Exam 2 Flashcards
mediators
things that sit in-between exposure and outcome.
Responsible for causing the outcome to happen
moderators
variables that are not in a causal sequence but that alter the relation or effect between an independent variable and a dependent variable
examples of facilitators
Childlessness
Education*
Gender (male)*
Income/SES*
Exercise enjoyment*
Expected benefits*
Perceived health/fitness*
Self-efficacy*
Self-motivation*
Dietary habits*
Coping with barriers
examples of inhibitors
Age*
Blue-collar occupation
PA intensity
Heart disease
PA perceived effort*
Marital status
Race/ethnicity*
Lack of Time
Mood disturbance*
Poor body image
Social isolation
Climate/season*
exercise prescription should…
be flexible in the different combinations of frequency and/or time/duration
Allow individuals to self-select frequency and time may influence adherence to exercise interventions.
Theories provide a framework for understanding why people do/don’t exercise, and can thus help individualize programs
social cognitive theory (SCT)
based on the principle that the individual, behavior , and environment all interact to influence future behavior.
task self-efficacy
refers to an individual’s belief that they can actually do the behavior, whereas
self efficacy
SCT is rooted
refers to one’s beliefs in their capability to successfully complete a course of action (i.e. exercise).
barrier self-efficacy
refers to whether an individual believes they can regularly exercise in the face of common barriers (i.e. lack of time, poor weather, fatigue).
Social Cognitive Theory and Self-Efficacy
The higher the sense of efficacy, the greater the effort, persistence, and resilience an individual will exhibit, especially when faced with barriers or challenges.
Self-efficacy is one of the most consistently found correlates of PA in adults and youth.
self-monitoring
person’s ability to:
Set goals (later in semester)
Monitor progress toward those goals (assessments: coming up)
Problem solve when faced with barriers (earlier in notes)
Take a moment and think about how the end of the semester poses barriers
Engage in self-reward (treat yourself!)
self-determination theory (SDT)
The theory proposes that motivation exists on a continuum from amotivation (low self-determination) to intrinsic motivation (high self-determination)
cognitive strategies
focus on changing the way individuals think, reason, and imagine themselves in regard to exercise behavior
behavioral strategies
refer to individual actions and reactions to environmental stimuli. Because actions and reactions are thought to be learned, the behavioral approach posits that these actions and reactions can be unlearned or modified
SMART goals
Specific: Goals should be precise
Measureable: Goals should be quantifiable
Action-oriented: Goals should indicate what needs to be done
Realistic: Goals should be achievable
Timely: Goals should have a specific and realistic time frame
Self-determined: Goals should be developed primarily by the patient/client
extrinsic rewards
include tangible, physical rewards (e.g., new pair of shoes) and social reinforcement (e.g., praise).
intrinsic rewards
ome from within, such as a feeling of accomplishment. Individuals are more likely to adhere to exercise over the long term if they are doing the activity for intrinsic reasons such as for fun, enjoyment, and challenge.
social support
guidance (advice, information)
reliable alliance
reassurance of worth
attachment
social integration (a sense of belonging and feeling comfortable in group exercise situations)
opportunity for nurturance
VO2 Application
VO2 for several forms of physical activity can be estimated
VO2 can be easily transferred into energy cost (kcals)
Exercise prescription & programming can be individualized to meet a client’s goals & needs.
absolute oxygen consumption
Volume of O2 consumed by the individual per unit of time (minutes), expressed in liters per minute (L/min) or milliliters per minute (mL/min)
Each liter of O2 consumed equals an EE of ~ 5 kcals (you will see this again throughout these notes)
relative oxygen consumption
O2 consumption relative to the individual’s body weight, expressed in mL/kg/min
Resting (VO2 rest) = ~3.5 mL/kg/min
Maximal (athlete; VO2max) = upwards of 80 mL/kg/min
to calculate METs
Divide the relative O2 consumption by 3.5
Ex:
35 mL/kg/min = 10 METs
35 mL/kg/min ÷ 3.5 mL/kg/min = 10 METs
calorie
Used to describe the energy from food & the energy used during both PA & at rest
MET-min
An index of EE that quantifies the total amount of physical activity performed in a standardized manner across individuals and types of activities. Calculated as the product of the number of METs associated with one or more physical activities and the number of minutes the activities were performed (i.e., METs × min).
Rationale for Measuring VO2
- baseline
- follow up
- motivation
- individualized program prescription
- diagnosis/prognosis of disease
Low levels of cardiorespiratory fitness (CRF) have been associated with …
an increased risk of premature death from all causes and CVD
More physical activity = Higher CRF, overall health
VO2 peak
is the highest rate of oxygen consumption, in the absence of a VO2 plateau
everyone will have some VO2 value that (by default) was the highest value during the exercise test
…but that doesn’t mean that it was the highest value they were capable of reaching…therefore we call that the VO2 peak
absolute vo2 (l/min OR mL/min
related to body size
A grown adult will have higher absolute VO2 values than an adolescent (but may not reflect actual fitness comparison)
If you want to compare improvements in cardiorespiratory functioning against yourself (and not include the influence of weight – this is option to use)
relative vo2 (mL/kg/min)
Allows comparison of fitness level amongst different populations/body sizes
(VO2 is relative to your body weight)
The decision to use a maximal or submaximal exercise test depends largely on:
Resources
Expertise
Rationale/ Health
maximal tests
require participants to exercise to the point of volitional fatigue, which may be inappropriate for some individuals and may require the need for emergency equipment
Exercise professionals often rely on submaximal exercise tests to assess CRF because maximal exercise testing is not always feasible in the health/fitness setting
test organization
Have all equipment (calibrated), thermoneutral environment
No eating 4 hours prior, exercise 24 hours before test, caffeine 12 hours before test, note any medications
Explain RPE scale (6 - 20) – participant is always in control
All resting measurements taken
Test administrator is prepared, confident, and knowledgeable
Allow participant to ask questions
submaximal aerobic test
85% of age-predicted HR max
(220-age) * .85
Participant can no longer comply with test demands
Participant stops the test
vo2 max test
VO2 plateau
Lactate > 8 mmol/L
RER > 1.15
Failure of HR to increase, within +/- 10 beats of age-predicted max
maximal vs submaximal
Maximal: provides the best assessment of exercise safety and disease presence and most accurate data (e.g., true peak/max HR) for exercise prescription purposes, but…
Submaximal: takes less time to perform, is less expensive, and generally does not require physician supervision (safer for those with established disease)
duration
8 - 12 minutes
3 minute stages
protocol selection
Should be specific to mode of exercise subject is accustomed to
Is it a maximal test or a submaximal test
You can utilize published common protocols or customized protocols
Bottom line – all tests are to be completed within 8-12 minutes
interpretation of results
Organize data and discuss with participant
Sources of error
Prediction of HR max
Equipment calibration
Accurate physiologic measurements
Did they reach steady state?
