Practice Test- Wrong Answer Review Flashcards
Components of Physical Fitness
Refers to a set of health or skill-related attributes that can be MEASURED by SPECIFIC TESTS including:
- Muscular Strength (1RM)
- Muscular Endurance ( # of reps)
- Cardiorespiratory Fitness (VO2 max)
- Flexibility (E.g. Thomas Test)
- Body Composition (BIA, Hydrostatic Weighing etc)
2008 ACSM Guidelines for increasing muscular strength and endurance
- Do 8-10 exercises for the major muscle groups (legs, hips, back, chest, shoulders, arms)
- To maximize strength development, use a resistance that allows 8-12 repititions of each exercise, at which point fatigue is experienced
- One set of each exercise is sufficient, although more can be gained with 2 or 3 sets
- Do resistance training on 2 or more non consecutive days each week
MR PLEASE
- Make a classification as to wheter or not the individual currently exercises regularly
- Do they exercise?
- Review medical hx for established CV, metabolic or renal disease
- Do they have CV/DM/CKD?
- Pertinent signs of CV, metabolic or renal disease identified
- Do they have s/s of CVD/DM/CKD?
- Level of desired aerobic exercise intensity
- How difficult should their exericse be?
- Establish if medical clearance is necessary
- Should we get clearance for this level of exercise?
- Administration of fitness tests and evaluation of results
- Let’s check your current level of fitness
- Setup of exercise prescription
- This is the plan
- Evaluation of progress with follow up tests
- How are we progressing?
Positive Risk Factors
for Risk Statification Scoring
- Age ( MEN >=45, Women >=55)
- Family Hx: MI, coronary revascularization or sudden death before 55 years of age in father or other 1st degree male relative OR before 65 years of age in mother or other 1st degree female relative
- Cigarette Smoking: Current or quit in the last 6 mo
- Sedentary Lifestyle: Not participating in at least 30 mintues of mod-intensity PA on at least 3 days/week for at least 3 months
- Obesity: BMI >30, or waist girth >40” men, >35” for women
- Dyslipidemia: LDL >130, HDL <40, On lipid lowering meds. Total chol >200
- Prediabetes Fasting BG >100, impaired OGTT >140 and <200
Negative Risk Factors for Risk Stratification Scoring
High HDL >= 60 mg/dL
Describe ACSM’s Risk Stratification for Low Risk
& Need for Medical Exam / Doctor Supervision
Low Risk
Asymptomatic, <=1 Risk Fctor
Medical Exam & GXT before exercise?
XX
NOT NECESSARY FOR EITHER MODERATE OR VIGOROUS EXERCISE
Doctor Supervision of Exercise Test?
XX
NOT NECESSARY FOR EITHER MODERATE OR VIGOROUS
Describe ACSM’s Risk Stratification for MODERATE Risk
& Need for Medical Exam / Doctor Supervision
MODERATE Risk
Asymptomatic,
>= 2 Risk FActor
Medical Exam & GXT before exercise?
Moderate: NOT necessary
Vigorous: GXT not necessary, YES medical exam
Doctor Supervision of Exercise Test?
SubMax: NOT necessary
Max: RECOMMENDED
Describe ACSM’s Risk Stratification for HIGH Risk
& Need for Medical Exam / Doctor Supervision
HIGH Risk
SYMPTOMATIC
KNOWN cardiac pulmonary or metabolic disease
Medical Exam & GXT before exercise?
Moderate: RECOMMENDED
Vigorous: RECOMMENDED
Doctor Supervision of Exercise Test?
SubMax: RECOMMENDED
Max: RECOMMENDED
Anatomical Plane for Oblique Twists
TRANSVERSE plane AKA Horizantal plane
Cuts the body into top and bottom halves. Twisting movements.
