Midterm 1 Flashcards
1
Q
goals of testing (9)
A
- evaluate strengths/ weakness
- evaluate health status
- identify cause of symptoms
- identify CAD
- inform exercise prescription
- evaluate effectiveness
- provide ergogenic aid
- identify talent
- develop knowledge
2
Q
components of physical fitness (5)
A
- CRF- cardiorespiratory fitness
- BC- body comp
- MS- muscular strength
- ME- muscular endurance
- Flexibility
3
Q
CRF- cardio respiratory fitness
A
ability to deliver O2 during sustained activity through circulatory and resp. system
4
Q
BC- body composition
A
% of different types of tissues that are related to health
5
Q
MS- muscular strength
A
ability to deliver maximal contractile force in a single contraction
6
Q
ME- muscular endurance
A
ability to execute contractions over a period of time sufficient for muscular fatigue
7
Q
Flexibility
A
ability it move a joint through its ROM
8
Q
fundamental principles of assessment (5)
A
- does it relate to specific assessment objective
- is there criterion test (gold standard) and error measurement
- calibration
- standardization
- interpretation
9
Q
test specificity
A
measure of the ability to correctly identify individual with no risk factors
10
Q
test sensitivity
A
probability of correctly identifying individuals who have risk factors for a specific disease/syndrome
11
Q
test validity
A
ability of test to measure accurately, with minimal error
- use gold standard
12
Q
test reliability
A
ability of a test to yield consistent and stable scores across trials over a time
13
Q
face validity
A
the degree to which a procedure of a test or assessment, appears to measure the variables or construct its supposed to measure
14
Q
describe status vs results from screening square
A
15
Q
test objectivity
A
intertester reliability
16
Q
whats the relationship between test reliability and validity
A
reliability affects validity
17
Q
parts of validity coefficient (validity)
A
- residual score: difference between criterion and predicted (absolute)
- standard error of estimate (SEE): measure of prediction error, used to quantify the accuracy of the prediction equation and validity of test
18
Q
parts of correlation (r) (reliability)
A
- typical error of measurement: the variation from any source technical, biological
- change in the mean: compares random change (error) to systematic change (motivation)
19
Q
how to calculate validity coefficient
A
initial % / second %
- if <0.8 it means poor
20
Q
what is scope of practice
A
what practices you should and can do with your abilities
- think legal and ethical elements
21
Q
risks associated with exercise
A
- myocardial infraction (MI)
- sudden cardiac death (SCD)
- congenital abnormalities
- coronary artery disease (CAD)
- cardiovascular diseases (CVD)
22
Q
Describe an evidence-based pre-screening process (4 steps)
A
- identify those with pre-existing medical conditions
- identify those at risk of cardiac events during testing
- identify those who should have prior medical evaluation before exercising
- identify signs and symptoms of chronic disease
23
Q
CAD risk factors: age, family history, smoking history, phys. inactivity, BMI/WC, BP
A
- age:
- men >45
- women >55 - family history:
- any disease <55 father, <65 mother or relative - smoking:
- current or smoking within 6 months - phys. inactivity:
- not meeting minimum 500-1000 METS of mod-vig activity
- or 75-150 min of walking/week - BMI & WC:
- BMI >30 kg m -2
- WC >102 cm (40 inch) men, >88 cm (35 inch) women - BP:
- systolic >130 mmHg
- diastolic >80 mmHg
- avg of > 2 readings
24
Q
Resting HR and BP
A
- HR: normal is 50-90 bpm (cut off for exercise is >99 bpm)
- BP: normal is <120/80 (cut of for exercise is >160/90
25
Describe a typical battery of resting measures
- HR
- BP
- 12 lead ECG
- O2 saturation
26
signs and symptoms of CV, metabolic or renal disease at rest (10)
- pain/discomfort
- dyspnea (difficulty breathing)
- dizziness/syncope (decreased brain perfusion, CAD, aortic stenosis)
- pallor/ cyanosis (poor perfusion)
- ankle edema (venous thrombosis)
- lower leg pain/ intermittent claudication (pain in lower limbs, more severe in uphill walking, disappears in 1-2 min)
- orthopnea/ paroxysmal nocturnal dyspnea (slowed breathing)
- palpitations/ tachycardia (irregular heart rate)
- heart murmur
- fatigue
27
