ACE CPT Exam

Supination of the foot

High arches in the foot

Hypertension

High blood pressure

SMART Guidelines

"Specific, Measurable, Attainable, Realistic, Timely"

Hypercholesterolemia

High levels of cholesterol in the blood.

Selective listening

A person only listens to key words.

Cardiac Output Formula

Heart rate x Stroke volume

Flat back

Decreased anterior lumbar curve

What does IBW stand for?

Ideal body weight

Dorsiflexion

Movement that bends the foot upward at the ankle

Antihistamines

Used to treat allergies

Mouth-to-mouth ventilations

a mask with a one-way valve used during airway CPR

Plantar Fasciitis

inflammation of the plantar fascia on the sole of the foot

Medial Tibial Stress Syndrome (MTSS)

- shin splints - Repetitive microtrauma causing inflammation along the outer covering of the tibia (tibialis anterior/posterior compartment) tight muscles pulling at tibia

YMCA Submaximal Step Test

-One of the most popular step tests used to measure cardiorespiratory endurance and is considered suitable for low-risk, apparently healthy, nonathletic individuals between the ages of 20 and 59. Procedure: 1. On the trainer's cue, client begins stepping and the stopwatch is started. Ensure client is keeping pace with the metronome (administers 96 clicks per minute). 2. At the 3-min mark, the test is stopped and the client immediately sits down. Count the client's HR for one whole minute. Record HR. 3. Perform 3-5 min cool down followed by lower extremity stretching.

Muscular Strength Tests

-1RM bench press test -1RM leg press test -1RM squat test

What is the purpose of a PAR-Q

-A minimal, yet safe, pre-exercise screening measure for low-to-moderate, but not vigorous, exercise training: 1. It serves as a minimal health-risk appraisal prerequisite 2. It is quick, easy, and non-invasive to administer 3. It is, however, limited by its lack of detail and may overlook important health conditions, medications, and past injuries

Pro-Agility Test

-Also known as the 20-yard agility test or the 5-10-5 shuttle run. Requires client to accelerate, decelerate, change direction, and then accelerate again. Goal is to complete the course as quickly as possible. Procedure: 1. Set up 10 yards of cones, positioning them 5 yards apart. 2. The trainer is positioned as the timer / judge at the center cone or line marker. 3. Ask client to straddle the middle cone or line marker facing the trainer and assume a 3-point stance. 4. On the trainer's command, the client turns and sprints to the cone or line marker to the left, making foot contact with the marker before changing direction and sprinting 10 yards across the center marker to make foot contact with the cone or line marker on the right, then changes direction once again and sprints back through the center line. The client does not need to touch the cone with his or her hand, but must touch the line with either foot. 5. Repeat test 2 more times. Client can take a few mins to recover between each test. The fastest of the 3 trials is noted as the final test score on the testing form.

Body-Weight Squat Test

-Assesses muscular endurance of the lower-extremity when performing reps of a squat and stand movement. Test is only suitable for individuals who demonstrate proper form. Procedure: 1. Explain and demonstrate proper technique 2. Allow for adequate warm-up 3. Evaluate depth of the squat: thighs should reach parallel to the floor. 4. Begin test. Have client perform as many controlled reps as possible. Once the client exhibits fatigue, terminate test. This includes inability to fully lower into the down position, pausing to rest, or faltering as he or she stands. 5. Record amount of reps performed and categorize performance from chart.

Ventilatory Threshold Testing

-Based on the physiological principle of ventilation. During submaximal exercise, ventilation increases linearly with oxygen uptake and carbon dioxide production. -As long as the exerciser can speak comfortably, he or she is almost always below VT1. The first point where it becomes more difficult to speak approximates the intensity of VT1, and the point at which speaking is definitely not comfortable approximates the intensity of VT2. -VT1 represents a level of intensity at which blood lactate accumulates faster than it can be cleared, which causes the person to breathe faster in an effort to blow off the extra CO2 produced by the buffering of acid metabolites. The need for oxygen is primarily met through an increase an increase in tidal volume and not respiratory rate. In well-trained individuals, VT1 is approximately the highest intensity that can be sustained for one to two hours of exercise. In elite marathon runners, VT1 is very close to their competitive pace. -VT2 occurs at the point where lactate is rapidly increasing with intensity, and represents hyperventilation even relative to the extra CO2 that is being produced. It probably represents the point at which blowing off the CO2 is no longer adequate to buffer the increase in acidity that is occurring with progressively intense exercise. VT2 is the highest intensity that can be sustained for 30 to 60 minutes in well-trained individuals.

Submaximal Talk Test for VT1

-Best performed using HR telemetry (HR strap and watch) for continuous monitoring. To avoid missing VT1, the exercise increments need to be small, increasing steady-state HR by approx. 5 beats per stage. 1. Predetermine testing stages. Objective is to increase HRss at each stage by approximately 5 bpm (usually about 0.5 mph, 1% grade, or 15 to 20 watts.) 2. Measure pre-exercise HR and BP if necessary 3. After warming up under 120 bpm, begin the test by adjusting the workload intensity to approx. 120 bmp. Maintain this intensity until HRss is achieved. Each stage should last approx. one to two minutes. 4. Toward the last 20-30 seconds of the stage, measure the HR and then ask the client to recite the Pledge of Allegiance three times or another predetermined passage or combination of phrases. Trainer should evaluate client's ability to talk without difficulty, asking the client to identify whether he or she felt this task was easy, uncomfortable-to-challenging, or difficult. 5. If VT1 is not achieved, progress through the successive stages, repeating the protocol at each stage until VT1 is reached.

Part-to-Whole Teaching Strategy For Bend-and-Lift Movements

-Breaking a skill down into its component parts and practicing each skill in its simplest form before placing several skills in a sequence. Follow this sequence: 1. Hip hinge - emphasizes glute dominance over quad dominance during the initial 15-20 degrees of movement 2. Lower-extremity alignment - promotes alignment among the hips, knees, and feet 3. Figure-4 Position - promotes optimal alignment between the trunk and tibia, as well as optimal position of the spine

MET Values

-Can be used as a way to express exercise intensity and is often used as a replacement of VO2 Max. Light - <3 METs Moderate - 3-6 METs Vigorous - >6 METs

What is risk stratification and why is it important?

-Categorized as low, moderate, or high and helps in determining the presence or absence of known cardiovascular, pulmonary, and/or metabolic disease, or risk factors / symptoms of. -Important because someone with only one positive risk factor will be treated differently than someone with several positive risk factors. Process involves 3 basic chronological steps: 1. Identifying coronary artery disease (CAD) risk factors 2. Performing a risk stratification based on CAD risk factors 3. Determining the need for a medical exam / clearance and medical supervision

Function-Health-Fitness-Performance Continuum (IFT Model)

-Exercise programs should follow a progression that first reestablishes proper function, then improves health, then develops and enhances fitness, and then enhances performance.

Standing Long Jump Test

-Goal is to jump as far as possible from a standing / stationary position. The jumping distance is measured from the takeoff line to the back edge of the client's rearmost heel. -A two-foot takeoff and landing are used. Clients should be encouraged to use their arms and legs for propulsion. Procedure: 1. Place a strip of tape across the floor and instruct the client to stand with his or her feet slightly apart, toes positioned just behind the takeoff line. 2. Using the arms and legs, the client should attempt to jump as far as possible, landing on both feet. 3. Measure the distance between the takeoff line and the rearmost point of contact. Allow 3 attempts and record the maximal distance achieved on the testing form.

Limitations of informed consent form

-It is not a liability waiver and therefore does not provide legal immunity -Intended to communicate the dangers of the exercise program or test procedures; it is recommended that the trainer also verbally reviews the content to promote understanding.

Push-up Test

-Measures upper-body endurance, specifically of the pectoralis muscles, triceps, and anterior deltoids. -Women should do modified push up. Procedure: 1. Test starts in the "down" position and the client can begin the test whenever ready. Hands should point forward and be positioned shoulder-width apart, directly under the shoulders. The hips and shoulders should be aligned (rigid trunk). 2. Count each complete push-up until the client reaches fatigue. A complete push up requires: full elbow extension with rigid torso in "up" position and the chest touching the trainer's fist, a rolled towel, or a foam block, without resting the stomach or body on the mat in the "down" position. 3. Test is terminated when the client is unable to complete a rep or fails to maintain proper form for two consecutive reps.

VT2 Threshold Test

-Only used for well conditioned individuals -Warm up <120 BPM set intensity at predetermined level and go for 20 min -During last 5 min, measure HR every min -Calculate the average of these 5 HR numbers -Multiply the average HR attained during the 15- to 20-minute high-intensity exercise bout by 0.95 to determine the VT2 estimate.

40-Yard Dash

-Purpose is to determine accelerations and speed. Performed extensively in football and other sports that require quick bouts of speed. Goal is to run as quickly as possible. 1. Client begins in a four-point (track start) or three-point stance with the front foot positioned on or behind the starting line. He or she should place the hands and feet on the line, but not beyond it. The client can lean across the line, but is not permitted to rock. This position must be held at least 3 seconds prior to starting. 2. Start the stopwatch at the first movement and stop it when the client's chest crosses the finish line. 3. The time is measured to one-hundredth of a second. 4. Have client perform two trials with appropriate recovery (at least 2 mins) between trials and record the average of the two trials on the testing form.

Rockport Fitness Walking Test (1 Mile)

-Purpose is to estimate VO2 Max from a client's immediate post-exercise heart rate. This is calculated by using the client's immediate post-exercise HR and his or her 1-mile walk time. This test is suitable for many individuals, easy to administer, and inexpensive. However, considering that walking may not elicit much of a cardiorespiratory challenge to conditioned individuals, this test will generally under-predict VO2 Max in fit individuals and is therefore not appropriate for that population group. Procedure: 1. Define the 1-mile course 2. On the trainer's "go", the stopwatch is started and the client begins 3. The client's 1-mile time, RPE, and immediate post-exercise heart rate (with either HR monitor or manual pulse) are recorded on the testing form. 4. Encourage a 3-5 minute cool down, followed by lower body stretching. 5. To determine VO2 max, client's info is plugged into a formula that is way too long to remember. Normative values for Rockport Walking Test: Males: <10:12 - excellent >16:24 - poor Females: <11:40 - excellent >17:32 - poor

What are muscle imbalances attributed to?

-Repetitive motion -Awkward positions / postures -Work environment -Side-dominance -Poor exercise techniques -Imbalanced resistance-training programs -Congenital conditions (e.g. scoliosis) -Pathologies -Structural deviations (e.g. tibial torsion and femoral anteversion) -Trauma (e.g. surgery, injury, and amputations)

Transtheoretical Model (TTM) of Behavior Change (aka Stages of Change Model)

-Separated into 4 components: 1. Stages of Change - -Precontemplation: people are sedentary and are not even considering an activity program. Activity = irrelevant to these peoples' lives -Contemplation: Still sedentary, but are beginning to consider activity as important and have begun to identify the implications of being inactive. However, still not ready to commit to making a change. -Preparation: Some physical activity, as individuals are mentally and physically preparing to adopt an activity program. Could include a sporadic walk, or a periodic gym visit, but is inconsistent. -Action: People engage in regular physical activity, but have been doing so for less than six months. -Maintenance: People engage in regular physical activity participation for longer than 6 months. 2. Processes of Change - Most important to understand, as it entails the processes of change that people use to get from one stage to the next. 3. Self-efficacy - Interrelated with and directly influences processes of change 4. Decisional Balance - The number of pros and cons perceived about adopting and / or maintaining an activity program. (Precontemplators and contemplators perceive more cons than pros).

Resting Heart Rate (RHR) Classification System

-Sinus bradycardia, or slow HR: RHR less than 60 bpm -Normal sinus rhythm: RHR 60 to 100 bpm -Sinus tachycardia, or fast HR: RHR more than 100 bpm Average RHR is approx. 70-72 BMP, averaging 60-70 bpm in males and 72-80 bpm in females. The higher values found in female RHR are attributed in part to: -smaller heart chamber -lower blood volume circulating less oxygen throughout the body -lower hemoglobin levels in women

Testing forms

-These forms are used for recording testing and measurement data during the fitness assessment. -Testing instructions and normative tables are used to determine client rankings for each fitness test. These forms can be assembled in a notebook or be accessible via a computer, personal digital assistant (PDA), or website.

Health-history questionnaire

-This form collects more detailed medical and health information beyond the CAD risk-factor screen, including the following: 1. Past and present exercise and physical activity info 2. Medications and supplements 3. Recent or current illnesses or injuries, including chronic or acute pain 4. Surgery and injury history 5. Family medical history 6. Lifestyle info (related to nutrition, stress, work, sleep, etc.)

Exercise history and attitude questionnaire

-This form provides the personal trainer with a detailed background of the client's previous exercise history, including behavioral and adherence experience. -This info is important when developing goals, designing programs, incorporating the client's preferences and attitudes toward exercise, and implementing strategies for improving motivation and adherence.

Medical release form

-This form provides the personal trainer with the client's medical info, and explains physical-activity limitations and/or guidelines as outlined by his or her physician.

