Physiological Assessments Flashcards
signs or symptoms that merit immediate exercise test termination
1) onset of angina, chest pain, or angina-like symptoms
2) significant drop (<10 mmHg) in SBP despite an increase in exercise intensity
3) excessive rise in BP: SBP reaches >250 mmHg or DBP reaches >115 mmHg
4) excess fatigue, shortness of breath, or wheezing (does not include heavy breathing due to intense exercise)
5) signs of poor perfusion: lightheadedness, pallor (pale skin), cyanosis (bluish coloration, especially around the mouth, nausea, or cold and clammy skin
6) increased nervous system symptoms (e.g., ataxia, dizziness, confusion, or syncope)
7) leg cramping or claudication
8) subject requests to stop
9) physical or verbal manifestations of severe fatigue
10) failure of testing equipment
the passage of fluid through a tissue, such as the transport of blood through vessels from the heart to internal organs and other tissues
perfusion
a bluish discoloration, especially of the skin and mucous membranes, due to reduced hemoglobin in the blood
cyanosis
failure of muscular coordination; irregularity of muscular action
ataxia
a transient state of unconsciousness during which a person collapses to the floor as a result of lack of oxygen to the brain (commonly known as fainting)
syncope
cramp-like pains in the calves caused by poor circulation of blood to the leg muscles; frequently associated with peripheral vascular disease
claudication
methods of body-composition assessments
1) Bioelectrical Impedance Analysis (BIA)
2) Air Displacement Plethysmography (ADP; e.g., Bod Pod)
3) Dual-energy X-ray Absorption (DXA)
4) Hydrostatic Weighing (underwater weighing)
5) Magnetic Resonance Imaging (MRI)
6) Near-Infrared Interactance (NIR)
7) Skinfold measurement
8) Total Body Electrical Conductivity (TOBEC)
gold standard of body measurement methods
Hydrostatic weighing
most commonly used body measurement method
skinfold measurment
3 skinfold locations for men
1) chest - diagonal fold midway between the anterior axillary line (crease of the underarm) and the nipple
2) thigh - vertical fold on vertical midline midway between the hip crease and proximal border of the patella
3) abdominal - vertical fold about 2 cm (1 in) to the right of the umbilicus (belly button)
3 skinfold locations for women
1) triceps - vertical fold on posterior midline of upper arm between shoulder (acromion) and elbow (olecranon)
2) thigh - vertical fold on vertical midline midway between the hip crease and proximal border of the patella (same as men)
3) suprailium (outer waist) - diagonal fold following the natural line of the iliac crest taken immediately superior to the crest of the ilium and in line with the anterior axillary line
Waist-to-hip ratio norms for males
Excellent: <0.85
Good: 0.85-0.89
Average: 0.9-0.95
At Risk: >0.95
Waist-to-hip ratio norms for females
Excellent: <0.75
Good: 0.75-0.79
Average: 0.8-0.86
At Risk: >0.86
For every 1-inch (2.5-cm increase in waist circumference in men, these associated health risks are found
1) blood pressure increases by 10%
2) blood cholesterol level increases by 8%
3) HDL decreases by 15%
4) Triglycerides increase by 18%
5) Metabolic syndrome risk increases by 18%
Risk criteria for waist circumference in females
Very low: <27.3 in (70 cm)
Low: 27.3-34.7 in (70-89 cm)
High: 35.1-42.5 in (90-105 cm)
Very high: >42.9 in (>110 cm)
Risk criteria for waist circumference in males
Very low: <31.2 in (80 cm)
Low: 31.2-38.6 in (80-99 cm)
High: 39.0-46.8 in (100-120 cm)
Very high: >46.8 in (>120 cm)
Exercise testing for cardiorespiratory fitness training (CFT) is useful to…
1) Determine functional capacity, using predetermined formulas based on age, gender, and body weight
2) Determine a level of cardiorespiratory function - maximal oxygen intake (VO2 max) or metabolic equivalent (MET) level - that serves as a starting point for developing goals for aerobic conditioning
3) Determine any underlying cardiorespiratory abnormalities that signify progressive stages of cardiovascular disease
4) Periodically reassess progress following a structured fitness program
T/F: Heart rate and oxygen uptake exhibit a fairly linear relationship to workload.
