KINS2205 Exam 3
Using _________ is more accurate than using just %HRmax when an accurate HRrest has been obtained
%HRR
Arm Ergometry Equation:
(Need work Rate in kgm/min) VO2 = 3.5 + (3 x ___kgm/min / wt)
•Resistance training may prevent and improve - - - -
- depression - anxiety - increase vigor - reduce fatigue.
•Methods of estimating the relative intensity of exercise
-%HRR -%HRmax -%VO2R - %VO2 - %METs
•Methods of prescribing the intensity of exercise
-(220 - age) (Fox HRmax prediction equation) •Use when you need to calculate quickly in your head! -[208 - (0.7 x age)] (Tanaka equation) •More accurate prediction, when you have time to stop and use a calculator
body comp norms
-10 to 22% body fat (men) -20 to 32% body fat (women) ACCORDING TO MOSER: -11 to 18% body fat (young men) -17 to 23% body fat (young women)
Senior Fitness Test
-30s chair stand -30s arm curls -8ft up and go -6min walk -2min step test -sit and reach -back scratch with normative scales
Altitude Acclimatization: 1968 T&F residence altitude at S. Lake Tahoe, Calif.
-7,377 ft à 6 world records, 12 gold & 24 total medals
Altitude Acclimatization:
-7-12 d of residence at given altitude -Staging - 3-7 d at moderate, lesser altitudes - ↓ possible AMS symptoms •6-12 d to ↑physical performance
•Medical considerations: altitude illnesses
-AMS is the most common form of altitude sickness. -AMS symptoms include headache, nausea, fatigue, (& decreased appetite, and poor sleep and, in severe cases, poor balance and mild swelling in the hands, feet, or face). -AMS develops within the first 24 h of altitude exposure. -Its incidence and severity increases in direct proportion to ascent rate and altitude. -If the ascent is stopped and physical exertion is limited, recovery from AMS occurs over 24-48 h after symptoms have peaked.
•Clothing considerations
-Adjust individual's clothing insulation to minimize sweating. •Adjust for exercise intensity and duration. Wear appropriate footwear to minimize the risks of slipping and falling in snowy or icy conditions
•Prevention of altitude sickness:
-Altitude acclimatization is the best countermeasure to all altitude sickness. -Minimizing sustained exercise/physical activity and maintaining adequate hydration and food intake will reduce susceptibility to altitude sickness and facilitate recovery. -When moderate to severe symptoms and signs of an altitude-related sickness develop, the preferred treatment is to descend to a lower altitude (rocket science!).
anthropometric methods (measuring body comp)
-BMI -circumferences -skinfold measures
•Rapid ascent
-Beginning within hours after rapid ascent to a given altitude up to about 14,107 ft (4,300 m), and lasting for the first couple of days, AMS may be present. -REST & minimal Voluntary PA for 24-48 hrs minimizes AMS. -When AMS subsides because of partial altitude acclimatization individuals may resume all normal activities and exercise training. Acclimatization
prescribed medications:
-Beta-blockers -Digitalis (Digoxin) - anti-arrhythmic, inotrope for heart failure (HF)
•Methods of estimating the absolute intensity of exercise
-Caloric expenditure (kcal · min−1) -Absolute oxygen uptake (VO2; mL ∙ min−1 or L ∙ min−1) -Relative oxygen uptake: •Metabolic equivalents (METs) mL ∙ kg −1 ∙ min−
Children and Adolescents Special Considerations KEYS:
-FUN -VARIETY -End games before they want to stop •Hungry to play it next time! -Provide opportunities for success •Success Motivates
Contraindications for exercising during pregnancy ABSOLUTE
-Hemodynamically significant heart disease -Restrictive lung disease -Incompetent cervix/cerclage -Multiple gestation at risk for premature labor -Persistent second or third trimester bleeding -Placenta previa after 26weeks of gestation -Premature labor during the current pregnancy -Ruptured membranes -Preeclampsia/pregnancy-induced hypertension
•Prepubescent children:
-Immature skeletons, -Should NOT participate in excessive amounts of vigorous intensity exercise •heavy resistance training
Exercise in High Altitude Environments •Special Considerations
-Monitor the environment: High altitude has more daily extremes of temperature, humidity, wind, and solar radiation. Follow appropriate guidelines for hot and cold environments. -Modify activity at high altitudes: •Consider altitude acclimatization status, physical fitness, nutrition, sleep quality and quantity, age, exercise time and intensity, and availability of fluids. •Provide longer and/or more rest breaks to facilitate rest and recovery and shorten activity times. Longer duration activities are affected more by high altitude than shorter duration activities.
Benefits of exercise during pregnancy
-Prevention of excessive gestational weight gain -Prevention of gestational diabetes mellitus -Decreased risk of preeclampsia -Decreased incidence/symptoms of low back pain -Decreased risk of urinary incontinence -Prevention/improvement of depressive symptoms -Maintenance of fitness -Prevention of postpartum weight retention
Exercise volume (quantity)
-Product of Frequency, Intensity, and Time (duration) or FIT of exercise. -Exercise volume may be used to estimate the gross EE of an individual's Ex Rx. -MET-min ∙ wk−1 and kcal ∙ wk−1 can be used to estimate exercise volume in a standardized manner.
•General recommendations include using the following: Supervision of these activities may be warranted.
-Progressively difficult postures that gradually reduce the base of support (two-legged stand, semitandem stand, tandem stand, and one-legged stand) -Dynamic movements that perturb the center of gravity (tandem walk and circle turns) -Stressing postural muscle groups (heel and toe stands) -Reducing sensory input (standing with eyes closed) -Tai chi
•Methods of estimating the intensity of exercise
-Rating of perceived exertion (RPE) -Affective valence -OMNI Scale -Talk Test -Feeling Scale
Type (mode)
-Rhythmic, aerobic type exercises involving large muscle groups are recommended for improving cardiorespiratory fitness. -The specificity principle states that the physiologic adaptations to exercise are specific to the type of exercise performed.