1.5-Mile Run Test

-Used by U.S. Navy to evaluate cardiovascular fitness levels of its personnel. -Purpose is to measure cardiovascular endurance and muscular endurance of legs. Goal is to cover the required distance in the least amount of time possible. Walking is permitted if necessary, though it will create an underestimation of the VO2 Max score. Due to intense nature of this test, it is not suitable for less-conditioned individuals. Procedure: 1. Record the client's weight in kg 2. On the trainer's "go", the stopwatch is started and the client begins. 3. Record the client's time and immediate post-exercise HR. 4. Encourage 3-5 min cool down and stretching of lower extremities 5. To determine VO2 max, client's info is plugged into a formula that is way too long to remember.

Curl-up Test

-Used to measure abdominal strength and endurance. Requires client to perform to fatigue. Procedure: 1. Ensure client is positioned properly: laying supine, with feet flat on floor, both knees bent at 90 degree angle, and arms crossed over chest. 2. Cue client to perform a controlled curl-up to lift the shoulder blades off the mat (approx. 30 degrees trunk flexion), and then lower the torso back down to momentarily rest the shoulders completely on the mat (head does not need to touch mat). 3. Count each complete curl-up until the client reaches fatigue. 4. Ensure client is not holding breath during reps. 5. Client must not flex cervical spine by curling the neck.

Vertical Jump Test

-Useful for assessing the vertical jump height in athletes who participate in sports that require skill and power in jumping (basketball, volleyball, or football). -Goal is to jump as high as possible from a standing position. Encourage client to use arms and legs for momentum. 1. Ask client to stand adjacent to the wall, with inside shoulder of the dominant arm approximately 6 inches from the wall. Measure the client's standing height by marking the fingers with chalk, extending the inside arm overhead and marking the wall. This mark will later be compared to the maximal height achieved on a vertical jump. 2. The client then lowers the arms and, without any pause or step, drops into a squat movement before exploding upward into a vertical jump. 3. At the highest point the athlete touches the wall, the client should brush his or her hand against the wall to mark it with chalk. 4. The measurement is determined by the vertical distance between the new chalk mark and the starting height. 5. Allow 3 reps and record the maximal height achieved on the testing form.

Progressive Training Program

-Utilized to effectively activate and condition the core, and for balance training Stage 1: Core Function - emphasizes core-activation exercises and isolated stabilization under minimal spinal loading Stage 2: Static Balance - Emphasizes seated and standing stabilization over a fixed base of support. Stage 3: Dynamic Balance - Emphasizes whole-body stabilization over a dynamic base of support.

Phase 3 Cardiorespiratory Training Zones (Ventilatory Threshold)

-Zone 1: -below VT1 -should train in this zone for 70-80% of training time -Focus on developing a solid base of exercise below the talk test threshold or VT1 (RPE = 3 to 4) on several days per week -Aerobic base enhanced through recovery workouts, warm-up, cool-down, and long-distance workouts -Zone 2: -From VT1 to just below VT2 -Should train in this zone for less than 10% of training time -Aerobic intervals at or just above VT1 (RPE of 5) during one or two cardiorespiratory sessions per week -Aerobic efficiency -Zone 3: -At or above VT2 -Should train in this zone for 10-20% of training time -Anaerobic intervals at or above VT2 (RPE of 7 to 8) during one or two cardiorespiratory sessions per week -Anaerobic endurance

Informed consent form

-a form that confirms the client has acknowledged that he or she has been specifically informed about the risks associated with activity. Used prior to assessments and provides evidence of disclosure of the purposes, procedures, risks, and benefits associated with the assessments.

1RM-Repetition Table

1 rep - 100% 1RM 2 reps - 95% 1RM 3 reps - 93% 1RM 4 reps - 90% 1RM 5 reps - 87% 1RM 6 reps - 85% 1RM 7 reps - 83% 1RM 8 reps - 80% 1RM 9 reps - 77% 1RM 10 reps - 75% 1RM 11 reps - 70% 1RM 12 reps - 67% 1RM 15 reps - 65% 1RM

Things that will help to increase state of motivation during a workout

1. Creating mastery 2. Providing clear and consistent feedback 3. Including the client in aspects of program design 4. Creating an aesthetically pleasing workout environment

Common causes for mistakes in measuring blood pressure

1. Cuff deflation is too rapid 2. Inexperience of the test administrator or inability of test administrator to read pressure correctly 3. Improper stethoscope placement and pressure 4. Improper cuff size or an inaccurate/uncalibrated sphygmomanometer 5. Auditory acuity of the test administrator or excessive background noise

Girth Measurement Sites

1. Abdomen - a horizontal measure is taken at the greatest anterior extension of the abdomen, usually at the level of the umbilicus. 2. Arm - Standing erect and arms hanging freely at the sides with hands facing the thighs, a horizontal measure is taken midway between the acromion and olecranon processes. 3. Butt / hips - A horizontal measure is taken at the maximal circumference of the butt. This measure is used for the hip measure in a waist-to-hip ratio measurement. 4. Calf - A horizontal measure is taken at the level of the maximal circumference between the knee and the ankle, perpendicular to the long axis. 5. Forearm - With arms hanging down and palms facing anteriorly, a measure is taken perpendicular to the long axis at the maximal circumference. 6. Midthigh - With the subject standing and one foot on a bench so the knee is flexed at 90 degrees, a measure is taken midway between the inguinal crease and the proximal border of the patella, perpendicular to the long axis. 7. Upper thigh - Standing and legs slightly apart, a horizontal measure is taken at the maximal circumference of the hip / upper thigh, just below the gluteal fold. 8. With the subject standing, arms at the sides, feet together, and abdomen relaxed, a horizontal measure is taken at the narrowest part of the torso (above the umbilicus and below the xiphoid process).

5 key postural deviations that occur frequently in individuals

1. Ankle Pronation / Supination and the Effect on Tibial and Femoral Rotation -Subtalar Joint Pronation -Foot movement: eversion -Tibial (Knee) Movement: internal rotation -Femoral Movement: internal rotation -tightens calf muscles and potentially limits ankle dorsiflexion -Subtalar Joint Supination -Foot movement: Inversion -Tibial (Knee) Movement: External Rotation -Femoral Movement: External Rotation 2. Hip Adduction -Hip adduction is a lateral tilt of the pelvis that elevates one hip higher than the other (aka "hip hiking"). This position progressively lengthens and weakens the right hip abductors, which are unable to hold the hip level. -Right hip adduction: right side is elevated and hips usually shifted right -Left hip adduction: left side is elevated and hips usually shifted left 3. Pelvic Tilting Anterior Pelvic Tilt: -Anterior tilting of the pelvis frequently occurs in individuals with tight hip flexors, which is generally associated with sedentary lifestyles where individuals spend countless hours seated (shortened hip flexor positions). With standing, this shortened hip flexor pulls the pelvis into an anterior tilt. -Spine tilts downward and forward -Hip flexors and erector spinae are shortened / tight -Hamstrings and rectus abdominis are lengthened / loose Posterior Pelvic Tilt: -Anterior tilts upward and backward -Rectus abdominis and hamstrings are tight -Hip flexors and back are loose 4. Shoulder Position and the Thoracic Spine -Scapulothoracic joint and glenohumeral joint collaborate to produce shoulder movements. -glenohumeral joint is highly mobile and less stable -scapulothoracic joint is less mobile and more stable 5. Head Position -With good posture, the earlobe should align approximately over the AC joint. However, given the many awkward postures and repetitive motions of daily life, a forward-head position is very common. To observe the presence of this imbalance, use the sagittal view and align a plumb line with the AC joint, and observe its position relative to the ear. A forward-head position represents tightness in the cervical extensors, upper traps, and levator scapulae, and lengthening of the cervical flexors.

Things to keep in mind when setting SMART Goals

1. Avoid setting too many goals -otherwise client will become overwhelmed 2. Avoid setting negative goals -Setting negative goals puts the focus on the behaviors that should be avoided, not the behaviors to be achieved. Client should focus on achievement, not avoidance. 3. Set short- and long-term goals 4. Revisit the goals on a regular basis

Components of Movement Training in IFT Model

1. Bend-and-lift movements - squat 2. Pushing movements - Forward, Overhead, Lateral, and Downward 3. Single-leg movements - lunging 4. Pulling movements - bent over row or pull up 5. Rotational (spiral) movements - rotation of the thoracic spine during walking

5 primary daily activity movements

1. Bending / raising and lifting / lowering movements 2. Single-leg movements 3. Pushing movements (in vertical / horizontal planes) and resultant movement 4. Pulling movements (in vertical / horizontal planes) and resultant movement 5. Rotational movements

Exercise testing for cardiorespiratory fitness is useful to:

1. Determine functional capacity, using predetermined formulas based on age, gender, and in some cases, body weight. 2. Determine a level of cardiorespiratory function [commonly defined as either maximal oxygen uptake (VO2 Max) or metabolic equivalent (MET) level] that serves as a starting point for developing goals for aerobic conditioning 3. Determine any underlying cardiorespiratory abnormalities that signify progressive stages of cardiovascular disease 4. Periodically reassess progress following a structured fitness program

How to prevent client relapse

1. Develop and maintain a social-support network for exercise 2. Make clients feel as though they belong in the program and are a part of a team of people who have common interests and goals. 3. Be assertive

Types of antihypertensive medications

1. Beta blockers - reduce resting, exercise, and maximal heart rates. 2. Calcium channel blockers - Can either reduce, increase, or impose no change on resting heart rate and exercising heart rate. Typically impose no change on maximal exercising heart rate. Commonly used for angina and irregular heart rates. 3. Angiotensin-converting Enzyme (ACE) Inhibitors - Do not have any effect on heart rate, but will cause a decrease in blood pressure at rest and during exercise. 4. Diuretics - Do not have any effect on heart rate. 5. Antihistamines - Do not have any effect on heart rate. 6. Cold medications - Generally do not have any effect on heart rate. However, sometimes they can increase heart rate. 7. Tranquilizers - Do not have any effect on heart rate UNLESS it is an anxiety-reducing dose, in which it decreases a resting heart rate. 8. Antidepressants - Can either increase or impose no change on resting heart rate, and has no effect on exercising heart rate nor maximal exercising heart rate. 9. Alcohol - Can either increase or impose no change on resting HR and exercising HR, impose no change on maximal exercising HR 10. Diet pills - Generally do not impose any change on heart rate. Sometimes, certain types can increase resting and exercising HR. 11. Caffeine - Can either increase or impose no change on both resting and exercising HR, impose no change on maximal exercising HR. 12. Nicotine - Can either increase or impose no change on resting and exercising HR, impose no change on maximal exercising HR.

For every 1-inch increase in waist circumference in men, the following associated health risks are found:

1. Blood pressure increases by 10% 2. Blood cholesterol level increases by 8% 3. High-density lipoprotein (HDL) decreases by 15% 4. Triglycerides increase by 18% 5. Metabolic syndrome risk increases by 18%

Methods for assessing body size

1. Body mass index (BMI) 2. Girth measurements, including waist-to-hip ratio 3. Height 4. Weight

What are the two different standardized Ratings of Perceived Exertion Scales?

1. Borg 15-Point Scale (6-20 scale) - Original scale for RPE. On this scale, each value corresponds to a heart rate. For example: Borg score: 6 = corresponding heart rate of 60 bpm Borg score: 12 = corresponding heart rate of 120 bpm Borg score: 20 = corresponding heart rate of 200 bpm Borg should only be used if HR equivalents are needed and the actual exercise HR is not a reliable indicator of exertion (e.g., when a client is taking medications that affect HR responses such as beta blockers). 2. Modified 0 to 10 category ratio scale, which is a revision of the original Borg Scale. The modified scale should always be used to gauge intensity when the trainer does not need to measure HR via the RPE.

Health-related assessments focus on the following components:

1. Cardiorespiratory fitness 2. Body composition and anthropometry 3. Muscular endurance - ability of muscle groups to sustain repeated activity and withstand fatigue 4. Muscular strength - ability of muscles to overcome external resistance 5. Flexibility 6. Anaerobic power - the amount of work performed in a given unit of time; usually represents one single and explosive bout, event, or repetition performed at maximal efforts 7. Anaerobic capacity - the sustainability of power output for brief periods of time 8. Speed 9. Agility - how accurately and rapidly a person can change direction; involves the stages of acceleration, stabilization, and deceleration 10. Reactivity 11. Coordination

When conducting assessments of posture and movement, what components should be included?

1. Client history - written and verbal -collect info on musculoskeletal issues, congenital issues (e.g. scoliosis). trauma, injuries, pain and discomfort, the site of pain or discomfort, and what aggravates and relieves pain or discomfort. -lifestyle info, including occupation, side-dominance, and habitual patterns 2. Visual and manual observation -identify observable postural deviations -verify muscle imbalances as determined by muscle-length testing -determine the impact on movement ability or efficiency by performing compensations -facilitate movement to distinguish correctible from non-correctible compensations

Stages of Motor Learning

1. Cognitive Stage - clients are trying to understand the new skill. Movements are often uncoordinated and jerky. Trainers should use the "tell, show, do" approach in this stage. 2. Associative Stage - Clients begin to master the basics and are ready for more specific feedback that will help them refine the motor skill. 3. Autonomous Stage - Clients are performing motor skills effectively and naturally, and the personal trainer is doing less teaching and more monitoring.