key components of information gathering (7)
1. learn about them (background, lifestyle, routine)
2. gain info to guide test selection
3. discover motivation for change
4. readiness for change
5. gain info about useful items for exercise
6. desire to undertake an assessment
7. build rapport
28
goals/ indications to exercise testing (9)
1. evaluate strengths/ weaknesses
2. evaluate health status
3. identify cause of symptoms
4. identify CAD
5. inform exercise prescription
6. effectiveness of prescription
7. provide ergogenic aid
8. identify talent
9. develop knowledge os sport/activity
29
types of contraindications for exercise testing
- absolute: no testing until condition has been stabilized
- relative: can be suppressed if the benefit outweighs the risk
30
common documentation formats
- GAQ
- SOAP
- ACSM logic model
31
typical monitoring options during exercise (8)
- HR
- BP
- rate of perceived exertion
- expired gas
- variety of scales: angina, dyspnea, leg pain
- electrocardiogram (ECG)
- O2 saturation
- blood glucose
32
typical measurements of physical characteristics
- variables to describe patient (height, weight,)
- lab tests (HDL , LDL, cholesterol)
33
important considerations for assessment accuracy (6)
1. pretest instructions (smoking, eating, caffeine >2 hr prior)(vigorous PA, alcohol >6hr prior)
2. test anxiety/environment
3. test quality
4. equipment calibration
5. practice technique and calibration (technical error of measure-TEM)
34
typical measures of anthropometry (6)
1. body mass index (BMI)
2. waist circumference (WC)
3. body comp:
- bioelectrical impedance analysis (BIA)
- plethysmography (hydrostatic weighing & bod pod)
- dual x-ray absorptiometry analysis (DEXA)
- skinfold measurement
4. circumference/ girth
5. seated height
6. arm span
35
pros and cons of basic measurements - BMI, height, weight, WC
pros:
- Ht and Wt analyze growth/ dev.
- BMI and WC identify risk
- easy, minimum risk
- practical, reliable
cons (BMI):
- doesn't measure body comp
- developed on white pop.
-doesn't account for frame size
36
pros/ cons of plethysmography (hydrostatic weighing) and what it does
- measures changes in water volume to directly measure body density
pros:
- none
cons:
- impractical
- complex
- poor reliability
- resource heavy
- not comfortable
37
pros/cons of plethysmography (bod pod)
and what it does
- measures body volume by monitoring change in air displacement/pressure with vs without project
- converts body density and predicts lean vs fat mass
pros:
- gold standard
- high validity
- practical
- good reliability
cons:
- resource heavy
- not accessible
38
pros/cons of Bioelectrical impedance analysis (BIA) and what it is
- measures body mass (body mass %)
- indirect method of measuring resistance of body tissue to small electrical currents
- fat mass: less water, more resistance (incr. impedance)
- lean mass: more water, less resistance (decr. impedance)
pros:
- measures body comp
- accessible
cons:
- poor reliability
- assumes frame size
- anything that changes resistance (water,food,electrolyte drink) will change prediction
- has diff. equations for demographics
39
pros/cons of dual energy x-ray absorptiometry (DEXA) and what it is
- imaging device that measures attenuation in x-ray imaging and creates an analysis of fat mass, fat free mass, and bone mineral density
pros:
- gold standard
- super high validity
- most practical
- really reliable
- diagnosis of osteoporosis
- segmental analysis
cons:
- resource heavy
- not accessible for most
- small dose of radiation
40
pros/cons of skinfolds and what it is
- measures BF% by measuring diff. spots on the body
- calculates the sum
pros:
- gold standard
- feasible
- good for talent ID
cons:
- high level of technical errors
- uncomfortable
- not appropriate for all populations
41
effective communication for resting measures and physical characteristics
- explain test before (Inform consent)
- depending on results- inform client that you need to compare results to the norms
- they should know what exactly "poor, fair, and good" mean
- avoid oversimplifications
- expect that your communication will be used against you later
42
common terms in muscular strength
- strength
- power
- speed
- agility
- endurance
- static (isometric)
- dynamic (concentric, eccentric, isokinetic, isotonic)
43