Contraindications for exercising during pregnancy RELATIVE:
-Severe anemia -Unevaluated maternal cardiac dysrhythmia -Chronic bronchitis -Poorly controlled Type 1 diabetes -Extreme morbid obesity -Extreme underweight -History of extremely sedentary lifestyle -Intrauterine growth restriction in current pregnancy -Poorly controlled hypertension -Orthopedic limitations -Poorly controlled seizure disorder -Poorly controlled hyperthyroidism -Heavy smoker
common errors hydrodensitometry
-Subject can not blow out entire vital capacity, any additional air increases the body fat measurement -Subject can not remain submerged without body movement long enough for scale needle to stabilize so an accurate reading can be obtained
•Rate of progression
-The recommended rate of progression in an exercise program depends on the individual's age, health status, physical fitness, training responses, and exercise program goals. -Progression may consist of increasing any of the components of the FITT principle of Ex Rx as tolerated by the individual.
•Prevention and treatment of altitude sickness:
-Various medications -Headaches - ibuprofen. -Oxygen or hyperbaric chamber therapy will usually relieve some symptoms such as headache, fatigue, and poor sleep. -Descent, oxygen therapy, and/or hyperbaric bag therapy.
•Medical considerations: cold injuries -frostbite
-air temperature -wind speed -wetness -The Wind Chill Temperature Index (WCT) integrates wind speed and air temperature
determinants of rate of heat exchange between skin and environment
-ambient temp -humidity -air motion -sky and ground reaction -clothing
sweat losses vary and depend on:
-amount and intensity of PA -clothing -protective equipment -environmental conditions
Children/Adolescent •Health/fitness testing example:
-body composition (BMI or skinfold thicknesses) -cardiorespiratory fitness (1-mile walk/run, PACER) -muscular fitness (pull-up/push-up tests) -flexibility (sit-and-reach test).
•The optimal Ex Rx should address the health-related physical fitness components of
-cardiorespiratory (aerobic) fitness, -muscular strength and endurance, -flexibility, -body composition, and -neuromotor fitness.
exertional heat stroke
-caused by hyperthermia CHARACTERIZED BY: -elevated body temp (>104 F) -rapid, weak, thread pulse -profound CNS dysfunction -multiple organ system failure that can result in delirium, convulsions, or coma
heat acclimatization adaptations
-decreased rectal temp, HR, RPE -increased exercise tolerance time and sweat rate -reduction in sweat salt
other techniques (measuring body comp)
-dual energy x ray (DEXA) -total body energy conductivity -bioelectrical impedance analysis (BIA) -near infrared interference
•Children and adolescents are physiologically adaptive to: 1) 2) 3) Thus, the benefits of exercise are much greater than the risks
-endurance exercise training -resistance training -bone loading exercise.
Exercise in Cold Environments •Many factors including:
-environment -clothing -body composition -health status -nutrition -age -exercise intensity (All factors interact to determine if exercising in the cold elicits additional physiologic strain and injury risk beyond neutral temp.)
•Serious risk of CVD complications, which is of particular concern in middle-aged and older adults, can be minimized by:
-following the preparticipation health screening and evaluation procedures outlined in Chapters 2 and 3, -beginning a new program of exercise at light-to-moderate intensity, and -employing a gradual progression of the quantity and quality of exercise.
-Clothing: Individual clothing and equipment - for
-greater range of temperature -humidity -wind conditions.
Pregnancy Ex Px: •Research on the effects of resistance exercise during pregnancy is limited, but show that compared to sedentary controls, resistance training either:
-has no effect (e.g., no difference in gestational age, preterm labor, or caesarian delivery; delivery of normal birth weight infants at term) -or produces better outcomes (e.g., lower incidence of low back pain; shorter labor duration; shorter recovery time/faster return to activity in postpartum) -12-15 reps to moderate fatigue; avoid Valsalva.
when metabolic heat > heat loss:
-hyperthermia may develop -sweat that drips from body/clothing provides no cooling benefit -less than or equal to 104 F is in safe limits
Hypothermia Risk factors:
-immersion -rain, wet clothing -low body fat -older age (i.e., ≥60 yr) -hypoglycemia
heat acclimatization results in
-improved heat transfer from body's core to external environment -improved CV function -more effective sweating -improved exercise performance and heat tolerance
In addition to greater strength, there is an impressive array of changes in health related biomarkers that can be derived from regular participation in resistance training, including:
-improvements in body composition -blood glucose levels -insulin sensitivity, and BP in individuals with pre-hypertension to Stage 1 hypertension
Ways to progressively overload muscles includes: performing more sets per muscle group and increasing the number of days per week the muscle groups are trained.
-increase resistance -more sets per muscle group -increasing the number of days per week the muscle groups are trained.
heat syncope symptoms
-lightheadedness -loss of consciousness
ExRx in hot environments
-may be performed if preventive steps are taken -if specifies a target HR, will achieve at lower absolute workload -higher intensity required as heat acclimatization develops -1st session in heat may last 5 to 10 min fir safety, can increase gradually
to determine sweat rate (L/h)
-measure body weight before and after exercise -provides fluid replacement guide
plethysmography
-measured by air rather than water displacement -Uses a dual-chamber plethysmograph that measures body volume by changes in pressure in a closed chamber -reduces the anxiety associated with the technique of hydrodensitometry -BODPOD
android obesity (circumference)
-more fat on trunk, apple shape -increased risk of high BP, metabolic syndrome, type 2 diabetes, dyslipidemia, CVD, premature death compared to gynecoid obesity (pear shape)
cause of heat cramps
-multifactorial -may be more related to muscle fatigue, dehydration, and decreased electrolyte concentrations
heat exhaustion treatment
-oral fluids preferred for conscious, able to swallow, and not losing fluid individuals -IV fluid for those unable to ingest oral fluid or who have severe dehydration
•A cycle ergometer may be preferable to a treadmill for those with: However, ________________ may be a factor for premature test termination when using a cycle ergometer.