Most common metabolic disorders

1. Diabetes 2. Thyroid disorders -Thyroid is a small gland in the neck that secretes hormones that increase oxygen uptake and heat production and affect many metabolic functions. -Hyperthyroid individuals have an increased level of these hormones and a higher metabolic rate, while individuals suffering from hypothyroidism have a reduced level of these hormones and require thyroid medication to regulate their metabolism to normal levels.

What do the following joints provide: mobility or stability? 1. Glenohumeral 2. Scapulothoracic 3. Thoracic Spine 4. Lumbar Spine 5. Hip 6. Knee 7. Ankle 8. Foot

1. Glenohumeral - mobility 2. Scapulothoracic - stability 3. Thoracic Spine - mobility 4. Lumbar Spine - stability 5. Hip - mobility 6. Knee - stability 7. Ankle - mobility 8. Foot - stability

1RM Squat Test

1. Warm up with one set of light resistance (~50 of anticipated 1RM weight) 2. Based on client's warm-up effort, determine a suitable workload for the second set that allows for three to five reps (~70-75% of anticipated 1RM weight) and then allow client to rest for 1 min. For increasing workload throughout test, increase weight by 10 to 20%. 3. Have client perform one heavy set of two to three reps at ~85 to 90% of the anticipated 1RM weight and rest for two mins. 4. Based on the client's third set, determine the next workload to find the client's 1RM effort. (use table) 5. Allow client to attempt this set. If they are successful, they should rest for 2 to 4 mins and repeat 1RM effort with a heavier load. 7. If attempt was unsuccessful, decrease the load accordingly (by 2.5 to 5%) and have the client try again after resting for 2-4 mins. 8. Continue the up or down increments until a true 1RM is achieved. (ideally within 3-5 sets).

Methods for assessing body composition

1. Hydrostatic weighing - Measures the amount of water a person displaces when completely submerged, thereby indirectly measuring body fat via body density. Based on Archimedes Principle, which provides the following equation: Density = Mass/Volume 2. Air displacement plethysmography - An egg-shaped chamber that measures the amount of air that is displaced when a person sits in the machine. Two values are needed to determine body fat: air displacement and body weight. (BodPod) 3. Bioelectrical impedance analysis (BIA) - Measures electrical signals as they pass through fat, lean mass, and water in the body. In essence, this method assesses leanness, but calculations can be made based on this information. 4. Dual-energy X-Ray Absorptiometry - A whole-body scanning system that delivers a low-dose x-ray that reads bone and soft-tissue mass. DXA has the ability to identify regional body-fat distribution. 5. Magnetic Resonance Imaging (MRI) - Uses magnetic fields to assess how much fat a person has and where it is deposited. 6. Near-infrared interactance (NIR) - Uses a fiber optic probe connected to a digital analyzer that indirectly measures tissue composition (fat and water). Typically, the biceps are the assessment site. Calculations are then plugged into an equation that includes height, weight, frame size, and level of activity. 7. Skinfold measurements - Used to "pinch" a fold of skin and subcutaneous fat. Several sites on the body are typically measured. The measurements are plugged into an equation that calculates body-fat percentage. 8. Total body electrical conductivity (TOBEC) - Uses an electromagnetic force field to assess relative body fat.

Goals of Physiological Baseline Assessments

1. Identify areas of health / injury risk for potential referral to the appropriate health professional(s) 2. Collect baseline data that can be used to develop a personalized fitness program and allow for comparison of subsequent evaluations 3. Educate a client about his or her present physical condition and health risks by comparing his or results to normative data for age and gender 4. Motivate a client by helping him or her establish realistic goals

Stratification Risk Classification

1. Low risk -asymptomatic -less than 2 risk factors -no medical exam, exercise test, or doctor supervision required 2. Moderate risk -asymptomatic -less than 2 risk factors -medical exam required for only VIGOROUS exercise -no exercise test or doctor supervision required 3. High risk -Symptomatic of pulmonary, renal, or metabolic disease -medical exam, exercise test, and doctor supervision required

Procedure for measuring exercise heart rate

1. Measuring for 30-60 seconds is generally difficult. Therefore exercise heart rates are normally measured for shorter periods that are then corrected to equal 60 seconds. 2. Generally, a 10- to 15-second count is recommended over a six-second count given the larger potential for error with the shorter count. 3. Count the first pulse beat at the start of the time interval, then multiply the counted score by either 6 (for a 10-second count) or 4 (for a 15-second count).

Sources of Self-Efficacy Information

1. Past performance - most influential source of self-efficacy 2. Vicarious experience 3. Verbal persuasion - usually occurs in the form of feedback from teaching or encouragement 4. Physiological state appraisals 5. Imaginal experiences

Supine Drawing-In (Centering) Exercise Progression for Core Activation

1. Pelvic Floor Contractions (the contraction to interrupt the flow of urine) 2. TVA contractions (drawing the belly button toward the spine) 3. Combo of both contractions 4. Contractions with normal breathing

What are the 3 potential determinants for a person's decision to engage in physical activity?

1. Personal attributes -demographic variables -health status -activity history -psychological traits -knowledge, attitudes, and beliefs 2. Environmental factors -access to facilities -time -social support 3. Physical-activity factors -intensity -injury

Purposes of pre-participation screening

1. identifying the presence or absence of known cardiovascular, pulmonary, and/or metabolic disease, or signs or symptoms suggestive of cardiovascular, pulmonary, and/or metabolic disease 2. identifying individuals with medical contraindications (health conditions and risk factors) who should be excluded from exercise or physical activity until those conditions have been corrected or are under control 3. Detecting at-risk individuals who should first undergo medical evaluation and clinical exercise testing before initiating an exercise program 4. identifying those individuals with medical conditions who should participate in medically supervised programs

Stages of Client-Trainer Relationship

1. Rapport - Develop a relationship marked by mutual understanding and trust 2. Investigation - PT's and clients review the clients' health and fitness data, any available test results, medical clearance info, and clients' goals and exercise history. Clients should portray good listening skills during this stage. 3. Planning - The PT designs an exercise program in partnership with the client, using both good listening skills and teaching skills. 4. Action - Clients are ready to begin working out. Ability to effectively teach new motor skills is vital at this point.

8 types of physiological assessments

1. Resting vital signs (heart rate, blood pressure, height, weight) 2. Static posture and movement screens 3. Joint flexibility and muscle length 4. Balance and core function 5. Cardiorespiratory fitness 6. Body composition 7. Muscular endurance and strength 8. Skill-related parameters (agility, coordination, power, reactivity, and speed)

What movements do the following joints perform: 1. Shoulder 2. Elbow 3. Lumbar spine 4. Hip 5. Knee 6. Ankle

1. Shoulder - internal / external rotation (subscapularis, supraspinatus, infraspinatus, teres minor) AND flexion / extension (anterior deltoids, trapezius, posterior deltoids) 2. Elbow - flexion / extension (biceps and triceps) 3. Lumbar spine - flexion / extension (iliopsoas, abdominals, and erector spinae) 4. Hip - flexion / extension (iliopsoas, rectus abdominus, tensor fascia latae, erector spinae, gluteus maximus, and hamstrings) 5. Knee - flexion / extension (hamstrings and quadriceps) 6. Ankle - plantarflexion / dorsiflexion (gastrocnemius and tibialis anterior) AND inversion / eversion (tibialis anterior and peroneals)

Key Deviations of the Thoracic Spine and Shoulders

1. Shoulders not level -Upper traps, levator scapula, and rhomboids are tight 2. Asymmetry to midline -Lateral trunk flexors are tight 3. Protracted (forward, rounded) -Serratus anterior, anterior scapulo-humeral muscles, and upper traps are tight 4. Medially rotated humerus -Pectoralis major and latissumus dorsi (shoulder adductors), and subscapularis are tight 5. Kyphosis and depressed chest -Shoulder adductors, pectoralis minor, rectus abdominis, and internal obliques are tight

Common overuse injuries

1. Tendinitis 2. Bursitis 3. Fasciitis

Procedure for measuring resting heart rate

1. The client should be resting comfortably for several minutes prior to obtaining RHR. 2. The RHR may be measured indirectly by placing the fingertips on a pulse site (palpation), or directly by listening through a stethoscope (auscultation) 3. Place the tips of the index and middle fingers (not the thumb, which has a pulse of its own) over the artery (typically, radial is used) and lightly apply pressure. 4. To determine the RHR, count the number of beats for 30-60 seconds and then correct that score to beats/minute, if necessary. 5. When measuring by auscultation, place the bell of the stethoscope to the left of the client's sternum just above or below the nipple line. 6. The client may also measure his or her own resting HR before rising from bed in the morning and report back.

Planes of Motion

1. Transverse 2. Frontal 3. Sagittal 4. Posterior or dorsal 5. Anterior or ventral

3 Phases of Healing

1. inflammatory response phase - immobilizes the injured area to begin the healing process. Lasts up to 6 days. 2. fibroblastic repair phase - Begins with the wound filling with collagen and other cells, which will eventually form a scar. Occurs at ~day 3 and lasts ~day 21. 3. maturation-remodeling phase - begins the remodeling of the scar, rebuilding of bone, and / or restrengthening of tissue into a more organized structure. Begins ~day 21 and can last for up to 2 years.

Interviewing techniques

1. minimal encouragers - brief words or phrases that encourage the client to share additional information (e.g. "please explain what you mean by occasional knee pain") 2. paraphrasing - restating the essence of a client's communication 3. probing - asking additional questions in an attempt to gather more information (e.g. "Please tell me more about the medications you are taking") 4. reflecting - restating the feelings and/or content of what the speaker conveys, but with different words. Different from paraphrasing because feelings or attitudes may be included (e.g. "I hear you say you've been unsuccessful at losing weight, but it appears that it makes you uncomfortable to discuss your previous attempts at weight loss") 5. clarifying - verifying an understanding of the content of client's communication 6. informing - expanding upon shared info. (e.g. if a client is concerned about having an asthma attack while working out, the trainer can share factual info on strategies to avoid an asthma attack) 7. confronting - using mild to strong feedback with a client. This can encourage accountability when clients display lack of motivation toward their workout sessions. 8. questioning - directing both open ended and closed ended questions to a client 9. deflecting - changing the focus of one individual onto another, usually to devalue and diminish the content of the communication. Use of this style is ill-advised unless the trainer is intentionally attempting to be empathetic by sharing appropriate experiences.

Communication styles

1. preaching style - judgmental and delivers info in a lecture-type format by describing what the client should do. This minimizes the chances for establishing rapport. 2. educating style - informational, providing relevant information in a concise manner, and allows the client to make a more informed decision. 3. counseling style - supportive, utilizing a collaborative effort to problem-solve and help the client make an informed decision. This is the most effective style and is recommended when implementing a plan and/or modifying a program design. 4. directing style - more instructive, in that the trainer provides instructions and direction. This style is most effective when safety and proper form and technique are essential.

Methods for measuring heart rate

1.) 12-lead electrocardiogram (ECG or EKG) 2.) Telemetry 3.) Palpation (accurate within 95% of a heart rate monitor) 4.) Auscultation with stethoscope (accurate within 95% of a heart rate monitor)

How many minutes per week of moderate intensity per week does the United States Department of Health and Human Services recommend?

150 mins

How to calculate maximal heart rate (MHR)

220-age

Chain of Survival for cardiac emergency

4 steps to increase the likelihood of survival during a cardiac arrest incident 1. Early access - early recognition of the emergency and immediate activation of EMS 2. Early CPR 3. Early defibrillation 4. Early advanced care

What percentage of people who start a new program will drop it within the first six months?

50%

How many minutes per week of vigorous intensity aerobic physical activity per week does the United States Department of Health and Human Services recommend?

75 minutes

Tai Chi

A Chinese system of slow meditative physical exercise designed for relaxation, balance and health. Improves balance and motor coordination.

The ABCs of the ACE Mover Method

A - Ask open ended questions B - Break down barriers C - Collaborate

Cyanosis

A bluish discoloration of the skin resulting from poor circulation or inadequate oxygenation of the blood.

Overuse injury

A body injury that occurs when a repeated movement with poor technique / poor body mechanics causes wear and tear on the body. E.g. runner's knee, swimmer's shoulder, tennis elbow, shin splints, and ITBS.

Claudication

A condition in which cramping pain in the leg is induced by exercise, typically caused by obstruction of the arteries.

Motivational interviewing

A method of speaking with people in a way that motivates them to make a decision to change their behavior. Designed to show supportive concern while challenging a client's current behavior.

Monoarticulate muscle

A muscle that crosses one joint

Biarticulate muscle

A muscle that crosses two joints

Bursitis

A painful condition that affects the small, fluid-filled sacs that cushion the bones, tendons and muscles near your joints. Bursitis occurs when bursae become inflamed. The most common locations for bursitis are in the shoulder, elbow and hip. But you can also have bursitis by your knee, heel and the base of your big toe. Bursitis often occurs near joints that perform frequent repetitive motion.

Passive listening

A person gives the impression of listening by using minimal noncommittal agreements (e.g. head nods or "uh huhs"

Intrinsic motivation

A person is engaged in exercise activity for the inherent pleasure and experience that comes from engagement itself.

Indifferent listening

A person is not really listening and is tuned out.