strength
the ability if a muscle group to develop maximal contractile force in a single contraction
44
endurance
the ability of a muscle group to exert sub max force for extended periods
45
power
the product of force and velocity
- power = force x velocity
46
common terms in endurance testing
- endurance
- muscle fatigue (central fatigue, peripheral fatigue)
- types of fatigue (type, duration, intensity, fitness, environment)
-
47
static (isometric)
force generated with no movement
48
dynamic and the types of dynamic movement
force generated with visible movement
- concentric: force outcome resistance and muscle shortens to move lever (forcemuscle)
- isokinetic: force exerted at a constant velocity as the joint moves through ROM, controlled mechanically/externally
- isotonic: resistance stays the same while muscle shortens and lengthens
49
Describe sources of fatigue in muscular endurance activities
loss of force/power output in response to voluntary effort leading to reduced performance
- central: progressive decline in voluntary drive to MN during exercise
- peripheral: loss of force/ power independent of neural drive
- depends on type, intensity, duration, fitness, environment
50
Describe the basic structure and function of muscle
structure:
- muscle > muscle belly > bundle of muscle fibers > single muscle fiber > myofibrils > single myofibril > contractile filaments (myosin, and actin - troponin, tropomyosin)
- maximum overlap of myosin XB's with actin activate sites at resting length
function:
- to move a joint
51
various methods for assessing muscular strength
- dynamometers (isometric dynamometers-back/leg, hand grip)
- cable tensiometers
- calisthenics
- 1 RM (constant resistance)
52
describe isometric dynamometers and the types and pros/cons
measures static strength generated from forearm/hand and leg/back muscles
- back/leg: forces of 0-2500lbs, lower body strength
- hand grip: forces of 0-100 lbs, overall body strength
pros: easily accessible
cons: none
53
describe cable tensiometers and pros/cons
- assess static strength by strength impairment in joint ROM
- force of 0-100 lbs
pros:
- good test quality
- reliable
cons:
- uses lots of resources
54
describe muscular calisthenics and pros/cons
- uses body weight dynamic movements to assess strength and endurance
- ex: push up, pull up, plank, sit up, 1 RM weighted pull up (dynamic strength)
pros:
- good for indiv
- good pre/post test
cons:
- not commonly used
- no norm values (hard to standardize)
55
Common tools for MSK testing
- free weights
- cable machine
- exercise machine
- dynamometer
- tensiometer
- biodex
56
what does free weights assess and the pros/cons
- constant resistance (isotonic)
- dynamic strength
pros:
- functional movement
cons:
- measures weakest point
57
what does a cable machine assess and the pros/cons
- variable resistance
- dynamic strength
pros:
- none
cons:
-alters mechanical advantage
- fluctuating forces
58
what does a exercise machine assess and the pros/cons
- constant/variable resistance (isotonic)
- dynamic strength
pros:
- none
cons:
- limited ROM
- predetermined increments
59
what does a biodex assess and the pros/cons
- isokinetic dynamometer
- dynamic strength
pros:
- detects weak points in ROM
- good for rehab
cons:
- not accessible
60
describe 1 RM
- gold standard
- dynamic strength
- the max weight that can be lifted for 1 complete repetition with proper form/velocity through complete ROM
- constant resistance protocol
- interpreted in absolute and relative
- incr. risk of muscle soreness
- incr. risk of injury
61
describe multi-functional
- strength, endurance, power
- speed of limb kept constant
- measures torque at 0-300 deg/s
- evaluates peak torque, total work, power
- compares strength curves
62
formula for relative endurance
(final force/initial force) x 100
63
Describe what and how the three energy systems contributed to muscular endurance
- PCr hydrolysis: produces ATP for short intense time periods (0-10 sec)
- Anaerobic glycolysis: produces ATP for moderate intensity ( 10 sec- 2 min) without oxygen it leads to lactate build up
- Oxidative phosphorylation: provides ATP for prolonged periods of time, low to moderate (over 2 min) using efficient exercise
64
what are the force/intensity relationships
- force angle relationship
- force length relationship