-poor balance -poor neuromotor coordination -impaired vision -impaired gait patterns -weight-bearing limitations and/or foot problems local muscle fatigue
factors that may contribute to errors in skinfold measures
-poor technique -inexperienced evaluator -extremely obese or lean subject -improperly calibrated caliper (tension should be set at 12g/mm) -do not use on obese patients, not sensitive to mild improvement (use BIA)
treatment of heat cramps
-prolonged stretching -dietary sodium chloride -IV normal saline
heat exhaustion is characterized by
-prominent fatigue -progressive weakness without severe hyperthermia -still have strong pulse
dual energy x ray (DEXA)
-reliable, accurate body comp assessment -limited applicability in routine health/fitness testing because of cost and the need for highly trained personnel
an ideal health related physical fitness test is
-reliable, valid, relatively inexpensive, and easy to administer -should yield results that are indicative of current state of fitness, reflect positive changes in current health status, be directly comparable to normative data
•Higher levels of muscular strength are associated with:
-significantly better cardiometabolic risk factor profile -lower risk of all cause mortality -fewer CVD events -lower risk of developing physical function limitations -lower risk for nonfatal disease.
•Overwhelming evidence exists that supports the benefits of physical activity in
-slowing physiologic changes of aging that impair exercise capacity -optimizing age-related changes in body composition -promoting psychological and cognitive well-being -managing chronic diseases -reducing the risks of physical disability -increasing longevity.
cause of heat syncope
-standing up for long period or at cessation of strenuous prolonged exercise -max cutaneous vessel dilation results in decrease of BP and insufficient oxygen delivery to brain
heat syncope
-temporary circulatory failure caused by pooling of blood in peripheral veins (lower extremities) -occurs more often in unfit, sedentary, non acclimatized individuals
skinfold measurements
-the amount of subcutaneous fat is proportional to the total amount of body fat -assume close to 1/3 total fat is subcutaneous, varies with sex/age/race
waist to hip ratio (WHR)
-the circumference of the waist (above the iliac crest) divided by the circumference of the hips -simple method to assess body fat distribution -health risk increases as WHR increases, risk varies with age and sex
hydrodensitometry
-underwater weighing -based on archimedes principle -Bone and muscle tissue are denser than water, whereas fat tissue is less dense -individual with more fat-free mass (FFM) for the same total body mass weighs more in water and has a higher body density and lower percentage of body fat
densitometry methods (measuring body comp)
-underwater weighing -plethysmography
how to measure circumference
-use cloth tape measure with spring loaded handle -reduces skin compression and improves consistency -use average of 2 measurements if no difference by more than 5mm
Bioelectrical Impedance Analysis (BIA)
-used as assessment techniques in routine health/fitness testing -accuracy similar to skinfolds with assurance of normal hydration -easy to perform on obese individuals -often yields high % body fat readings in a lean/normal BMI population
BMI
-used to assess wight relative to height -calculated by dividing body weight (kg) by height (m squared)
•Hypothermia:
-when heat loss exceeds heat production causing the body heat content to decrease. -Core temperature <98.6o F (37o C)
densitometry
-whole-body density using the ratio of body mass to body volume -used as a reference or criterion standard ("gold standard") for assessing body composition for many years
high health risk WHR
-young men > 0.95 -young women > 0.86 -60 to 69 age range: cutoff values > 1.03 (men) and > 0.90 (women)
•Cold exposure: Physiological responses due to skin and internal temperature receptors:
-↓HR -↑ systolic & Diastolic Blood Pressure -↑Energy cost
active individuals should drink _____L of fluid for each pound of body weight lost
0.5L
-Frostbite occurs when tissue temperatures fall lower than _______
0° C (32° F)
-Muscular strength may be maintained by training muscle groups as little as __________ as long as the training intensity or the resistance lifted is held constant.
1 d · wk−1
A target volume of ≥500-1,000 MET-min ∙ wk−1 is recommended for most adults. This volume is approximately equal to _________ kcal ∙ wk−1 of moderate intensity, physical activity, ~150 min ∙ wk−1 of moderate intensity exercise, or pedometer counts of ≥5,400-7,900 steps ∙ d−1.
1000 kcals
Exercise bouts of less than ____ min may yield favorable adaptations in _________________ individuals
10min very deconditioned
•Only ____% of individuals aged ≥65 years engage in regular aerobic and muscle strengthening activities.
11%
•Very high altitude __________ . - _______O2 available at sea level
13,123 - 29,000 ft (4,000-9,400 m) 18-->1% O2
•Previously inactive women should progress from _____________ at the appropriate RPE or target HR to ____________
15 min∙d−1 (~3 d∙wk−1) ~30 min∙d−1 on most days of the week
normal BMI
18.5-24.9
For general muscular fitness, particularly among those who are untrained or recreationally trained an individual should resistance train each major muscle group __________ with at least _______ separating the exercise training sessions for the same muscle group.
2-3 d · wk−1 48 hourd
•Neuromotor exercise training, which combines balance, agility, and proprioceptive training, is effective in reducing and preventing falls if performed __________
2-3 d ∙ wk−1.
A reasonable rest interval between sets is ____ min
2-3min
Adults should train each muscle group for a total of ______ sets with ______ repetitions per set with a rest interval of ______ between sets to improve muscular fitness.
2-4 sets 8-12 repetitions 2-3 min between sets
A _________ maximum voluntary contraction held for 3-6 s followed by a 10-30 s assisted stretch is recommended for ______ techniques.
20%-75% PNF
HRMax age predicted equation (Tanaka)
208-(0.7x age)
overweight BMI
25-29.9
Bone loading activity on at least _______ d ∙ wk−1 - e.g. jumping activities such as sprinting, basketball, jumping rope, hopscotch
3 d ∙ wk−1
•Moderate altitude to locations between____________ - _________O2available at sea level (1 mile - 53% O2)
3,937 and 7,874 ft (1,200-2,400 m) 66-->38% O2
-Aerobic exercise is recommended on ______________ for most adults, with the frequency varying with the intensity of exercise.
3-5 d ∙ wk−1
Pregnancy - Exercise Training Considerations FITT:
3-5d/week (no ideal # days) Moderate (if inactive start light) RPE 10-15min WARMUP 10-15min COOl-DOWN •Volume: Progress to 150 min/wk of moderate PA
Light __________ HRR or VO2R to moderate-intensity aerobic exercise can be beneficial in individuals who are deconditioned.
30%-<40% HRR or VO2R
Older adults can benefit from holding the stretch for ________
30-60 seconds
-_____ sets per muscle group is more effective than ____sets; however, even a _______ set per exercise will significantly improve muscular strength, particularly among novices.