Active listening

A person shows empathy and listens as if he or she is in the speaker's shoes. This is the key to effective listening.

Angina

A pressure or tightness in the chest, but can also be experienced in the arm, shoulder, or jaw. This pain may be accompanied by shortness of breath, sweating, nausea, and palpitations of the heart.

Atherosclerosis

A process in which fatty deposits of cholesterol and calcium accumulate on the walls of the arteries, causing them to harden, thicken, and lose elasticity. When this process affects the arteries that supply the heart, it is called CAD (coronary artery disease).

thermoregulation

A process that allows your body to maintain its core internal temperature. All thermoregulation mechanisms are designed to return your body to homeostasis. This is a state of equilibrium.

Anthropometric Meausurements

A series of quantitative measurements of the muscle, bone, and adipose tissue used to assess the composition of the body. The core elements of anthropometry are height, weight, body mass index (BMI), body circumferences (waist, hip, and limbs), and skinfold thickness. Two examples of this approach are: 1. Body Mass Index (BMI) 2. Waist-to-hip ratio (WHR)

Emphysema

A serious disease that destroys lung tissue and causes breathing difficulties.

Readiness to change questionnaire

A simple questionnaire that trainers can administer to clients verbally during the lifestyle and health-history portion of the investigation stage (interview) or distribute them to complete on their own. The more "yes" responses indicated on the questionnaire, the more likely the person is to commit to changing key behaviors.

Plumb line

A string with a weight used to provide a vertical reference line. You can create a plumb line by suspending a piece of string from the ceiling or fixed point to a height 0.5 to 1 inch above the floor. Ensure to select a location with a solid, plain background or a grid pattern that offer contrast against the client. Ensure client wears form-fitting clothes and have them remove shoes and socks. Objective is to observe the client's symmetry against the plumb line and the right angles that the weight-bearing joints make relative to the line of gravity. Plumb Line Positions: 1. Frontal Views Anterior: -Client should be positioned between the plumb line and a wall, facing the plumb line. With good posture, the plumb line will pass between the feet and ankles, and intersect the pubis, umbilicus, sternum, mandible (chin), maxilla (face), and frontal bone (forehead). Posterior: -Client should be positioned between the plumb line and a wall, facing away from the plumb line. With good posture, the plumb line should ideally bisect the sacrum and overlap the spinous processes of the spine. 2. Sagittal View -Client should be positioned between the plumb line and the wall, facing sideways with the plumb line aligned immediately anterior to the lateral malleolus (anklebone). -With good posture, the plumb line should ideally pass through the knee, femur, and A-C joint, and in line with or slightly behind the ear lobe. 3. Transverse View -All transverse views of the limbs and torso are performed from frontal- and sagittal-plane positions.

Which of the following responses correctly describes a phenomenon called "winged scapulae"? A. A Protrusion of the inferior angle and vertebral "medial) border of the scapula B. A protrusion of the vertebral (medial) border outward C. A protrusion of the superior angle and spine of the scapula D. A protrusion of the inferior angle and glenohumeral (lateral) border of the scapula

A. A Protrusion of the inferior angle and vertebral (medial) border of the scapula

A client who can walk continuously for 10 minutes at a moderate intensity before needing to take a break would start in which Cardiorespiratory Training phase of the ACE IFT Model? A. Base Training B. Interval Training C. Performance Training D. Fitness Training

A. Base Training

Which of the following is the MOST important factor for personal trainers to focus on to create a client-centered approach to personal training? A. Building rapport B. Client excitement C. Goal setting D. Challenging exercises

A. Building rapport

Which of the following is WITHIN the scope of practice for ACE Certified Personal Trainers? A. Conducting fitness assessments and health screenings to identify exercise limitations B. Counseling clients through behavior challenges that negatively impact exercise adherence C. Recommending a specific diet to help a client meet his or her weight-loss goal D. Continuing a rehabilitation exercise program for clients following physical therapy

A. Conducting fitness assessments and health screenings to identify exercise limitations

Which of the following postural deviations could indicate that a client has an internally (medially) rotated humerus and / or scapular protraction? A. Front view: Palms face backward B. Posterior view: scapular winging visible C. Side view: Upper back has an exaggerated curve D. Front view: Sternum not in line with the plumb line

A. Front view: Palms face backward

A client who has problems performing activities of daily living would benefit MOST from improving which of the following? A. Functional movements B. Muscular strength C. Agility, coordination, and reactivity D. Performance-based movements

A. Functional movements

During a training session, an ACE trainer asks the client to explain what benefits might be gained by increasing her exercise frequency from 2 days/week to 3 days/week. Which of the following BEST identifies the type of communication skill used by the trainer? A. Open-ended questioning B. Summarizing C. Offering affirmation D. Closed questioning

A. Open-ended questioning

Hypotension

Abnormally low blood pressure

Steady state training

Activity that takes place at a set pace without variation to resistance or movement factors; HR does not vary by more than 5bpm

Behavioral contracts

Agreements between the counselor and the client -- The contract includes behaviors that need to be changed and the reinforcers and punishers needed for behavior change - An operant technique used to increase the frequency of adaptive behavior

Emergency ABCs

Airway, breathing, circulation, and severe bleeding

Myocardial infarction

Also known as a heart attack. Caused by atherosclerosis, which narrows the vessels that carry blood to the heart.

Cardiovascular Drift

An increase in heart rate during exercise to compensate for a decrease in stroke volume. This compensation helps maintain a constant cardiac output. Caused by an increasing core temperature and fluid lost from sweating.

Muscle strain

An injury that occurs when a muscle is stretched beyond the limits to which it is accustomed, resulting in microscopic tears of the muscle fibers. There are Grade I, II, and III tears.

Femoral torsion

An inward turning of the thigh bone (femur) at the hip. The entire leg is rotated so the knee caps point inward. Both legs are usually involved. This rotation causes in-toeing, a condition where a child's feet point inwards when they walk.

Iliotibial band syndrome

An overuse injury accompanied by pain along the outside of the thigh and knee.

Anaerobic power versus anaerobic capacity

Anaerobic power: Involves a single repetition or event and represents the maximal amount of power the body can generate Anaerobic capacity: Represents the sustainability of power output for brief periods of time.

What is myocardial infarction?

Another term for a heart attack

Bronchodilators

Asthma medications that relax or open the air passages in the lungs, allowing better air exchange.

Autogenic Inhibition

Autogenic inhibition is often seen during static stretching, such as during a low-force, long-duration stretch. When this occurs, the muscle spindle is activated and causes a reflexive contraction in the agonist muscle (known as the stretch reflex) and relaxation in the antagonist muscle.

In which Muscular Training phase of the ACE IFT Model would drills to build agility and power be incorporated? A. Base Training B. Load / Speed Training C. Functional Training D. Movement Training

B. Load / Speed Training

Which exercise would be MOST appropriate in the Movement Training phase of the ACE IFT Model Muscular Training component? A. Butt kicks B. Body-weight lunges C. High marches D. Plyometric squat

B. Body-weight lunges

During an initial exercise session, a client presents with symptoms of dizziness and mentions this occasionally occurs during workouts. Which would be the MOST appropriate action by an ACE trainer? A. Modify the current program to a more suitable activity level B. Discontinue exercise and have the client seek a qualified healthcare provider's clearance C. Create a new program to help address the issues identified D. Continue exercise with caution and seek a healthcare provider's clearance

B. Discontinue exercise and have the client seek a qualified healthcare provider's clearance

When a client can consistently perform moderate-intensity physical activity for 20 minutes or more on at least three days per week, he or she should be training in which cardiorespiratory phase of the ACE IFT Model? A. Movement Training B. Fitness Training C. Base Training D. Performance Training

B. Fitness Training

A nutrition fact label states that one serving of the product contains 3,300 mg of sodium. Which of the following BEST categorizes this product's sodium content? A. Minimal B. High C. Low D. Moderate

B. High

Which of the following would be OUTSIDE the scope of practice for ACE Certified Personal Trainers? A. Leading a client through exercises to improve shoulder stability B. Offering solutions to a client who exhibits signs of depression that impact exercise adherence C. Discussing proper techniques and appropriate uses for dynamic stretching D. Teaching a client techniques for self-myofascial release

B. Offering solutions to a client who exhibits signs of depression that impact exercise adherence

Which of the following should be developed early in the client-personal trainer relationship in order to build a strong foundation? A. Investigation B. Rapport C. Sympathy D. Action

B. Rapport

Which of the following resources would be MOST appropriate for an ACE Certified Personal Trainer to utilize when providing dietary advice to clients? A. Industry resources for personal trainers (e.g. Myfitnesspal.com) B. Resources developed of endorsed by the Federal Government (e.g. www.ChooseMyPlate.gov) C. Textbooks on nutrition and weight loss from national publishers D. Published articles from health and nutrition magazines and websites

B. Resources developed of endorsed by the Federal Government (e.g. www.ChooseMyPlate.gov)

Scapular winging during the shoulder push stabilization screen would MOST likely be due to... A. Weak core and low back B. Scapulothoracic joint instability C. Curved thoracic spine D. Strong serratus anterior

B. Scapulothoracic joint instability

What is the MOST appropriate solution for an ACE trainer to provide to a client who has tight iliotibial (IT) bands? A. Prescribe a series of ballistic stretches B. Teach the client self-myofascial release techniques C. Teach the client to perform self-deep tissue massage D. Refer the client to a physical therapist

B. Teach the client self-myofascial release techniques

What does skill or performance related parameters of fitness include?

Balance, power, speed, agility, reactivity, and coordination

Plantar flexion

Bends the foot downward at the ankle

Korotkoff sounds

Blood flow sounds that healthcare providers observe while taking blood pressure with a sphygmomanometer over the brachial artery in the antecubital fossa. These sounds appear and disappear as the blood pressure cuff is inflated and deflated.

What site is standardly used when measuring blood pressure?

Brachial artery

Which of the following client types is MOST likely to exhibit positive health behaviors? A. A client with a strong emotional state B. A client with an external locus of control C. A client with an internal locus of control D. A client with strong willpower

C. A client with an internal locus of control

A client has soreness after a weekend tennis tournament. Which of the following is an appropriate action that is WITHIN the scope of practice for ACE Certified Personal Trainers? A. Provide deep tissue massage to the affected area B. Suggest using common, low-dosage anti-inflammatory medications C. Implement a therapeutic exercise program to reduce soreness and improve function C. Discuss proper techniques for stretching the affected muscles

C. Discuss proper techniques for stretching the affected muscles

According to the Centers for Disease Control and Prevention, which of the following is a key risk factor for chronic disease? A. Prior habit of tobacco use B. Moderate alcohol use C. Lack of physical activity D. Increased risk of falls

C. Lack of physical activity

What is resting heart rate influenced by?

Fitness status, fatigue, body composition, drugs and medication, alcohol, caffeine, and stress

When working with clients who have been referred by their physicians for exercise programming, which of the following steps would be MOST important for the personal trainer to take? A. Ask the client if the personal trainer can contact the referring physician B. Call the referring physician to thank him or her for the referral and promise to refer clients with medical needs in return C. Obtain written permission from the client prior to communicating with the referring physician D. Provide the physician with an update on the client's first session and planned exercise program

C. Obtain written permission from the client prior to communicating with the referring physician

Which of the following observations during the passive straight-leg (PSL) raise represents normal length of the hamstrings? A. Raised leg achieves 70 degrees of movement B. Pelvis rotates posteriorly after the raised leg passes 70 degrees of movement C. Raised leg stops just short of 90 degrees of movement D. Opposite leg lifts off the mat as the raised leg approaches 80 degrees of movement

C. Raised leg stops just short of 90 degrees of movement

Which of the following is one of the five primary movement patterns that are the focus of Movement Training? A. Diagonal movements B. Triplanar movements C. Single-leg movements D. Jumping movements

C. Single-leg movements

Which assessment does NOT use predicted maximal heart rate or predicted VO2 Max, but instead provides an actual measured HR that corresponds to the client's unique metabolic response to exercise? A. YMCA bike test B. Bruce submaximal treadmill test C. Submaximal talk test for VT1 D. Rockport fitness walking test

C. Submaximal talk test for VT1

Which of the following observations would NOT be noted as a postural deviation? A. The palms of the hands face backward B. The superior, anterior portion of the pelvis rotates downward and forward C. The cheekbone is in line with the collar bone D. The subtalar joint is in pronation

C. The cheekbone is in line with the collar bone

Which of the following BEST describes what is at the heart of a client-centered approach to personal training? A. The personal trainer has specialized skills that help the client overcome barriers to achieve fitness and performance goals B. The personal trainer sets personalized goals and associated programming for the clients C. The personal trainer is focused on the client, helping the client achieve his or her goals for health, fitness, and improved quality of life D. The personal trainer is very knowledgeable, providing education to help the client reach his or her unique goals

C. The personal trainer is focused on the client, helping the client achieve his or her goals for health, fitness, and improved quality of life

While having a client perform the external and internal rotation test, you observe that he can rotate the forearms internally about 50 degrees toward the mat and externally to about 90 degrees so that the arms touch the mat. Based on the observations, which of the following notes would you make? A. Good mobility for both internal and external rotators B. Tight internal rotators; good mobility for external rotators C. Tight external rotators; good mobility for internal rotators D. Tightness in both internal and external rotators

C. Tight external rotators; good mobility for internal rotators

CAD Risk Factor Thresholds (for us with ACSM Risk Stratification)

CAD POSITIVE Risk Factors: 1. Age - Men 45+ yrs old and women 55+ yrs old. 2. Family history - Myocardial infarction, coronary revascularization, or sudden death before 55 yrs old in father or other first-degree male relative, or before 65 yrs old in mother or other first-degree female relative. 3. Cigarette smoking - Current smoker or those who quit within the previous six months, or exposure to environmental tobacco smoke (i.e. secondhand smoke) 4. Sedentary lifestyle - Not participating in at least 30 minutes of moderate-intensity physical activity on at least 3 days/week for at least 3 months. 5. Obesity - BMI that is 30+ or waist girth more than 40 inches for men and 35 inches for women. 6. Hypertension - Systolic blood pressure of 140+ mmHg and/or diastolic blood pressure of 90+ mmHg, confirmed by measurements on at least 2 separate occasions, or currently on antihypertensive medications. 7. Dyslipidemia - Low-density lipoprotein (LDL) cholesterol of 130+ mg/dL or a high-density lipoprotein (HDL) cholesterol of 40 or less, or on lipid-lowering medication. 8. Prediabetes - Fasting plasma glucose between 100 and 125 mg/dL CAD NEGATIVE Risk Factors: 1. HDL Cholesterol of 60+ Risk Classification: Low risk: less than 2 risk factors. No medical exam, exercise test, or doctor supervision required. Moderate risk: 2+ risk factors. Medical exam only required for vigorous exercise, no exercise test or doctor supervision required. High risk: Symptomatic or known cardiovascular, pulmonary, renal, or metabolic disease. Medical exam, exercise test, and doctor supervision required.

