Exercise Prescription Exam 1

Select one physical fitness component and explain how you can determine the relative worth or predictive accuracy of a field test developed to assess this component.

see pg. 58-59

Describe the effects of miscuffing on BP readings.

undercuffing=overestimation overcuffing=underestimation

Moderate-intensity aerobic activity that noticeably increases heart rate and lasts more than 10 minutes would be equivalent to 2.0 to 3.0 METs 3.0 to 6.0 METs 6.0 to 8.0 METs greater than 8.0 METs

3.0 to 6.0 METs

Name four types of CVD. Which is most prevalent?

hypertension (most prevalent), CHD (coronary heart disease), stroke, heart attack (myocardial infarction)

Individuals who do not exercise regularly are at a greater risk for developing all of the following except cancer musculoskeletal disorders coronary artery disease hypothyroidism

hypothyroidism

Name three sources of error in measurement of BP.

improper cuff size, poor auditory reaction time of the technician, client having full bladder

Dose-response relationship means a higher-intensity workout is associated with larger reductions in weight engaging in less than 5 hours of high-intensity activity per week is associated with negative health consequences lowering the risk of heart disease is dependent on the frequency of weekly exercise sessions improvements seen in health benefits are dependent on the volume of physical activity performed

improvements seen in health benefits are dependent on the volume of physical activity performed

Elaborate on factors relating to activity tracker accuracy during walking, running, and cycling.

running and cycling the pedometer should be worn at hip for more accuracy, while walking should be worn at the wrist.

Name three absolute and three relative contraindications to exercise testing.

(see pg. 33 in textbook)

Describe the anatomical locations for placement of the 10 electrodes used to obtain a 12-lead ECG recording.

(see pg. 52 of textbook)

What is the recommended sequence of testing for administering a complete physical fitness test battery?

1.Resting blood pressure and heart rate 2.Body composition and balance 3.Cardiorespiratory endurance 4.Muscular fitness 5.Flexibility

Although health benefits associated with smoking cessation happen within weeks or months, the relative risk of a former smoker dying from coronary heart disease approximates that of a nonsmoker within _____________ of quitting (American Heart Association 2017). 2 years 5 years 10 years 15 years

10 years

What is the minimal recommended amount of aerobic exercise that adults should engage in per week? 30 min of vigorous-intensity exercise 60 min of vigorous-intensity exercise 90 min of moderate-intensity exercise 150 min of moderate-intensity exercise No minimal recommendation has been established.

150 min of moderate-intensity exercise

What is the recommended minimum amount of daily physical activity for health?

150 min. of aerobic MIPA (3.0-6.0 METS) per week or 75 min of aerobic VIPA (>6.0 METS) or a combination; moderate-high intensity resistance training 2 nonconsecutive days per week; balance and flexibility suggested for older adults

What percentage of the American population does not get the recommended amount of physical activity for health benefits?

49.5% meet recommended amount of either the aerobic or muscle-strengthening activity needed for health benefits; 79.3% fail to meet the full set of physical activity guidelines for health

Explain the importance of BP cuff size selection.

BP cuff size selection is vital to obtain accurate readings; to big or to small a cuff can lead to inaccurate measurements. undercuffing=overestimation and overcuffing=underestimation

What effect do arm position and body posture have on BP readings?

BP generally increases from lying to sitting. Raising the arm above heart level underestimates BP, and below heart level overestimates

Identify cardiovascular, pulmonary, metabolic, and musculoskeletal diseases or disorders that may limit exercise performance (name three signs or symptoms for each category).

CVD: hypertension, heart murmurs, chest pains Pulmonary: asthma, bronchitis, coughing up blood Metabolic: diabetes, obesity, thyroid disease Musculoskeletal: osteoporosis, osteoarthritis, low back pain

Explain the etiology of CHD.

Coronary heart disease is cause by a lack of blood supply to the heart muscle (myocardial ischemia) resulting from a progressive degenerative disorder known as atherosclerosis--condition where lipid plaques (LDLs, cholesterol, etc.) form on the inside walls of arteries--these plaques restrict blood flow to the heart and can cause heart attack

In terms of SBP and DBP, differentiate the elevated, stage 1 hypertension, and stage 2 hypertension categories.

Elevated: systolic: 120-129 diastolic: <80 Stage 1: systolic: 130-139 diastolic: 80-89 Stage 2: systolic: > or = 140 diastolic: > or = 90

Select one physical fitness component and give an example of how each of the seven training principles can be applied to it.