4 sets 2 sets single set
After the individual has been exercising regularly for at least 1 month, the FIT of exercise is gradually adjusted upward over the next ________ months — or longer for older adults and very deconditioned individuals
4-8 months
Moderate ___________ heart rate reserve [HRR] or VO2R to vigorous __________ HRR or VO2R) intensity aerobic exercise is recommended for most adults.
40%-<60% heart rate reserve 60%-<90% HRR
6-11 years - ____% meet guidelines
42%
•Less than __% of individuals aged _____ years engaging in regular aerobic and muscle strengthening activities.
5% >85 years
-The goal of 10,000 steps ∙ d−1 is often cited, BUT it appears that achieving a pedometer step count of at least ___________________ steps ∙ d−1 can meet recommended exercise targets.
5,400-7,900 steps
An increase in exercise time/duration per session of _______min every 1-2 wk over the first ______wk of an exercise training program is reasonable for the average adult
5-10min 4-6 weeks
A target volume of ≥___________ MET-min ∙ wk−1 is recommended for most adults.
500-1,000
When can frostbite occur?
5min 10min 30min Depending on the wind speed and temp.
•Children and adolescents (defined as individuals _______ years) are ______ physically active than their adult counterparts.
6-17 years old more
•The 2008 Physical Activity Guidelines for Americans call for children and adolescents to engage in at least _________ of moderate-to-vigorous intensity PA and to include:
60 min ∙ day−1
A total of _____seconds of flexibility exercise per joint is recommended. Holding a single flexibility exercise for _______ seconds to the point of tightness or slight discomfort is effective.
60 seconds 10-30 seconds
•High altitude between _______________________ - ______O2 available at sea level
7,874 and 13,123 ft (2,400-4,000 m) 38 -->18%
•12-19 years- _____% meet guidelines
8%
-Shoveling snow raises the HR to ___ HRmax and systolic BP increases to ____ mm Hg.
97% 200 mm Hg
Children limit total entertainment screen time to <____ hours per day
<2 hours per day!!!
•Low altitude refers to locations__________ - _____ O2 available at sea level
<3,937 ft (1,200 m) 66%
•The risk of frostbite is ____ when the ambient temperature is greater than ________
<5% −15° C (5° F) (However, wet skin exposed to the wind cools faster)
dehydration of ____% loss in body mass negatively impacts endurance, strength, and power exercise performance
> or equal to 2%
obese BMI
> or equal to 30
For older adults and very deconditioned individuals, ≥__ set of _____ repetitions of moderate-intensity (i.e., 60%-70% 1-RM), resistance exercise is recommended.
>/ 1 set 10-15 repetitions
-A total EE of ≥_______________ MET-min ∙ wk−1 is a reasonable target volume for an exercise program for most adults.
>/500-1,000
•The term older adult defined as individuals ≥____years and individuals ________________ that affect movement, physical fitness, or physical activity.
>/65 years 50-64 yr with clinically significant conditions or physical limitations
•Physical performance decreases with increasing altitude _________
>3,937 ft (1,200 m)
______ should train each muscle group for a total of 2-4 sets with 8-12 repetitions per set with a rest interval of 2-3 min between sets to improve muscular fitness.
Adults
•______ should not be a barrier to PA because positive improvements are attainable at any age.
Age
Valsalva maneuver
Any forced expiratory effort against a closed airway such as when an individual holds his or her breath and tightens his or her muscles in a concerted, strenuous effort to move a heavy object or change positions in bed.
•_____________ is of great importance to younger and older adults (see Chapters 8 and 10), especially among women.
Bone health
___________: at least 20-60 min of aerobic, resistance, neuromotor, and/or sports activities (exercise bouts of 10 min are acceptable if the individual accumulates at least 20-60 min · d−1 of daily aerobic exercise)
Conditioning:
___________: at least 5-10 min of light-to-moderate intensity cardiorespiratory and muscular endurance activities (post exercise)
Cool-down
FITT-VP principle of exercise prescription
Frequency (how often) Intensity (how hard) Time (duration or how long) Type (mode or what kind) Total Volume (amount) Progression (advancement)
Although muscular power is important for athletic events, muscular strength and endurance are of __________ importance in a general training regimen focusing on health/fitness outcomes for young and middle-aged adults.
GREATER
•Rapid ascent -Monitoring exercise ______ provides a safe, easy, and objective means to quantify exercise intensity at altitude, as it does at sea level.
Heart rate
-_____________ performed more than 3 d ∙ wk−1 increases the incidence of musculoskeletal injury, and is thus not recommended for anyone, whether elite athletes or not.
High intensity interval training (HIIT)
•____________________ of PA should be light at the beginning in particular for older adults who are highly deconditioned, functionally limited, or have chronic conditions that affect their ability to perform physical tasks.
Intensity and duration
-________________ can increase the total volume and/or average exercise intensity performed during an exercise session (monitor injury status!).
Interval training
______ exercises and those that strengthen the pelvic floor are recommended to ________ the risk of incontinence during and after pregnancy
Kegel decrease
_________ , subsequent to a period of adaptation to resistance training and improved musculotendinous conditioning, older individuals may choose to follow guidelines for younger adults (higher intensity with 8-12 repetitions per set
Later
___________ intensity PA should be encouraged for individuals with cognitive decline given the known benefits of PA activity on cognition.
Moderate
________________, aerobic exercise done at least 5 d ∙ wk−1; or _______________, aerobic exercise done at least 3 d ∙ wk−1; or a weekly combination of 3-5 d ∙ wk−1 of moderate and vigorous intensity exercise is recommended for most adults to achieve and maintain health/fitness benefits
Moderate intensity vigorous intensity
Exercise testing for clinical purposes is generally ________________ for children or adolescents unless there is a health concern
NOT indicated (Health/fitness testing may be performed outside of the clinical setting)
_____________ are effective tools for promoting physical activity and can be used to approximate exercise volume in steps per day
Pedometers
Older Adults Exercise Prescription -For older adults, activities should be defined relative to an individual's physical fitness within the context of a __________.
RPE
________ ascent to high and very high altitude increases individual susceptibility to altitude illness.
Rapid
__________, aerobic exercise of at least moderate intensity that involves large muscle groups and requires little skill to perform is recommended for all adults to improve health and CRF Other exercise and sports requiring skill to perform or higher levels of fitness are recommended only for individuals possessing adequate skill and fitness to perform the activity.