Rheumatoid arthritis

Causes joint inflammation and pain. It happens when the immune system doesn't work properly and attacks the lining of the joints. The disease commonly affects the hands, knees or ankles, and usually the same joint on both sides of the body.

What does COM stand for?

Center of Mass

What does COPD stand for?

Chronic Obstructive Pulmonary Disease

Bone fractures

Classified as either low or high impact. Low-impact trauma, such as a short fall on a level surface or repeated microtrauma to a bone region, can result in a minor or a stress fracture. High impact trauma often occurs in motor vehicle accidents or during high-impact sports such as football.

EBP (evidence based practice)

Client, personal trainer / expertise, and research findings

Ligament

Connects bone to bone

Tendon

Connects muscle to bone

Coronary Artery Disease

Coronary artery disease develops when the major blood vessels that supply your heart become damaged or diseased. Cholesterol-containing deposits (plaques) in your coronary arteries and inflammation are usually to blame for coronary artery disease. The coronary arteries supply blood, oxygen and nutrients to your heart.

Coronary artery disease (CAD)

Coronary artery disease is a result of atherosclerosis, a disease that narrows large arteries and limits blood supply to vital organs. Coronary artery disease may reduce blood supply to the heart muscle and can lead to chest pain, heart attack, and possibly sudden death.

Correctible and non-correctible factors of muscle imbalances and postural deviations

Correctible: 1. Repetitive movements (muscular pattern overload) 2. Awkward positions and movements (habitually poor posture) 3. Side dominance 4. Lack of joint stability 5. Lack of joint mobility 6. Imbalanced strength-training programs Non-correctible: 1. Congenital conditions (e.g. scoliosis) 2. Some pathologies (e.g. rheumatoid arthritis) 3. Structural deviations (e.g. tibial or femoral torsion, or femoral anteversion) 4. Certain types of trauma (e.g. surgery, injury, or amputation)

A periodized training plan that incorporates workouts below the first ventilatory threshold (VT1), between VT1 and the second ventilatory threshold (VT2), and above VT2, would be MOST appropriate for which of the following clients? A. A woman training to hike Mount Whitney B. A man playing in a local recreation basketball league C. A man training for a 50-mile charity bike ride D. A woman training to qualify for the Boston Marathon

D. A woman training to qualify for the Boston Marathon

Which of the following is within the ACE Certified Personal Trainer Scope of Practice? A. Evaluating a client's nutrition intake to guide meal planning B. Recommending nutritional supplements only after conducting extensive research on their effectiveness and safety C. Creating therapeutic exercise programs to help clients with low-back pain to improve core stability D. Designing exercise programs that lead to increased energy expenditure and positive changes in body composition

D. Designing exercise programs that lead to increased energy expenditure and positive changes in body composition

Which response would warrant immediate termination of exercise testing? A. Ratings of perceived exertion >14 (6 to 20 scale) B. Heart rate >age-predicted maximum C. Systolic BP >220 mmHg D. Diastolic BP >115 mmHg

D. Diastolic BP >115 mmHg Test must be terminated if SBP reaches >250 mmHg or diastolic BP reaches >115, or if SBP drops more than 10 mmHg

An ACE trainer begins working with a new client who has obesity and is apprehensive about beginning an exercise program. Which of the following approaches would be MOST effective in helping the client achieve early success in this first session? A. Administer the Rockport Fitness Walking Test to determine the client's cardiovascular fitness B. Assess the client's body composition using skinfold measurements to record the client's baseline body-fat percentage C. Conduct the push-up and body-weight squat tests to determine upper- and lower-body strength to inform exercise program design D. Have the client perform exercises that provide the trainer with basic feedback about the client's current movement abilities and fitness

D. Have the client perform exercises that provide the trainer with basic feedback about the client's current movement abilities and fitness

Which of the following cardiorespiratory fitness tests uses the immediate post-recovery heart rate to assess a client's fitness level? A. First ventilatory threshold test B. Rockport fitness walking test C. YMCA bike test D. YMCA submaximal step test

D. YMCA submaximal step test

During the Thomas Test, you observe that your client can lower her right thigh to about 10 degrees above the table with the knee flexed at about 90 degrees. Based on these observations, which of the following notes would you make? A. Right leg has normal ROM B. Tightness in the right rectus femoris C. Limited ROM in lumbar spine D. Tightness in the right iliopsoas

D. Tightness in the right iliopsoas

What is the primary purpose of the ACE Personal Trainer Certification program? A. To enhance the earning potential of personal trainers B. To enhance the value of personal trainers C. To protect personal trainers from lawsuits D. To protect the public from harm

D. To protect the public from harm

Delayed Onset Muscle Soreness

DOMS Describes muscle pain and soreness that typically occurs within 24 to 48 hours following strenuous exercise. It can result in restricted range of motion, tenderness and muscle weakness for a short period.

Sway back

Decreased anterior lumbar curve and increased posterior thoracic curve from neutral

What is Cardiorespiratory fitness (CRF)?

Defined by how well the body can perform dynamic activity using large muscle groups at a moderate to high intensity for extended periods of time. CRF depends on the efficiency and interrelationship of the cardiovascular, respiratory, and skeletal muscle systems.

Dyspnea

Difficult or labored breathing.

How to calculate Waist-to-Hip Ratio

Divide waist measurement by hip measurement

Sarcoplasmic hypertrophy

Does not result in greater muscle contraction force. Related to transient hypertrophy.

Skinfold Measurement Protocol

Equipment: -Skinfold caliper -Marking pencil (optional)\ Pre-Test Procedure: -To ensure testing accuracy, the client should be optimally hydrated and always be measured prior to exercise. Test administration: 1. All measurements are taken on the right side of the body while the client is standing 2. Skinfold locations should be properly identified using anatomical landmarks and measurements. Use of a marking pencil will help ensure precise landmarks and consistency. 3. Hold the calipers in the right hand, grasping the skinfold site with left hand. 4. The thumb and index finger of the left hand are opened to about 8 cm and positioned 1 cm above the measurement site. Grasp or pinch the skinfold site, making a fold line that corresponds to the site instructions. 5. To accurately assess subcutaneous fat, the skin and underlying fat are simultaneously pulled firmly away from the underlying muscle tissue. 6. The pinch is maintained while the calipers are positioned perpendicular to the site and on the site location, midway between the top and the base of the fold. 7. Slowly release the caliper trigger, reading the dial to the nearest 0.5 mm approximately two or three seconds after release. 8. After taking the skinfold reading, gently squeeze the trigger to remove the caliper before releasing the skinfold pinch. 9. Moving onto the next site, repeat the above steps. Each site should be measured a minimum of two times to ensure consistency between measurements. If subsequent readings produce a difference greater than 2 mm, a third measurement is necessary and the average of the two acceptable scores should be taken. It is recommended that the trainer wait 20 to 30 seconds between measurements to allow skin and fat to redistribute. -Body composition can be determined by adding the three skinfold measurements and plugging the values into the conversion tables.

Procedure for taking blood pressure

Equipment: 1. Sphygmomanometer (BP monitor and cuff) 2. Stethoscope 3. Chair Steps: 1. Have the client sit with both feet flat on the floor for two full minutes 2. Cuff placement: -While the right arm is considered standard, many individuals favor placing the cuff on the left arm due to the increased proximity to the heart, which amplifies the heart sound. -Smoothly and firmly wrap the BP cuff around the arm with its lower margin about 1 inch above the antecubital space (the front of the elbow). -ensure that correct size cuff is being used 3. Turn the bulb knob to close the cuff valve (turning it all the way to the right, no more than finger tight) and rapidly inflate the cuff to 160 mmHg, or 20 to 30 mmHg above the point where the pulse can no longer be felt at the wrist. 4. Place the stethoscope over the brachial artery using minimal pressure (do not distort the artery). -Stethoscope should lie flat against the skin and should not touch the cuff or the tubing -Client's arm should be relaxed and straight at the elbow 5. Release the pressure by slowly turning the knob to the left at a rate of about 2 mmHg per second, listening for the korotkoff sounds. -Systolic BP is determined by reading the dial at the first perception of sound (a faint tapping sound) -Diastolic BP is determined by reading the dial when the sounds cease to be heard of when they become muffled. 6. If a BP reading needs to be repeated on the same arm, allow at least 60 seconds between trials so that normal circulation can return to the area. 7. Share measurements with the client as well as the classification of values.

Cardiorespiratory tests

Ergometer Tests - YMCA Bike Purpose: To measure HR response to incremental (and predetermined) three-minute workloads that progressively elicit higher heart rate responses. The heart rate responses are then plotted on a graph against workloads performed. As exercise HR correlates to a VO2 score, the HR response line is extended to determine maximal effort and estimate the individual's VO2 max. Pre-Test Procedures: 1. Estimate the submaximal target exercise HR as 85% of the predetermined MHR using the Tanaka, Monahan, and Seals formula or the Gellish et al. formula. 2. Measure and record client's weight in pounds and convert that value to kg by dividing the weight by 2.2. 3. Measure and record seated, resting BP. 4. Discuss RPE 5. Adjust seat height and record the seat position for future tests to ensure consistency between tests 6. If a cadence meter is available on the bike, instruct the client to ride at 50 rpm. 7. Allow for a two- to- three minute warmup period at a low intensity (3/10 effort). Protocol: 1. Each stage is three minutes long. The first workload is set at 150 kgm/min (25 watts) 2. Continually coach the client to maintain the 50 rpm cadence. Measure and record HR and RPE at the end of each minute; measure and record BP at the start of the third minute. Before progressing to the next stage, the HR at the end of the third minute must be within 5 bpm of the HR at the end of second minute to indicate attainment of HRss. If the subject has failed to achieve HRss between those two timeframes, have him or her perform another minute at the same workload. During the last 15 seconds of stage 1, measure the client's HR. This HR will determine which workload follows in stage two. 3. Continue to record HR, RPE, and BP for each stage. 4. The tension settings may loosen during the test. It is important for the tester to pay attention to both the settings and the cadence throughout the test to ensure consistent workloads. Additionally, discourage the client from talking during the test, as the effort to talk raises the heart rate. First stage: 150 kgm/min Second stage:

Android obesity

Excess weight around the abdomen. "Apple shaped"

Gynoid obesity

Excess weight around the hips and thighs. "Pear-shaped"

Pallor

Extreme or unnatural paleness

Muscle imbalances associated with sway-back posture

Facilitated / Hypertonic (Shortened) 1. Hamstrings 2. Upper fibers of posterior obliques 3. Lumbar extensors 4. Neck extensors Inhibited (Lengthened) 1. Iliacus / psoas major 2. Rectus femoris 3. External oblique 4. Upper-back extensors 5. Neck flexors

Muscle imbalances associated with kyphosis-lordosis posture

Facilitated / Hypertonic (Shortened) 1. Hip flexors 2. Lumbar extensors 3. Anterior chest / shoulders 4. Latissimus dorsi 5. Neck extensors Inhibited (Lengthened) 1. Hip extensors 2. External obliques 3. upper-back extensors 4. Scapular stabilizers 5. Neck flexors

Muscle imbalances associated with flat-back posture

Facilitated / Hypertonic (Shortened) 1. Rectus abdominis 2. Upper-back extensors 3. Neck extensors 4. Ankle plantar flexors Inhibited (Lengthened) 1. Iliacus / psoas major 2. Internal oblique 3. Lumbar extensors 4. Neck flexors

Syncope

Fainting or sudden loss of consciousness caused by lack of blood supply to the cerebrum

Type II muscle fibers

Fast twitch, meaning they fire more quickly. They are also more powerful than type I fibers and are recruited for activities that require more intensity: sprinting, lifting heavy weights. These fibers provide major strength, but they also fatigue more easily than type I fibers.

