Designs For Fitness Exam #1

BMI to BF% equation (Deurenburg et al)

%BF = (1.20 x BMI) + (0.23 x Age) - (10.8 x sex) - 5.4 -0 for women and 1 for men.

How do you calculate the rate pressure product?

(HRxSBP)/100

ACSM recommendations

-ACSM recommends a minimum of 30 min of moderate-intensity aerobic activity 5 days per week or 20 min of vigorous-intensity aerobic exercise 3 days per week. (1000 kcals/wk) - Children should do at least 60 min of physical activity every day. Most of the 60 min per day should be either moderate or vigorous aerobic activity and should include vigorous aerobic activities at least 3 days per week.

SF sites

-Abd - Vertical -Tri - Vertical -Bi - Vertical -Chest - Diagonal -Calf - Vertical -Mid axillary - Vertical -Subscap - Diagonal -Suprailliac - Diagonal -Thigh - Vertical

BMI relationship to %BF depends on

-Age -Gender: Men tend to have higher BMIs bc muscle is denser than fat -Ethnicity -PA

What factors influence adherence?

-Biology: gender, age, race -Psychology: enjoyment, expected benefit, perceived health, barriers. -Behavioral: habits (smoking, dietary) -Social support: support from family -Environmental: Access to equipment, safety. -Program: Variety

2C model assumptions

-Density of fat is 0.901 g/cc. -Density of the FFB is 1.100 g/cc. -Densities of fat and the FFB components (water, protein, mineral) are the same for everyone. -Densities of FFB components are constant for an individual, and their proportion remains constant. -Person being measured differs from reference body only in the amount of fat. *Just breaks people up in to FFB and FB

Dyslipidemia

-HDL less than 40 -LDL greater than or equal to 130 -On lipid lowering meds -Total cholesterol greater than or equal to 200

Medical hx questionnaire used to

-HPI, surgeries, hospitalizations -Asses previous medical dx and s/s of illness that have occurred in the last year or in the present. -Analyze FMHx of DM, HTN, hx of stroke, heart disease.

CVD, CHD, DM risk factors

-HTN -Dyslipidemia -Insulin resistance -Abd adiposity -Highest for adults over 60 and those who are obese. **Must have greater than or equal to 3 of these.

When taking a client blood pressure you should ___

-Have them seated, feet flat, no crossed legs. -Arms bared, resting or "Own the arm". -Palpate the brachial -Wrap cuff snuggly -Stethoscope head over brachial artery -Ear pieces tilted forward -Inflate cuff to 140-180 mmHg -Record in even #'s

FMHx

-MI, coronary revascularization or sudden death before 55 yrs in father or first degree relative. -Before 65 yr in mother or first degree female relative

basic elements of individualized prescription

-Mode: How exercise is performed -Rate of progression: Change one variable at a time -Frequency: How many sessions? -Intensity: How hard? -Duration: Time? How long per session? Inversely related to intensity Also called FITT-VP

Test administration

-Prepare in advance -Follow standardized procedure -PRACTICE

Pretest instructions

-Pretest instructions: Tell clients how to prepare -Lots of rest and water 24 hrs before -No strenuous activity night before -No smoking/drinking the night before

sources of error in hydrostatic weighing

-Residual volume -Technician error -Subject factors -Prediction equations

Assumptions of Skinfold Method

-SKF is a good measure of SubQ fat -Distribution of fat is similar for all individuals w/in the same gender -Sum of several SKFs can be used to estimate total body fat -Relationships exist between the sum of SKF (ƩSKF) and body density (Db)

Medical clearance for exercise

-Split up in to sedentary and non sedentary -Clients only need medical clearance if they have a known metabolic dx and are not asymptomatic (absolute contraindication) -Clients do not need medical clearance if they have a known metabolic dx or have a relative contradiction and the benefit of exercise outweighs the cost.

-Test Interpretation

-Use established normative values -KISS (Keep it simple stupid) -Positive point of view

Tests should be three things

-Valid - Measure accurately with minimal error -Reliable - stable and consistent results -Objective - Repeatable by anyone anywhere

Cigarette Smokig

-current smoker -exposure to environmental smoke -Smoking cessation within previous 6 months

Prediabetes

-fasting plasma glucose >/_100 mg -2 hr oral tolerance greater than or equal to 140 and less than or equal to 199. -TWO SEPARATE OCCASIONS

When measuring residual lung volume, you should be sure you get average two RVs that are within ____ of each other.

0.1L, 5%

Name 3 absolute contraindications for exercise

1. Acute myocardial infarction (within 2 days) or other acute cardiac event 2. Unstable angina 3. Uncontrolled cardiac arrhythmias causing symptoms or hemodynamic compromise

Body composition assessment is good for

1. Estimating healthy body weight 2. Nutritional recommendations and exercise prescriptions 3. Estimating competitive weight for an athlete 4. Monitoring growth 5. Identifying those at risk of under/over fatness 6. Assessing changes associated with aging malnutrition, diseases 7. Nutrition and exercise interventions

Name 3 relative contraindications for exercise

1. Left main coronary stenosis 2. Uncontrolled metabolic disease 3. Known electrolyte abnormalities (hypo- kalemia, hypomagnesemi

What is the test sequence

1.Resting hemodynamics 2.Body composition 3. Cardiovascular 4.Muscular fitness 5.Flexibility

At what rate should you deflate the cuff?

