blood as ..,
Lipoproteins
… are classified by their density: chylomicrons, very low density lipoprotein (VLDL), low density lipoprotein (LDL), and high density lipoprotein (HDL)
Lipoproteins
… is responsible for aiding in the removal of lipids from the circulation, through reverse cholesterol transport
HDL
If HDL levels are less than … mg/dL, very little reverse cholesterol transport occurs, leading to further vascular lipid accumulation and accelerated atherosclerosis rates
40 mg.dL-1
Excessive amounts of total blood cholesterol (superior … mg/dL) and LDL or bad cholesterol (superior … mg/dL), is associated with increased risk of atherosclerosis and coronary artery disease
200 mg.dL-1
130 mg.dL-1
Obesity is defined as an excessive accumulation of body fat and is associated with a body mass index superior or equal to …
30 kg.m-2
… … involves a clustering of metabolic risk factors including hyperglycemia (or current blood glucose medication use), elevated blood pressure (or current hypertension medication use), dyslipidemia (or current lipid lowering medication use), and central adiposity based on waist circumference
Metabolic syndrome
Most pulmonary diseases are grouped into two categories:
chronic obstructive pulmonary disease is (COPD)
chronic restrictive pulmonary disease (CRPD)
… is an umbrella term for a collection of pulmonary diseases, including chronic bronchitis, emphysema, and asthma
COPD
… is characterized by progressive airflow limitation associated with an abnormal inflammatory lung response that limits the lung’s ability to move air during inhalation and exhalation
COPD
… … is characterized by a cough lasting for at least three months, resulting in chronic pulmonary inflammation which leads to damage of the bronchial lining and impeded lung function in airflow obstruction
Chronic bronchitis
… is the permanent enlargement of air spaces along with necrosis of alveolar walls, causing an accumulation of air in the lung tissue
Emphysema
… consist of both inflammation and increased smooth muscle constriction in the lungs in response to various stimuli
Asthma
During an… episode, inflammatory mediators are released causing bronchial smooth muscle spasm, edema formation, and the production of mucus resulting in vascular congestion
asthmatic
…, also known as interstitial lung disease, is made up of a small group of diseases that cause inflammation resulting in lung tissue necrosis and decreased lung volume
CRPD
Both clients with … and … have limited gas exchange within the lungs, frequent shortness of breath, and difficulty breathing
COPD and CRPD
Exercise has been shown to decrease coronary inflammatory markers, decrease stress and damage on the coronary arteries, an increase new blood vessel growth (…) and vascular regeneration which are all likely to promote faster recovery from myocardial infarction
angiogenesis
Regular exercise can also decrease blood platelet adhesiveness, fibrinogen levels, and blood viscosity, all of which reduce the risk of clotting and the likelihood for second … infarction
myocardial
Endurance exercise does lower … SBP and DBP values by 5 to 7 mm HG, and for individuals at risk for developing hypertension, endurance exercise is thought to slow blood pressure rise and delay hypertension development
resting
The most beneficial aspect for patients with type two diabetes that start an exercise program is the improved … … that is reported with exercise training which may result in lower medication requirement and greater control blood glucose levels
insulin sensitivity
… also provides a positive benefits on other blood lipid values by lowering blood concentrations of LDL and increasing concentrations of HDL
Exercise
What does FITT-VP stands for?
Frequency
intensity
time
type
volume
progression
PAD stands for:
Peripheral artery disease
DM stands for:
Diabetes mellitus
Being physically active and exercising … days a week is recommended for the patient with type two diabetes
5 to 7 days a week
Patients with type two diabetes that exercise in the early evening should be completed with caution because exercising at this time could cause … conditions later in the night, possibly during sleep cause dire consequences dire consequences
hypoglycemic
An individual who suffers an myocardial infarction has likely had a significant level of myocardial … as one key predisposing factor
ischemia
Myocardial ischemia, or simply ischemia, indicates a shortage of … blood flow to the heart myocardium
oxygenated
… is an imbalance of oxygen supply and demand
Ischemia
If oxygen supply fails to match an increased demand, even briefly, then … is present
ischemia
Often times, ischemia is associated with chest pain, or …
angina
CHF stands for:
Congestive heart failure
If the heart is deficient such as in the case of congestive heart failure (CHF) or because the arteries are partially blocked as in atherosclerosis, oxygen delivery to target muscle is impaired and exercise capacity is limited and the client has reach the “… …”
ischemic threshold
Any client experiencing … should exercise in the presence of someone with more specific training then the exercise physiologist (EP-C)
ischemia
An … … occurs when there is prolonged ischemia and can result in heart tissue death or necrosis
myocardial infarction (MI)
The ischemia duration necessary to produce an infarct varies; therefore, the EP-C must design exercise prescriptions that safely avoid the … … or the heart rate at which angina symptoms develop
ischemic threshold
Also, because … result in the loss of heart tissue, any necrosis will negatively impact the movement of an action potential throughout the heart as well as the contractile state of the heart as a pump, lowering ejection fraction and limiting exercise capacity and tolerance
necrosis
Normally, a single exercise session causes a linear increase in … while a steady constant DBP is maintained
SBP
The client with hypertension can exercise once hypertension is …
controlled
In the presence of uncontrolled hypertension (superior to 180/110 mm HG), exercise is only engaged … initiating drug therapy
after
For resting SBP greater than 180 mm Hg or resting DBP greater than 110 mm Hg, even if blood pressure medications are being taken, exercise is … and is not engaged until blood pressure is under control
contraindicated
During exercise, if SBP becomes greater than 220 mm Hg or DBP greater than 105 mm Hg, exercise is …, and blood pressure is allowed to return toward resting values
stopped
… can attenuate heart rate response by as much as 30 bpm
Betta blockers
Clients taking Betta blockers are advised to have … cool-down periods, where blood pressure is monitored after exercise to ensure that blood pressure does not fall to unsafe levels
longer
What is another name for the blood pressure cuff?
Sphygmomanometer
In more severe cases of PAD, some clients may need to begin exercising for only a total of … minutes per day will gradually increases of five minutes per day every 2 to 4 weeks depending on individual progression
15
A long warm-up may be needed for persons with PAD as a … environment mean aggravate symptoms of intermittent claudication
cold
Patients with … need constant blood glucose monitoring and the ability to measure before, during, and after exercise
diabetes
If preexercise or during exercise blood glucose measurements are less than … mg.dL, a carbohydrate snack 15 g is administered, and a blood glucose reading of greater than 100 mg.dL is obtained before starting or continuing exercise
70 mg.dL-1
When pre-exercise blood glucose values are greater than … mg.dL-1 with the presence of blood ketones or are greater than 300 mg with either presence or absence of ketones, blood glucose should be lowered prior to initiating exercise
250
When an active retinal hemorrhage is present or recent laser corrective surgery for retinopathy is completed, exercise is …
avoided
Because clients with … experience greater time for proper healing process, they should practice good foot care by inspection of feet before an after exercise and they wearing proper shoes and cotton socks to avoid foods sores and blisters
diabetes
Exercise with a partner or under the supervision of an exercise physiologist to reduce the risk of problems associated with … events
hypoglycemic
Exercise is not recommended during peak … action because hypoglycemia may result
insulin
… presents few, if any, exercise limitations, and individuals with elevated blood lipid levels are encouraged to engage in regular physical activity and exercise
Dyslipidemia
To optimize blood lipid concentrations, clients with dyslipidemia are encouraged to exercise for … durations
longer
In general, most lipid lowering drugs have no … on exercise responses
impact
Individuals who are obese are recommended to engage in moderate physical activity at least five, if not all, days of the week and progress to accumulating more than … kcal a week of energy expenditure
2000 Kcal
The primary goal when developing an exercise prescription for clients with … is to reduce barriers for activities of daily living and to help increase quality of life
COPD
The exercise physiologist must educated the client with COPD to push past the feeling of …
dyspnea
…, most commonly used for individuals with CVD, does not cause any concerns when prescribing exercise
Aspirin
Over-the-counter (OTC) cold and flu medications often contain some form of ephedrine that has been shown to … systemic blood pressure
increase
CCBs and ACE inhibitors increase … diameter
arterial
… … make setting initial exercise intensity difficult, may limit functional capacity, inhibit using HR as an exercise intensity target and require more rigorous patient self monitoring
Betta blockers
… … may also block symptoms of hypoglycemia and increase the risk of undetected hypoglycemia during and after exercise
Betta blockers
Two common nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen are used cautiously in patients with diabetes because both may increase the risk of …
hypoglycemia
… … are well known for decreasing mortality and risk of a second myocardial infarction but also have a profound effect on exercise response
Betta blockers
Although … … lower HR and myocardial contractility, these medications also increase exercise capacity by decreasing coronary ischemia
Betta blockers
Beta blockers may also block symptoms of … and increase the risk of an detected hypoglycemia during and after exercise
hypoglycemia
CCBs are used for treating … and …
hypertension and angina
Ace inhibitors are used for treating …
hypertension
… and … both increase arterial diameter, thereby lessening blood pressure and decreasing the work by the heart
CCBs and ACE inhibitors
CCB’s effect is …, whereas ACE inhibitors have a peripheral effect
central
CCB’s and ACE inhibitors pose less concern regarding exercise responses than … …
Betta blockers
… … do work in the lungs and can produce an irritating dry cough
ACE inhibitors
… and other cholesterol-lowering drugs tend to have very little effect on HR and contractility and thus no direct impact on exercise response and exercise capacity or the exercise prescription
Statins
Because the … is the site of action of statins and other cholesterol-lowering drugs, liver function should be checked regularly
liver
Statins alone or in combination with fabric acid are often associated with unusual … …
muscle soreness
Muscle soreness is an indication that a condition referred to as … might be evolving
rhabdomyolysis
People showing signs of rhabdomyolysis may need … recovery time or lower exercise intensities
increased
…, commonly used in congestive heart failure (CHF) and for certain persistent arrhythmias, increases contractility, slows HR, and mediates arrhythmias
Digitalis
Diuretics are used to control … and … by triggering the kidney to excrete water
hypertension and edema
The increased water excretion due to … use may result in an increased resting and submaximal HR
diuretics
Individuals using diuretics to control edema should check their … … regularly
body weight
In pulmonary disease, … are commonly used as a bronchodilator for both short term and long term relief and management of asthmatic symptoms
B2-agonists
Injury to a muscle or tendon is called a …
strain
Injury to a ligament or tissue that connects bones, is called a …
sprain
In either case, an acute strain or sprain occurs most often during an ..: contraction and/or when tissue is in an excessively stretched state
eccentric
In sport, the most common injury is a direct impact to the muscle that often causes a …
contusion
A … is a soft-tissue hemorrhage and/or hematoma that occurs after disruption of the muscle fibers, with subsequent information and edema
contusion
What does ecchymosis mean?
Discoloration
What does MRI stand for?
Magnetic resonance imaging
What does the acronym PRICE stand for when it comes to treatment?
Protect
restrict activity
ice
compression
elevation
… are collagenous fibrous structures that connect bone to bone and provide passive soft-tissue restraint of bone-to-bone contact
Ligaments
The most common side of a sprain is the ankle, and the most common mechanism for causing a sprain is … (foot falls inward) versus eversion
inversion
The initial inflammatory phase when getting injured is about … days or longer.