Ex. musculoskeletal fitness Specificity: work certain muscles out using resistance training to gain strength and endurance Overload: must load body greater than accustomed to gain strength Progression: progressively increase load or volume or time Initial values: at first we'll see great strides in strength gain, and it'll slow down over time Interindividual variability: everyone reacts different to different stimuli Diminishing returns: genetic ceiling that limits strength gains Reversibility: muscle gains can reverse back if exercise is discontinued

About half of the adult population in the United States meets both the aerobic and strength physical activity recommendations. True False

False

The noncommunicable disease risk associated with physical inactivity alone is equal to that of obesity. True False

False

True or False? An individual who has Type 2 diabetes and does not participate in regular exercise does not need medical clearance prior to engaging in moderate-intensity aerobic exercise.

False

How does GPS technology contribute to understanding environmental influence on exercise and physical activity?

GPS provides contextual information of physical activities, which provides a better understanding of how people interact with their environment and where most PA may occur for a particular person.

Explain the obesity paradox.

Hypothesis that essentially states that the prognosis for survival from CVD is better for those who are already overweight or mildly obese compared to leaner individuals.

Explain how you would select an app for your client.

I'd select an app based of their exercise type/goals/preferences

Which is more important: test validity or test reliability? Explain your choice.

In my opinion reliability is more important because reliability affects validity. Tests with poor reliability also have poor validity because unreliable tests fail to produce consistent results.

Name three methods for measuring BP. Which one is considered the gold standard? Is each method accurate at high altitude?

Invasive (direct), ausculatory, and oscillometry gold standard=direct measuremnt of intra-arterial BP oscillometry devices may be inaccurate at high altitudes

Explain how chronic adherence to moderate-to vigorous-intensity physical activity affects the aging process.

Life expectancy directly related to physically active life. PA may delay onset or development of many chronic diseases. PA may reverse or limit effects of existing chronic diseases. Regular LTPA and exercise may increase telomere length; short telomeres associated with numerous chronic diseases. Target 40- to 60-year-olds for increasing LTPA.

Explain the relationship between physical inactivity and low back pain.

Low back and other musculoskeletal injuries are sometimes caused by muscle imbalances and weakness that result from a lack of physical activity.

Define metabolic syndrome and identify its relationship to CVD.

Metabolic syndrome is a combination of CVD risk factors associated with hypertension, dyslipidemia, insulin resistance, and abdominal obesity. Individuals with 3 or more CVD risk factors are classified as having metabolic syndrome. Risk factors for metabolic syndrome include waist circumference, blood pressure, fasting blood glucose, triglycerides, and HDL-C.

identify the three elements of an exercise prescription. For older or less fit clients, which the elements should be increased first during the initial stage of their exercise programs?

Modality for exercise session/program Intensity of exercise session Duration of exercise session Frequency of exercise sessions Rate of progression through exercise program increasing the duration of the exercise not the intensity

Identify the positive and negative risk factors for CHD. Specify the criteria for each of these risk factors.

Negative: men >or=45 yr, women >or=55 yr CVD event before 55 yr for male, or 65 for women smoker SBP>or=130, OR DBP>or=80 on 2 separate occasions or individual taking antihypertensive medication LDL >or=130 HDL<or=40 fasting plasma glucose >or=126 BMI >or=30 no PA 30min for 3 days/wk, 3 months Positive: HDL >or=60

Identify the cutoff values for classifying resting BPs.

Normal: < 120/80 elevated: 120-129/<80 stage 1: 130-139/ 80-89 stage 2: 140/90

Identify the cutoff values for classifying TC, LDL-C, HDL-C and triglycerides.

Optimal/desirable values: TC: <200 LDL-C: <100 HDL-C: 40-59 or < 40 Triglycerides: <150

Identify the component parts of a typical normal ECG tracing. What does each component represent relative to the cardiac cycle?

P wave: atrial depolarization PR interval: delay in impulse of AV node QRS complex: ventricular depolarization T wave: ventricular repolarization

Identify the purpose of each component of the comprehensive health evaluation.