Rhythmic
-____________ exercises, each targeting one major muscle group, such as biceps curls, triceps extensions, quadriceps extensions, leg curls, and calf raises can also be included in a resistance training program.
Single joint
___________: at least 10 min of stretching exercises performed after the warm-up or cool-down phase
Stretching
____________ by an experienced exercise leader can enhance ___________ to exercise and may improve safety for individuals with ______________________
Supervision adherence chronic diseases and health conditions
T/F: optimize but do NOT maximize fluid intake that matches volume of consumed to lost and limits body weight change in heat
TRUE
What should be used for the health screening of pregnant women before their participation in exercise programs?
The Physical Activity Readiness Medical Examination for Pregnancy (PARmed-X for Pregnancy) or the electronic Physical Activity Readiness Medical Examination (ePARmed-X+)
T/F -All muscle groups to be trained may be done so in the same session (i.e., whole body), or each session may "split" the body into selected muscle groups so that only a few of groups are trained in any one session. This split weight training routine entails 4 d ∙ wk−1 to train each muscle group 2 times ∙ wk−1; however, each session is of shorter duration than a whole body session used to train all muscle groups
True
T/F The exact composition of FITT-VP will vary depending on the characteristics and goals of the individual.
True
T/F The likelihood of physical limitations also increases with age
True
T/F -It is recommended that most adults accumulate 30-60 min ∙ d−1 of moderate-intensity exercise, 20-60 min ∙ d−1 of vigorous exercise, or a combination of moderate and vigorous exercise per day to attain the volumes of exercise recommended in the following discussion.
True
T/F Currently, there is a paucity (scarcity) of evidence demonstrating increased mortality or cardiovascular event risk during exercise or exercise testing in the oldest segment of the population, therefore eliminating the need for exercise testing unless medically indicated (e.g., symptomatic CVD, uncontrolled diabetes).
True
T/F Each muscle group should be trained for a total of two to four sets. These sets may be derived from the same exercise or from a combination of exercises affecting the same muscle group.
True
T/F Education: The training of participants, personal trainers, coaches, and community emergency response teams
True
T/F Increasing the overload by adding resistance, sets, or training sessions per week is not required during a maintenance resistance training program.
True
T/F Neuromotor exercise training results in improvements in balance, agility, and muscle strength and reduces the risk of falls and the fear of falling among older adults
True
T/F Older Adults Exercise Prescription -Apparently healthy younger adults - moderate and vigorous intensity PA defined relative to METs (moderate intensity, 3-5.9 METs; vigorous intensity ≥6 METs)
True
T/F Only the youngest children (6-7 years) are as physically active as recommended by experts
True
T/F PA may help regulate weight gain during pregnancy
True
T/F Postpartum PA Women with higher CRF levels and more rigorous exercise routines prior to and during pregnancy may be able to resume exercise sooner
True
T/F ROM is improved acutely and chronically following flexibility exercises.
True
T/F The relative adaptations to exercise and the percentage of improvement in the components of physical fitness among older adults are comparable with those reported in younger adults and are important for maintaining health and functional ability and attenuating many of the physiologic changes that are associated with aging.
True
T/F This recommended amount of exercise may be accumulated in one continuous exercise session or in bouts of ≥10 min over the course of a day.
True
T/F •An individual's goals, physical ability, physical fitness, health status, schedule, physical and social environment, and available equipment and facilities should be considered when designing the FITT-VP principle of Ex Rx for a client or patient.
True
T/F •Exercise-related cold stress may increase the risk of morbidity and mortality in at-risk populations such as those with CVD and asthmatic conditions. Inhalation of cold air may also exacerbate these conditions.
True
T/F •Frostbite cannot occur if the air temperature is >0° C (32° F).
True
T/F •Physical performance testing has largely replaced exercise stress testing for the assessment of functional status of older. Most physical performance tests require little space, equipment, and cost; can be administered by lay or health/fitness personnel with minimal training; and are considered extremely safe in healthy and clinical populations
True
T/F •Physiologic responses to acute, graded exercise are qualitatively similar to those seen in adults.
True
T/F •The physical performance decrement will be greater as elevation, PA duration, and muscle mass increases but is lessened with altitude acclimatization.
True
T/F •Vigorous exercise can be initiated after safely participating in moderate exercise.
True
T/F •Women who are pregnant should avoid contact sports and sports/activities that may cause loss of balance or trauma to the mother or fetus. E.g. soccer, skiing, roller blading, racquet sports
True
-__________________ to train the same muscle group adds variety, may prevent long-term mental "staleness," and may improve adherence to the training program.
Using different exercises
Step Equation
VO2 = 3.5 + (0.2 x Steps/min) + (1.33 x 1.8 x ht (m) x Stps/m)
•In any activity, avoid using the _________________, prolonged isometric contraction, and motionless standing.
Valsalva maneuver
-__________ intensity exercise performed more than 5 d ∙ wk−1 might increase the incidence of _______________ injury, so this amount of vigorous intensity, physical activity is not recommended for most adults.
Vigorous musculoskeletal
___________: at least 5-10 min of light-to-moderate intensity cardiorespiratory and muscular endurance activities
Warm-up
Dynamic or slow movement stretching involves
a gradual transition from one body position to another, and a progressive increase in reach and range of motion as the movement is repeated several times.
•For most adults, an exercise program including _____ , ______ , ______ , and neuromotor exercise training is indispensable to improve and maintain physical fitness and health.
aerobic resistance flexibility
-The minimum threshold of intensity for benefit seems to vary depending on an individual's CRF level and other factors such as _______________
age, health status, physiologic differences, genetics, habitual physical activity, and social and psychological factors.
