Chapter 6 (Study Group) - Physical Activity Science and Prescription Flashcards
With regards to physical activity guidelines for children (6-17 years of age), which of the following is incorrect?
A. Should aim for 60mins or more per day of physical activity of moderate to vigorous intensity. This might include running, cycling, playing tag or basketball.
B. The activity should be vigorous on at least 3 days of the week
C. Children should participate in muscle and bone strengthening activities for at least 1 hour at least 3 days per week. This might include jumping, playing hopscotch, climbing trees or playing with playground equipment.
D. Children should be seen and not heard so should quietly sit and watch their screens with headphones on or do their homework and refrain from making any noise
D is incorrect
Which of the following is not an example of a balance exercise?
A. Walking heel to toe
B. Practising standing from a sitting position
C. Using a wobble board
D. Yoga corpse pose savasana
D is incorrect - some yogis say this is the hardest pose with respect to calming the fluctuations of the mind
How is the physical activity vital sign PAVS equation calculated?
A. (minutes/week) x (weeks/monthx0.5) = minutes/fortnight
B. (days per week) x (minutes per day) = minutes/week
C. (hours/week) x (weeks/year) = hours/year
D. (hours/week) x (weeks/month) = hours/month
B
With regards to MHR maximum heart rate, which of the following is correct?
i) MHR calculation is not accurate in the elderly or in people taking a beta blocker
ii) 64-76% of MHR is considered light activity
iii) MHR is calculated as 200-age
iv) <50% of MHR is considered very light
A. (i) (ii) and (iv) are correct
B. (i) (ii) and (iii) are correct
C. (i) and (iv) are correct
D. All of the above are correct
C (i) and (iv) are both correct. B 64-76% MHR is considered moderate. C: MHR = 220-age (not 200)
MHR = 220-age 100%. >94% MHR very hard; 77-93% vigorous; 64-76% moderate; 50-63% light; <50% very light intensity
With regards to physical activity, which of the following groups may benefit the most from HIIT High intensity interval training?
A. Sedentary patients
B. Overweight or obese patients
C. Elderly patients
D. Postpartum women because they are too busy and don’t have time to do a proper workout
B “This type of exercise can improve insulin sensitivity, blood pressure, and body composition in adults. Interestingly, adults with overweight or obesity and those at higher risk of cardiovascular disease and type 2 diabetes tend to have greater cardiovascular benefits when doing HIIT compared to normal-weight or healthy adults” p37 https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
Which of the following regarding physical activity is correct?
A. Standing for 1 hour a day is associated with a 10% reduction in mortality of all causes
B. 75mins/week of brisk walking compared with a sedentary individual averaged ~1yr of life gained
C. 90-150mins/week of brisk walking compared with a sedentary individual averaged ~2.5years of life gained
D. Physical activity needs to be in the form of structured purposeful exercise to result in health benefits compared with non-exercise physical activity
C Correct. A False (2 hours - 10% reduction) p200. B False ~1.8years of life gained p201. D False (p200)
Which of the following exercise intensity does not correlate to moderate intensity?
A. Perceived exertion Borg (10 point scale) 3-4
B. HRR Heart rate reserve 40-59%
C. MHR Maximum heart rate 77-93%
D. MET 3-6
C MHR 64-76% would be moderate intensity. I know this question is waaay too details but it was a great opportunity to highlight this chart: https://www.instituteoflifestylemedicine.org/wp-content/uploads/2015/04/ExerciseIntensity.pdf (from the ACLM exam webinar slide deck)
Greta is a 34 year old lady who attends following a positive pregnancy test. She is 8/40 by dates. She walks/runs for 45 minutes 3 times a week, does 2 x 1 hour mat pilates classes, and plays competitive basketball once a week. She is otherwise healthy with no injuries. She asks about exercise in pregnancy. Which of the following is correct?
a. You advise that she should undertake 150 minutes of moderate intensity exercise per week, preferably spread out over the week
b. Greta can continue with her current exercise and sports regime given this was an established level of fitness pre-pregnancy
c. Given her pregnancy has been confirmed she should now avoid pilates and basketball, but can continue with her regular running and walking
d. During pregnancy, heart rate or estimated absolute energy requirements of specific activities is often a better indicator of intensity than perceived exertion
A (BR manual p. 212)
Women doing vigorous exercise regularly pre pregnancy can continue at this level in conjunction with their health care provider for adjustment as the pregnancy progresses. After first trimester they should avoid activities lying on their back. Pregnant women should also avoid sports with a risk of contact or falling (eg. Basketball/soccer/contact sports, horseriding, downhill skiing).