Inflammation occurs in response to acute tissue damage and is mediated chemically (histamine and bradykinin) to increase blood flow and capillary permeability, causing edema
2 to 3
Edema is an accumulation of … in surrounding tissues that act as a brace or immobilizer and protects the damaged tissue
fluid
The repair phase begins within … days after injury and varies in length depending on the type of tissue an extent of damage but could last up to two months
3 to 5 days
Following an injury and as the scar tissue develops, exercise should be designed to prevent muscle … and maintain joint integrity at the site of injury, and promote synthesis and optimum organization of new collagen fibers
atrophy
The final … phase following an injury is characterized by weakened, repaired tissue
remodeling
Tissue remodeling following an injury can take up to … months, and exercise should be progressive and gradually work toward activity-specific exercises
2 to 4 months
Muscle fiber size, fast twitch fibers, and rate of force production increase with … … as well, for an overall increase in muscle and connective tissue durability
resistance training
Injuries are generally categorized as … or …
acute or overuse
Examples of … injury include tendinopathies, plantar fasciitis (PS), and low back pain (LBP)
overuse
… is an acute inflammatory tendinopathy
Tendinitis
… describes a tendon with significant degenerative changes in the absence of an inflammatory response
Tendinosis
… is the more common of the two as most individuals seek treatment only after the acute inflammatory process has resolved
Tendinosis
Common sites for … include rotator cuff, common wrist flexor and extensor tendons, patellar tendon, and Achilles tendon
tendinopathies
There is considerable evidence that supports the use of appropriately graded … exercise as a safe and effective means for strengthening the muscle tendon unit (MTU) across the affected joint
eccentric
… exercise should be avoided early in the healing process of tendinopathies and plantar fasciitis until non-sport activities are pain-free
Concentric
… is an inflammation of a small fluid-filled sac called the bursa
Bursitis
The … acts as a cushion to reduce friction between muscles, tendons and joints
bursa
Common areas for … are the shoulders, hips, knees, and elbows
bursitis
Bursitis is best managed conservatively with rest, … modalities, and NSAIDs
thermal
Plantar fasciitis occurs more commonly with repeated trauma to the origin of the plantar fascia on the … … …
medial calcaneal tubercle
Classic symptoms for … … include pain with first weight-bearing steps in the morning or during the first few minutes of running
plantar fasciitis
… … … can be dramatic, acute, or chronic
Low back pain (LBP)
Arthritis and osteoporosis are two … conditions
chronic
… is an inflammation of the joints.
The two most common types of arthritis are … and …
Arthritis
rheumatoid arthritis and osteoarthritis
… … is an autoimmune, chronic inflammatory disease affecting the synovial lining of joints and other connective tissue
Rheumatoid arthritis (RA)
Individuals with rheumatoid arthritis (RA) typically present with severe … pain and inflammation, reduce muscle mass, decreased muscular strength and endurance, and decreased mobility and impaired physical activity
joint
… is a relatively common chronic degenerative joint disease that is more prevalent with age
Osteoarthritis (OH)
The most common anatomical location for … are the large weight-bearing joints, including the hips and knees, and the cervical and lumbar spine, the distal interphalangeal joints of the fingers, and carpometacarpal joint of the thumb
osteoarthritis (OA)
Obesity is associated with osteoarthritis (OA); it has been reported that for each kilogram of increased body mass, there is a risk of osteoarthritis genesis of…%
14
… programs provide an alternative environment that may benefit clients who do not tolerate land-based exercise because of pain or obesity
Aquatic
Individuals should be aware that prolonged and/or excessive use of … can cause G.I. bleeding and may reduce kidney function
NSAIDs
Steroids may predispose individuals to … fractures
stress
Oral corticosteroids may cause skeletal …, truncal obesity, osteoporosis, and G.I. bleeding
myopathy
…, or the silent disease, is characterized by low bone density or bone mass and deterioration of the bone microarchitecture and/or geometry that increases skeletal fragility and risk of fracture
Osteoporosis
Diagnosis of … is based on bone densitometry measured by dual energy x-ray absorbtiometry (DEXA) scan
osteoporosis
… is defined as bone density between normal and osteoporosis and describes those at risk for osteoporosis, with a density SD between -1 and -2.5
Osteopenia
… are three times more likely to suffer from osteoporosis
Woman
… fracture can easily develop into a life-threatening event for an older adult
Osteoporotic
… osteoporosis is age related, and secondary osteoporosis is due to other factors such as drug regimens for treating other diseases that can decrease bone at any time during the lifespan
Primary
Peak bone density, or highest lifetime bone density, is achieved in the 20s, and loss of bone density begins around the age of … to … years
25 to 30
Recent longitudinal data indicate that… loss begins earlier in men (25 to 30 year) then woman (40 to 44 year)
bone
Men and women lose bone at about the same rate until women begin to approach …, which occurs around the age of 52 years
menopause
… loss accelerates in woman in late perimenopause (40 to 50 year) and continues at an increased rate through early post menopausal years
Bone
It appears that the age range around … is the time of peak bone velocity when bone growth occurs at the fastest lifetime rate
puberty (13 to 15 years)
Nutritional support for bone growth and Maintenance requires adequate amount of … and …
calcium and vitamin D
At birth, children have a … heart rate and respiration rates, which decline with age as the nervous system innervations of these organs mature
high
The heart rate of young children seated and at rest ranges between … and … bpm, and maximal heart rate is higher than adults
100 and 110 bpm
Due to increased metabolism, children recover … from a bout of exercise compared with adults; thus, heart rate, oxygen consumption and minute ventilation return to resting values more quickly than adults
faster
Although heart rate is higher in children, stroke volume is …, resulting in cardiac output values lower than adults
lower
Systolic blood pressure, and to lesser extent diastolic blood pressure, is … in children than in adults and rest and during exercise
lower
During exercise in hot environments, the evaporation of sweat is the main avenue for … dissipation in humans
heat
Children … sustain exercise for as long as adults when temperatures exceed 40°C, or approximately 100°F
cannot
There it is no evidence that exercise, including resistance training, weightlifting, and plyometric training, has any adverse effects on children and adolescents when exercises are performed properly and our supervised by qualified adults
👍🏼
The advisory committee reports to children and adults sense should perform at least … minutes of moderate or vigorous activity daily, with vigorous activity included at least three days a week
60 min
Sedentary activities such as watching television, using a computer, or playing video games should be limited to less than … hours a day
2 hours per day
Muscle and bone strengthening activities should be included at least … days a week for children and adolescents
Three
As a result of an interior and superior shift of maternal center balance, half of pregnant women suffer with lower back and pelvic …
pain
Significant hormonal changes also occur in pregnant woman, including increases in … and …, which contribute to water retention and increased blood volume
Estrogen and aldosterone
It is important to note, the energy cost of pregnancy requires additional food, depending on gestational age; from … Kcal/day to … Kcal/day
114kcal/day to 421kcal/day
In order to meet the needs to the increased tissue and metabolism, pregnancy causes an increased … …
blood volume
In pregnant woman, at rest, cardiac output, stroke volume, and heart rate …, while vascular resistance decreases
increase
Slight … of the maternal heart may occur as a result of the elevated heart rate and stroke volume during pregnancy
hypertrophy
In pregnant woman, lying supine after 16 weeks of pregnancy may compress the … … …, causing a reduced venous return or less blood back to the heart, due to the expanded fetoplacental unit
inferior vena cava
… exercises during the third trimester of pregnancy may lead to hypertension and dizziness
Supine
Exercise improves circulation and helps decrease pregnancy-related … that often occurs in the extremities
edema
Exercise training can reduce the risk of developing … (high blood pressure and protein in the urine) and gestational diabetes in pregnant women
preeclampsia
The American Congress of obstetricians and gynecologists recommends that pregnant woman accumulate … minutes of moderate intensity exercise on all or most days of the week
30
The … for pregnancy health screening tool, developed by the Canadian society for exercise physiology, should be used to screen all pregnant woman seeking to start or continue exercising during pregnancy
PARmed-X
Although any activity is encouraged for pregnant woman, moderate intensity, or …to … % of heart rate reserve, is recommended to achieve health benefits
40 to 60 %
During all exercises, the exercise physiologist must coach the pregnant client to breathe appropriately to avoid the … maneuver and hypertension/dizziness
Valsalva
Pregnant woman can safely participate in aerobic, resistance, and combination types of exercises but it is recommended to avoid any activities that may cause trauma to the abdomen like ice hockey, soccer and basketball or have a higher risk of falling like horseback riding, skiing, gym gymnastics or vigorous racquet sports
👍🏼
During pregnancy, scuba diving or exercise at altitudes higher than 6000 feet should be avoided to ensure appropriate fetal … supply, unless a woman already live at high altitude
oxygen
Exercising in a cool comfortable environment is important to prevent fetal harm due to … during pregnancy
hyperthermia
Pregnant woman should ensure that they are properly hydrated by ingesting a paint (16 ounces or 500 mL) of water prior to exercise and a cup every 20 minutes during exercise with the goal of replacing any fluid lost during exercise exercise; to help ensure maximum … ability
thermoregulatory
All woman, whether novice or experienced, who exercise while pregnant should be aware of the warning signs when exercise should be terminated and the physician consult it such:
as vaginal bleeding, shortness of breath prior to exertion, dizziness, headache, chest pain, muscle weakness, calf pain or swelling, preterm labor, decreased fetal movement, or leaking of amniotic fluid
👍🏼
Beside the additional caloric need of pregnancy (second and third trimesters), exercise results in an additional calorie cost.
Caloric intake should therefore be adjusted so that appropriate … weight gain is achieved
gestational
In older adults, the loss of strength, muscle mass, and bone density are … in women then in men
larger
In older adults, vessels become stiffer, and elasticity is lost in cardiac tissue, including the heart valves; this result in … blood pressure and higher resistance to flow, which creates more work for the heart
higher
In older adults, at maximal levels of exercise, total peripheral resistance and blood pressure are … than in a younger person
higher
For older adults, stretches may produce greater benefits when they were held for … to … seconds
30 to 60 seconds
What TTM stands for?
Transtheoretical model
The TTM (transtheoretical) proposes that individuals move through a series of stages of change during physical activity adoption; which are:
Precontemplation
contemplation
preparation
adoption / action
maintenance
TTM stage:
Inactive and not thinking about becoming more active; these individuals do not currently engage in physical activity and do not plan on doing so in the near future
Individual is neither intending on making behavior change nor considering the benefits the change may bring
Precontemplation
Stage 1
TTM stage:
Inactive and thinking about becoming more active; these individuals are thinking about adopting physical activity and are planning to become more physically active within a reasonable timeframe
Individual is weighing the pros and cons of behavior change and is considering implementing changes in less than six months
Contemplation
Stage 2
TTM stage:
Doing some physical activity; these individuals are currently doing physical activity but are not meeting the standards and guidelines identified by the ACSM
Individual has developed a behavior change plan and intends to implement it within the next month
Preparation
Stage 3
TTM stage:
Doing enough physical activity; these individuals are currently engaging in physical activity 5 days a week for at least 30 minutes each session these individuals have participated in regular physical activity for < than six months
Individual has been making positive activity and behavior changes for six months or less
Action or Adoption
Stage 4
TTM stage:
Making Physical activity a habit.
These individuals have been participating in regular physical activity and their recommended levels for at least six months and is working on relapse prevention strategies
Individual is maintaining positive behavior changes for six months or more
Maintenance
Stage 5
The … has been used to explain a variety of health behaviors, understand physical activity behavior, and to create physical activity interventions
TTM (transtheoretical method)
… … …, first known as social learning theory, is one of the most popular theoretical frameworks for understanding physical activity adoption
Social cognitive theory (SCT)
Social cognitive theory (SCT) emphasizes … …, which is the interaction between individuals and their environments
reciprocal determinism
Social cognitive theory (SCT) identifies three main factors that influence behavior and behavioral choices, such as:
the environment (neighborhood and proximity to Gym)
individual personality characteristics and/or experience (including cognitions)
behavioral factors
A key concept related to social cognitive theory (SCT) is …
Self-efficacy refers to one’s believe in his or her ability to successfully engage in and perform a specific behavior
self-efficacy
The social ecological model is a comprehensive approach integrating multiple variables and layers that influence behavior;
these layers include:
intrapersonal and interpersonal factors
community and organizational factors
institutional factors
environmental factors
and public policies
The social ecology model is specific to the promotion of health behaviors and focuses on assumptions related to influencing the physical and social environments; multi dimensional environments; interactions between individuals, families, communities and how individuals influence their surroundings
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Define personal factors in social ecological model
Knowledge
motivation
self-efficacy
Define social factors in social ecological model
Social support
friends
family
cultural influences
Define institutional factors in social ecological model
School/work environments
facilities
Define community factors in social ecological model
Built environment (sidewalks and safe walking)
media influence
Define public policy in social ecological model
Pricing of physical activity opportunities
insurance rates for health behaviors
In the health belief model suggest that as individuals take greater investment in their personal health, they are more likely to make relevant and meaningful behavior changes
The model identifies 4 main components that may influence an individuals health behavior choices:
Perception of susceptibility or risk of the identified health threat
Perception of the severity of the identified health threat, including clinical and/or medical and social consequences
Perception of the benefits from taking action to reduce the identified health threat
Perception of barriers and/or costs of taking action to reduce the identified health threat
Health belief model equations:
Susceptibility + seriousness = Perceived threat
Benefits + barriers = outcome expectation
Threat + expectations = likelihood of action
Comprehensive review of literature notes that the most powerful determinants of health behaviors were … and …
the perception of barriers and the costs of taking action
… … was the least powerful predictor of health behaviors
Perceived severity
The … … … is an intention-based model used to explain physical activity behavior.