Passive static stretching involves
assuming a position while holding a limb or other part of the body with or without the assistance of a partner or device (such as elastic bands or a ballet barre)
-Health Screening: monitor ______ participants
at-risk
•Neuromotor exercise training involves motor skills, such as: and is sometimes called _________ fitness training.
balance coordination gait agility proprioceptive training functional fitness training
•Incorporation of ___________ strategies such as social support, self-efficacy, the ability to make healthy choices, and perceived safety all may enhance participation in a regular exercise program.
behavioral
If they are able, older adults should consider exceeding the recommended minimum amounts of PA to improve management of _____________ and health conditions for which a _________ level of PA is known to confer a therapeutic benefit.
chronic diseases higher
Proper resistance exercise techniques employ controlled movements through the full ROM and involve ___________ and _________ muscle actions.
concentric and eccentric
-The recommended time/duration of physical activity may be performed ___________ (i.e., one session) or _____________ and can be accumulated over the course of a day in one or more sessions of physical activity that total at least ____ min ∙ session−1.
continuously intermittently 10min
Structured physical activity sessions should end with an appropriate __________ , particularly among individuals with CVD. The cool-down should include a gradual reduction of effort and intensity and optimally, flexibility exercises
cool-down
during exercise induced heat stress, dehydration increases physiologic strain measured by:
core temp, HR, RPE
Performing flexibility exercises ≥2-3 d ∙ wk−1 is recommended with _______ flexibility exercise being most effective
daily
•Stretching exercises may result in an immediate, short-term _________ in muscle strength, power, and sports performance performed after stretching, with the negative effect particularly apparent when strength and power are important to performance.
decrease
•The progressive _________ in atmospheric pressure associated with ascent to ________ altitudes reduces the partial pressure of oxygen (driving pressure for gas exchange) in the inspired air, resulting in __________ arterial oxygen levels.
decrease higher decreased
•The Ex Rx should include a plan to _________ periods of physical inactivity in addition to _________ physical activity.
decrease increasing
•Muscular strength ________ rapidly with age, especially for those >50 yr. Although resistance training is important across the lifespan, it becomes more rather than less important with increasing age.
decreases
The exercises should be executed using correct form and technique, including performing the repetitions ___________ and in a __________ manner, moving through the full ______ of the joint, and employing proper________ techniques
deliberately controlled ROM breathing
•Most older adults ________ require an exercise test prior to initiating a _______ intensity PA program
do not moderate
Light to moderate intensity exercise in the postpartum period is important for return to prepregnancy body mass index and __________________
does not interfere with breastfeeding.
-There is a _________________ association between the volume of exercise and health/fitness outcomes (i.e., with greater amounts of physical activity, the health/fitness benefits also increase).
dose-response
greatest risk of exertional heat stroke
during prolonged exercise when ambient wet-bulb globe temp exceeds 28 C (82 F)
Many older adults _______ the age-predicted HRmax during a maximal exercise test, which should be taken into account when considering test termination
exceed
•Healthy, pregnant women without exercise contraindications are encouraged to:
exercise throughout pregnancy
Postpartum PA should progress ___________ because of normal _______________ in the initial postpartum period
gradually deconditioning
•Adding a treadmill ______________ may be required because of reduced balance, decreased muscular strength, poor neuromotor coordination, and fear.
handrail support
Exercise planning: ___________________ when designing exercise programs and activities
hazards of mountainous terrain
Regular exercise during pregnancy provides ________________ and reduces the risks associates with sedentary behavior
health benefits
•The _________________ of enhancing muscular fitness (the functional parameters of muscle strength, endurance, and power) are well established.
health benefits
Some individuals will want to or need to include only some of the ___________________________ of physical fitness in their training regimen or exercise less than suggested by the guidelines
health-related components
For adults of all ages, the goals of a _________________________________ should be to a) make activities of daily living (ADLs) (e.g., stair climbing, carrying bags of groceries) less stressful physiologically b) effectively manage, attenuate, and even prevent chronic diseases and health conditions such as: 1) 2) 3) . For these reasons, although resistance training is important across the age span, its importance becomes even greater with age
health-related resistance training program -osteoporosis -Type 2 diabetes mellitus -obesity
•If exercise testing is recommended, the associated ECG has _____ sensitivity (i.e., ~84%) and ______specificity (i.e., ~70%) than in younger age groups (i.e., <50% sensitivity and >80% specificity), producing a ______ rate of false negative outcomes.
higher lower higher
If the objective of the resistance training program is mainly to improve muscular endurance rather than strength and mass, a ________ number of repetitions, perhaps 15-25, should be performed per set along with _________ rest intervals and _______ sets
higher shorter fewer
heat acclimatization results in:
higher and more sustained sweating rates
Active static stretching involves
holding the stretched position using the strength of the agonist muscle as is common in many forms of yoga.
•Women who are pregnant should avoid exercising in a _________ environment, be well hydrated, and dressed appropriately to avoid ___________.
hot humid heat stress
There are severe scenarios (i.e., immersion, rain, low ambient temperature with wind) where whole body or local thermal balance cannot be maintained during exercise-related cold stress that contributes to:
hypothermia, frostbite, and diminished exercise capability and performance
•Because of __________ thermoregulatory systems, youth should avoid exercise in _______ environments, be properly hydrated, and appropriately modify activities.
immature hot humid
•The ROM around a joint is improved __________ after performing flexibility exercise and shows chronic improvement after about _____ wk of regular stretching at a frequency of at least ____ times ∙ wk−1.
immediately 3-4 wk at least 2-3 times ∙ wk−1.
•Individuals with sarcopenia, a marker of frailty, need to ____________ muscular strength before they are physiologically capable of engaging in _______ training.
increase aerobic
•The acute physiologic responses to exercise are generally __________ during pregnancy compared with nonpregnancy.
increased
•The most common altitude effect on physical task performance is an _______ time for task completion or more frequent _________.
increased rest breaks
•The ____________ prevalence of cardiovascular, metabolic, and orthopedic problems among older adults increases the overall likelihood of an _______ test termination.
increased early
Walking in snow •_________ energy requirements and myocardial oxygen demands - consider atherosclerotic CVD - may have to slow their walking pace.
increases
Exercise that promotes muscle strength and mass also effectively __________ bone mass (i.e., bone mineral density and content) and bone strength of the specific bones stressed and may serve as a valuable measure to prevent, slow, or even reverse the loss of bone mass in individuals with ________________
increases osteoporosis
•Progression of PA should be________________ to tolerance and preference; a conservative approach may be necessary for the most deconditioned and physically limited older adults.
individualized and tailored
Exerting muscles to the point of failure increases the likelihood of __________ or debilitating residual muscle soreness, particularly among _________.
injury novices
Older Adults Exercise Prescription •An important distinction between older and younger adults should be made relative to ________.
intensity
-The resistance training intensity and number of repetitions performed with each set are _________ related.
inversely
•Older adults are the _____ physically active of all age groups.
least
Older Adults - Exercise Testing •The initial workload should be ______ (<3 metabolic equivalents [METs]) and workload increments should be small (i.e., 0.5-1.0 MET) for those with low work capacities. The _______________ protocol is a good example of such a protocol.
light Naughton treadmill
•Individuals free from CVD symptoms should be able to initiate a _________________ exercise program without undue risk.
light intensity <3 METs
-For weight management, __________ durations of exercise _________________ may be needed, especially in individuals who spend large amounts of time in sedentary behaviors.
longer ≥60-90 min ∙ d−1
-Children have a much ______ anaerobic capacity than adults, thus _______ ability to perform sustained vigorous intensity exercise
lower less
•Obese/inactive youth and/or with chronic diseases: Obese teens are more likely to have HTN & cardiac arrhythmias
lower intensity & volume.