TRANSVERSE = TWIST
Number of Bones in Body
200
Short Bone
Tarsals (ankle)
Carples (Wrist)
Approximately as wide as they are long
Planes and their Axis and movements
The mediolateral axis is perpendicular to the SAGGITAL plane
The Saggital Plane splits from Left from Right and describes FLEXION/EXTENSION movements
FORWARD AND BACK movements
The Anteroposterior axis is perpendicular to the FRONTAL plane
The Frontal Plane splits from front and back and describes ABD and AD-duction movements
SIDE TO SIDE movements
The longitudinal/vertical axis is perpendicar to the TRANSVERSE plane
Transverse plane splits top from bottom and in in regards to ROTATING movements
TWIST
Axes of Movement
-
Mediolateral (or horizantal) axis: Perpendicular to the Sagittal Plane. FLEXION and EXTENSION occur around this axis
- S-M-F-E : Sam Moves, Flexes and Extends
-
Anteroposterior axis: Perpendicular to FRONTAL Plane. ABDUCTION AND ADDUCTION occur around this access
- FAAA
- Fiona Acts, Abducts and Adducts
- FAAA
- Longitudinal Axis: Perpendicular to the TRANSVERSE plane. INTERNAL AND EXTERNAL ROTATION occur in this plane
- TLR
- Tyler’s Loopy, Rotates
- TLR
Axis Perpendicular to the Transverse Plane
LONGITUDINAL Axis
Name the 3 Major Muscle Actions
- Concentric Action - when a muscle shortens under tension
- Requires the muscle to overcome the force of gravity
- E.g. the flexion of a Bicep curl
- NOTE: A ballistic movement contains both concentric and eccentric action
- Eccentric Action
- E.g. the extension of a bicep curl
- The tension is not great enough to cause movement but instead SLOWS the speed of movement in the opposite direction
- Muscle lengthens and the joint moves in the opposite direction than the muscle is pulling caused by another force (e.g. gravity)
- NOTE: A ballistic movement contains both concentric and eccentric action
- Isometric Action
- STATIC action.
- Muscle exerts a force that is EQUAL in magnitiude to an opposing force
- Muscle length does not change and the joint position is maintained
- The Contractile part of the mmuscle shortens, but the eleastic connective tissue lengthens proportionately, so there is no overall change in the entire muscle length
- E.g. Plank
Muscle Structure and Function
Muscle Fibers
Myofibrils
Sarcomeres
Muscle Fibers: Each cylindrical fiber forms one cell. It is composed of a large number of myofibrils
Myofibrils: Run the length of the muscle and give skeltal muscle its striated apperance. A myofibril is composed of a series of sarcomeres
Sarcomeres: The fundamental units of contraction which contain the thick filament Myosin and Thin filamin Actin (thin is actin’), bouded by connective tissue called the Z line
Energy Sources and Duration of use
ATP
Phosphocreatine (PC)
Glycolysis
Flycogenolysis and Fat Oxidation
- ATP
1. Small amount available immediately, good for ~1 second - Phosphocreatine (PC)
- Stored in muscle cells
- Lasts 3-5 seconds e.g. muscle contraction
- Glycolysis
- Anaerobic breakdown of glucose
- Provides ~2 minutes of energy. e.g sprints, 400 meter dash, MAX WORK
- Produces lactic acid, Hydrogen ions which accumulate and interferes with muscle contraction
- Flycogenolysis and Fat Oxidation
- Oxygen must be present to create long term energy
- Comes from muscle glycogen, blood glucose, fatty acids (triglycerides), and intramuscular fat
- Used for SUBMAXIMAL activities >2 minutes and less than 2 hours. E.g. marathon
Protein for Athletes
Endurance
High-intensity, high-volume resistance training
Vegetarian Athletes
Endurance: 1.2-1.4 g/kg BW
High-intensity, high-volume resistance training: 1.2-1.7 g/kg BW
Vegetarian Athletes: 1.3-1.8 g/kg BW
Hydration for Exercise
Before exercise
During Exercise
Dehydration increases risk of heat cramps, heat exhaustion, and heat stroke
BEFORE: Athletes should consume 5-7 ml/kg BW of water or sport beverage at least four (4) hours prior to competition. IF this consumption does not yield urine OP, consume additional 3-5 ml/kg BW Two (2) hours before the event
DURING: Consuming 400-800 mL during endurance exercise is adequate for most
AFTER: Replace 16-24 oz water for each pound lost
Prescribing Exercise: Key Definitions
Dose
Effect
Potency
Slope
Maximal Effect
Variability
Side Effect
- Dose
- Amount of exercise prescribed. The “bout”of exercise
- The dose is different for elite performance than functional health
- Effect
- The body’s response to the dose
- Potency
- the ABILITY of an exercise to BRING ABOUT a certain result
- Intensity of the exercise.
- Closely related to dose
- High intensity may be done less frequently than moderate. Running vs walking
- Slope
- Reflects how much of an effect RESULTS from a change in dose
- Changes can be short term or long term, depending on the effect being measured
- E.g. HR and lactate response vs serum cholesterol
- Maximal Effect
- Getting the highest response from the dose
- Specific doses may impact some risk factors / outputs, but not others.