The TBP is an extension of the theory of reasoned action and identifies … as the primary influence in determining behavior
theory of planned behavior
intention
Self-determination theory (SDT) is built around the premise that individuals have 3 basic psychological needs that must be met in order to be motivated to engage in a behavior:
Competence
relatedness
autonomy
Define competence in self-determination theory (SDT)
Competence is the sense of being capable of completing an activity or mastering a task in the perception of being effective in the task
Define relatedness in the self-determination theory (SDT)
Relatedness is the need to be connected and involved with the social world
Define autonomy in the self-determination theory (SDT)
Autonomy is characterized by maintaining a perceived internal locus of control and the sense that behaviors are freely choosen
An individual who is … motivated to participate in physical activity would be motivated by the genuine love of physical activity
intrinsically
An … motivated individual will engage in physical activity for reasons such as weight control and stress reduction
extrinsically
An … person would not engage in physical activity because he or she has no motivation at all
amotivated
The self-determination theory (SDT) considers the … context in which the individual operates
social
… Theory is an evolution of learning theory and refers to individuals becoming accustomed to a positive or negative stimulus.
This theory is based on the concept of “hedonic psychology”, which states that the perceived utility of a behavior or experience is defined by an individual’s effective response to the behavior
Hedonic
Individuals seeking to enhance or prolong pleasure and avoid or minimize pain are engaging in what is known as the … principal
hedonic
Research demonstrates that exercising at or just below the … threshold produces positive effect and pleasure, whereas intensities above the ventilatory threshold produces less pressure
ventilatory
Regular … of weight by way of weighing oneself on a schedule is associated with weight loss and the prevention of weight gain
self-monitoring
Meeting the physical activity recommendations in terms of steps per day
Superior or equal to 7500 steps per day
Limiting setting time in terms of steps per day
Superior to 5000 steps per day
Goals should be SMART:
Specific
measurable
attainable
relevant
time-bound
Setting specific … goals in the context of a long-term goal is the more successful approach to enhancing performance than setting a long-term goal in isolation
short-term
Self-control, however, is based on the limited resource or energy, called …, and when someone has to perform several acts of self control, they willpower is depleted
This depletion of willpower, or self-control strength, is also called … because the ego refers to the classic psychological term for the rational, decision-making component of personality
willpower
ego-depletion
…talk refers to talking about the cost of changing and the benefits of not changing.
Sustain talk is used as a way for the client to not feel obligated to adopt any change
Sustain talk
… talk refers to talk about the benefits of changing a clients behavior and the costs of not changing.
The goal of an motivational interviewing (MI) intervention is the generate change talk, as this indicates client movement towards readiness to adapt change
Change
Client commonly will have body-related barriers to exercise, such as social physique …, which is a form of anxiety linked to discomfort with having one’s body on display for others to see
anxiety
… variables observed to create challenges includes the use of mirrors, aggressive colors within the gym setting (red or black), intimidating group exercise environment, and revealing instructor clothing
Environmental
From a scientific perspective, however, … is defined as the process by which one responds to an environmental demand that is perceived as threatening
stress
… is what people do to alleviate, eliminate, or manage stress, and this term has as many meanings as the term stress
Coping
In emotion-focused coping, people engage in behaviors to … their attention from the problem or to simply make themselves feel better
distract
The physiological and psychological response of a person to a stressor is called …
strain
The … … … is a response pattern of stress and consist of three broad stages, each with a wide variety of nonspecific in specific responses, all working together to restore homeostasis and ensure the survival of the organism
general adaptation syndrome (GAS)
First stage of the general adaptation syndrome (GAS) when it comes to stress
The first stage is called the alarm reaction, where does the stressor is first recognized by the system and the fight-or-flight response is initiated
Second stage of the general adaptation syndrome (GAS) when it comes to stress
The second stage is that of resistance, where a cascade of cardiovascular, metabolic, hormonal and immune changes is generated as a compensatory stress reaction
During the stage, some compensatory reactions may include the release of glucocorticoids (cortisol), the activation of the hypothalamic-pituitary-adrenal (HPA) axis, and changes in autonomic neurontransmitters and inflammatory cytokines
Third stage of the general adaptation syndrome (GAS) when it comes to stress
The last stage is that of exhaustion, when the organism has depleted all biochemical substrates and additional resources is no longer able to mount a defense to the stressor
There is evidence that those experiencing higher levels of chronic, unremitting … have difficulty recovering from strenuous resistance exercise, taking 2 to 4 times as long to recover as those reporting lower levels of chronic stress
stress
… is the ability to achieve stability through change, and the allostatic load model refers to the rapid activation of bodily systems to cope with a stressor and restore homeostasis as effectively and efficiently as possible
Allostasis
In regard to …, all of the systems in the body are involved including the autonomic nervous system and HPA axis along with the cardiovascular, immune, and metabolic systems
allostasis
Overactivity of the … systems, where there is limited time for rest and restoration, can increase the risk of cardiovascular disease
allostatic
The physical changes in response to chronic or intense … can lead to, contribute to, or worsen life-threatening and life-altering conditions such as myocardial infarction, stroke, cancer, or autonomic diseases
stress
Ulcers, inflammatory bowel disease, and irritable bowel syndrome are all disorders in the digestive track that are influenced by …
stress
… are due to an increase in gastric juices and erosion of the lining of the stomach or upper small intestine
Ulcers
… … disease may involve inflammation of the colon and small intestine, whereas irritable bowel syndrome may involve diarrhea, constipation and abdominal pain
Inflammatory bowel disease
Intense … can also be a physical disorder that results from exposure to chronic stress
The two most common recurrent headaches are migraines and tension-type headaches
headaches
… are typified by intense throbbing and pulsating sensations in the head, often accompanied by sensations of nausea and sensitivity to stimuli
Migraines
… … … are the result of the contraction and tightening of muscles in the neck and head, which is a common reaction of persons under stress
Tension-type headaches
Unresolved, … stress profoundly affects the cardiovascular system, including the heart, blood vessels and blood itself
chronic
High levels of stress has been associated with abnormally enlarged … and hypertension
heart
Persons under stress have higher concentrations of activated platelets and more …, free fatty acids, and Lipoproteins in the blood, which promotes the development of plaques in the arteries or atherosclerosis leading to increased blood pressure and increased likelihood of myocardial infarction and stroke
triglycerides
Corticosteroids, specifically …, are released in response to a stressful event (especially social stressors), and high concentrations of cortisol in the blood overtime can increase the risks of cardiovascular disease
cortisol
In addition, by blocking the uptake of … from the cells, high levels of cortisol increase insulin resistance and can lead to the development of type 2 diabetes
glucose
Cortisol also contributes to the accumulation of fat in the … region, and this visceral fat is readily released into the bloodstream
abdominal
The sympathetic nervous system activity and the release of cortisol after a stressful events suppress the immune system, which limits the number of … that are activated in response to a viral challenge
lymphocytes
Psychological … has been correlated with a reduction in and activity of natural killer (NK) cells, which combat cancerous tumor cells and monitor neoplastic (new and abnormal) growth
stress
There is a significant association between stressful life events and relapse incidence of … …
multiple sclerosis (MS)
Persons who continually deal with exposure to high levels of occupational stress can develop a psychological response called …
burnout
Burnout is characterized by physical, mental, and emotional …
Burnout is defined as a debilitating psychological condition brought about by unrelieved work stress, which results in depleted energy reserves, lowered resistance to illness, increased dissatisfactions and pessimism, and increased absenteeism and inefficiency at work
exhaustion
Elevated levels of glucocorticoids (cortisol) are associated with shrinkage and toxic degeneration of the brain’s memory Center, the …, in which loss of neurons and their connectivity occurs
hippocampus
Continuous exercise … lactate threshold has consistently been shown to reduce mood during exercise, which may serve to undermine its effectiveness for stress management
above
For those with a history of depression, as little as … minutes of self-selected cycle exercise was enough to improve mood
15 min
Emotional support when it comes to stress
The provision of empathy, love, trust and caring (actively listening to concerns)
Instrumental support when it comes to stress
The provision of tangible aid and services that directly meet a need (providing services at no additional cost to client when they are experiencing a traumatic stressor)
Informational support when it comes to stress
The provision of advice and information concerning the problem (understanding why an issue is causing significant stress)
Appraisal support when it comes to stress
The provision of information useful for self-evaluation purposes such as constructive feedback and affirmation (helping client brainstorm possible solutions to a problem)
… breathing, or breathing from the stomach (as opposed to the chest) is superior for the experience of these benefits in order to reduce stress
Diaphragmatic
… breathing consist of deep breath into the lungs and exhaling as the diaphragm contracts and relaxes
Diaphragmatic
… … … is a technique that teaches people how to focus on certain muscle groups and alternatively contract and relax muscles, focusing on the sensation of relaxation
Progressive muscle relaxation
… is a method of increasing control over bodily processes, such as heart rate, muscle tension or sweating in response to a stressor
The procedure involves attaching sensors to the body that provide immediate biophysiological feedback on how a persons body is responding to a stressor (seeing fluctuations in heart rate or electrodermal activity)
Biofeedback
… is the external application of pressure to muscles and tendons that can range from smooth, light pressure to deep kneading motion, depending on technique, the purpose of the massage and individuals preference
Massage
… … massage has been an effective method for reducing stress, muscle tension, pain, and asthma symptoms and has been shown to boost immune function
Deep tissue
After three weeks of … therapy, breast cancer patients showed a boost in their dopamine and serotonin levels and number of NK immune cells and lymphocytes, which could potentially promote a better and faster recovery
massage
… is an exercise of the mind in which the individual actively focuses on calming and quieting the body while keeping mind alert
Meditation
… meditation focuses on sounds and phrases, and the same word or verse is repeated over and over again to promote concentration
Mantra
… meditation uses a visual image, and the person focuses on that image to eradicate distracting thoughts from the mind
Yantra
… meditation incorporates breathing, visualization, relaxation and repetition.
Transcendental meditation has been shown to reduce stress and improve mental and physical health by decreasing blood pressure, heart rate, respiratory response and stress hormone production
Transcendental
Alternatives to meditation is the practice of …, which has been associated with facets of recovery from illness and improved health outcomes
prayer
… is the discipline of paying attention to the present moment in a deliberate (purposeful) and non-judgmental manner
Mindfulness
…, by being in the present moment, without worry about the future or preoccupation with the past, one may observe automatic emotions and behaviors with greater clarity in perspective
Mindfulness
Sessions of yoga, Tai Chi, or other martial arts performed routinely are effective for reducing symptoms of stress and improving sense of …
well-being
What does the acronym STEPS stand for when it comes to avoiding legal liability
Screening
testing
evaluation
programming
supervision
The primary sources of law can be divided into four categories:
constitutional law
statutory law
case law
administrative law
A … is a breach of legal duty amounting to a civil wrong or injury for which of court of law will provide compensation/damages
Tort
A … by definition is a wrongful act, whether intentional or accidental, from which an insult, injury, or death occurs to another person or perhaps an organization that sustains pecuniary damage
tort
The individual or group that is injured or sustains pecuniary damage is known as the …, whereas the individual or group responsible for the tortuous act is known as the … or tortfeasor
plaintiff
defendant
Tortuous acts are divided into the following three categories:
intentional misconduct
negligent contact
“no-fault” contact
… conduct falls under the category of strict liability and relates to ultra hazardous activities and product liability that will not be addressed in this chapter
“No-fault”
Because it is extremely difficult to document an intentional tort, courts typically give the benefit of doubt to the defendant and presume that the tort is one of …
negligence
When considering the lawsuits filed against fitness facilities and/or fitness instructors, the overwhelming majority are suits alleging …
negligence
Definition of negligence and … … are similar in that they both are concerned with prudence in caution in dealing with clients
standard of care
Failure to exercise that degree of standard of care utilized by prudent instructors or management represents …
negligence
Exercise physiologist can use three major risk management strategies to lessen the chances of becoming embroiled in legal liability with negligence tort.