PARQ+: determine client's readiness for PA Signs and symptoms of disease and medical clearance: identify if client needs medical referral and obtain evidence of physician approval for exercise testing and participation Coronary risk factor analysis: determine number of CHD risk factors for client Medical history: review of client's past, present, and family history to identify conditions requiring medical referral/clearance Lifestyle evaluation: obtain information about client's living habits Informed consent: make sure client understands risks and benefits of physical fitness assessments and get client consent to perform tests on them

At minimum, a pretest health screening should include four items. Name these

PARQ, evaluate clients past 3 months of exercise, identify signs/symptoms of diseases, analyze coronary risk factors, determine if medical clearance is needed

Define physical fitness. Name and define the four components of physical fitness.

Physical fitness is the ability to perform occupational, recreational, and daily activities without becoming unduly fatigued. Cardiorespiratory endurance: ability of heart, lungs, and circulatory system to supply oxygen and nutrients efficiently to working muscles musculoskeletal fitness: ability of muscular and skeletal systems to perform work; requires muscular strength, endurance, power, and bone strength body weight/composition: size or mass of individual; weight in terms of relative amounts of fat, muscle, and bone tissues Flexibility: ability to move joint through a full ROM Balance: ability to keep body's center of gravity within base of support in a static or moving position

Explain how regular physical activity may prevent or delay select forms of cancer and cognitive decline.

Physical inactivity is a modifiable risk factor associated with increased risk of breast, colon, and endometrial cancers; mechanisms by which PA reduces risks aren't full known, however, it is thought to positively affect immune system function and hormonal balance. Exercise increases blood flow to the working muscles and brain and is associated with improved cognitive performance, much like how aerobic PA protects the CV system, MIPA and VIPA protects the brain.

Explain how physical inactivity differs from sedentary behavior.

Physical inactivity means you are someone not getting the correct amount of physical activity that qualifies you as being physically active (30min, 3 days, at least 3 months of MIPA). A sedentary person is one who sits or lays for long periods of time without being physically active.

Explain how regular physical activity affects each of the CHD risk factors as well as overall CHD risk.

Physically active people have lower incidences of myocardial infarction and mortality from CHD at a later age compared with their sedentary or less active counterparts. Living a PA lifestyle and sitting less than 4 hours a day may reduce CVD by 23-74%.

Which of the following is not a symptom of coronary artery disease? Shortness of breath at rest or with mild exertion Swollen hands Dizziness or syncope Pain or discomfort (or other anginal equivalent) in the chest, neck, jaw, arms, or other areas that may result from ischemia

Swollen hands

Which of the following is defined as a loss of consciousness? Syncope Orthopnea Paroxysmal nocturnal dyspnea Angina

Syncope

According to the American Heart Association, overweight adolescents have a 70% chance of becoming overweight adults, which increases to an 80% chance if one or both parents are overweight or obese. True False

True

Smoking is the largest preventable cause of disease and premature death. True False

True

The prevalence of cardiovascular disease is similar for men and women. True False

True

The volume of physical activity recommended for reducing disease risk may not be sufficient for preventing weight gain. True False

True

True or False? A sedentary 35-year-old female with controlled Type 2 diabetes mellitus and no signs or symptoms should get medical clearance prior to starting a moderate intensity exercise program.

True

Which prospective participant needs to obtain a physical examination and signed medical clearance from a physician before starting an exercise program? a client whose resting BP is 155/80 a client with a history of ankle sprain over 18 months ago a client with back pain while sitting in a chair at work a client on medication for heart disease

a client on medication for heart disease

What is persuasive technology, and how can it be used to promote physical activity?

a computer system, device or application that intentionally changes a person's attitude or behavior; uses media and social interaction to persuade individuals to adopt healthy behavior without conscious knowledge.

What percentage of Americans have some form of CVD?

about 1/3 have some form of CVD; equally prevalent in both men and women

Using the body mass index (BMI) classification, what is the prevalence of obesity in the United States? about 15% about 25% about 35% about 50% about 66%

about 35%

Dyspnea can be defined as an abnormally uncomfortable awareness of breathing. substernal chest pain. orthopnea. syncope.

an abnormally uncomfortable awareness of breathing.