- Moderate exercise improves risk factors
- Strenuous exercise can modify, or revers risk factors and improve VO2Max
- Variability
- The effect of a specific dose of exercise differs from one individual to another, OR within one individual depending on the circumstance
- Side Effect
- Possible adverse effects such as injury or death
Characteristics of an Exercise Dose
FITT Principle
-
F: Frequency: How often? 5 days a week, 3-4 days a week. 7 days a week
- # of times per day or week
-
I: Intensity: How hard? Moderate, Vigorous/Hard, Very Hard
- % VO2 max, % max HR, RPE, Lactic Threshold
- T: Time: How Long? Duration in minutes: 30 min/day, 30-45 min per day, 60-120 min/day
-
T: Type: What Kind? Mode or kind of activity
- Aerobic vs Anaerobic .
- Walk. Jog. Run.
- Resistance or cardiorespiratory endurance.
- Swimming vs running vs rowing
Calculating Heart Rate Reserve
HRR = HRmax − HRrest
How much your Heart Rate can speed up with exercise. Allows a better target heart rate to be determined for optimum training capacity based on both maximum and resting heart rate.
E.g. 34 yo F
Max HR: 208-0.7(34) = 184.2
RHR: 66 bpm
HRR: 184.2-66 = 118
Determining Target Heart Rate
Direct Method
Indirect Method
Direct Method - GXT method. HR is monitored at each stage and plotted on a graph against the VO2/MET equivalent of each stage
Indirect Methods
- Heart Rate Reserve- HRR: Difference between HRmax and HRrest
-
Percent Heart Rate Max - % HRmax - Fixed percentage of max HR. Simple and validated. Direct relationship between %MaxHR and %VO2 max;
- 55-75% VO2 max = 70-85% HRmax
- 60-80% VO2 max = 75-90% HRmax
Comparison of Resistance Training Modes
Weight Machines
Free Weights
Body Weight
Balls & Chords
-
Weight Machines
- Both single joint and multijoint
- Occurs in only ONE anatomical plane
- Motion is controlled by the machine
-
Free Weights
- Require use of stabilizing and assiting muscles to hold the correct body position during an exercise
- Can occur in different planes.
- Encourages different muscle groups to work together while performing exercises that are similar to the participatn’s chosen sport or activity
- Greater variety of exercises
-
Body Weight
- Minimal equipment
- Difficulty in adjusting the body weight to the individual’s strength level
-
Balls & Chords, tubing
- Inexpensive. Can be used to enhance strength, lcal musclar endurance and power.
- Challenge proprioception. Helps with agility, balance and coordination
Warm up
Cool Down
Warm Up - Increases body and muscle temperature, increases blood flow and may enhance performance. 5-10 minutes of moderate to high intensity aerobic exercise such as slow jogging or stationary cycling
Cool Down - May reduce risk of cardiovascular issues (E.g. low BP)
Priciples of Training (PROS)
Principle of Progression
Principle of Regularity
Principle of Overload
Principle of Specificity
-
Principle of Progression- increase demands
- Demands must continually increase over time to realize goals
- denotes the concept of systematically manipulating program variables to optimize training adaptations over time
- Important after the first 2-3 months, when the training threshold for adaptations is higher
- Increase weight incrementally by 5-10% and decrease repetitions after each goal is met
-
Principle of Regularity - HOW OFTEN
- Training must be completed several times weekly
- Use it or lose it - training adaptations cannot be stored
- Long term gains in strength and performance require consistent training
-
Principle of Overload - increase in level of difficulty
- Body must be stressed beyond the point to which it has alrady adapted
- If the training stimulus is not challenging, adaptations will not occur
- Overload can be maniupated by changing
- INTENSITY,
- VOLUME,
- SPEED,
- REST INTERVALS, AND
- TYPE OF EXERCISE
-
Principle of Specificity - changing variables for specificity
- Adaptations are specific to muscle actions, velocity, ROM, muscle groups, energy systems, intensity, and volume of training
- Training-induced adaptations are consistent with the design of a resistance training program
- SAID - Specific Adaptations to Imposed Demand
- Training adaptations do not transfer from one body part to another, or one activity to another
- Systematically manipulating program variables to optimize training adaptations over time
Spinal Curves
Changes in Thoracic Kyphotic Curve and
Lumbar Lordotic Curve
Issues: Increased anterior pelvic tilt
Tightness in hip flexors
Sitting at desk all day
Increased anterior pelvic tilt: Increases LORDOTIC curve in the lumbar area, which increases the stresses on the ligaments, vertebrae and musculature of the spine (Especially L5)
Tightness in hip flexors: Can cause increased lordosis by causing an anterior pelvic tilt
Tightness in hamstrings: Can reduce lordosis, causes forward placement of the head for balance
Sitting at desk all day: Increases the thoracic Kyphosis and Decrease the lumbar lordotic curve. Putting a towel in the lumbar spine can help with maintaining lordotic curve
Being overweight, wearing high heels, lacking appropriate muscle length or sterngth - all effect degree of lordosis
Effect of sleep on spine health
The spine is particularly vulnerable at the beginning of the day because the discs imbibe tissue fluid while recumbent in sleeping postures, resulting in tighter discs that are more vulnerable to sprain or other injury
ACSM Guidelines for STRETCHING
Frequency
- 2-3 times per week with daily producing the best results
- Total of 60 seconds per stretch (10-30 sec per rep can be effective) repeated 2-4 times.