Criteria for waist circumference in adults

Females: Very low risk - <27.3 in Low - 27.3-34.7 in High - 35.1-42.5 in Very high - >42.9 Males: Very low risk - <31.2 in Low - 31.2-38.6 in High - 39.0-46.8 in Very high - >46.8 in

Goal of load training (phase 3 of IFT)

Focus is on strength training to improve muscle motor unit recruitment

Goal of power training (phase 4 of IFT)

Focus is to increase rate coding, or the speed at which the motor units stimulate the muscles to contract and produce force.

Part-to-Whole Teaching Strategy For Single Leg Movements

Follow this sequence: 1. Half-kneeling lunge rise (start in half-kneeling position rather than on feet) - teaches the proper mechanics of the rising portion of the lunge. 2. Lunges (regular) - teaches the proper mechanics of the full lunge 3. Lunge matrix - promotes stability and mobility throughout the kinetic chain using variations of the standard lunge movement

Jackson and Pollock Three-Site Skinfold Locations

For Men: 1. Chest - a diagonal skinfold taken midway between the crease of underarm and the nipple 2. Thigh - A vertical skinfold taken on the anterior midline of the thigh between the inguinal crease at the hip and the proximal border of the patella 3. Abdominal - A vertical skinfold taken 2 cm to the right of the umbilicus For Women: 1. Triceps - A vertical fold on the posterior midline of the upper arm taken halfway between the shoulder and elbow processes 2. Thigh - A vertical skinfold taken on the anterior midline of the thigh between the inguinal crease at the hip and the proximal border of the patella 3. Suprailium - A diagonal fold following the natural line of the iliac crest taken immediately superior to the crest of the ilium and in line with the anterior axillary line

How to calculate BMI

Formula: kg/m^2 1. Convert weight from pounds to kilograms by dividing by 2.2 2. Convert height from inches to centimeters by multiplying by 2.54, and then to meters by dividing by 100 3. Plug in and calculate

Resistance Exercise FITT-VP Guidelines and Recommendations

Frequency - Each major muscle group should be trained 2-3 days/week. Intensity - -60-70% 1-RM (vigorous-to-very vigorous intensity) for experienced strength trainers to improve strength. -More than or equal to 80% 1-RM (vigorous-to-very vigorous intensity) for experienced strength trainers to improve strength. -40-50% 1-RM (very light-to-light intensity) for older individuals beginning exercise to improve strength. -40-50% 1 RM (very light-to-light intensity) may be beneficial for improving strength in sedentary individuals beginning a resistance-training program. -Less than or equal to 50% 1-RM (light-to-moderate intensity) to improve muscular endurance. -20-50% 1-RM in older adults to improve power. Time - No specific duration of training has been identified for effectiveness. Type - -Resistance exercises involving each major muscle group are recommended. -Multijoint exercises affecting more than one muscle group and targeting agonist and antagonist muscle groups are recommended for all adults. -Single-joint exercises targeting major muscle groups may also be included in a resistance-training program, typically after performing multijoint exercise(s) for that particular muscle group. -A variety of exercise equipment and/or body weight can be used to perform these exercises. Repetitions - -8-12 reps are recommended to improve strength and power in most adults. -10-15 reps are effective in improving strength in middle-aged and older individuals starting exercise. -15-20 reps are recommended to improve muscular endurance. Sets - -2-4 sets are recommended for most adults to improve strength and power. -A single set of resistance exercise can be effective, especially among older and novice exercisers. -Less than or equal to 2 sets are effective in improving muscular endurance. Pattern - -Rest intervals of 2-3 minutes between each set of reps are effective. -A rest of more than or equal to 48 hours between sessions for any single muscle group is recommended. Progression - -A gradual progression of greater resistance, and/or more reps per set, and/or increasing frequency is recommended.

Aerobic (Cardiovascular Endurance) Exercise FITT-VP Guidelines and Recommendations

Frequency - More or equal to 5 days/week of moderate exercise, or more than 3 days/week of vigorous exercise, or a combination of moderate and vigorous exercise on more or equal to 3-5 days/week. Intensity - Moderate and/or vigorous intensity is recommended for most adults. Light-moderate intensity exercise may be beneficial in deconditioned individuals. Time - 30/60 minutes/day of purposeful moderate exercise, or 20-60 minutes /day of vigorous exercise, or a combination of moderate and vigorous exercise per day can be beneficial, especially in previously sedentary individuals. Type - Regular, purposeful exercise that involves major muscle groups and is continuous and rhythmic in nature is recommended. Volume - A target volume of more than or equal to 500 - 1,000 MET-minutes/week is recommended. Increasing pedometer step counts by more than or equal to 2,000 steps/day to reach a daily step count of more than or equal to 7,000 steps/day is beneficial. Exercising below these volumes may still be beneficial for individuals unable or unwilling to reach this amount of exercise. Pattern - Exercise may be performed in one (continuous) session per day or in multiple sessions of more than or equal to 10 minutes to accumulate the desired duration and volume of exercise per day. Exercise bouts of less than 10 minutes may yield favorable adaptations in very deconditioned individuals. Progression - A gradual progression of exercise volume by adjusting exercise duration, frequency, and/or intensity is reasonable until the desired exercise goals (maintenance) is attained. This approach may enhance adherence and reduce risks of musculoskeletal injury and adverse cardiac events.

FITT-VP

Frequency, intensity, time, type, volume, pattern, progression.

Role clarity

From the beginning of the relationship with each client, a PT should clarify their role, as well as the client, as part of a written agreement. What are the responsibilities / expectations of both ends of the party?

Process Goal

Goal relating to what you do rather than the product resulting from what you do

Cardiac Arrest Survival Act

Grants Good Samaritan protection for anyone in the U.S. who acquired an AED or who uses an AED in a medical emergency, except in cases of misconduct / recklessness.

Hatha Yoga

Hatha yoga is a generic term that refers to any type of yoga that teaches physical postures. Nearly every type of yoga class taught in the West is Hatha yoga. When a class is marketed as Hatha, it generally means that you will get a gentle introduction to the most basic yoga postures. Improves arthritis, asthma, low-back pain, and postural problems.

Talk Test

If a client can perform a cardiorespiratory exercise (e.g. walking) and talk comfortably in sentences that are more than a few words in length, he or she is likely below the first ventilatory threshold (VT1). By exercising below or up to the talk-test threshold, clients should be exercising at a moderate intensity classified by ratings of perceived exertion (RPE) of 3 to 4 (0-10 scale).

Dislipidemia

If you have dyslipidemia, it usually means your LDL levels or your triglycerides are too high. It can also mean your HDL levels are too low.

Lumbar dominance during a squat

Implies a lack of core abdominal and gluteal muscle strength to counteract the force of the hip flexors and erector spinae as they pull the pelvis forward during a squat movement. The muscles of the abdominal wall and gluteal complex do not contribute enough in this situation to spare the back and foster proper execution of the squat. Chronically tight hip flexors, such as those experienced by individuals who sit for prolonged periods throughout the day, may also contribute to the problem.

Glute dominance during a squat

Implies reliance on eccentrically loading the gluteus maximus during a squat movement. The first 10 to 15 degrees of the downward phase are initiated by pushing the hips backward, creating a hip-hinge. In the lowered position, this maximizes the eccentric loading on the gluteus maximus to generate significant force during the upward, concentric phase. The glute-dominant squat pattern is the preferred method of squatting, as it spares the lumbar spine and relieves undue stress on the knees. Glute dominance also helps activate the hamstrings, which pull on the posterior surface of the tibia and help unload the ACL to protect it from potential injury.

Quadriceps dominance during a squat

Implies reliance on loading the quadriceps group during a squat movement. The first 10 to 15 degrees of the downward phase are initiated by driving the tibia forward, creating shearing forces across the knee as the femur slides over the tibia. In this lowered position, the gluteus maximus does not eccentrically load and cannot generate much force during the upward phase.

The right-angle rule of the body

Model that demonstrates how the human body represents itself in vertical alignment across the major joints -- the ankle, knee, hip, and shoulder, as well as the head.

Lordosis

Increased anterior lumbar curve form neutral

Kyphosis

Increased posterior thoracic curve from neutral

Lower levels of activity are seen with...

Increasing age, fewer years of education, and low income.

Line of gravity

Intersection of the mid-frontal and mid-sagittal planes and is represented by a plumb line hanging from a fixed point overhead.

Primary exercises

Involve multiple muscles from one or more of the larger muscle areas (e.g. chest or thigh) that span 2 or more joints (multijoint exercises) and are generally performed in a linear fashion.

Assisted exercises

Involve smaller muscle groups from more isolated areas that span one joint (e.g. single joint)

Extrinsic motivation

Involves the engagement in exercise for any benefit other than for the joy of participation (wanting to be healthy, lose weight, make spouse happy, etc.)

Cardiac arrhythmia

Irregular heartbeat

What is Lean Body Mass (LBM) and what is it composed of?

LBM is metabolically active tissue that allows the body to perform work. 1. Connective tissue 2. Bones 3. Blood 4. Nervous tissue 5. Skin 6. Organs

Ataxia

Lack of muscle coordination

Scoliosis

Lateral spinal curvature often accompanied by vertebral rotation

Normal ROM for Healthy Adults

Lower-Extremity Movements / Active ROM: 1. Dorsiflexion: 20 degrees 2. Plantar flexion: 50 degrees 3. Flexion-hyperextension: 10 degrees 4. Flexion of leg: 135 degrees 5. Hip hyperextension: Less than 20 degrees 6. Hip abduction: 50 degrees 7. Internal rotation of leg at the hip: 35 degrees 8. External rotation of leg at the hip: 50 degrees 9. Hip flexion without pelvic rotation: 120 degrees Shoulder Joint ROM: 1. External shoulder rotation in transverse plane: 90 degrees 2. Internal shoulder rotation in transverse plane: 90 degrees 3. External shoulder rotation in sagittal plane: 90-100 degrees 4. Internal shoulder rotation in sagittal plane: 70-80 degrees 5. Horizontal adduction in transverse plane: 130 degrees 6. Horizontal extension in transverse plane: 45 degrees past neutral 7. Abduction in frontal plane: 180 degrees 8. Hyper-adduction in frontal plane: 75 degrees

Waist-To-Hip Ratio (WHR) Norms

Male: Excellent: <0.85 Good: 0.85-0.89 Average: 0.90-0.95 At Risk: >0.95 Female: Excellent: <0.75 Good: 0.75-0.79 Average: 0.80-0.86 At Risk: >0.86

Relative strength

Maximal force a person is able to exert in relation to his or her body weight.

Minute ventilation

Measured as the volume of air breathed per minute.

Y Balance Test

Measures dynamic balance in right anterior leg, left anterior leg, right leg postermedial, left leg postermedial, right leg posterolateral, and left leg poserolateral.

What is the essential body fat percentage range for men and women?

Men: 2-5% Women- 10-13%

Palpated sites

Most Common Sites: 1. Radial artery - the ventral aspect of the wrist on the side of the thumb, and less commonly, the ulnar artery on the pinky side, which is deeper and harder to palpate. 2. Carotid artery - Located in the neck, lateral to the trachea. More easily palpated when the neck is slightly extended. When using the carotid artery for pulse detection, instruct the client not to push too hard, as this may evoke a vagal response and actually slow down the heart rate. Other Sites: Brachial artery, femoral artery, posterior tibial artery, popliteal artery, and abdominal aorta.

OARS Skills

O - Ask open ended questions A - Affirmation R - Reflective listening S - Summarizing -this aligns with the ABC Method. ABC Method is the "umbrella term"

McGill's Torso Muscular Endurance Test Battery: Trunk Flexor Endurance Test

Objective: Assess muscular endurance of the deep core muscles. Equipment: 1. Stopwatch 2. Board (or step) 3. Strap (optional) Pre-Test Procedure: 1. After explaining the purpose of the flexor endurance test, describe the proper body position. -Starting position requires the client to be seated, with the hips and knees bent to 90 degrees, aligning the hips, knees, and second toe. -Instruct the client to fold his or her arms across the chest, touching each hand to the opposite shoulder, lean against a board positioned at a 60-degree incline, and keep the head in a neutral position. -Important to ask the client to press the shoulders into the board and maintain this "open" position throughout the test after the board is removed. -Instruct client to engage the abdominals to maintain a flat-to-neutral spine. The back should never be allowed to arch during the test. -The trainer can anchor the toes under a strap or manually stabilize the feet if necessary. 2. Goal of test is to hold this 60-degree position for as long as possible without the benefit of the back support. 3. Encourage the client to practice this position prior to attempting the test. Test Procedure: 1. The trainer starts the stopwatch as he or she moves the board about 4 inches back, while the client maintains the 60-degree, suspended position 2. Terminate the test when there is a noticeable change in the trunk position (deviation from neutral spine, increase in low back arch, back touching the back rest).