True
What is the calculation/formula used most often to estimate maximum heart rate (MHR)? Also, what is the standard deviation?
220 - Age
12 heart beats per minute
2 methods used to determine MHR
1) standard formula: “220 - Age” or either Tanaka or Gellish formulas
2) Graded Exercise Test (GXT)
Tanaka formula for determining MHR
208 - (0.7 X Age)
Gellish formula for determining MHR
206.9 - (0.67 X Age)
Standard deviation for Tanaka and Gellish MHR formulas
7 bpm
What is the oxygen uptake at rest?
1 MET or 3.5mL/kg/min
Activities of daily living require how many METs?
5
Variables that should be constantly assessed before, during, and after a GXT
1) Heart rate - monitor continuously and record that last 15 seconds of each minute
2) Blood pressure - measure and record the last 45 secs of each stage
3) RPE - record the last 5 secs of each minute
4) Signs and symptoms - Monitor continuously and record both personal observations and client’s subjective comments
Disadvantages to cycle ergometer testing
1) underestimation of cardiorespiratory fitness due to leg fatigue (inexperience with cycling)
2) exercise BP may be higher than when using a treadmill test due to prolonged muscular contractions
Contraindications to cycle ergometer testing
1) obese individuals who are not comfortable on standard seats or are physically unable to pedal at the appropriate cadence
2) individuals with orthopedic problems that limit knee ROM to less than 110 degrees
3) individuals with neuromuscular problems who cannot maintain a cadence of 50 rpm
YMCA bike test determines these two things
1) MHR
2) VO2 max
How many stages are in the YMCA bike test?
4
How many stages of the YMCA bike test must be completed in order to accurately estimate HR?
2
For the YMCA bike test, between which two bpm points must HR be observed?
110 bpm and 85% of MHR (or 70% of heart rate reserve)
In the YMCA bike test, the exercise HR of stages 2 and 3 must be within how many bpm to achieve steady state HR (HRss)?
5
In the YMCA bike test, approximately what percentage of subjects will not achieve HRss, thereby invalidating the test?
10%
To compare VO2 across individuals with different weights, perform these steps
1) Convert L/min to mL/min by multiplying by 1,000
2) Convert body weight from lb to kg by dividing by 2.2
3) Divide mL/kg
the volume of air breathed per minute
minute ventilation
T/F: At higher or near-maximal intensities, the frequency of breathing becomes more pronounced resulting in minute ventilation rising disproportionately to the increase in oxygen uptake.
True
T/F: During submaximal exercise ventilation increases disproportionately with oxygen uptake and CO2 production.
False
Increases linearly
Prior to VT1 (lactate threshold), what is the major fuel source used during submaximal exercise intensity?
Fats/lipids
Prior to reaching VT2, oxygen needs are primarily met through an increase in…
tidal volume
Post reaching VT2, oxygen needs are primarily met through an increase in…
respiratory/breathing rate
Contraindications to ventilatory threshold testing
1) individuals with certain breathing problems (e.g., asthma, coronary obstructive pulmonary disease (COPD))
2) individuals prone to panic/anxiety attacks
3) recovery from a recent respiratory infection
Recommended exercise intensity increments per stage for the submaximal talk test
5 bpm
For the submaximal talk test, what should be the starting intensity after appropriate warm-up has been performed?
120 bpm or 3-4 our of 10 on RPE (10 point scale)
How long is each stage of the submaximal talk test?
60-120 (1-2 min) seconds
How long must selected intensity be maintained in order for the VT2 threshold test to be valid?