- Older adults may benefit form 30-60 sec with each stretch
- Can be passive, static, dynamic, ballistic, or contact-relax style as in proprioceptive neuromuscular facilitation (PNF)
- PNF = 3-6 sec light to moderate volutional muscle contraction with 10-30 sec assisted stretch
- Should not cause pain
- Should not take joint past normal ROM
Types of Stretches
Static
Active
Passive
Ballistic
Dynamic
Proprioceptive Neuromuscular Facilitation (PNF)
-
Static
- Muscle is slowly lengthened to a point where further movement is limited, and it is held for a period of time
- Preferred when designing a flexbility program for older adults
-
Active:
- Assume a position witha muscle in a lengthened position and hold it there wit NO assistance other than the strength of the agoist muscles.
- E.g. Quadricept holds the leg straig in the active hamstring stretch
- The tension of the agonist in an active stretch helps to relax the muscles being stretched by reciprocal inhibition
-
Passive:
- No active muscular contraction in the stretched muscle
- E.g. fitness pro holds the leg of a client in a hamstring stretchand gently presses the leg into a stretch as the client is totally relaxed
-
Ballistic
- Involves using velocity and a fast bouncy movement to stretch the muscle
- May be considered for adults in sports that involve ballistic movements but may not be safe because the forces involved with bouncing may push tissues past a safe length where the client can control the movement and prevent injury
-
Dynamic
- Includes moving while stretching, but it does not include bounding or pushing muscles past their normal ROM.
- e.g. Arm circles, progressing from smaller to larger as shoulders warm up
-
Proprioceptive Neuromuscular Facilitation (PNF)
- Used in clinical setting
Foundation of the Spine
The Pelvis serves as the foundation for the spine
The ability of the trunk muscles to control pelvic positioning is essential for maintaining a neutral spine and a healthy back.
If either hip flexors or hip extensors are too tight, posture may be compromised
Low back Pain
In Adults
In Youths
In Adults: most often caused by series of inappropriate movements and deconditioning over time
In youths: most often caused by: Stress fracture of the pars interarticularis
Functional Curve
Structural Curve
-
Functional Curve
- can be removed and resumed by a deliberate change in posture
- May be present due to a spasm or tightness of a particular muscle group and will disappear when the client is lying down or bending or when the spasm has dissipated
- A functional curve may eventuall become structural if one assumes an unhealthy posture over several years
-
Structural Curve
- Always present independent of the person’s position
- Fixed
- Not flexible
*
Spinal Anatomy
Motion Segment
Facet Joint
Ligaments
Discs
-
Motion Segment
- Consists of two vertebrae and their intervening discs
-
Facet Joint
- Involves the jjunctions of both the superior and inferior processes
- Supports load and controls the amount and directon of spinal movement
-
Ligaments
- A series of ligaments reinforces spinal support
-
Discs
- Allow flexibility and act as shock absorbers
Muscular Strength and Endurance in Older Adults
- Decreases with age b/c of decrease in motor units as well as reduction in the size of the remaining muscle fibers
- Intense resistance training (80% 1RM) results in large increases in strength which is attributed to neural factors
- Begin with light intensity 40-50% ROM for the first few weeks to allow for adaptation to the activity
- at least 1 set of 10-15 reps of 8-10 exercises that use the major muscle groups
- For the frail elderly, resistance training may be more important than aerobic conditioning to help maintain balance and posture, thus reducing risk for falls
Primary Stabilizers of the Spine
Secondary Stabilizers of the Spine
Primary:
Transverse Abdominis (TrA)
Multifundus (MF)
Secondary:
Obliques (internal and external)
Quadratus Lumborum (QL)