McGill's Torso Muscular Endurance Test Battery: Trunk Lateral Endurance Test

Objective: Assesses muscular endurance of the lateral core muscles. Similar to the trunk flexor endurance test, this timed test involves static, isometric contractions of the lateral muscles on each side of the trunk that stabilize the spine. Equipment: 1. Stopwatch 2. Mat (optional) Pre-Test Procedure: 1. After explaining the purpose of this test, describe the proper body position. -The starting position requires the client to be on his or her side with extended legs, aligning the feet on top of each other or in a tandem position (heel-to-toe). -Have the client place the lower arm under the body and the upper arm on the side of the body. -When the client is ready, instruct him or her to assume a full side-bridge position, keeping both legs extended and the sides of the feet on the floor. The elbow of the lower arm should be positioned directly under the shoulder with the forearm facing out and the upper arm should be resting along the side of the body or across the chest to the opposite shoulder. -The hips should be elevated off the mat and the body should be in straight alignment. The torso should only be supported by the client's foot / feet and the elbow / forearm of the lower arm. 2. Goal of the test is to hold this position for as long as possible. Once the client breaks the position, the test is terminated.

McGill's Torso Muscular Endurance Test Battery: Trunk Extensor Test

Objective: Assesses muscular endurance of the torso extensor muscles. Equipment: 1. Elevated, sturdy exam table 2. Nylon strap 3. Stopwatch Pre-Test Procedure: 1. After explaining the purpose of the test, explain the proper body position. -The starting position requires the client to be prone, positioning the iliac crests at the table edge while supporting the upper extremity on the arms, which are placed on the floor or on a riser. -While the client is supporting the weight of his or her upper body, anchor the client's lower legs to the table using a strap or trainer's body weight. 2. Goal is to hold a horizontal, prone position for as long as possible. Once the client falls below horizontal, the test is terminated. Test Procedure: 1. The client lifts / extends the torso until it is parallel to the floor with his or her arms crossed over the chest. 2. Start the stopwatch as soon as the client assumes this position. 3. Terminate the test when the client can no longer maintain the position. 4. Record the client's time on the testing form.

Shoulder Mobility Testing: Internal and External Rotation of the Humerus at the Shoulder

Objective: To assess internal (medial) and external (lateral) rotation of the humerus at the shoulder joint. This test should be performed in conjunction with Apley's scratch test to determine if the limitation occurs with internal or external rotation of the humerus. Equipment: Mat Instructions: 1. Explain purpose of the test 2. Instruct the client to lie supine, with his or her back flat on a mat in a bent-knee position (knees and second toe aligned with the ASIS). 3. Ask the client to abduct the arms to 90 degrees, with a 90-degree bend at the elbows and the forearms perpendicular to the mat (pointing up toward the ceiling). -Upper arms MUST remain aligned with the shoulders throughout the test. -The backs of the upper arms should rest against the mat throughout the test. 4. External (lateral) rotation to evaluate lateral rotators -Ask client to slowly rotate his or her forearms backward toward the mat, aiming to rest the forearms and the backs of the hands on the mat adjacent to the head, while maintaining the 90-degree bend at the elbows. -Client should engage the abdominals to avoid arching low back, and avoid flexing the spine forward. -Client should maintain a neutral wrist position throughout the movement. 5. Internal (medial) rotation to evaluate lateral rotators -Have client return to the starting position -Ask client to slowly rotate the forearms forward toward the mat, turning the palms downward while maintaining the 90-degree bend at the elbows. -Client should avoid raising the shoulders off the table or flexing the spine forward. -Client must maintain a neutral wrist position throughout the movement.

Shoulder Mobility Testing: Apley's Scratch Test for Shoulder Mobility

Objective: To assess simultaneous movements of the shoulder girdle Movements include: 1. Shoulder extension and flexion 2. Internal and external rotation of the humerus at the shoulder 3. Scapular abduction and adduction Instructions: 1. Explain the purpose of the test and allow a warm-up 2. Shoulder flexion, external rotation, and scapular abduction: -From a sitting or standing position, the client raises one arm overhead, bending the elbow and rotating the arm outward while reaching behind the head with the palm facing inward to touch the medial border of the contralateral scapula or to reach down the spine (touching vertebrae) as far as possible. -client should avoid any excessive arching in the low back or rotation of the torso during the movement -Have the client repeat the test with the opposite arm 3. Shoulder extension, internal rotation, and scapular adduction -From a sitting or standing position, the client reaches one arm behind the back, bending the elbow and rotating the arm inward with the palm facing outward to touch the inferior angle of the contralateral scapula or to reach up the spine (touching vertebrae) as far as possible. -client should avoid any excessive arching in low back or rotation of the torso during the movement -have client repeat the test with the opposite arm

Balance Assessment: Stork-Stand Balance Test

Objective: To assess static balance by standing on one foot in a modified stork-stand position. Equipment: 1. Flat, non-slip surface 2. Stopwatch Instructions: 1. Explain purpose 2. Ask the client to remove his or her shoes and stand with feet together, hands on the hips. 3. Instruct the client to raise one foot off the ground and bring that foot to lightly touch the inside of the stance leg, just below the knee. -Client must raise the heel of the stance foot off the floor and balance on the ball of the foot -Stand behind the client for support if needed -Allow 1 minute of practice trials -After the practice trial, perform the test, starting the stopwatch as the heel lifts off the floor. -This test is performed with the eyes open. 4. Repeat with opposite leg 5. Allow up to three trials per leg position and record the best performance on each side.

Balance Assessment: Sharpened Romberg Test

Objective: To assess static balance by standing with a reduced base of support while removing visual sensory information. Equipment: -Flat, non-slip surface -Stopwatch Instructions: 1. Explain purpose of test 2. Instruct the client to remove his or her shoes and stand with one foot directly in front of the other (heel-to-toe position), with eyes open. 3. Ask client to fold his or her arms across the chest, touching each hand to the opposite shoulder. 4. Allow sufficient practice trials. Once the client feels stable, instruct the client to close his or her eyes. Start the stopwatch to begin the test. 5. Always stand in close proximity as a precaution to prevent falling. 6. Continue the test for 60 seconds or until the client exhibits any test-terminator cue. 7. Allow up to two trials per leg position and record the best performance on each side. Client needs to maintain his or her balance with good postural control (without any excessive swaying) and not exhibit any of the test-termination criteria for 30 or more seconds.

Shoulder Mobility Testing: Shoulder Flexion and Extension Test

Objective: To assess the degree of shoulder flexion and extension. This test should be performed in conjunction with Apley's scratch test to determine if the limitation occurs with shoulder flexion or extension. Equipment: -Exercise mat -Pillow (optional) Instructions: 1. Explain purpose of test 2. For shoulder flexion, do the following: -Instruct client to lie supine on a mat, with the back flat and a bent-knee position (knees and second toe aligned with the ASIS), and with the arms at the sides. -Have the client engage the abdominal muscles to hold a neutral spine without raising the hips from the mat. -Instruct the client to raise both arms simultaneously into shoulder flexion, moving them overhead, keeping them close to the sides of the head, and bringing them down to touch the floor or as close to the floor as possible. -client must maintain extended elbows and neutral wrist position (the arms will naturally rotate internally during this movement). -Have the client avoid any arching in the low back during the movement. -Have the client avoid any depression of the rib cage, which may pull the shoulders off the mat. 3. For shoulder extension, do the following: -Instruct client to lie prone, extending both legs, with arms at the sides, and resting the forehead gently on a pillow or the mat. -Ask client to slowly raise both arms simultaneously into extension, lifting them off the mat while keeping the arms close to the sides (arms will naturally rotate internally during this movement). -A small amount of extension in the thoracic spine is acceptable during the movement. -The client should avoid any attempts to lift the chest or head off the mat during the movement.

Flexibility and Muscle-Length Testing: Passive Straight-Leg (PSL) Raise

Objective: To assess the length of the hamstrings Equipment: -Stable table or exercise mat Instructions: 1. Explain the objective of the test and allow a warm-up. 2. Instruct the client to lie supine on a mat or table with the legs extended and the low back and sacrum flat against the surface. 3. Place one hand under the calf of the leg that will be raised while instructing the client to keep the opposite leg extended on the mat or table. Restrain that leg from moving or rising during the test. 4. Slide the other hand under the lumbar spine into the space between the client's back and the mat / table. 5. Advise the client to gently plantar flex his or her ankles to point the toes away from the body. This position avoids a test limitation due to a tight gastrocnemius muscle (which would limit knee extension with the ankle in dorsiflexion). Additionally, a straight-leg raise with dorsiflexion may increase tension within the sciatic nerve and create some discomfort. 6. Slowly raise one leg, asking the client to keep that knee loosely extended throughout the movement. 7. Continue to raise the leg until firm pressure can be felt from the low back pressing down against the hand 8. This indicates an end-range of motion of the hamstrings with movement now occurring as the pelvis rotates posteriorly. 9. Throughout the movement, the client needs to maintain extension in the opposite leg, and keep the sacrum and low back flat against the mat or table.

Flexibility and Muscle-Length Testing: Thomas Test for Hip Flexion / Quadriceps Length

Objective: To assess the length of the muscles involved in hip flexion. This test can actually assess the length of the primary hip flexors. Should not be conducted on clients with low back pain, unless cleared by their physician. Equipment: -Stable table Instructions: 1. Explain objective of the test and allow a warm-up. 2. Instruct the client to sit at the end of a table with the mid-thigh aligned with the table edge. Place one hand behind the client's back and the other under his or her thigh. 3. While supporting the client, instruct him or her to flex one thigh toward the chest and gradually assist as he or she rolls to the table top with back and shoulders flat. Instruct client to continue to pull one knee toward the chest only until the low back is flat.

Movement Screening: Thoracic Spine Mobility Screen

Objective: To examine bilateral mobility of the thoracic spine. Lumbar spine rotation is considered insignificant, as it only offers approximately 15 degrees of rotation. Equipment: -Chair -Squeezable ball or block -48-inch broomstick Instructions: 1. Discuss protocol with client 2. Instruct the client to sit upright toward the front edge of the seat with the feet together and firmly placed on the floor. The client's back should not touch the backrest. 3. Place a squeezable ball or block between the knees and a dowel across the front of the shoulders, instructing the client to hold the bar in the hands (front squat grip). 4. While maintaining an upright and straight posture, the client squeezes the block to immobilize the hips and gently rotates left and right to an end-range of motion without any bouncing. 5. Competent trunk rotation should reach 45 degrees in each direction.

Movement Screening: Shoulder Push Stabilization Screen

Objective: To examine stabilization of the scapulothoracic joint during closed-kinetic-chain pushing movements Instructions: 1. Discuss protocol with client 2. Instruct the client to lie prone on the floor with arms abducted in the push-up position 3. Ask client to perform several full push-ups to full arm extension with good control (modify to bent-knee push up position if necessary).

Movement Screening: Bend and Lift Screen

Objective: To examine symmetrical lower-extremity mobility and stability, and upper-extremity stability during a bend-and-lift movement Equipment: Two 2- to 4-foot broomsticks Instructions: 1. Briefly discuss the protocol so the client understands what is required. 2. Ask the client to stand with the feet shoulder-width apart with the arms hanging freely to the sides. 3. Place the two broomsticks on the floor adjacent to the outside of each foot. 4. Ask the client to perform a series of basic bend-and-lift movements (i.e. a squatting movement) to grasp the broomsticks and lift them off the floor, holding the lowered position for one to two seconds to allow the trainer to make some brief observations before returning to the starting position. The number of reps performed is determined by the number needed to make the necessary evaluations. -Ask client to pretend the broomsticks are 25 lb weights -Important to remember not to cue the client to use good technique, but instead observe his or her natural movement.

Movement Screening: Hurdle Step Screen

Objective: to examine simultaneous mobility of one limb and stability of the contralateral limb while maintaining both hip and torso stabilization during a balance challenge of standing on one leg. Equipment: -Two chair or table legs to anchor string -36-inch piece of string 48-inch wooden or plastic broomstick Instructions: 1. Briefly discuss protocol with client 2. Fasten a piece of string spanning two points at a height even with the underside of the foot positioned parallel with the floor, when it is raised to a height that flexes the hip to 70 degrees (approx. just above halfway up the tibia. 3. Have client stand with both feet together and the front edge of the toes aligned directly beneath the string. 4. Place the broomstick across the client's shoulders, holding it parallel to the floor (similar to the placement of the bar during the traditional barbell squat). 5. Instruct the client to load onto one leg and slowly lift the opposite leg over the string, flexing the hip to clear the string and then gently touching the heel of the raised leg to the floor in front of the string before returning to the starting position. 6. Have client repeat the movement with the opposite leg, completing a series of repetitions with each leg so that the trainer can make the necessary evaluations. 7. Allow sufficient practice trials to accommodate learning before administering the test screens.

What is osteoarthritis?

Occurs when the protective cartilage that cushions the ends of the bones wears down over time.

Ligament sprains

Often occur with trauma such as falling. Most common joints affected are ankles, knees, thumb / finger, and shoulder. Divided into Grade I, II, and III.

When does the blood lactate threshold occur?