2 - 5 mmHg/sec

We record BP to the nearest ______?

2 mmHg, round down.

Exercise environment

68-73 F -Give privacy -Prep area in advance

Span thumb and forefinger ______ apart

8 cm

For some specific populations, measurement of waist circumference at the midpoint between the iliac crest and floating ribs has been shown to be/have ___.

A good predictor of visceral fat

multi-component model assumptions

Account for mineral and/or water contribution to FFB • Improve estimation of %BF • Avoid errors in %BF estimation through use of pop-specific reference bodies accounting for: - age, - gender, - ethnicity

What should you do after hearing the first Korotkoff sound?

After the last Korotkoff sound is heard, the cuff should be deflated slowly for at least another 10 mmHg

Factors that influence waist circumference cut-points include ___.

Age

The largest single source of error in underwater weighing is ___.

Air left in lungs after exhalation

When predicting %BF from circumferences and skeletal diameters, circumference results ___.

Are more accurate if combined with skeletal diameter measurements

Generalized SKF equations differ from population-specific SKF equations in that Generalized equations ___.

Are more universally applicable than are population-specific equations

If you miss a measurement the reading how long should you wait to take it again?

At least 30 seconds

How many skinfold measurements should you take?

At least two at each site in a rotational order.

Why do we hear systolic blood pressure?

At this point when the artery is partially compressed by the cuff, blood pressure is high enough that it can get blood flowing through the compressed artery. Because of the compression, blood flow is turbulent and knocks against the walls of the artery creating the sounds

Obesity

BMI greater than or equal to 30 kg/m2 OR Waist circumference >102 cm (40 in) for men and >88 cm (35 in) for women

The universal BMI cutpoint of 30 kg/m2 to identify obesity is:

Based on the thought that excess weight is due to excess fat mass

The best field method for assessing the body composition of obese individuals is ___.

Bioelectrical impedance analysis

equation more specific to elderly, lean, or obese adults

Brozek - Recommended for obese men and women

What diseases are associated with a sedentary lifestyle, and what are the major risk factors for these diseases?

CHD, hypertension, hypercholesterolemia, cancer, obesity, psych disorders, pulm disorders and musculoskeletal disorders.

The largest source of error in bioelectrical impedance analysis is ___.

Client hydration status

For a given volume, the relationship between body mass and body density is ___.

Direct

Advantages of BIA

Does not require a high degree of technician skill More comfortable Less invasion of client's privacy Can be used to estimate body composition of obese individuals

What are the responsibilities of a fitness professional

Educate - benefits, do's, donts Screening - prehealth screening for medical clearance Selection, admin, interpret - tests to assess each component of physical fitness Design - individualized exercise plans Lead - exercise classes Critique - technique , performance errors Motivate - clients to adhere to routines

When you are using the supine whole-body BIA method for your client, you need to be sure that ___.

Electrodes in a pair are at least 5 cm apart

HTN

Elevated BP: SBP 120-129 AND DBP 80 mmHg HTN stage 1: SBP 130-139 OR DBP 80-89 HTN stage 2: SBP greater than or equal to 140 OR DBP greater than or equal to 90. ***Measured on two separate occasions -On anti-HTN meds

The prediction formula that should be used to convert the body density from SKF to percent body fat (%BF) for young Black or white collegiate athletes (18 - 34 years old) is the ___ formula.

Evans et al.

Blood pressure should be a _____ number

Even

If you are having a hard time hearing your client's blood pressure, you may want to ___.

Have your client raise his/her arm and pump the hand a few times

Standard SKF procedures require that you, the technician:

Increase the span between your grasping thumb and index finger for obese clients Place the jaws of the SKF caliper so they just barely touch your thumb and index finger Release your grasp of the skin while you read the SKF caliper dial

Skin fold thickness provides an

Indirect measurement of subcutaneous adipose tissue

For a given mass, the relationship between body density and body volume is ___.

Inverse

Since the type of SKF caliper can affect the accuracy of the SKF site measurement, when working with a client interested in losing fat mass, you should:

Keep using the same caliper every time

Age

Men: greater than of equal to 45 yrs Women: greater than or equal to 55 yrs

The type of sphygmomanometer considered to be the gold standard for indirect measurement of blood pressure is the ___.

Mercury column manometer

Dose Response Relationships

Minimum requirements: 1000 kcals/wk. Decreases disease risks, moves sedentary to low PA activity, insufficient - Will not give full health benefits. What you should be doing: 2000 kcals/wk. Healthy body weights, prevents weight gain, moves from sedentary to active.

How many SKFs needed to predict Db?

Most equations use 2-3

Sedentary lifestyle

Not meeting recommendations for 30 min moderate-intensity PA on at least 3 days/wk FOR AT LEAST 3 months

Bioelectrical impedance analysis is preferred over skinfold thickness assessments for clients who are ___.

