midterm

Exercise

A type of PA consisting of planned, structured, and repetitive bodily movement done to improve and/or maintain one or more components of physical fitness

Physical Activity Guidelines Advisory Committee Report 2

Additional health benefits result from greater amounts of PA. Individuals who maintain a regular program of PA that is longer in duration, of greater intensity, or both are likely to derive greater benefit than those who engage in lesser amounts.

muscular fitness assessment include the following:

Aerobic warm-up Equipment familiarization Strict posture Consistent repetition duration (movement speed) Full ROM Use of spotters (when necessary)

The Concept of Maximal Oxygen Uptake

Maximal volume of oxygen consumed per unit of time (VO2max) is accepted as the criterion measure of CRF. This variable can be expressed in relative (mL · kg−1 · min−1) or absolute (mL · min−1) values. Relative values allow for comparisons amongst individuals of different body sizes. VO2max is the product of cardiac output (Q) and arterial venous oxygen difference (A-VO2 diff).

Exercise in Hot Environments

Muscular contractions produce metabolic heat that is transferred from the active muscles to the blood and then to the body's core. Subsequent body temperature elevations elicit heat loss responses of increased skin blood flow and increased sweat secretion so that heat can be dissipated to the environment via evaporation.

CFR

cardiorespiratory fitness

Physical fitness

a set of attributes or characteristics individuals have or achieve that relate to their ability to perform PA and activities of daily living

The Cool Down

cool-downs may be useful to allow the body to return to near-resting levels (e.g., volume of oxygen consumed per unit time[VO2], heart rate [HR]) after the exercise session. Low-to-moderate intensity flexibility exercises, such as static stretching, may also be performed during the cool-down phase to help facilitate a more relaxed physiologic state.

MSI

musculoskeletal injury

SCD

sudden cardiovascular death

Exertional Heat Illness heat cramps

❖The cause of heat cramps is multifactorial. Evidence suggests that muscle cramps may be more related to muscle fatigue and neuronal excitability compared to hydration status or electrolyte concentrations. ❖Water loss and significant sweat sodium may be a contributing factors and may play a role in cramping in individuals identified as "heavy sweaters."

Self-Guided Methods

- Preparticipation health screening by self-reported medical history or health risk appraisal should be done for all individuals wishing to initiate a physical activity program. easily accomplished by using the PAR-Q+

Body Composition methods

Anthropometric methods= Height, weight, and body mass index (BMI) Circumferences Skinfold measurements Densitometry= Hydrodensitometry Plethysmography

Physical Activity (PA)

Any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase in caloric requirements over resting energy expenditure

Algorithm components

Classifying individuals who do or do not currently participate in regular exercise Identifying individuals with known CV, metabolic, or renal diseases or those with signs or symptoms suggestive of cardiac, peripheral vascular, or cerebrovascular disease, Types 1 and 2 diabetes mellitus (DM), and renal disease Identifying desired exercise intensity

Conditioning Phase

During the conditioning phase, training exercises could include aerobic, resistance, flexibility, and/or sports activities, depending on the specific goals of the exercise session.

Basic Principles and Guidelines: Test Organization

Ensure all necessary documents are available in the individual's file and available for the test's administration. Ensure appropriate room temperature. Calibrate all equipment. As best as possible, minimize individual anxiety. Provide a comfortable seat and/or examination table. The exercise professional should be familiar with the emergency response plan.

Cardiac and Respiratory Concerns in Cold

Exercise in cold environments appears to increase risk of EIB in both asthmatic and non-asthmatic individuals. The incidence rate of acute URI is directly correlated to cold weather. Acute URI can exacerbate underlying EIB. Face masks and specific warm-up routines may limit the effects of cold air inhalation in athletes with known EIB.

Exertional Heat Illness heatstroke

Exertional Heatstroke ❖Exertional heatstroke is caused by hyperthermia and is characterized by elevated body temperature (>40° C or 104° F), profound central nervous system dysfunction, and multiple organ system failure that can result in delirium, convulsions, or coma.

Modes of Testing

Field tests= 1.5-mi run/walk test, Cooper 12-min test, Rockport One-Mile Fitness Walking Test, The 6-min walk test Step tests. Motor-driven treadmills Mechanically braked cycle ergometers

Flexibility

Flexibility is the ability to move a joint through its complete range of motion. Flexibility depends on a number of specific variables including: Distensibility of the joint capsule Adequate warm-up Muscle viscosity Flexibility is best assessed at each specific joint by using a goniometer.

Frostbite

Frostbite occurs when tissue temperatures fall <0° C (32° F). Frostbite is most common in exposed skin (i.e., nose, ears, cheeks, and exposed wrists) but also occurs in the hands and feet. Contact frostbite may occur by touching certain cold objects with bare skin. Air temperature, wind speed, and wetness exacerbate heat loss.

AMS, HACE, HAPE

HACE is a potentially fatal, although uncommon: <2% of individuals ascending >3,658 m (12,000 ft). HACE most often occurs in individuals who have AMS yet continue to ascend without treatment; deterioration to coma may occur in as little as 12 h. HAPE is potentially fatal, although rare: <0.6% of individuals ascending >3,658 m (12,000 ft).

Exertional Heat Illness heat exhaustion

Heat Exhaustion ❖Heat exhaustion occurs during exercise/PA in the heat when the body cannot sustain the level of cardiac output needed to support skin blood flow for thermoregulation and blood flow for metabolic requirements of exercise. ❖Heat exhaustion is characterized by prominent fatigue and progressive weakness without end-organ damage.