-Muscular strength may be ___________ by training muscle groups as little as 1 d · wk−1 as long as the training intensity or the resistance lifted is held constant.
maintained
•Most young individuals are healthy and able to start moderate intensity exercise training without ________________.
medical screening
Resistance training may be effective for preventing and treating the "__________ syndrome
metabolic
Proprioceptive neuromuscular facilitation (PNF)
methods take several forms but typically involve an isometric contraction of the selected muscle/tendon group followed by a static stretching of the same group (i.e., contract-relax)
Children and Adolescents Special Considerations Resistance Exercise:
moderate FATIGUE, NOT to Failure 8-15 reps, 2-3 sets
-Older and very deconditioned individuals who are more susceptible to musculotendinous injury should begin a resistance training program conducting ______ repetitions (i.e., 10-15) at a ___________ intensity , or an RPE of______.
more Moderate intensity (60%-70% of 1-RM) 5-6 RPE
-Resistance training regimens should include ________ or compound exercises that affect more than one muscle group.
multijoint
-Each set should be performed to the point of ____________ but not ___________.
muscle fatigue Failure
•Common components of the Ex Rx seem to be helpful at least under some circumstances to reduce ______________ injury and complications. These include the warm-up and cool-down, stretching exercises, and ___________ progression of volume and intensity.
musculoskeletal gradual
Older Adults Exercise Prescription •Individuals who are frequent fallers or have mobility limitations may also benefit from specific ____________ exercises to improve: - - - (e.g., Tai Chi), in addition to the other components of health-related physical fitness.
neuromotor -balance -agility -proprioceptive training
Maximal exercise testing should ____________ on women who are pregnant unless __________
not be performed medically necessary If a maximal exercise test is warranted, the test should be performed with physician supervision after the woman has been medically evaluated for contraindications to exercise.
heat exhaustion
occurs during exercise/PA in heat when body can't sustain level of cardiac output needed to support skin blood flow for thermoregulation and blood flow for metabolic requirements
For __________ and very deconditioned individuals, ≥1 set of 10-15 repetitions of moderate intensity (i.e., 60%-70% 1-RM), resistance exercise is recommended.
older adults
Older Adults Exercise Prescription Low aerobic capacity, muscle weakness, and deconditioning are more common in ___________ than in any other age group and contribute to loss of independence, and therefore an appropriate Ex Rx should include: - - - -
older adults -aerobic -muscle strengthening -endurance -flexibility exercises
Neuromotor exercises involving balance, agility, coordination, and gait are recommended on ≥2-3 d ∙ wk−1 for __________________ and are likely beneficial for ______________ as well.
older individuals younger adults
The oldest segment of the population (≥75 yr and individuals with mobility limitations) most likely has __________________________
one or more chronic medical conditions
-To avoid creating muscle imbalances that may lead to injury, _____________________, such as the lower back and abdomen or the quadriceps and hamstring muscles, should be included in the resistance training routine.
opposing muscle groups (i.e., agonists and antagonists)
Progression/Maintenance of Resistance Training Recommendation As muscles adapt to a resistance exercise training program, the participant should continue to subject them to ____________ to continue to increase muscular strength and mass by gradually ___________ resistance, number of sets, or frequency of training.
overload increasing
-As muscles adapt to a resistance exercise training program, the participant should continue to subject them to ___________ to continue to ________ muscular strength and mass.
overload or greater stimuli increase The most common approach is to increase the amount of resistance lifted during training.
circumference
pattern of body fat distribution recognized as an important indicator of health and prognosis
•The exercise professional should also provide regular feedback, __________________, and other behavioral/programmatic strategies to enhance adherence.
positive reinforcement
high altitude pulmonary edema (HAPE) -
potentially fatal, although not common, illness that occurs in <10% of individuals ascending >12,000 ft (3,658 m); repeated ascents and descents >12,000 ft (3,658 m) & exercise strenuously early in the exposure
high altitude cerebral edema (HACE) -
potentially fatal, although not common, illness that occurs in <2% of individuals ascending >12,000 ft (3,658 m).
insufficient _________ has been associated with a greater risk of accidental _______.
power falls
Flexibility exercises may acutely reduce _____ and ______ so it is recommended that flexibility exercises be performed after exercise and sports.
power and strength
•In addition to focusing on muscular strength and endurance, older adults (≥65 yr) may benefit from ________________ because this element of muscle fitness declines most rapidly with aging and insufficient power has been associated with a greater risk of _________________.
power training accidental falls.