First, he must adhere to the standard of care in the screening process, fitness profiling, evaluation, programming and supervision of clients
Second, the EPC must use waivers and assumption of risk forms in various venues of the client-instructor relationship.
Third, the EPC must ensure that he or she has purchased appropriate liability insurance for the activities in which his or her client is engaged
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3 major causes of injury or death associated with physical activity:
Inherent injuries: due to accidents that are not preventable and are no one’s fault
Negligence: injuries due to the fault of the defendant (sometimes the plaintiff)
Extreme forms of negligence: injuries due to the gross negligence, willful and wanton, or reckless conduct of the defendant
Protective legal documents are an important line of defense for the EPC in that they can provide evidence in a court of law that the client was made aware of the risks but decided to assume search risk as outlined
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Frequently, protective legal documents in the form of prospectively signed … or exculpatory agreements may prevent a claim from going forward, as a judge can dismiss a case through a pretrial motion termed a summary judgment
waivers
… … insurance (PLI), also called professional indemnity insurance but more commonly known as errors and omissions, protects individuals who provide professional advice and service as part of their job responsibility
Professional liability
The exercise physiologist should hold both … and … liability insurances
“general” and “professional”
… laws or key laws include those pertaining to sexual harassment, workplace safety and maintaining privacy of clients and employees
Federal laws
The definition of … … is any kind of intimidation, browbeating, bullying, or coercion of a sexual nature; the inappropriate promise of promotions in exchange for sexual favors; or the threat of loss of job security for failure to provide search favors
sexual harassment
Under the US Department of labor, the … is the principal federal agency charged with the enforcement of safety and health legislation in the workplace
OSHA
In an effort to improve worker safety, … has established regulations that have some specific implications for the fitness industry
OSHA
The exercise physiologist frequently become responsible for understanding, recognizing, and dealing with the … pathogen threat inherent within fitness center operations, especially during an emergency response
blood-borne pathogen
Enter the US Department of health and human services, the …… of 1996 was established to protect the privacy of health information
health insurance portability and accountability act (HIPAA)
… requires that all information gathered about a client’s health status must be kept confidential in the fitness facility
HIPAA
Clients are to assist instructor personnel in maintaining a neat and safe environment, such as in putting weights back in their racks or not leaving clothing or bottles on the floor where they could become a hazard to others; this means respecting not only the workout areas but also other areas such as lounges or locker rooms
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… are agreements pertaining to the legal rights and obligations between individuals as well as between collective bodies
Contracts
Examples of contracts used in the health fitness fields are:
employment contracts for employees and independent contractors
informed consents
waivers
membership contracts
The two important federal laws that prohibit employment discrimination related to preemployment inquiries include the … … … and the Americans with disabilities act (ADA) of 1990
Civil rights act of 1964
The … … … prohibits discrimination on the basis of race, color, gender, religion and national origin
civil rights act of 1964
The … … … of 1990 prohibits employment discrimination on the basis of disabilities or perceived disabilities
Americans with disabilities act (ADA)
There are two or the federal employment regulations related to hiring, which bear mentioning:
background checks and drug testing
… investigation is normally the process of researching criminal records, commercial records, and in some cases, financial records of an individual
Background
Under the federal trade commission fair credit reporting act (FCRA), applicants must give … … to prospective employers if employers wish to obtain applicants’ credit reports
written permission
The … … … and the mandatory guidelines for federal drug test testing programs were specifically designed for federal employees with certain sensitive occupations relating to safety and security
drug-free workplace act of 1988
An additional federal regulation and requirement related to pre-hiring in hiring is the … … …, which prohibits different pay rates on the basis of gender
equal pay act of 1963
Another employment regulation is the … … …, which prohibits discrimination on the basis of age for people older than 40 years
age discrimination in employment act (ADEA)
Yet, another necessary regulation is the … … …, which requires all employers to complete an employment eligibility verification form on individuals hired after November 6, 1986
immigration reform and control act of 1986 (IRCA)
Fitness … … and … represent a type of contract with employees as the applicant is agreeing to abide by such policies and procedures as a term of his or her employment
facilities policies and procedures
Adherence to … and … is recognized to be one of the most important keys to profitability within a business
policies and procedures
… and … are guidelines as well as mandates to the daily operation of the facility, and observing these assists employees in becoming more proficient because of the implied consistency of practice
Policies and procedures
Once developed, the number one priority of any facility should be the … and … of its membership
health and safety
Screening members through … … … is essential to determine whether they are ready for the stress of exercise or whether medical clearance is needed
Health risk appraisals
The … … … is the procedure by which a facility can identify those members who are at an increased risk for experiencing exercise related cardiovascular incidents as well as musculoskeletal problems and the consequent need for physician referral before exercise program and can commence
health risk appraisal
Additionally, it should be noted that too frequently abbreviated screening devices such as the … … … are utilized when more comprehensive health risk appraisals are warranted
physical activity readiness questionnaire (PAR-Q)
And undercover investigation of fitness facilities indicated that “gyms” are some of the most likely environments for the transmission of …
germs
Of all facility policies, the … …, and particularly the emergency medical policy, is the most consequential
emergency policy
The … … primary purpose is to ensure that minor problems do not escalate into major incidents and that major incidents do not intensify to fatal events
emergency plan’s
However, the most likely emergency is a… …, indicating that the client is having a heart attack, stroke, or some other potentially fatal event
“code blue” or “member down”
Additionally, in the case of a sudden cardiac arrest, an … source attached to a resuscitation mask dramatically increases the chance of survival
oxygen
A well-rehearsed … response plan guarantees a timely response in carrying out the multiple duties expected of staff, such as who coordinates the scene, who are first and assistant responders, who takes charge of crowd control, who meets and directs paramedics to the scene, and who is responsible for securing the members file along with notifying the nearest relative
emergency
They are clear differences between leadership and management that can be summarized as in leadership, people are lead; in management, resources are managed
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Operationally, … is the ability to facilitate and influence others (superiors, peers and subordinates) to make recognizable strides toward shared and unshared objectives
leadership
… is the ability to use organizational resources to accomplish predetermined objectives
Management
… transcends the workplace, whereas management is often confined to the workplace
Leadership
For example, in a health and fitness setting, … is demonstrated when the exercise physiologist motivate and inspire his clients or patients to make needed lifestyle changes
leadership
However, management in this situation may require the exercise physiologist to add additional or longer training days, make a referral to other health professionals, or schedule additional consultations.
This would require having well organized, managed schedule and referral system in place
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Evidence-based management is a decision making process that considers equally 3 inputs:
Input number one is the best available research
The second input is the personal experience of the exercise physiologist
The third input for effective evidence-based management is understanding and knowing stakeholder expectations
Although leadership theory is dynamic and continually evolving, four major models of leadership are consistently reference in the literature:
Classical
transactional
visionary
organic
The … model also began to gain popularity in the 1970s and signaled the area of the manager
When talking about leadership
transactional
The … model emerged shortly there after, in the mid-1980s and involves the leader using emotion to inspire and create buy-in of the followers
When talking about leadership
visionary
The most recent models, organic, tends to overlap with visionary.
The … leadership model centers on the collective vision of the group as a team
When it comes to leadership
organic
Within the organic model, leadership development is grass roots; that means, leadership development takes place … the organization and socialization occurs as one is practicing their profession and not before they enter the profession
within
… leadership’s purpose is to open up communication and to increase the quality and frequency of conversations about performance and development
Situational
… leaders give individual attention, inspire others to excel and stimulate people to think in new ways
Transformational
… leaders view leadership as the process of exchanging one thing for another, it usually comes down to exchanging rewards (salary and benefits) for performance or work
Transactional
Although more of a concept than a theory, … … is recognized as a set of skills (StreetSmarts) that includes awareness of self and others and the ability to handle emotions and relationships
emotional intelligence (EI)
Practicing emotional intelligence (EI) involves four critical skills:
Being able to recognize and perceive emotions of others
using emotions to assist (not hinder) thoughts and thinking
ability to analyze and understand emotions
managing personal emotions based on personal goals, self-knowledge, and social awareness
Successful leaders have a high … …, which appears to be directly related to emotional intelligence (EI)
emotional quotient (EQ)
… … has been described as the ability to adapt or respond appropriately to any number of different contexts, where the context is determined by environmental factors and stakeholder values
Contextual intelligence (CI)
… … is a cluster of individual leadership skills that are integrated and demonstrated simultaneously
Contextual intelligence (CI)
As opposed to academy intelligence, often measured by IQ, … … has been shown to be the best predictor of success in real life performance situations
contextual intelligence (CI)
The 3D-thinking model of contextual intelligence (CI) is the simultaneous integration of 3 distinct time orientations:
Hindsight
inside
foresight
Pretty much as past present and future
4 obstacles to contextual intelligence (CI):
The pace of change
complexity
learned behavior
inappropriate orientation to time
Mary Parker Follet introduced the … … of management and is perhaps the single greatest contributor to how management practice is understood today
behavioral model
The … model of management placed a large emphasis on the individual’s ability to define and shape his or her own roles and life and was the precursor to what eventually became known as human resource management
behavioral
… behavior, similar to a human resource management, is the capacity to understand, explain, and improve the attitudes and behaviors of individuals and groups within organizations
Organizational
Integrated model of organizational behavior that includes five major elements:
Individual outcomes
individual mechanisms
individual characteristics
group mechanisms
organizational mechanisms
… planning is the process of diagnosing the organization’s external and internal environments and include deciding on a vision and mission, developing overall goals, creating and selecting general strategies to be pursued, and allocating resources to achieve the organizations goals
Strategic
Strategic thinking requires conceptualizing the …, … and … from the organization’s and stakeholder’s vantage point
past, present, and future
Planning is a fundamental aspect of leadership and management, including in the health and fitness context, and should include the following steps:
Determining stakeholders
Delineating values
Creating a vision
Drafting a mission
Establishing goals and objectives
After strategy is implemented, it is necessary to evaluate the progress; evaluation is most commonly done with an SWOT analysis, which stands for:
Strengths
weaknesses
opportunities
threats
An individual is an … … if the person for whom the services are performed can only control the result of the work but not the means or methods of accomplishing the result
independent contractor
An … is an individual who performs services for a client/business that has control over the details of how the services are performed
employee
An … employee is one who is paid a base salary on a scheduled (weekly, by weekly, monthly) basis and is typically not eligible for overtime pay
exempt
A … employee is paid on an hourly basis and is usually eligible for overtime pay
Nonexempt
During the recruiting process, … … define the skills necessary to complete the job and serve as a guide for questions to ask during the interview
job descriptions
Performance evaluation forms should include sections for the following:
Employee strengths
employee weaknesses
goals from the review, with explanations of achievement or challenges that were met in the process of achieving success
company-defined skills and competencies
AED’s in a facility shall be located within a … minute walk to any place in AED could be potentially needed it
1.5 min walk
Facilities should use …/… documents with all facility members and users
waivers of liability and/or assumption of risk
A risk management team might consist of a healthcare professional, local emergency medical service professional, and key staff members
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Fiscal management definition:
Money the business owes to another individual or business
Accounts payable
Fiscal management definition;
Money owed to the business by individuals or businesses
Accounts receivable
Fiscal management definition;
Any property owned by a business that has monetary value
Asset
Fiscal management definition;
A Financial statement that presents the assets, liability, and equity of the business at a specific point in time
Balance sheet
Fiscal management definition;
A plan forecasting expected income and expenses for a given period
Budget
Fiscal management definition;
Money, goods, land, or equipment that is used to produce other goods and services
Capital
Fiscal management definition;
Movement of money in and out of business through the collection of revenue and payments of expenses
Cash flow
Fiscal management definition;
A decline in the value of any given asset over a period, often because of wear and tear, or age
Depreciation
Fiscal management definition;
The monetary value of the property or an interest in a property in excess of claims or liens against it
Equity
Fiscal management definition;
Financial statement that includes the revenue, expenses, and net income/loss of business for a specified period
Income statement
Fiscal management definition;
A debt owed to an individual or business
Liability
Fiscal management definition;
Gross income less expenses, representing the profit of the business for a specific period
Net income
Fiscal management definition;
The difference between an expected and an actual result
Variance
… is the process of recording and summarizing business and financial transactions and analyzing, verifying, and reporting the results
Accounting
… and … statements are two of the most important financial statements a manager needs to understand
Balance sheets
profit & loss
… … indicates the financial status of a business at any given time and is separated into assets, liabilities, and owner’s equity
Balance sheet
… are anything a company owns that has monetary value (cash, buildings, land, and equipment)
Assets
Assets are typically divided into two categories:
Current (short term)
fixed (long-term)
… assets are those that can and are expected to be turned into cash within the next 12 months
examples of current assets include the following: cash and cash equivalents, inventory, accounts receivable and prepaid expenses
Current
… assets are those that have been acquired for long-term used by the business.