- force velocity relationship
- intensity duration relationship
65
force angle relationship
- muscle tension will be greatest at some point during ROM about a joint
- muscle tension varies with joint angle
66
force length relationship
- maximum tension occurs near the resting length of a sarcomere
67
force velocity relationship
- power (W) = force (N) x velocity (m/s)
- force (N) = m (kg) a (m/s2)
- velocity (m/s)= d (m)/t (s)
68
Describe the power-velocity relationship
- force is greatest at slow velocity
- power is decreased at slow velocity
- continues till ~50% max velocity
- power increases with concentric movement velocity till the velocity hits ~ 50%, which then the max shortening decreases and so does power
69
physiological factors that affect power and what they mean
- force production: capability: XB potential
- force frequency relationship: sending AP fast
- type II, IIB fiber types: size principle
- muscle recruitment: size principle
- size of soma: recruitment threshold
70
how to calculate power in different situations (white board)
power = work/ time
- work = force x distance
- force = mass x acceleration
71
Describe common field tests to assess muscular power
- vertical jump test
- margari-kalamen stair test
- broad jump test (long jump)
72
vertical jump test
- indiv jumps as high as possible from static position
- 3 trails
peak leg power (W) = [60.7 x jump height (cm)] + [45.3 x body mass (kg)] - 2055
73
margaria kalamen stair test
- indiv runs up a set of stairs as fast as possible taking three steps at a time
- power = work/time
- work= (mass x acceleration x distance)/time
74
broad jump test (standing long jump)
- indiv starts with feet together and does a countermovement and jumps straight forward as far as possible
- distance determined by measuring the rear heel and the start line (best of 3 trials)
75
Describe other methods to assess power
technology:
-video analysis software (dartfish): videos indiv doing various activities using frame by frame analysis to calculate markers of performance
- high speed camera: movements for sprints, jumps, weightlifting
- frame by frame analysis: marks time points for joint angle, time, distance calculates force, torque, power velocity
76
reactive strength
- to isolate concentric movements and compare to eccentric- concentric movement
- Eccentric utilization ratio
- not battery standard
77
rate of force development (RFD)
- maximal contractile fate of force development
- the ability of the neuromuscular system to generate very steep increase in muscle force within fractions of a sec
- good for force and power
- measured with a load cell or force plate
78
dynamic strength index (DSI) and the relationship to RFD
the time taken to reach peak force
- high DSI = high RFD
79
explosive strength
- rapid rate of joint movement rise or contractile rate of torque development
- correlated with maximal strength and related to dynamic performance
- RFD is important
80
factors affecting mobility and flexibility
- muscle length and elasticity: longer elastic muscles = > ROM
- joint structure: plays a role in the ROM, also genetics, and chronic disease
- muscle strength and balance: weak/imbalanced leads to low support/mobility
- connective tissue (CT) health: healthy tendons/ ligaments needed for flexibility
- age: mobility/ felx. decrease with age
- injury/scarring: scar tissues limit joint mobility
- CNS control: golgi tendons and muscle spindles affect stretch/relax response
81
flexibility and some tests
- more passive: ability of soft tissue to passively lengthen
- stretching ROM
- sit and reach, goniometer
82
mobility and some tests
- active: ability for a joint to move through its ROM
- about moving
- back stretch challenge
- broomstick challenge
83
reasons to test flexibility
- correlation b/w poor mobility/flex and decreased performance of various activities of daily living (ADL)
- poor flex is leads to injury
- identifies deficiencies and imbalances
- compares changes over time
- used in injury rehab
84
what are field tests for felxiblity
- goniometer
- sit and reach
- thomas test
85
goniometer
- gold standard for assessing ROM
- uses a protractor the measures the angle b/w two arms that adjust to line up with the joint movement
- stabilization arm is at the start position