•Older adults may particularly benefit from _________________ because this element of muscle fitness declines most _________ with aging, and insufficient power has been associated with a greater risk of accidental falls.
power training rapidly
•The influence of _________________on the electrocardiographic (ECG) and hemodynamic responses to exercise may differ from usual expectations.
prescribed medications
Older adults should gradually exceed the recommended minimum amounts of PA and attempt continued ___________ if they desire to improve and/or maintain their physical fitness
progression
-Each resistance exercise should be performed with __________ technique regardless of training status or age.
proper
PNF stretching
proprioceptive neuromuscular facilitation
Handrail support for gait abnormalities will _______ the accuracy of estimating peak MET capacity based on the exercise duration or peak workload achieved.
reduce
For the same perceived effort, jogging or running pace will be _______ at altitude relative to sea level, independent of altitude acclimatization status
reduced
•In individuals with osteoarthritis, _____________________can reduce pain and disability.
resistance training
FITT-VP principle of Ex Rx will need to be ____________ according to the individual response, need, limitation, and adaptations to exercise as well as evolution of the goals and objectives of the exercise program.
revised
•Volume of resistance exercise
sets and repetitions
Pregnancy - Special Considerations Women who are pregnant and 1) and/or 2) or 3) should consult their physician before beginning an exercise program and have their Ex Rx adjusted to their medical condition, symptoms, and physical fitness level
severely obese and/or have gestational diabetes mellitus or hypertension
Increasing muscle power in healthy older adults should include both _______________ using light to moderate loading (30-60% of 1RM) for 6-10 repetitions with ________ velocity.
single- and multiple-joint exercises (1-3 sets) high
Static stretching involves
slowly stretching a muscle/tendon group and holding the position for a period of time (i.e., 10-30 s). Static stretches can be active or passive.
•Performing "_____________" is beneficial, especially in inactive or deconditioned individuals, and, for that reason, should be encouraged except where there are safety concerns.
some exercise
•Adolescents may safely participate in ___________ - need proper instruction and supervision. Generally, adult guidelines for resistance training may be applied.
strength training
Because of the physiological changes that accompany pregnancy, assumptions of _____________ protocols in predicting maximal aerobic capacity may be compromised and are therefore most appropriately used in determining the effectiveness of training rather than accurately estimating maximal aerobic power
submaximal
•For strength training involving use of selectorized machines or free weights, initial training sessions should be ____________ and _____________ by personnel who are sensitive to the special needs of older adults. Watch for individual orthopedic limitations.
supervised monitored
Pregnancy - Special Considerations PA in the ___________ position should be avoided or modified after ________weeks of pregnancy
supine 16 wk
Power
the rate at which work is done
•The recommended Ex Rx for women who are pregnant should be modified according to :
the woman's symptoms, discomforts, and abilities during pregnancy.
When a ____________ is known, then % HRR is better than using: a) just %HRmax, and b) %VO2max predicted from a submax test
true HRmax
-Each muscle group should be trained for a total of ______________.
two to four sets
Ballistic methods or "bouncing" stretches
use the momentum of the moving body segment to produce the stretch
Measurement of SaO2 by noninvasive pulse oximetry is a _________________
very good indicator of acclimatization.
Flexibility exercises are most effective when the muscles are _______.
warm
During pregnancy, the metabolic demand increases by ___________ Women should _________ caloric intake to meet the caloric costs of pregnancy and exercise
~300 kcal∙d−1. increase
Postpartum PA Generally, gradual exercise may begin ________ after a normal vaginal delivery or about __________ (with medical clearance) after a cesarean section delivery
~4-6 wk 8-10 wk
CHAPTER 6 REVIEW
•An exercise program that includes aerobic, resistance, flexibility, and neuromotor exercise training beyond ADL to improve and maintain physical fitness and health is essential for health/fitness benefits among most adults. •This edition of the Guidelines employs the FITT-VP principle of Ex Rx, that is, Frequency (how often), Intensity (how hard), Time (duration or how long), and Type (mode or what kind), with the addition of total Volume (amount) and Progression (advancement). •The ACSM recommends that most adults engage in moderate intensity, aerobic exercise training ≥30 min ∙ d−1, ≥5 d ∙ wk−1 to total ≥150 min ∙ wk−1; vigorous intensity cardiorespiratory exercise training ≥20 min ∙ d−1, ≥3 d ∙ wk−1 to total ≥75 min ∙ wk−1; or a combination of moderate and vigorous intensity exercise to total an EE of ≥500-1,000 MET-min ∙ wk−1 or >100 kcal/wk •On 2-3 d · wk−1, adults should also perform resistance exercises for each of the major muscle groups and neuromotor exercise involving balance, agility, gait, and coordination (e.g., such as standing on one leg, walking or running through cones, dance steps). •A series of flexibility exercises for each of the major muscle tendon groups ≥2-3 d ∙ wk−1 is recommended to maintain joint ROM. •The exercise program should be modified according to an individual's habitual physical activity, physical function, physical fitness level, health status, exercise responses, and stated goals. •Adults, including physically active adults, should concurrently reduce total time engaged in sedentary behaviors and intersperse frequent, short bouts of standing and physical activity between periods of sedentary activity throughout the day.
Pregnancy: Reasons to Terminate Exercise Stop acute exercise and consult health care provider if:
•Headache, dizziness, lightheaded •Vaginal bleeding, contractions, fluid leakage •Chest pain •Muscle weakness, calf pain/swelling •Pre-exercise dyspnea
__________________ status are often better indicators of ability to engage in PA than _______________.
•Health and functional chronological age
•_________ or __________ can be improved across all age groups by engaging in flexibility exercises.
•Joint ROM or flexibility
•________________and _______ can also be improved by engaging in flexibility exercises, especially when combined with resistance exercise.
•Postural stability and balance
Children and Adolescents Special Considerations
•Structured activities -Sports skills, games, jogging, cycling •Unstructured activities -Playgrounds & parks •Resistance Exercise - -Prepubescent - to moderate FATIGUE, NOT to Failure •8-15 reps, 2-3 sets
The primary altitude illnesses are:
•acute mountain sickness (AMS) •high altitude cerebral edema (HACE) - potentially fatal, although not common, illness that occurs in <2% of individuals ascending >12,000 ft (3,658 m). •high altitude pulmonary edema (HAPE) - potentially fatal, although not common, illness that occurs in <10% of individuals ascending >12,000 ft (3,658 m); repeated ascents and descents >12,000 ft (3,658 m) & exercise strenuously early in the exposure
-Many types of resistance training equipment can effectively be used to improve muscular fitness including:
•free weights •machines with stacked weights •pneumatic resistance •resistance bands.
-Swimming in water <25° C (77° F)
•may be a threat to CVD patients - may not feel angina symptoms •Increases Systolic & Diastolic BP
The optimal duration or number of repetitions of these exercises is not known, but neuromotor exercise routines of ≥_______ min in duration for a total of ≥_____ min per week of neuromotor exercise are effective.
≥20-30 min ≥60 min per week
oldest segment of population
≥75 yr and individuals with mobility limitations) most likely has one or more chronic medical conditions.