These assets include the following:
Fixed assets
Property (land and buildings)
Equipment
office furniture
… are financial obligations or credits owed by the business.
They are defined as current (short term) or noncurrent (long-term)
Liabilities
… liabilities are debts the business is obligated to pay within the next 12 months.
Examples include the following:
Current liabilities
Accounts payable
income taxes
accruals
deferred revenue, rent, or taxes
… liabilities are adapt and expenses that are not due in the next 12 months.
Examples include the following:
Noncurrent liabilities
Future payments on loans
deferred revenue, rent, or taxes
… … is the owner’s investment in the business plus any profits or minus any losses
Owner’s equity
A … and … statement, also referred to as an income statement, summarizes the financial performance over a specific time (month, quarter, all year).
This financial tool includes actual expenses and revenues in the stated time frame as well as a look at how those numbers compare with a year-to-date planned
profit and loss statement
Two of the most common budget processes in the health and fitness industry are:
zero-based
trend-line
….. budgeting is the process often used when opening a new facility or when making significant changes in operation of an existing facility.
This process uses assumptions of business expenses and revenues to develop a budget rather than relying on previous year’s actual numbers
Zero-based
….. budgeting is the most common process used and involves using previous year’s financial data to develop the budget for the current and upcoming years.
This process makes the assumption that facility expenses and revenues will continue on the trend seen over the past years
Trend-line
Once the method of creating the budget has been determined, there are four main steps to follow to develop a complete and accurate budget:
Determine budget expectations
Forecast revenues
Forecast expenses
Project profits and losses
Income management
All revenue, which is reported on the income statement, must be diligently tracked throughout the year. Areas of revenue include the following:
Membership dues
Fitness center
Food and beverage
Other services
Definition of membership dues
Membership and entrance fees are generally a facility’s main sources of revenue, accounting for 75 to 80% of total revenue
Definition of fitness center in income management
This category would include fees for fitness programs, Personal Training, specialty group exercise session, and locker/towel rentals
Expenses can be broken down into … or …
variable or fixed categories
… costs are those that fluctuate on the basis of usage of resources or participation in the program.
Possible variable expenses include payroll, benefits, employee education and training, supplies, marketing, equipment maintenance and repairs, and inventory
Variable
… expenses are those that are relatively consistent year after year and include insurance, rent, property tax, management fees, and principal and interest owed on the any debts or loans
Fixed
Fixed expenses often cannot be negotiated, but most variable expenses can be effectively reduced by following a few guidelines:
- Obtain at least free quotes from different vendors to find the right price for the best product. Be sure to repeat this process on a regular basis for any items that may be purchased repeatedly to ensure the cost reflects industry norms. Negotiate with vendors to get the best deal on goods and services
- Illuminate unnecessary expenses. Fill empty spaces or cost center with profit center (make an office or storage closet into a massage room)
- Contract out services (landscaping) to limit staff usage, equipment and Training expenses, and liability concerns
- Use internal resources when possible. A business may prefer to hire a few part-time employees to create and publish all marketing efforts instead of signing a contract with marketing firm
What are the five P’s of marketing?
People (not formerly considered part of the marketing mix)
Place
Product
Price
Promotion
Once the exercise physiologist decides to establish a fitness business, a … analysis needs to be performed to better understand the people most likely to frequent the facility
demographic
Researchers have found that individuals who reside within … mile radius of a fitness or recreational facility tend to be more physically active and thus become a target audience
1 to 5
Marketing
… can be both tangible (selling a membership) and non-tangible (helping someone achieve fitness goal)
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Product
Marketing
Possibly, the most common … of exercise physiologist is Personal Training services, which can include something to sell (training sessions) or something to achieve (increase strength), or both
product
Marketing
… refers to where the product can be purchased and/or delivered.
For most exercise physiologist, the service will be delivered out of a particular physical location such as a commercial, corporate, private fitness facility, or clinic
Place
Definition of cost of delivery for Price (marketing)
The most important factor is the cost of delivering the service. Cost includes marketing, materials (paper or online), equipment, facility, and the time value of the exercise physiologist
Definition of acceptable profit margin for price (marketing)
The cost as noted earlier includes everything except a profit, which is one of the ultimate goals of delivering the product.
Therefore, the price above the cost of delivery becomes the actual profit margin
Definition of market value for a price (marketing)
Another important pricing factor is the balance between perceived value and actual demand for a product.
A product with high demand, yet low perceived value (yes we want it, but we are not willing to pay much for it), may have to be priced very differently than the product with low demand but great perceived value
Marketing
As the fifth “P” in the marketing mix, … is an ever-expanding and complex process of educating, presenting, and engaging stakeholders so that consumer loyalty and sustained relationships develop, grow, and are maintained
promotion
Eight promotional strategies when it comes to marketing and branding
Advertising
Referrals
Direct mail/email
Internet
Business to business (B2B)
Sponsorship
Personal sales
Public relations
Traditionally, direct mail efforts produce a return rate between … to …%.
Email marketing has been found to be effective in reaching specific customers with similar interests
1 to 3%
Like client referrals, ….. referrals can be a very inexpensive and powerful way to reach a target audience. Taking the extra time to meet business owners in the area can pay huge dividends in terms of reaching new prospects
Business to business (B2B)
In sales, a … is defined as someone who fits the profile of a target market and has shown an interest in the product or service
Lead
Once a solid lead list is in place, the goal is to turn those leads into …
A lead becomes a prospect when he or she has expressed the need for the Fitness product or service after an initial contact has been made
prospects
… … can be used in several ways from writing a news release to announce a new program or service to writing a weekly column or blog in the local paper or website about exercise in physical activity
Public relations
When it comes to public relations, seven suggestions for writing simple and effective news releases are provided:
Identify and address the target audience
Keep it simple and short (never longer than a page)
The basics of who, what, when, where, why, and how belong in the first short paragraph
Use short paragraphs and emphasize one major point in each paragraph
Avoid acronyms and technical jargon
With permission, quote authority
Careful and deliberate
… physicians, Physiologist, and physical educators founded the American College of sports medicine (ACSM) in 1954 to provide a professional society for individuals sharing a common interest in health and fitness
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11 - eleven
What does CoAES stand for?
Committee on the accreditation for the exercise science
The ACSM code of ethics is further defined by four standards:
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Although each standard implies many personal and public practices that define the professional nature of an exercise physiologist, the following five areas are of great importance:
Practicing within one’s scope of practice
Acknowledging conflicts of interest
Providing evidence-based information
Maintaining certification
Personal characteristics of professional behavior
… … is the range of responsibility that determines the boundaries within which a profession operates
Scope of practice
The ACSM exercise physiologist is a health fitness professional with a minimum of a bachelors degree in exercise science.
The EP-C performs pre-participation health screenings, conduct physical fitness assessments, interprets results, develops exercise prescriptions, and applies behavioral and motivational strategies to apparently healthy individuals and individuals with medically controlled diseases and health conditions to support clients in adopting and maintaining healthy lifestyle behaviors
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… … can be defined as a significant financial interest in a business or other direct or indirect personal gain or consideration provided by a business that may compromise, or have the appearance of compromising, an ACSM member’s professional judgment
Conflict of interest
… … practice has been defined in terms of a provision of healthcare that incorporates the most current and valid research results
Evidence-based
The four step process that can be used to disseminate scientifically sound information to clients when it comes to evidence-based information
Step one: develop a question
Step two: search for evidence
Step three: evaluate the evidence
Step four: incorporate evidence into practice
Evidence can be found in three ways:
Personal experience
Academic preparation
Research knowledge
Exercise physiologist recertification requirements include the following:
Accumulate 60 continuing education credits (CECs)
Maintain current cardiorespiratory resuscitation (CPR) certification
Pay the required recertification fee
Have the option to repeat the certification exam
What does the acronym WISE stands for;
which provides a helpful summary of personal characteristics and behaviors important to the success of an exercise physiologist
Wisdom
integrity
stewardship
enthusiasm
Define age as a risk factor for men and women
For men: superior or equal to 45 years of age
For women: superior or equal to 55 years of age
Define family history as a risk factor
For men: 55 years of age
ACE inhibitor is an … medication
antihypertensive
Criteria for prediabetes fasting glucose
100 - 125 mg.dL-1
HDL concentration in order to meet the criteria for negative risk factor
Superior or equal to 60 mg.dL-1
According to the social ecological model, the park close to Carl’s house is an example of which system:
Mesosystem
The mesosystem in the socioeconomic model includes environment, health agencies, community, competing sedentary activities, technology, mass media and access to information
Carl has decided to make the change to be more physically active; this is an example of which stage of readiness?
Preparation
Commitment usually occurs at the beginning of the … stage
action
Define isotonic:
Muscle contraction, which exerts a constant tension
Define isokinetic
Muscle resistance throughout the range of motion (ROM) by controlling speed of movement
Define hyperplasia
Increased cell production in a normal tissue
Define Cardiovascular (CV) fitness
The ability of the circulatory and respiratory systems to supply oxygen during sustained physical activity
Define muscular strength
The ability of muscle to exert force
Define muscular endurance
The ability of muscle to continue to perform without fatigue
Define body composition
The relative amounts of muscle, fat, bone and other vital parts of the body
Define flexibility
The range of motion around a joint
Recommended order of fitness assessments
Heart rate
Blood pressure
Body composition
Cardiovascular assessment
Muscular fitness
Flexibility
Free common sites for locating and palpating pulse and heart rate
Radial
brachial
carotid
Define extrinsic factors
Identify outside factors that support a desire to attain a goal
Define intrinsic factors
Remain important long after goals achieved
Define anorexia nervosa
Eating disorder characterized by restrictive eating due to being afraid of gaining weight, even though at least 15% below expected weight for age and height
Define bulimia nervosa
Eating disorder of usually normal weight individuals characterized by cycles of overeating and purging or other compensatory behaviors
How many calories are contained in alcohol?
7 kcal per gram
What to do when fainting?
Supine with legs elevated
Define patellofemoral pain syndrome
Common disorder in young athletes that produces anterior knee pain
LLC stands for
Limited liability corporation
Define Sole:
One person owned business
Define individual contractor
Provides services for an individual or business
Define HIPAA
Strict policies regarding safety and security of private records
Define FERPA
Policy for the stewards of education data to ensure students’ personal information is probably safeguarded and is only used for legitimate purposes and only when absolutely necessary
In which stage of motivational readiness is a person who is an irregular exerciser?