Exertional Heat Illness heat syncope

Heat Syncope ❖Heat syncope is a temporary circulatory failure caused by the pooling of blood in the peripheral veins, particularly of the lower extremities. ❖Occurs more often among physically unfit, sedentary, and nonacclimatized individuals

HAPE

High Altitude Pulmonary Edema

Exercise in Cold Environments

Hypothermia develops when heat loss exceeds heat production, causing the body heat content to decrease. The environment, individual characteristics, and clothing all impact the development of hypothermia Exercise in wet and windy environments markedly increases heat losses and can increase risk of hypothermia.

Preparticipation Health Screening part 2

If indicated during screening, medical clearance should be sought from an appropriate health care provider. The manner of clearance should be determined by the clinical judgment and discretion of the health care provider.

Physical Activity Guidelines Advisory Committee Report 1

Important health benefits can be obtained by performing a moderate amount of PA on most, if not all, days of the week.

Indications for a Clinical Exercise Test

Indications for clinical exercise testing encompass three general categories: Diagnosis (e.g., presence of disease or abnormal physiologic response) Prognosis (e.g., risk for an adverse event) Evaluation of the physiologic response to exercise (e.g., blood pressure [BP] and peak exercise capacity)

principles of exercise prescription

Individual goals, physical ability, physical fitness, health status, schedule, physical and social environment, and available facilities

Muscular Power

Muscular power is the rate of performing work. With aging, muscular power declines at a faster rate than muscular strength or muscular endurance. Muscular power may be the most valuable of the muscular fitness variables for predicting maintenance of functional independence and improving quality of life.

Field Walking Test

Non-laboratory-based clinical exercise tests are also frequently used in patients with chronic disease. These are generally classified as field or hallway walking tests and are typically considered submaximal Similar to maximal exercise tests, field walking tests are used to evaluate exercise capacity, estimate prognosis, and evaluate response to treatment 6MWT, incremental and endurance shuttle walk tests

Nonfreezing Cold Injuries

Nonfreezing cold injuries (NFCIs) typically occur when tissues are exposed to cold-wet temperatures between 0° and 15° C (32° and 60° F) for prolonged periods of time. NFCIs may occur due to actual immersion or by the creation of a damp environment inside boots or gloves, as often seen during heavy sweating.

Informed Consent

Obtaining informed consent (IC) from individuals is an important ethical and legal consideration and should be completed prior to (a) the collection of any personal and confidential information, (b) any form of fitness testing, or (c) exercise participation

Recommended Sequence of Evaluation

Prior to engaging in physical activity or structured exercise programs. Informed consent, Exercise preparticipation health screening, Health history, Cardiovascular (CV) risk factor analysis

Exercise in High-Altitude Environments

Proper acclimatization is typically more effective than premedication for the prevention of acute altitude illnesses. Above 3,000 m, ascent should be limited by a sleeping altitude increase of 500 m per night, with a rest day of every 3-4 d.

Sensitivity, Specificity, and Predictive Value

Sensitivity: the ability to positively identify individuals who truly have IHD Specificity: the ability to correctly identify individuals who do not have IHD The predictive value is a measure of how accurately a test result correctly identifies the presence or absence of IHD and is calculated from sensitivity and specificity.

Preparticipation Health Screening part 1

The need for medical clearance before initiating or progressing exercise programming is determined using the ACSM screening algorithm Self-guided screenings can be an acceptable substitute for this method.

The Warm-Up

The warm-up is a transitional phase that allows the body to adjust to the changing physiologic, biomechanical, and bioenergetic demands of the specific exercise session.

Components of theExercise Training Session

Warm-up/initiation Conditioning Cool-down Each single exercise session should be designed with a training goal in mind.

Muscular Endurance

ability of a muscle group to execute repeated muscle actions over a period of time sufficient to cause muscular fatigue or to maintain a specific percentage of the 1-RM for a prolonged period of time. There are numerous versions of the push-up test that can be sued to assess muscular endurance.

AMS

acute mountain sickness

AMI

acute myocardial infarction

HACE

high altitude cerebral edema

Maximal vs. Submaximal Exercise Testing

maximal or submaximal exercise test depends largely on the reasons for the test, risk level of the individual, and availability of appropriate equipment and personnel. Maximal tests require individuals to exercise to the point of volitional fatigue, which may be inappropriate for some individuals and may require the need for emergency equipment. Often rely on submaximal exercise tests to assess CRF b/c maximal exercise testing is not always feasible in the health/fitness setting.

Body Composition

the ratio of body fat to lean body tissue, including muscle, bone, water, and connective tissue such as ligaments, cartilage, and tendons The BMI is used to assess weight relative to height and is calculated by dividing body weight in kilograms by height in meters squared (kg · m−2).

Submaximal Exercise Tests

treadmill= Determine appropriate submaximal endpoint. Ensure steady state with 3-min+ stages. HR values are extrapolated to age-predicted HRmax. Step test protocols Åstrand and Ryhming Multistage step test Canadian Home Fitness Test Queens College Step Test

Review of Pretest Instructions

• Perform the informed consent process. • Perform exercise preparticipation health screening. • Complete pre exercise evaluation. • Follow "individual instruction" section.