From Physical Activity Guidelines for Americans, p80; “During pregnancy, perceived exertion is often a better indicator of intensity than heart rate or estimated absolute energy requirements of specific activities. On a rating-of-perceived-exertion scale of 0 to 10, where 0 is sitting and 10 is the greatest effort possible, moderate-intensity activity would be an effort of 5 to 6. Another way to gauge moderate intensity is with a talk test, where carrying on a conversation (but not singing) is still possible.”
Julian (age 50) comes to you for advice on disease prevention. He is an executive working long hours (10-12 hour work days including up to 10 hours sitting in meetings or at his desk). He exercises religiously for at least 1 hour per day (walking or cycling at a moderate-vigorous intensity). He does not smoke, he eats a balanced diet with minimal animal products or processed foods, and his BMI, blood pressure and cholesterol are all low-normal range. Which of the following do you discuss with Julian?
a. He is higher risk due to his sedentary job and he should immediately reduce his work hours or change professions to a more active role
b. He could consider 2 minute bouts of light or moderate intensity walking every 20 minutes whilst working – this has been shown to decrease both blood glucose and insulin levels in a population of overweight and obese adults, and may attenuate his longer term risk
c. The risk from sedentary behaviour is offset by his excellent exercise regime, but he should consider adding a strength and flexibility training to his schedule
d. Results from a large trial following adults older than 45 years old for an average of 2.8 years showed that 6.9% of all-cause mortality was attributed to sitting. This effect was diminished to non-significant levels when physical activity level was taken into account.
B (BR manual p 192)
Sedentary behaviour is an independent risk factor for all-cause mortality. Results from a large trial following adults older than 45 years old for an average of 2.8 years showed that 6.9% of all-cause mortality was attributed to sitting. This was consistent across genders, age groups, BMI, physical activity and in healthy participants vs participants with pre-existing CVD/diabetes.
Yazmin is a 62 year old lady who has recently been diagnosed with diabetes on a glucose tolerance test. Her only other past history includes asthma for which she takes a regular preventer. She does not smoke or drink alcohol. Her blood pressure is 120/80 today and her BMI is 29. She has normal renal and liver function, and her Hba1c is 6.3%. She has been doing some reading and asks your advice around exercise. She does not participate in regular exercise and hasn’t for many years, but is keen to start regular moderate intensity activity. She has no cardiac symptoms with her current level of activity. Which of the following is TRUE?
a. As she has no current symptoms, Yazmin can commence a light exercise regime – eg walking for 10 minutes a day at a pace where she is able to talk and sing
b. Yazmin is high risk for an exercise related cardiac event and she should see a cardiologist prior to doing any exercise over her current baseline activity
c. Yazmin should see a medical provider for medical clearance, and exercise stress testing may be helpful in her case for stratifying her risk.
d. Yazmin should be referred for medical clearance on the basis of her asthma requiring preventer medication
e. A and C
f. B and D
E (BR manual p193-194)
“If a patient has walked into your office and is not out of breath, she can do low level physical activity”; screening should not present a barrier for low level activity. Pulmonary disease does not require medical clearance, as it does not increase the risk of cardiovascular complications. The algorithm for pre-participation screening process (American College of Sports Medicine) states that individuals not participating in regular exercise who are asymptomatic with known cardiovascular, metabolic or renal disease state that medical clearance is required.
Which of the following is correct regarding the American College of Sports Medicine’s three stages of exercise progression?
a. The three stages are: Initial stage (1-6 weeks), Improvement stage (4-8 months), and Maintenance stage (indefinite)
b. In the initial stage, moderate intensity activities should be performed starting at 15 minutes and increasing to 30 minutes; recommended frequency is 3-4 times a week
c. In the improvement stage, frequency and intensity are increased first, then duration is increased, aiming for 20-30 minutes of continuous moderate to vigorous activity
d. A and B are correct
e. All of the above are correct
D (BR manual p.196)
In the improvement stage, intensity is usually increased AFTER target duration and frequency have been achieved.