Preparation
Preparation is an individual who is planning for or irregularly exercising, whereas the stage of action represents a person who is currently exercising
Nitrates and nitroglycerin are … (used to reduce chest pain associated with angina pectoris)
antianginals
Betta blockers are … (used to reduce blood pressure by inhibiting the action of adrenergic neurotransmitters at the better receptors, thereby promoting peripheral vasodilation
antihypertensives
… helps lower blood platelet coagulation making the blood less sticky
Aspirin
A triglyceride is a … molecule connected to three fatty acid molecules
glycerol
… fatty acids only have single bonds
Saturated
Monounsaturated fatty acids have … double bond
one
… fatty acids have two or more double bonds
Polyunsaturated
… are inorganic substances that perform various functions in the body. Many play an important role in assisting enzymes (or coenzymes) that are necessary for the proper functioning of body systems
Minerals
… are considered to be either macrominerals or microminerals
Minerals
Macrominerals are needed in relatively large doses such as …
Calcium
phosphorus
magnesium
potassium
sulfur
sodium
chloride
Microminerals are needed in very small amounts such as
Iron
zinc
selenium
manganese
molybdenum
iodine
copper
chromium
fluoride
The … plane divides the body into right and left parts, and the midsagittal plane is represented by an imaginary vertical line passing through the midline of the body, dividing it into right and left halves
sagittal
The … plane is represented by an imaginary vertical line passing through the body, dividing it into front and back halves
frontal
The … plane represents an imaginary horizontal plane passing through the midsection of the body and dividing it into upper and lower portions
Transverse
Voluntary act or … when it comes to negligence
Commission
Failure to act or … when talking about negligence
Omission
Which stage defines people having the greatest risk of relapse?
Action
People in the action stage are at the greatest risk of relapse. Instruction about avoiding injury, exercise boredom, and burn out is important for those who have recently began an exercise program. Providing social support and praise are the most important contributors to maintain activity
Which plane represent an imaginary horizontal plane passing through the midsection of the body and dividing it into upper and lower portions?
Transverse
Which vitamins are fat-soluble?
Vitamins A, D, E and K
They are also stored in bidy fat after consumption
Which vitamins are water-soluble? And where are they found?
Vitamins C and B complex
They must be consumed on a regular basis, and excess amounts are excreted
They are found in citrus fruits, broccoli, cauliflower, brussels sprouts, whole grain breads and cereals and organ meats
Define ischemia:
Insufficient blood flow that results from a temporary or permanent reduction of blood flow in one or more coronary arteries
Which numbers define prehypertension?
SBP: 120 - 139 mm Hg
Or
DBP: 80 - 89 mm Hg
Which level of LDL-C is considered optimal?
< 100 mg.DL-1
Which level of LDL-C is considered high?
> = 130 mg.dL-1
superior or equal
Synovial joints are the … common type of joints found in the human body
Most common type
Which of the following personnel is responsible for program design as well as implementation of that program?
Administrative assistant
personal trainer
manager or Director
health fitness specialist
Manager or director
The Informed consent document …
Is a legal document
provides immunity from prosecution
provides an explanation of the test to the client
legally protects the rights of the client
Provides an explanation of the test to the client
A measure of muscular endurance is…
One repetition maximum
Three repetition maximum
number of curl ups in one minute
number of curl ups in three minutes
Number of curl ups in one minute
Which of the following is an example of a biological barrier to exercise?
Obesity
pregnancy
disease
injury
Pregnancy
Which of the following is the first step in constructing a business plan?
Determine sales goals
conduct a comprehensive demographic analysis
establish a budget
evaluate the competition
Conduct a comprehensive demographic analysis
The following are the steps that should be taken when an individual sets out to establish his or her personal training business:
Perform a demographic and competitor analysis, develop and establish a budget, develop and establish management policies, and determine what type of marketing is most appropriate as well as sales goals and pricing of services
All of the following are major agonist muscles involved in knee flexion except:
Gracilis
gastrocnemius
soleus
Popliteus
Soleus
Which of the following is NOT an example of social support?
Encouragement from a friend to join the walking group
A family member requesting to join you on your daily walks.
Spouses synchronizing schedules so that they can attend the same group fitness classes.
A friend inquiring why you have not been an exercise class lately
A friend inquiring why you have not been an exercise class lately
Which of the following is an appropriate measure to take in an effort to counteract dehydration?
Drink excessive amounts of water prior to exercise, even if euhydrated.
Consume a low sodium meal prior to and post exercise bout
Take snack breaks during longer training sessions.
Consumer high-protein meal prior to exercise bout
Take snack breaks during longer training sessions
What is the planning tool that addresses the organization’s short and long-term goals; identifies the steps needed to achieve the goals; and gives the timeline, priority, and allocation of resources to each goal?
Financial plan.
Strategic plan.
Risk management plan.
Marketing plan
Strategic plan
After six months of Personal Training and coaching sessions, your client expresses to you that she believes she can now implement what you have told her an exercise on her own. This is an example of enhanced…
Self-worth.
Self-esteem.
Self-regulation.
Self-efficacy
Self-efficacy
Which of the following marketing strategies is the most costly and generates the lowest return on investment?
Lead boxes.
Direct mail.
Reputation management.
Television advertising
Television advertising
Which of the following is considered an abnormal curvature of the spine with lateral deviation of the vertebral column in the frontal plane?
Lordosis.
Scoliosis.
Kyphosis.
Primary curve
Scoliosis
Scoliosis is an abnormal lateral deviation of the vertebral column
… is an abnormal increase posterior curvature, especially in the thoracic region
Kyphosis
… is an abnormal, exagerrated anterior curvature in the lumbar region
Lordosis
… refers to the thoracic and sacral curvatures of the vertebral column that remain in the original fetal positions
Primary curve
Copies of … privacy rule do not need to be provided to the individual
HIPAA
Which of the following conditions refer to the loss of skeletal muscle mass typically observed with aging?
Osteopenia.
Osteoporosis.
Sarcopenia.
Rheumatoid arthritis
Sarcopenia
Define osteoporosis
Bone mass density is severely reduced, significantly increasing risk of fracture. Bone mass density is superior to 2.5 standard deviation inferior to mean peak value for young normal adults
Define osteopenia
Low bone mass; bone mass density between 1.0 and 2.5 standard deviations inferior to mean peak value for young normal adults
Define rheumatoid arthritis
Autoimmune disease; body attacks and eventually destroy the surface of the joint
All of the following are rotator cuff muscles except:
Infraspinatus.
Teres minor.
Subscapularis.
Trapezius
Trapezius
What are the muscles of the rotator cuff?
SITS
Subscapularis. Infraspinatus. Teres minor. Subscapularis
Compare running, swimming will result in … even if exercise intensity is the same.
A higher heart rate.
A lower heart rate.
A lower cardiac output.
A higher cardiac output
Lower heart rate
At any given intensity, Heart rate will be … during swimming than exercises performed in standing position, such as running, because of postural differences
Lower
Attempting to decrease sweating via clothing insulation adjustments and use of clothing vents are recommended during exercise in what type of environment?
High altitude environment.
Cold-weather environment.
Dry heat environment.
Wet environment
Cold-weather environment
In an effort to better insulate against colder temperatures. Multiple layers layers should be worn instead of one heavy layer
Which of the following statements about confidentiality is not correct?
Our records must be kept by the program Director/manager under lock and key.
Data must be available to all individuals who needs to see it.
Data should be kept on file for at least one year before being discarded.
Sensitive information like participants name needs to be protected.
Data should be kept on file for at least one year before being discarded
Within a skeletal muscle fiber, large amounts of calcium are stored in the…
Nuclei.
Mitochondria.
Myosin.
Sarcoplasmic reticulum
Sarcoplasmic reticulum
Biceps curls, pull ups, and box squat jumps are all … (dynamic) exercises involving both concentric and eccentric muscle action
isotonic
Lactic acid production will … during submaximal effort exercise
decrease
Maximal … will stay the same as both submaximal and maximal exercise
heart rate
Cardiac output will decrease during submaximal exercise and … during maximal exercise
increase
Older adults who have a mobility disability or are at increased risk for falls should incorporate neuromuscular exercise at least…
2 to 3 days per week
All of the following are major agonist muscles involved hip flexion except:
Rectus femoris.
Sartorius.
Iliopsoas.
Quadratus lumborum
Quadratus lumborum
The quadratus lumborum is a major agonist muscle involved in … flexion of the lumbar spine
lateral
Model or approach that combines behavioral skills training, cognitive intervention, and lifestyle coaching?!
Relapse prevention
What describes the term net income?
Gross income (revenue) less expenses representing the profit of a business or department for specific period of time
When measuring regional body circumferences, an average of duplicate measures is used provided that those measurements do not differ by more than:
3 mm.
10 mm.
5 mm.
12 mm
5 mm
When recording regional body circumferences, it is recommended that 2 measurements be recorded in rotational order and then averaged together. This helps ensure reliability and accuracy of the measurements
Which of the following represents the demarcation point of a very high health risk for young women when using waist to hip ratio? (WHR)
> 0.86
0.95
1.00
1.03
> 0.86
Males tend to carry more visceral fat around the abdomen and subsequently have higher waist to hip ratio than females. (WHR)
Very high risk value is set at >0.95 for young men and >1.03 for men between the ages of 60 and 69 years old
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Which of the following variables is unique to the Rockport 1 mile fitness walking test’s regression equation to estimate Vo2max?
Age
Heart rate
Gender
Body mass
Gender
The Rockport regression equation adjusts for the physiological advantage males have over females
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What is the suggested work rate for a deconditioned, female individual performing the Astrand-Rhyming cycle ergometer protocol?
300 or 450 kg.m.min-1
50 or 75 W
The Queens college step test, also known as McArdle step test is performed for how long?
3 minutes
Then, to estimate VO2max, early recovery heart rate is measured for 15 seconds (multiplied by four)
Which of the following is not a general category for clinical Exercise testing?
Prognosis
Implementation
Evaluation
Diagnosis
Implementation
Clinical exercise testing generally consist of three components:
Prognosis (determining the risk for an adverse event)
Evaluation (determining the physiological response to exercise)
Diagnosis (determining the presence of a disease/disorder)
Which of the following is considered the gold standard to objectively measure exercise capacity?
Maximal Exercise test using indirect calirometry
Maximal exercise testing, usually conducted as a graded exercise or exercise tolerance test, provides the truest measure of exercise capacity (peak oxygen uptake VO2peak) for each individual
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Whose legal responsibility is it to supervise the clinical exercise laboratory and interpret all clinical Exercise testing results in a diagnostic setting?
The test administrator
The clinical exercise physiologist
The on-call physician assistant
The supervising physician
The supervising physician
Which graded exercise protocol is most widely used in the United States in clinical setting?
Bruce treadmill Protocol
Heart rate, blood pressure (BP), and electrocardiogram (ECG) should be recorded regularly during the clinical exercise test and through at least…min of recovery
Six minutes
The normal heart rate response to incremental exercises to increase work clothes at and heart rate of…bpm per one metabolic equivalent (MET)
10 BPM
What is the frequency of combined aerobic exercise recommended for most adults?
3 to 5 days per week
HRR is equal to:
HR max - HR rest
Moderate intensity aerobic exercise is considered to fall in the range of … % of an individuals HRR
40 to 59%
Vigorous exercise includes an HRR range of %
60 to 89%
Which of the following methods is not recommended for estimating exercise intensity for exercise prescription?
HRR
Oxygen uptake reserve (VO2R)
Ventilatory threshold (VT)
Maximum heart rate percentage (%HRmax)
Maximum heart rate percentage (%HRmax)
Direct measurements of physiological responses such as HRR, oxygen uptake reserve (VO2R), and Ventilatory Threshold (VT) are preferred because these tend to be less subject to variation and provide a truer indication of fitness
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EE stands for:
Energy expenditure
An exercise volume between 500 and 1,000 MET per minute per week is roughly equivalent to … kcal per week of moderate intensity physical activity
1000
What is the minimum recovery time recommended for a muscle group following resistance training bout?
48 hours
To get the most accurate and appropriate information, the following order of testing is recommended:
Resting measurements
body composition
cardiorespiratory fitness
muscular fitness
flexibility
Which of the following is not a valid test for muscular strength?