20 minutes
How is HR response at VT2 determined when using a 15-20 min test?
95% of the 15-20 min HR avg
Type of clients that are eligible to perform the VT2 threshold test
clients that are deemed low to moderate risk and are successfully training in phase 3 (anaerobic endurance) of the ACE IFT model
Contraindications for outdoor walk/run testing (field testing)
1) extreme weather conditions
2) individuals with health challenges that would preclude continuous walking
3) individuals with breathing difficulties exacerbated by pollution or outdoor allergens
4) running tests are not recommended for those who are deconditioned
purpose of the Rockport fitness walking test (1 mile)
estimate VO2 max from a client’s immediate post-exercise HR
How is VO2 max estimated for the Rockport fitness walking test?
1) immediate post-exercise HR
2) 1-mile walk time
purpose of the 1.5 mile run test
measure cardiovascular endurance and muscular endurance of the legs
Contraindications for step tests
1) individuals who are extremely overweight
2) individuals with balance concerns
3) individuals with orthopedic problems (e.g., knee or low-back)
4) individuals who are extremely deconditioned
5) individuals who are short in stature
Purpose of step tests
to determine fitness level by immediate post-exercise recovery HR
How long is the YMCA submaximal step test performed for?
3 min
3 reasons to call EMS during exercise testing
1) Unconsciousness
2) Chest pains (e.g., angina) or symptoms of heart attack or cardiac distress
3) Extreme difficulty in breathing that cannot be controlled with rest
6 benefits of muscular fitness
1) enhances ability to carry ADL, which translates to an increase in self-esteem and independence
2) musculoskeletal integrity
3) enhances or maintains fat-free mass and positively impacts RMR
4) guards against osteoporosis by protecting or enhancing bone density
5) enhances glucose tolerance
6) reduces the cardiovascular response to resistance-type activities
Contraindications and considerations for push-up test
1) shoulder, elbow, or wrist problems
2) individuals may stop before reaching failure/fatigue
Contraindications for the curl-up test
1) low-back issues
2) cervical neck issues
Contraindications for body-weight squat test
1) deconditioned or frail with lower-extremity weakness
2) balance concerns
3) orthopedic issues (esp in the knees)
4) improper squatting technique
What is the appropriate depth for the body-weight squat test?
thighs reach parallel to the floor (i.e., 90 degree flexion at the knee)
2 ways in which strength is measured/expressed
1) absolute
2) relative
defined as the greatest amount of weight that can be lifted at one time
absolute strength
takes the person’s body weight into account and is used when comparing strength between individuals
relative strength
formula/calculation for relative strength
Absolute Strength / Body Weight
absolute strength = amount of weight lifted
When only should 1-RM tests be performed?
During either Phase 3 or 4 of the ACE IFT model
Contraindications and considerations for 1-RM testing
1) Proper form and control are necessary; novice lifters may not have the familiarity or skill to handle the heavier free weights
2) Beginning exercisers are often unsure of their abilities and tend to quit before their true maximum
3) Proper breathing patterns are necessary; clients should avoid the Valsalva maneuver or any other form of breath-holding
4) Individuals with hypertension and/or a history of cardiovascular disease
1-RM testing protocol (warm-up and working sets)
- 1st warm-up set: 5-10 reps at 50% (then rest 60 secs)
- 2nd warm-up set: 3-5 reps at 70-75% (then rest 60 secs)
- 3rd warm-up set: 2-3 reps at 85-90% (then rest 2 min)
- 3-5 tries to attain 1-RM score (rest 2-4 min b/w each try)
When should power, speed, agility, and quickness tests be performed?
During phase 4 of the ACE IFT model
equations for “power”
Power = Force X Velocity Power = Work / Time
equation for “force”
Force = Mass X Acceleration
equation for “velocity”
Velocity = Distance / Time
equation for “work”
Work = Force X Distance