Protocol compliance
What can we do with VO2 measurements? USE the data to make training sessions/programs informed with scientific data!
Translation and identifying training zones
Identify disease presence
Establish baseline values
Monitor training progress
VO2
cardiac output (Q) x a-VO2 diff
Q = HR X SV
main cardiovascular changes
Cardiac output
Stroke volume
Heart rate
Arteriovenous oxygen difference
Heart size
Blood volume
Blood flow
principle of adaptations
if a specific physiologic capacity is taxed by a physical training stimulus regularly, the physiologic capacity expands.
training threshold
the point beyond which the physiologic capacity must be challenged to affect a training stimulus; required for adaptations.
progression
is needed as the physiologic capacities of the body increase.
detraining
a cessation or diminution of training that results in a decrease in physiologic capacity. Linked with principle of reversibility
overtraining
is when the overload is excessive relative to the amount of time allotted for recovery, resulting in a chronic overtaxing of physiologic systems and a decrease in performance.
specificity
physiologic systems that are appropriately trained will adapt.
adaptations following 3 month aerobic training: VO2
rest: stays the same
submaximal exertion: stays the same
max: increases
adaptations following 3 month aerobic training: Q (cardiac output)
rest: stays the same
submaximal exertion: stays the same
max: increases
adaptations following 3 month aerobic training: HR
rest: decreases
submaximal exertion: decreases
max: stays the same
adaptations following 3 month aerobic training: SV (stroke volume)
rest: increases
submaximal exertion: increases
max: increases
adaptations following 3 month aerobic training: aVO2 diff
rest: stays the same
submaximal exertion:
max: increases
low to moderate initial fitness
<40 mLkgmin
recommended minimum intensity:
30% VO2R or HRR
average to good initial fitness
40 - 51 mLkgmin
recommended minimum intensity:
45% VO2R or HRR
high initial intensity
52 - 59 mLkgmin
recommended minimum intensity:
75% VO2r or HRR
very high initial intensity
> /= 60 mLkgmin
recommended minimum intensity:
90% - 100% VO2R or HRR
how much to improve fitness: moderate
300 min/wk
how much to improve fitness: vigorous
150 min/wk
volume from purposeful exercise should be…
> 1,000 kcal/wk
2,000 - 4,0000 recommended
intensity threshold for improving cardiorespiratory fitness
When selecting intensity for clients, know the initial fitness level.
Higher %VO2 peak or %VO2 reserve levels result in greater improvements of cardiorespiratory fitness versus lower intensities.
Interval training, versus continuous training, may enhance cardiorespiratory fitness to a greater degree.
Interval training has been shown to be safe in patients with cardiac and metabolic diseases
maximal HR
208 - 0.7 (age)
Steps in establishing the target workload
Select the desired intensity in %VO2R units.
Calculate the target VO2.
Convert the target VO2 to a workload using the ACSM metabolic equations.
caloric cost of exercise
1 L of O2 = 5 kcal · min-1
3.5 mL/kg/min (i.e., 1 MET) = 1 kcal/kg/hr
Significant reductions in cardiovascular risk occur when weekly caloric expenditure exceeds 1,000 kcal.
Optimal caloric expenditure is from 2,000 – 4,000 kcal/week.
Lactate threshold
the point at which an exponential inflection of lactic acid in bloodstream (crossover effect).
exercise progression
The recommended rate of progression depends on the individual’s health status, fitness, training responses, and exercise program goals.
Progression may consist of modifying any of the FITT components of exercise prescription.
Ventilatory threshold
point at which ventilation (L*min) exponentially increases with no further increase in VO2
rate of progression
An increase in exercise time/duration per session of 5–10 min every 1–2 wk over the first 4–6 wk of an exercise training program is reasonable for the average adult.
After the individual has been exercising regularly for at least 1 month, the FIT of exercise is gradually adjusted upward over the next 4–8 months — or longer for older adults and very deconditioned individuals — to meet the recommended quantity and quality of exercise presented in the Guidelines text.
exercise progression
The recommended rate of progression depends on the individual’s health status, fitness, training responses, and exercise program goals.
“initiation” stage
aka tough beginning
Allow time for adaptation to occur
At lower intensity and duration compared to later stages, especially in those who are not previous exercisers
Goal is to limit extreme fatigue and muscle soreness.
In other words, you are starting small and building to towards an enhanced exercise capacity.
Indicators of progression that is too rapid (overtraining) include the following:
Loss of interest
HR stays same or increases
Inability to complete
Excessive muscle soreness
Frequency, intensity, and duration influence weekly training volume – consider keeping increases in weekly kcal expenditure to around….
10%