Grip strength test
YMCA benchpress test
3 repetition maximum benchpress test
10 rep max shoulder press test
YMCA bench press test
The YMCA bench press test is a valid test for upper body muscular … because the test is conducted with a set resistance and the goal is to successfully complete as many repetitions as possible
endurance
The … Skinfold site is performed using a diagonal fold method:
Thigh
Medial calf
Suprailiac
Abdominal
Suprailiac
The … skinfold site should be a diagonal fold in line with the natural angle of the iliac crest taken in the anterior axillary line immediately superior to the iliac crest
supra iliac
Resting systolic blood pressure (SBP) above 200 mm HG or DBP above 110 mm Hg are the appropriate contraindications for Maximal Exercise testing in the clinical setting
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Clinical Exercise testing among adult patients with chronic heart failure (HF) should observe the recommendations except:
Maximal Exercise testing is not a realistic way to identify candidates for cardiac transplantation or other advanced treatments due to inherent risk of heart stress
Maximum Exercise testing with measurement of respiratory gas exchange is reasonable to identify high-risk patients presenting with chronic Heart failure (HF) who are candidates for cardiac transplantation or other advanced treatments
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… pertains to the ability to correctly identify patients who do not have a given condition
Sensitivity
Specificity
Positive percent value
Negative predictive value
Specificity
In regard to ischemic heart disease (IHD), specificity is the percentage of patients without IHD who have a negative test for IHD. So, specificity represents the true negative cases among the test sample
All of the following are among the ACSM guidelines to determine “maximal” effort during a graded exercise test (GXT) except:
Achievement of age-predicted HRmax
A postexercise Venous lactate concentration greater than 8 mmol.L
A rating of perceived exertion (RPE) at peak exercise greater than 17 on the 6 to 20 scale or greater than 7 on the 0 to 10 scale
A peak respiratory exchange ratio (RER) greater than or equal to 1.10
Achievement of age-predicted HRmax
ACSM considers “failure of HR to increase with increases in workload” as the criterion used to confirm that maximal effort has been elicited
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To be classified as hypertensive, the SBP must equal or exceed 140 mm Hg or the DBP must equal or exceed 90 mm Hg as measured on two separate occasions, preferably days apart.
An elevation of either the systolic or diastolic pressure is classified as hypertension
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At minimum, professionals performing fitness assessments on others should possess … and … certification
CPR and ACSM EP-C
… involves holding the stretched position using the strength of the agonist muscle as is common in many forms of yoga
Passive static stretching
Active static stretching
Proprioceptive neuromuscular facilitation (PNF)
Dynamic stretching
Active static stretching
Static stretching is characteristic of a lack of movement during the stretch, where the stretch is held for a period of time of 10 to 30 seconds.
The primary difference between active and passive static stretching is the source of assistance.
In passive static stretching, the muscle/tendon group being stretched is held by a partner or device such as an elastic band
Rhabdomyolysis is muscle damage resulting in excretion of … into the urine that may harm kidney function
myoglobin
Children should attempt to accumulate 60 or more minutes of physical activity daily, this may be continuous or discontinuous activity. Children should not focus on just one or two modes. Exposing them to a wide variety of physical activities is suggested to enhance adherence
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Moderate intensity aerobic exercise done at least … days per week, or vigorous intensity aerobic exercise done at least … days per week is recommended for most adults to achieve and maintain health and fitness benefits
5 (moderate)
3 (vigorous)
Define light intensity aerobic exercise
30 to 39% HRR or VO2R
Can be beneficial in individuals who are deconditioned
The recommended exercise duration for moderate exercise is… Minute per day
30 to 60 minutes per day
Ideal resistance training volume for most adults should be… sets with … repetitions
2-4 sets with 8-12 repetitions
The increase in systolic blood pressure SBP is expected to rise … to … mm Hg per MET of effort
5 to 10 mm Hg
Which of the following would not terminate a maximal or submaximal exercise test in the low-risk adult?
Subject request to stop
Shortness of breath
A slight decrease in diastolic pressure
Failure of HR to increase with increased intensity
A slight decrease in diastolic pressure
DBP represents the pressure in the heart during diastole (rest)
The ACSM recommends that, in apparently healthy individuals, aerobic exercise intensity be prescribed within what percentage of HR max range?
60% and 90%
The ACSM recommends how many reps of each exercise for muscular endurance?
15 to 25 reps
To determine Program effectiveness, psychological theories provide a conceptual framework for assessment and …
Management of programs or interventions
Application of cognitive-behavioral or motivational principles
Measurement
All of the above
Application of cognitive-behavioral or motivational principles
Which of the following is a possible medical emergency that a client can experience during an exercise session?
Hypoglycemia
Hypotension
Hyperglycemia
All of the above
All of the above
The mode of activity should be selected based on the principle of …, that is, with attention to the desired outcomes and to maintain the participation and enjoyment of the individual
specificity
A source of intimal injury thought to initiate the process of atherogenesis is…
Dyslipidemia
Hypertension
Turbulence of blood flow within the vessel
All of the above
All of the above
Initial causes of coronary artery disease (CAD) are thought to be an irritation of, or an injury to, the tunica intima (the innermost of the three layers in the wall) of the blood vessel
Risk factors that contribute to the development of coronary artery disease (CAD) include: 💯
age (men >45 year; woman >55 year)
a family history of myocardial infarction or sudden death (male first-degree relatives <55 year and female first-degree relatives <65 year)
cigarette smoking
hypertension (arterial BP >140/90 mm Hg measured on two separate occasions)
hypercholesterolemia (total cholesterol >200 mg DL or 5.2 mmol.L, or HDL < 40 mg.DL or 1.04 mmol.L)
diabetes mellitus in individuals older than 30 year or in individuals who have had type one diabetes more than 15 year or type two diabetes in individuals older than 35 year
Systolic blood pressure (SBP) is an indicator of the amount of blood pumped out of the heart in … minute in a healthy vascular system and normally increases as workload increases because the peripheral and central stimuli that control the specific process also normally increase with an increase in workload
One minute
Failure of the SBP to increase as workload increases indicates an abnormal response to increasing workload. Additionally, an abnormally elevated SBP response to aerobic exercise indicates an unhealthy vascular system
Which of the following is a change seen as a result of regular aerobic exercise?
Decreased HR at rest
Increased stroke volume at rest
No change for cardiac output at rest
All of the above
All of the above
Effect of regular (chronic) exercise.
Stroke volume increases at rest as a result of increased time for ventricular filling and an increased myocardial contractility
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Little or no change occurs in cardiac output at rest because the decline in HR is compensated for by the increase in stroke volume
While assessing the behavioral changes associated with an exercise program, which of the following would be categorized under the cognitive process of the transtheoretical model (TTM)?
Stimulus control
Reinforcement management
Self reevaluation
Self liberation
Self reevaluation
Key components of the transtheoretical model (TTM) are the processes of behavioral change.
These processes include 5 cognitive processes (consciousness raising, dramatic relief, environmental reevaluation, self reevaluation, and social liberation)
and 5 behavioral processes (counter conditioning, helping relationships, reinforcement management, self liberation, and stimulus control)
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A measure of muscular endurance is…
One rep max
Three rep max
Number of curl ups in one minute.
Number of curl ups in three minutes
Number of curl ups in one minute
3 common assessments for muscular endurance include:
The benchpress, for upper body endurance (a weight is lifted in cadence with a metronome or other timing device; the total number of lifts perform correctly and in time with the cadence).
The push-up, for upper body endurance (the client assumes a standardized beginning position with the body held rigid and supported by the hands and toes for men and hands and knees for a woman; the body is lowered to the floor and then pushed back up to the starting position; the score is the total number of properly perform push-ups completed without a pause by the client, with no time limit).
The curl up (crunch), for abdominal muscular endurance (the client begins in the bent-knee sit up with knees at 90°, the arms at the side, palms facing down with middle fingers touching masking tape. A second piece of tape is placed 10 cm apart. OR set a metronome to 50 BPM and the client performs slow, controlled curl ups to lift the shoulder blades of the mat with the trunk making a 30° angle, in time with the metronome at a rate of 25 per minute done for 1 minute. Or the client performs as many curl ups as possible in one minute
In those with known cardiovascular disease (CVD), aerobic exercise may illicit increases in diastolic blood pressure DBP at the beginning of exercise
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An exercise program for elderly persons generally should emphasize increased…
Frequency
Intensity
Duration
Intensity and frequency
Frequency
The loss of elasticity (or hardening) of the arteries is known as…
Atherosclerosis
Arteriosclerosis
Atheroma
Adventitia
Arteriosclerosis
…, also called hardening of the arteries, is a loss of arterial elasticity and is associated with aging
Arteriosclerosis
… is a form of arteriosclerosis characterized by an accumulation of obstructive lesions within the arterial wall
Atherosclerosis
What is the planning tool that addresses the organizations short and long-term goals; identifies the steps needed to achieve the goals; and gives the timeline, priority, and allocation of resources to each goal?
Financial plan
Strategic plan
Risk management plan
Marketing plan
Strategic plan
Health and fitness programs, financial plans, risk management efforts and marketing plans only address subsegments within the overall strategic plan
When periodizing training for a marathon runner (26.2 miles) who is doing a long run each Sunday, which is appropriate? Each Sunday run should…
Be the same distance at about 20 to 22 miles
Gradually increasing distance weekly with a slight lower distance Sunday every fourth week or so
Gradually increase in distance every week by about 10%
Rapidly increase distance weekly and then avoid all the long runs the last two months
Gradually increase in distance weekly with a slightly lower distance Sunday every fourth week or so
The runner could become over trained if he or she just build up to a longer distance each week without a down week built in periodically, even if done gradually
With each year of life (age), we estimate that we lose one beat in terms of our heart rate Max (220-age)
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Which grouping lists the 3 training principles that you need to consider when prescribing exercise for individuals? 💯
Overload. Specificity. Progression
Overload is pushing the body beyond what it is used to.
Specificity is being careful to choose exercises that closely relate to the outcome goal.
Progression has to do with developing a systematic method of improving
… is a stretching technique that combines the use of isometric contractions with passive static stretching. This stretching technique involves the use of a partner and a few cycles and, therefore, is more time-consuming
PNF
Identify the appropriate subjective self-evaluation tool used as a quick health screening before beginning any exercise program
Physical activity readiness questionnaire + (PAR-Q +)
The PAR-Q+ is a screening tool for self-directed exercise programming. The health status questionnaire (HSQ) is a screening tool with similarities to the PAR-Q+ but it takes longer to complete versus the quick completion of the PAR-Q+
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The … would involve continuous electrical heart monitoring during exercise stress test used in clinical setting when deemed appropriate by a physician
E-ECG
When engaging in physical activity or exercise at high altitude, HR will be higher than at sea level for the same perceived exertion because of the decreased supply of oxygen available.
If one was to compete in endurance-oriented events at high altitude, it would be wise to properly acclimate to the competition or event altitude prior to the actual competitive event.
Also note that dehydration is often an issue at high altitude, so it is important to adequately hydrate before, during, and after training or competing
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The six activities of daily living (ADL) are eating, bathing, dressing, toileting, transferring (walking), and continence
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Which exercises should be avoided after the first trimester for a pregnant woman?
Supine position exercises
When someone has no diagnosed cardiovascular, metabolic, or a renal disease; and has no signs or symptoms suggestive of search, medical clearance is not needed for light to moderate intensity exercise
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With a glucose reading equal to 112 mg.dL, the patient would be classified as what?
He would be classified as having impaired fasting glucose (IFG)
The pre-participation health screening process is based upon…
Individual’s current physical activity level; presence of signs or symptoms and/or known metabolic, Renal, or cardiovascular disease; and exercise intensity at which individual desires to exercise
Verbal encouragement, material incentives, self-praise, and use of specific contingency contract are examples of…
Shaping
Reinforcement
Antecedent control
Setting goals
Reinforcement
Studies designed to measure the success of a program based on some quantifiable data that can be analyzed examine…
Incomes
Outcomes
Client progress notes
Attendance records
Outcomes
Muscular strength may be maintained by training muscle groups as little as … day per week as long as the training intensity or the resistance lifted is held constant
1 day per week
… exercise training involves motor skills such as balance, coordination, gait and agility and proprioceptive Training and is sometimes called functional fitness training
Neuromotor
Glycolated hemoglobin (…) is a blood chemistry test that reflects mean blood glucose control over the past 2 to 3 months
HbA1C
Hypoglycemia, defined as a blood glucose level … (<3.9 mmol.L)
<70 mg/dL
Hyperglycemia refers to a blood glucose superior or equal to … or 16,7 mmol.L
Superior or equal to 300 mg/dL
The social cognitive theory (SCT) posits which of the following as the most important factor relating to behavior change?