Obese

Anatomical landmarks for marking the triceps SKF site are best identified by standing:

On the client's R side

How much physical activity is needed for improved health benefits?

Over the minimum recommendation. The minimum recommendation is more for weight maintenance. If someone wants health benefits they should exercise 60 minutes/5 days moderate intensity (2000 kcals/wk)

If your client shows up for their SKF appointment in a dehydrated state, then it is safe to think that their ƩSKF value will be:

Overestimated

What are the benefits of regular physical activity in terms of disease prevention and healthy aging?

Participating in moderate-intensity physical activity on a daily basis also reduces the risk of hypertension, diabetes, and stroke, as well as colon and breast cancer

If your client is dehydrated at the time of the assessment, then the bioelectrical impedance analyzer will likely produce a higher than expected value for ___.

Percent body fat (%BF)

The purpose of the Gulick handle on an anthropometric tape measure is to ___.

Promote constant tension application on the tape

The variable that provides a simple index regarding the work of the heart is the ___.

Rate pressure product

The best and most simple way to determine body fat distribution is by assessing the ___.

Ratio between waist and hip circumferences

First equation for BodPod

Siri, assumes FF tissue is 1.1 g/mL

To classify your client's frame size, you should utilize ___.

Skeletal diameter of the elbow

The predictive accuracy of the bioelectrical impedance analysis method is similar to that of ___.

Skinfold thickness

Basic principles of program design

Specificity: muscle group, intensity, contraction Overload: increase workload to make gains Progression: gradual, systematic Initial: lowest starting point equals biggest gain Individuality: account for individual differences Diminishing returns: closer to goal, change Reversibility: use it or lose it

Skinfolds that require a diagonal fold include:

Subscapular

When taking a circumference measurement of the waist and hip, you need to take special care that the ___.

Tape is positioned so it is parallel to the floor

How much of the arm should the cuff encircle for adults and children?

The bladder inside the cuff should encircle 80% of the arm in adults and 100% of the arm in children less than 13 years old. If in doubt, use a larger cuff.

What is the first Korotkoff sound?

The first Korotkoff sound you hear as you deflate the cuff is the maximum pressure generated during each cardiac cycle; this is the systolic pressure.

When calculating mean blood pressure for a client who is exercising, an adjustment to the denominator must be made to account for the fact that ___.

The heart is spending less time in diastole during exercise

What is diastolic blood pressure?

The level of pressure at which the sounds disappear permanently when the artery is no longer compressed and blood flow is completely restored is the resting or diastolic pressure.

A major source of error in the SKF method is attributable to the:

The technician

Sources of error in ADP

Thoracic gas volume -Technician error -Subject factors -Manufacture equations

Single-frequency (i.e. 50 kHz) bioelectrical impedance analysis provides an indirect measurement of ___.

Total body water

What is cuff HTN?

Undercuffing occurs when the bladder is too small for the arm circumference, leading to the overestimation of BP, known as cuff hypertension

When using a bioelectrical impedance analyzer, it is best to ___.

Understand if the equation programmed into the device is suitable for your client

What happens when you use a cuff too small?

Using a bladder that is too small for the circumference of the limb results in overestimation of the blood pressure.

How is Db converted to body fat?

Using appropriate pop-specific conversion formula. -w/in +/-3.5%

What should you do if someone has faint Korotkoff sounds?

When the Korotkoff sounds are faint and difficult to hear (this happens particularly in relatively small individuals, especially women), have the person raise his or her arm over their head and make a fist several times.

Are adults in the United States getting enough physical activity?

a small percentage (20.7%) of adults over the age of 18 met the 2008 federal physical activity guidelines for adults in terms of both aerobic and muscle strengthening activities. Slightly more than half (50.5%) met either the aerobic activity or the muscle-strengthening guideline, but not both (CDC 2011a). Generally, women (54%) are less likely to meet the full aerobic and muscle-strengthening recommendations than men (43.8%), and older (≥65 yr) adults are less likely (64.6%) to meet it than younger (18-24 yr) adults (39.4%)

Schutte equation

came up with an equation for black men

Lohman et al

came up with an equation for young adult women.

Ortiz Equation

derived an equation for black women

What is masked hypertension?

individuals exhibit elevated BP readings outside of the physician's office yet have normal BP values in the office. While white coat hypertension is more prevalent in older adults, masked hypertension occurs more frequently in younger adults.

Formula for BMI

kg/m^2

What is overcuffing?

overcuffing underestimates BP because the bladder is too large for the arm circumference

Transtheoretical Model

precontemplation - Does not exercise and does not intend to start. contemplation - Client is not exercising and does not intend to start preparation - Exercising, but not meeting minimum requirement. action - Has not been exercising for more than 6 months maintenance - Has been exercising for more than 6 months

Terminal digit bias

tendency of the technician to round BP values to the nearest 0 or 5 mmHg

Cuff hypertension is the result of

undercuffing

Name three sources of error in measurement of BP.

• Improper rate of inflation or deflation of the cuff pressure • Improper stethoscope placement or pressure • Expectation bias and inexperience of the technician

Field Methods for Assessing Body Composition

• Skinfold • Bioelectrical impedance • Anthropometry (girths, etc.)