If the client answers yes to any of the seven general health questions on the PAR-Q+ questionnaire, he or she will need to seek additional medical clearance before performing any structured physical activity decrease the intensity of the recommended activity level answer the follow-up questions have the exercise specialist make note of the special conditions that require monitoring

answer the follow-up questions

Describe the proper positioning of the wrist for assessing resting blood pressure with a wrist cuff.

arm should be at heart level

Name three methods for measuring heart rate.

auscultation, palpation, 12-lead ECG

All of the following are considered to be vigorous-intensity aerobic activities (>6.0 METs) EXCEPT bicycling at 8 mph jogging backpacking aerobic dancing

bicycling at 8 mph

Identify exercise modes suitable to develop each of the four components of physical fitness.

cardio: walking, jogging, cycling muscular: free weight, body weight exercises, bands body comp: same as muscular and cardio flexibility: static stretches, yoga, PNF stretches balance: yoga, pilates, balance exercises

Identify the reference (criterion) method for each of the four components of physical fitness.

cardiorespiratory: VO2 max using GXT musculoskeletal: 1-RM bw/body comp: hydrodensitometry flexibility: ROM at joint using goniometer

What NCDs are related to physical inactivity?

cardiovascular diseases, diabetes, obesity, chronic respiratory disorders, and cancers

Orthopnea refers to: dyspnea occurring at rest in the recumbent position. dull ache or "knifelike," sharp, stabbing pain in the chest. shortness of breath. an unpleasant awareness of the forceful or rapid beating of the heart.

dyspnea occurring at rest in the recumbent position

Choose one of the psychological models related to successful behavior change and give specific examples of how this model could be applied to a client undertaking a resistance training program to develop muscular fitness.

example: health belief model: client will engage in resistance exercise on a regular basis because they perceive the threat of a disease is severe (i.e. musculoskeletal injury, osteoporosis, etc.) (see textbook for other models)

Name the three stages of an exercise program. On average, how long should each stage last?

initial conditioning: 1-6 weeks improvement: 4-8 months maintenance: lifelong commitment to exercise

Describe three things you should do to ensure accurate BP readings during exercise.

instruct client to refrain from grasping the handlebars limit arm movement during the BP measurement position cuff so tubing is superior instead of inferior

Identify two BP devices that are best suited for assessing BP during exercise.

mercury column manometer and calibrated aneroid manometer

The American College of Sports Medicine (ACSM) recommends resistance training for adults (18-65 years) a minimum of moderate- to high-intensity strength training on 3 nonconsecutive days per week moderate- to high-intensity strength training on 2 nonconsecutive days per week low- to moderate-intensity strength training on 2 nonconsecutive days per week low- to moderate-intensity strength training on 3 nonconsecutive days per week

moderate- to high-intensity strength training on 2 nonconsecutive days per week

Potential exercise program participants should be screened for the presence and/or signs and symptoms of various cardiovascular, metabolic, and renal diseases to increase revenue generation. increase the likelihood that participants will drop out. encourage them to participate in vigorous exercise. optimize safety during exercise participation.

optimize safety during exercise participation.

Define obesity and overweight relative to BMI.

over 20 years old with BMI 25 - 29.9 define as overweight and BMI 30 or more is defined as obese

Identify three positively related and three negatively related factors associated with physical activity participation.

pg. 68 table 3.3

The exercise preparticipation health screening process is based on: informed consent, PAR-Q, and medical clearance. resting heart rate, resting blood pressure, and height and weight. physical activity level; signs and symptoms of cardiovascular, metabolic, or renal disease; presence of known cardiovascular, metabolic, or renal disease. cardiovascular disease risk factors, medical history, and informed consent.

physical activity level; signs and symptoms of cardiovascular, metabolic, or renal disease; presence of known cardiovascular, metabolic, or renal disease.

Identify the positive and negative risks factors for CHD.

positive: age, family history, dyslipidemia, hypertension, tobacco use, diabetes mellitus or prediabetes, obesity, and physical inactivity negative: HDL-C

Which statement best defines a MET? the energy cost of sleeping in a supine position the energy cost of sitting quietly the energy cost of walking slowly the energy cost of jogging at a comfortable pace the energy cost of maximal exertion

the energy cost of sitting quietly

Explain why pedometers and accelerometers worn at the hip occasionally give different counts that worn at the wrist.

to be more accurate, hip wearers should be moving faster and properly walking. Whereas for someone who shuffles or struggles to walk (such as slower speeds) a wrist worn pedometer is better; wrist pedometers should not be worn on a bike

Give examples of moderate-intensity physical activity.

walking briskly (3.0 mph but not racewalking), skateboarding (noncompetitive), water aerobics/calisthenics, bicycling slower than 10 mph, tennis (doubles), ethnic and cultural dancing, general gardening, and yoga

What types of exercise are effective for counteracting bone loss due to aging?

weight bearing activities (i.e. resistance training)