Perception of risk of untoward health outcomes
Self-efficacy an expectation of outcome related to behavior changes
Believe that behavior change is worth the improvement in health
None of the above
Self-efficacy and expectation of outcome related to behavior changes
Which of the following is NOT a sign of exertional heat stroke?
Hypoventilation
Hyperventilation
Disorientation
Vomiting
Hypoventilation
Hypoventilation is an indication of heat syncope.
Exertional heat stroke signs and symptoms include the following disorientation, dizziness, irrational behavior, apathy, headache, nausea, vomiting, hyperventilation and wet skin
Which of the following is an absolute aerobic exercise contraindication during pregnancy?
Preeclampsia
Restrictive lung disease
Persistent third trimester bleeding
All of the above
All of the above
There are relative and absolute contraindications to aerobic exercise during pregnancy. Absolute contraindications include restrictive lung disease, hemodynamically significant heart disease, incompetent cervix, women with multiple gestation at risk for premature labor, persistent second or third trimester bleeding, placenta previa after 26 week of gestation, premature labor during current pregnancy, ruptured membranes, and pregnancy induced hypertension or preeclampsia.
Relative contraindications include those with severe anemia, unelevated maternal cardiac arrhythmia, chronic bronchitis, poorly controlled type one diabetes, extreme morbid obesity or extremely underweight (BMI <12 kg.m), a history of sedentary lifestyle, intrauterine growth restriction in current pregnancy, poorly controlled hypertension, orthopedic limitations, poorly controlled seizure disorder, poorly controlled hyperthyroidism, or are a heavy smoker.
You are a personal trainer providing your services to various Health clubs in your region. Although you set your own fees, the percentage of those fees you receive is determined by the health clubs with which you work. What type of business model does this represent?
Sole proprietorship
S corporation
Partnership
Independent contractor
Independent contractor
A sole proprietorship represents a business model were only one person owns the business.
S corporations are businesses where there is no double taxation on salary and business income, each partner in the corporation has the autonomy to distribute dividends, and risk to personal assets is significantly reduced.
Business partnerships may be formed between two or more individuals and is beneficial in that all parties are able to combine resources together for the growth of the business.
Drinking excessive amounts of water may lead to … (a below-normal blood sodium level) which may affect cognitive function
hyponatremia
Consuming a meal containing sodium will aid in thirst production and consuming a high-protein meal prior to exercise may contribute to dehydration during activity
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Why is it important for an individual to perform a cool-down following an exercise bout?
In order to avoid postexercise hypotension and dizziness
In order to avoid postexercise hypertension and dizziness
In order to decrease HR and metabolic end products
Both A and C
Both A and C
The cool down phase allows blood to return to the heart and brain instead of pooling in the lower extremities, potentially causing hypotension and dizziness
In response to regular resistance training, …?
Older men and women demonstrate similar or even greater strength gains when compared with younger individuals
Younger men have greater gains in strength than older men.
Younger woman have greater gains in strength and older woman.
Younger men and woman demonstrate similar or greater strength gains compared with older persons
Older men and women demonstrate similar or even greater strength gains when compared with younger individuals
Which of the following statements best describes capital budgets?
Include the costs of equipment and building or facility expense.
Include the costs to operate a program.
Are not necessary with fitness programs.
Are included as part of the balance sheet in financial reports
Include the costs of equipment and building or facility expense
Capital budget refer to the budgeting of program implementation or facility. How much does it cost to start the program and to implement the first stage? Capital budgets usually include equipment, facility expense, staffing, initial marketing, and so on and the start-up.
Operating a program is part of the operating budget, not the capital budget. Capital budgets are critical in determininf whether to start a program. Capital budgets are not included in the balance sheet
All of the following are isotonic resistance exercises except…
Dumbbell bicep curls
Pull ups
Box squat jumps
The half-squat wall-sit
The half-squat wall-sit
This exercise is an example of an isometric exercise; muscle is contracted and strengthened but only at the joint angle the exercises performed in.
Biceps curls, pull-ups, and box squat jumps are all isotonic (dynamic) exercises involving both concentric and eccentric muscle action
When talking about rotator cuffs strain or impingement.
The subdeltoid bursa, supraspinatus muscle, and nerves become impinged between the coracoid and acromion process with shoulder abduction. The resulting pain leads to decreased ROM, disuse, and muscle atrophy.
Such impingement of the rotator cuff is common in assembly line workers performing repetitive overhead tasks
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Older adults who have a mobility disability or are at increased risk for falls should incorporate neuromuscular exercise at least … to … days per week
2 - 3 days per week
Which of the following transtheoretical model (TTM) stages of change is correctly defined?
Action; individual has been regularly active for less than six months
Preparation; individual has been making behavior changes for less than 30 days
Action; individual has been regularly active and making positive behavior changes for more than six months
None of the above
Action; individual has been regularly active for less than six months
Regarding pregnancy and exercising
The pregnant woman will notice an increase in her HR (due to increased gestational hormones during her first trimester and to maintain BP during second and third trimesters) and that her BP should remain relatively unchanged.
Additionally, pregnant women experience a decrease in thermoregulatory control, so you will need to counsel the pregnant woman on wearing appropriate attire, maintaining adequate hydration, and refraining from exercising in hot and humid environments. As the pregnant woman progresses in her pregnancy, you should address modifications to her exercise prescription regarding her personal discomfort and abilities. You should also discussed increased caloric need (approximately 300 kcal per day) she will experience due to her pregnancy and determine the amount that will cover both this increased caloric need as well as cover the amount of kilocalories expended during her exercise sessions
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Why is it important that women not perform any exercises in the supine position after the first trimester?
Blood flow to the heart is reduced during exercise performed in the supine position due to the weight of the fetus lying compressing the inferior vena cava.
In order to ensure that orthostatic hypotension and obstruction of venous return do not occur, exercises performed in the supine position are discouraged.
Commitment usually occurs at the beginning of the … stage
TTM - Transtheoretical model
action
The mesosystem in the socioeconomic model includes environment, health agencies, community, competing sedentary activities, technology, mass media, and access to information.
The proximity of a park to someone’s home would be a factor at the mesosystem level
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What are the signs of a second-degree hamstring strain?
Painful active contraction with limited range of motion
The purpose of the informed consent form is to ensure the client has full knowledge of tests to be performed, understands the relative risks, is informed of alternative procedures, is given the chance to ask questions, and gives consent voluntarily.
The informed consent document does not protect the trainer from liability
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Males tend to carry more visceral fat around the abdomen and subsequently have … waist to hip ratio (WHR) than females
Higher
Cycle ergometry has become increasingly popular in Europe; however, it has been shown that cycle ergometry can underestimate peak exercise capacity by 5 to 20%
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Resting systolic blood pressure SBP above … mm.Hg or diastolic blood pressure DBP above … mm.Hg are contraindications for maximal Exercise testing in the clinical setting
200
110
All of the following are along the ACSM guidelines to determine “maximal” effort during a graded exercise test (GXT) except…
Achievement of age-predicted HRmax
A postexercise venous lactate concentration greater than 8 mmol.L
A rating of perceived exertion (RPE) at peak exercise greater than 17 on the 6-20 scale or greater than 7 on the 0-10 scale
A peak respiratory exchange ratio (RER) greater than or equal to 1.10
Achievement of age predicted HRmax
Another criterion used to confirm that a “maximal” effort has been elicited is the failure of HR to increase with increases in workload 💯
At minimum, professionals performing fitness assessments on others should possess … and ACSM EP-C certification
CPR
The primary difference between active and passive static stretching is the source of assistance.
In … static stretching, the muscle/tendon group being stretched is held by a partner or device such as an elastic band
passive
Muscular fitness refers to …, …, and …
Muscular endurance
Muscular power
Muscular strength
Dietary fats include …, …, and …
Triglycerides
Sterols (cholesterol)
Phospholipids
Triglycerides represent more than …% of the fat stored in the body
90%
The model or approach that combines behavioral skills training, cognitive intervention, and lifestyle coaching is which of the following?
Relapse prevention
The social cognitive model
The TTM
The socialecological model
Relapse prevention
Which of the following is a restrictive lung disease?
Asthma
Tuberculosis
Cystic fibrosis
Emphysema
Tuberculosis
When determining the intensity level, the RPE is a better indicator than percentage of maximal HR for all of the following groups except:
Individuals on Betta blockers
aerobic classes that involve excessive arm movement
Individuals older than 65 years.
Individuals involved in high intensity exercise
Individuals involved in high intensity exercise
Which of the following statements regarding exercise for persons with controlled cardiovascular disease is true?
Resistance exercise training is dangerous and should be avoided
The physician supervised exercise test is not necessary to establish exercise intensity
Anginal pain is normal during exercise, and participants should be pushed through the pain
Exercise intensity should be set at an HR of 10 bpm less than the level at which signs/symptoms where evidenced during an exercise test
Exercise intensity should be set at an HR of 10 bpm less than the level at which signs/symptoms where evidenced during an exercise test
Using the original Borg scale, it is recommended that the exercise intensity elicit an RPE within the range of:
12 to 16
Which of the following medications have been shown to be most effective in preventing or reversing exercise-induced asthma?
B2 agonists
Beta blockers
Diuretics
Aspirin
B2-agonists
Persons with WI pacemakers may be chronotropically (HR) competent with exercise but require longer warm-up and gradual increase in intensity during the initial exercise portion of their session
People with WI-mode programmed pacemakers
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A specific benefit of regular exericse for patients with angina is:
Improved ischemic threshold at which angina symptoms occur
Increased myocardial oxygen demand at the same submaximal levels
Eradication of all symptoms
Elevation of BP
Improved ischemic threshold at which angina symptoms occur
Abdominal bracing involves:
Engaging the stabilizers such as the transverse abdominus and multifidus
Cardiac output is defined as:
Volume of blood being pumped by the heart in a minute
The ankle’s most stable position is in … due to the overall shape of the …
Dorsiflexion
Talus
An intensity that causes slight increase in HR and breathing
Light intensity exercise
Define light intensity exercise
An intensity that causes slight increases in HR and breathing
30-39% HRR or VO2R
2-2.9 METs
RPE 9-11
An intensity that causes noticeable increases in HR and breathing
Moderate intensity exercise
Define moderate intensity exercise
An intensity that causes noticeable increases in HR and breathing
40-59% HRR or VO2R
3-5.9 METs
RPE 12-13
An intensity that causes substantial increases in HR and breathing
Vigorous intensity exercise
Define vigorous intensity exercise
An intensity that causes substantial increases in HR and breathing
> = 60% HRR or VO2R
> = 6 METs
RPE >= 14
Tanaka age-predicted HRmax equation?
Age-predicted HRmax = 208 - 0.7(age)
Equation for Gulati HRmax
206 - (age x 0.88)
Walking 1 mile yields about … steps
2000 steps
Walking at a moderate intensity for 30 minutes yields about … steps
3000 to 4000 steps
Walking, especially downhill, may aggravate symptoms in individuals with … …
spinal stenosis
For those with low work capacities, the modified … treadmill protocol is a good example of a protocol with light initial workload (<3METs) and the small workload increments (0.5 - 1 MET)
Naughton
Maximal exercise testing should not be performed on women who are pregnant unless medically necessary
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Metabolic syndrome criteria when it comes to waist-to-hip ratio (WHO) for men and women
Men: >0.9
Women: >0.85
Multiple sclerosis (MS) is a chronic, inflammatory autoimmune disease of the …
central nervous system (CNS)
… disease is one of the most common neurodegenerative diseases
Parkinson
Convert feet to centimeters
ex: 6.2 ft
x 30.48
6.2 x 30.48 =188.98 cm
Convert inches to centimeters
ex: 68in
x 2.54
68in x 2.54 = 172.7cm