- movement arm tracks the joint measured
86
sit and reach
- most common for lower back/hamstring flex
- participants sit on floor with legs extended, leaning forwards to push the maker and exhale to maximize distance
- two trials
87
thomas test
- tests quads, hamstrings, hip flexor
hip flexor position:
- to the floor: normal/neutral/ negative test
- to the roof: tight/short/ positive test
quad position:
- small angle: normal/neutral/negative test
- big angle: tight/short/positive test
88
what are field tests for mobility
back stretch
89
back stretch
- tests shoulder mobility
- dominant arm over shoulder, non-dominant arm around the back, reaching to touch fingers together
measurements:
- dominant over non dom. = positive value
- non-dom. over dominant = negative
90
types of balance
- static: ability to maintain upright position with center of gravity under supporting base
- dynamic: ability to maintain upright position with center of gravity outside supporting base
91
what are field tests for balance
- single leg balance
- y balance test
92
what type of balance is single leg balance and the protocol
- static balance
eyes open:
- client stands barefoot in front of chair and arms crossed across shoulders, client lifts one leg but not touching the other ankle, trying to hold for max 45 sec repeat on both legs
eyes closed:
- same as eyes open but with eyes closed
93
what is sarcopenia screening
- screening for a sarcopenia: a progressive muscle disorder involving accelerated loss of muscle mass
94
what are the training recommendations for sarcopenia prevention (frequency, target muscle, reps per set, sets per muscle group, rest periods, total workout duration)
- frequency: 1-3x/week
- target muscle group: whole body
- reps per set: 6-12 with gradual increase in intensity
- sets per muscle group: 1-3 sets or a single set of 10-30 reps to failure
- rest periods: 2-3 min b/w sets, 3-5 min b/w exercise
- total workout duration: under an hour
95
functionally fit
ability to perform everyday activities safely and independently without fatigue
- functional fitness is a multidimensional characteristic
96
what are the senior fitness tests
- 30 s chair stand
- 30 s arm curl
- 6 min walk or 2 min step test
- chair sit and reach
- back stretch
- 8 foot up and go
97
goals of functional testing
- decrease risk/falls/injuries
- decrease age -related bone mineral loss
- maintain lean mass
- improve glycolytic pathways
- increase QOL, functional independence, ADLs
98
what does chair sit to stand test assess and protocol
- lower body strength
- number of full stands in 20 s with arms folded across chest
99
what does arm curl test assess and protocol
- upper body strength
- number of bicep curls in 30 s holding hand weight (women 5lbs, men 8lbs)
100
what does 6 min walk/2 min step test assess and protocol
- aerobic endurance
- 6 min walk: number of yards walked in 6 min around a 50 yard course
- 2 min step: number of full steps completed in 2 min, raising each knee to midway b/w patella and iliac crest
101
what does chair sit and reach test assess and protocol
- lower body flex
- from sitting with one leg extended, reaching forward to touch toes
102
what does back stretch test assess and protocol
- upper body flex
- one hand over head, other around back, reaching to touch fingers
103
what does 8 foot up and go (TUG) test assess and protocol
- agility/balance
- number of sec it takes to go from sit to stand and walk 8 feet and sit back down
104
Short Physical Performance Battery (SPPB)
- a collection of exercises that correlate with performance in ADL
- includes test of : balance, speed, agility, lower body strength
- each test has its own score then sum is for a final score
105
what are the tests for SPPB
- gait speed test
- balance test
- chair stand test
106
gait speed test
- walk as quickly as possible to a cone then back
107
balance test
- three progressive test: side by side, semi-tandem, full tandem, single leg
108
chair stand test
- perform 5 chair stands as quickly as possible
109
considerations for MSK testing
- test selection: goals of testing
- safety: what can go wrong?
- communication: coaching/monitoring (during test), prepared to answer questions (after test)
- interpretation: what are the results, are they compared to norms, are they the avg, baseline measurements