Onset of VT1

How to convert VO2 Max when comparing 2 individuals

Oxygen uptake is dependent on the size of the individual being tested. 1. Convert L/minute to mL/minute by multiplying by 1,000 2. Convert body weight from pounds to kg by dividing by 2.2 3. Divide mL/kg

Formula for converting body density to percent fat

Percent fat = (495 / BD) - 450

chronic obstructive pulmonary disease (COPD)

Permanent, destructive pulmonary disorder that is a combination of chronic bronchitis and emphysema.

IFT Cardiorespiratory Training Model

Phase 1: Aerobic Base Training (Function) -focused on developing an initial aerobic base in clients who have been sedentary or near-sedentary, and to improve health and to serve as a foundation for training for cardiorespiratory fitness in phase 2. -exercises at this phase should be performed at a steady-state intensity in the low-to-moderate range. Clients should be able to pass the "talk test". -no assessments recommended in this phase Phase 2: Aerobic Efficiency Training (Health) -focuses on enhancing the client's aerobic efficiency by progressing the program through increased duration of sessions, increased frequency of sessions when possible, and the introduction of aerobic intervals. Aerobic intervals are introduced at a level that is at or just above VT1, or an RPE of "5". Phase 3: Anaerobic Endurance Training (Fitness) -focus is on designing training programs that help improve performance in endurance events or to train fitness enthusiasts for higher levels of cardiorespiratory fitness. This is accomplished through the introduction of higher-intensity intervals that load the cardiorespiratory system enough to develop anaerobic endurance, and balancing training time spent below VT1, between VT1 and VT2, and at or above VT2. Phase 4: Anaerobic Power Training -focus is to build on the training done in previous three phases, while also introducing new intervals that are designed to enhance anaerobic power. These new intervals are designed to develop peak power and aerobic power with intervals performed well above VT2, or an RPE of greater than or equal to 9, which will enhance the client's ability to perform high-intensity work for extended periods. -clients training in this phase will be training for competition and have specific goals that relate to short-duration, high-intensity efforts during longer endurance events, such as speeding up to stay with the pack in road cycling, or paddling vigorously for several minutes to navigate some difficult rapids while kayaking. -Difference between this phase and phase 3 is that intervals will be performed at a higher intensity, for a shorter duration, and with longer recovery intervals between work intervals.

IFT Functional Movement / Resistance Training Model

Phase 1: Stability & Mobility Training (Function) -focus is on introduction of low-intensity exercise programs to improve muscle balance, muscular endurance, core function, flexibility, and static / dynamic balance to improve client's posture. Overall, goal is to develop postural stability. -Assessments in this phase should focus on posture, balance, movement, and ROM of ankle, hip, shoulder complex, and thoracic and lumbar spine. Phase 2: Movement Training (Health) -focus is on training movement patterns through programming that is built upon progress from phase 1. -5 primary movements in this phase: bend-and-lift, single-leg, pushing, pulling, and rotational (spiral) movements. Phase 3: Load Training (Fitness) -Exercise program is advanced with the addition of an external force or increasing the external load, placing emphasis on muscle force production. (resistance training). -Many clients will never move out of this phase. -good exercise form should still be highly emphasized. Phase 4: Performance Training (Performance) -Emphasizes specific training to improve speed, agility, quickness, reactivity, and power. -Exercise selection could include plyometric jump training, medicine ball throws, kettlebell lifts, and traditional olympic-style lifting.

What phase(s) of the IFT Model can 1RM be performed?

Phase 3 or 4

What does PAR-Q stand for?

Physical Activity Readiness Questionnaire

Health Belief Model

Predicts that people will engage in a health behavior based on the perceived threat they feel regarding a health problem and pros and cons of adopting the behavior: 1. Perceived seriousness - the feelings one has about the seriousness of contracting an illness or leaving an illness untreated. 2. Perceived susceptibility - a person's subjective appraisal of the likelihood of developing the problem. 3. Cues to action - events, either bodily (i.e. physical symptoms) or environmental (i.e. health promotion info), that motivate people to make a change.

Antihypertensives

Primarily affect one of the four different sites: the heart (to reduce its force contraction; the peripheral blood vessels (to open or dilate them to allow more room for the blood), the brain (to reduce the sympathetic nerve outflow), or the kidneys (to reduce blood volume by excreting more fluid. Common types of antihypertensive medications: 1. Beta blockers - commonly prescribed for a variety of cardiovascular and other disorders. Block beta-adrenergic receptors and limit sympathetic nervous system stimulation and result in a reduction in resting, exercise, and maximal heart rates. 2. Calcium channel blockers - prevent calcium-dependent contraction of the smooth muscles in the arteries, causing them to dilate, which lowers blood pressure. 3. Angiotensin-converting Enzyme (ACE) Inhibitors - ACE inhibitors block an enzyme secreted by the kidneys, preventing the formation of a potent hormone that constricts blood vessels. If this enzyme is blocked, the vessels dilate, and blood pressure decreases. ACE inhibitors should not have an effect on heart rate, but will cause a decrease in blood pressure at rest and during exercise. 4. Angiotensin-II Receptor Antagonists - A newer class of antihypertensive agents. These drugs are selective for angiotensin II (type 1 receptor). Angiotensin-II receptor antagonists are well-tolerated and do not adversely affect blood lipid profiles or cause "rebound hypertension" after discontinuation. Clinical trials indicate that angiotensin-II receptor antagonists are effective and safe in the treatment of hypertension. 5. Diuretics - medications that increase the excretion of water and electrolytes through the kidneys. Usually prescribed for high blood pressure, or when a person is accumulating too much fluid.

Primary Assessment and Secondary Assessment in emergencies

Primary Assessment: 1. Check the ABCs (Airway, breathing, circulation, and severe bleeding) to recognize emergency as life-threatening or not. This includes checking to see if victim is responsive and able to speak by tapping on shoulder and asking if they are okay. If conscious, you should introduce yourself and gain consent for helping. If no reply, trainer should call EMS and imply that there is consent to help. If no sign of trauma to the spine, perform a head-tilt chin lift (technique for opening airway). If any sign of trauma to face, neck, or head, use the jaw thrust method to open airway instead. Put an ear close to the client's mouth to feel for breath and listen for air movement for 5-10 secs. If there is no air movement or it is irregular, the rescuer should give 2 breaths into mouth while pinching nose. Then, check for a pulse. Without a pulse, victim should be given immediate CPR, starting with chest compressions. Secondary Assessment: 1. Once a person is conscious and speaking, or unconscious with stable ABCs, a secondary assessment can be completed to address non-life-threatening issues. For a victim of trauma or someone who is unconscious, a head-to-toe assessment might be done to look for additional injuries, such as deformities, abrasions, tenderness, or swelling. Vital signs should be taken, such as pulse and blood pressure, and it is important to check skin color and temperature. Conscious victims may be asked about signs or symptoms, medications, med history, pain, and any events leading up to incident.

Bench Press Test

Procedure: 1. Have client warm up with one set of light resistance (~50% of anticipated 1RM weight) that allows 5-10 reps, then rest for one minute. 2. Based on client's warm up effort, determine a suitable starting workload for the second set that allows 3-5 reps (~70-75% of the anticipated 1RM weight), and then allow the client to rest for one minute. 3. To determine workload increases throughout test, increase by approximately 5 to 10% 4. Next, have client perform one heavy set of two to three reps at ~85-90% of the anticipated 1-RM weight and rest for 2 minutes. 5. Based on the client's third set, determine the next workload to find the client's 1RM effort. The 1RM chart can be used to make these calculations. 6. Allow client to attempt this set. If they are successful, they should rest for 2 to 4 mins and repeat 1RM effort with a heavier load. 7. If attempt was unsuccessful, decrease the load accordingly (by 2.5 to 5%) and have the client try again after resting for 2-4 mins 8. Continue the up or down increments until a true 1RM is achieved. (ideally within 3-5 sets)

1RM Leg-Press Test

Procedure: 1. Warm up with one set of light resistance (~50 of anticipated 1RM weight) 2. Based on client's warm-up effort, determine a suitable workload for the second set that allows for three to five reps (~70-75% of anticipated 1RM weight) and then allow client to rest for 1 min. For increasing workload throughout test, increase weight by 10 to 20%. 3. Have client perform one heavy set of two to three reps at ~85 to 90% of the anticipated 1RM weight and rest for two mins. 4. Based on the client's third set, determine the next workload to find the client's 1RM effort. (use table) 5. Allow client to attempt this set. If they are successful, they should rest for 2 to 4 mins and repeat 1RM effort with a heavier load. 7. If attempt was unsuccessful, decrease the load accordingly (by 2.5 to 5%) and have the client try again after resting for 2-4 mins. 8. Continue the up or down increments until a true 1RM is achieved. (ideally within 3-5 sets).

Scapular winging

Protrusion of the inferior angle and vertebral (medial) border outward

Scapular protraction

Protrusion of the vertebral (medial) border outward

Exercise-Induced Feeling Inventory (EFI)

Quantifies a client's emotions and feelings following an exercise session. Uses a 0-4 scale (e.g. 0 = do not feel, 1 = feel slightly, 2 = feel moderately, etc.) Should be administered during the initial interview, with the trainer asking the client to rate previous exercise experience. This will establish a baseline from which to compare future assessments. The EFI is then administered shortly after a client completed a workout to help trainers identify whether the recommended programming is a positive experience. Instructions: 1. Administer the survey verbally or give it to the client to self-complete. However, it is important to remember that clients are not always completely honest with self-administered surveys, so trainers should consider varying delivery format. 2. Administer the survey more frequently initially (e.g. every session for the first two weeks), then gradually diminish the frequency to avoid a desensitization effect. 3. The survey can also be re-administered each time a change is made in the client's program. 4. Instruct the client to score each of the 12 words using a 0-4 scale, checking the appropriate box that describes how he or she feels at this time. Scoring: -The survey consists of four distinct subscales, each defining a particular emotional state. -As people define adjectives differently, the idea of using three adjectives to define the same emotional state (a subscale) tends to minimize deviations in how people define words. -The four subscales are: 1. Positive engagement: Items 4, 7, and 12 2. Revitalization: Items 1, 6 and 9 3. Tranquility: Items 2, 5 and 10 4. Physical exhaustion: Items 3, 8, and 11 -Each adjective can earn a total of 4 points, creating a total for each subscale that ranges between 0 and 12. -Track subscale scores over a period of four to six weeks and plot the results on a graph. Overall goal is to use information to manipulate these variables to increase the likelihood of continuing with his or exercise program.

Sinus Bradycardia

RHR <60 bpm

Sinus Tachycardia

RHR greater than 100 bpm

Normal Sinus Rhythm

RHR of 60-100 bpm

How to calculate cardiorespiratory training load

RPE x Exercise duration

How to calculate RPE-Training Volume Model

RPE x Frequency x Duration

Herniated disc

Refers to a problem with one of the rubbery cushions (disks) that sit between the individual bones (vertebrae) that stack to make your spine.

Situational motivation

Refers to motivation as people are actually exercising

exercise adherence

Refers to voluntary and active involvement in an exercise program

How to calculate relative strength

Relative Strength = Absolute strength / Body Weight

Repetition-volume calculation versus load-volume calculation

Repetition-volume calculation: Volume = Sets x Reps Load-volume calculation: Volume = Exercises weightload x Reps x Sets (and then summing the total for each muscle group or entire session)

What is another term used for "Second Ventilatory Threshold' (VT2)?

Respiratory Compensation Threshold (RCT)

Myofibrils hypertrophy

Results in greater muscle contraction force and physical muscle mass.

What is the result of excessive sarcomere overlap within the myofibril of the muscle?

Results in less sarcomeres and overall reduces its force-generating capacity in normal-resting length and lengthened positions.

What is the result of inadequate sarcomere overlap within the myofibril of the muscle?

Results in more sarcomeres and overall reduces its force-generating capacity in normal-resting length and shortened positions.

Classification of Blood Pressure for Adults Age 18 and Older

Systolic: Normal - 120 or lower Prehypertensive - 120-139 Hypertension Stage 1 - 140-159 Hypertensions Stage 2 - 160+ Diastolic: Normal - 80 or lower Prehypertensive - 80-89 Hypertension Stage 1 - 90-99 Hypertension Stage 2 - 100+

Static Posture Assessment

Serves as a starting point from which a personal trainer can identify muscle imbalances and potential movement compensations associated with poor posture. Movement begins from a position of static posture. Therefore, the presence of poor posture is a good indicator that movement may be dysfunctional. Can offer valuable insight into: 1. Muscle imbalance at a joint and the working relationships of muscles around a joint (muscle imbalance often contributes to dysfunctional movement). 2. Altered neural action of the muscles moving and controlling the joint. For example: Tight or shortened muscles are often overactive and dominate movement at the joint, potentially disrupting healthy joint mechanics.

1RM Bench Press Testing Protocol

Set 1: 5-10 reps @ ~50% of 1RM (1 min rest) Set 2: 3-5 reps @ ~70% of 1RM (1 min rest) Set 3: 2-3 reps @ ~85%-90% of 1RM (2 min rest) Sets 4+ (3-5 trials): 1 rep @ 1RM (2-4 min rest)

SMART Goals

Specific - Goals must be clear and unambiguous, stating specifically what should be accomplished. Measurable - Goals must be measurable so that clients can see whether they are making progress. Attainable - Goals should be realistically attainable by the individual client. The achievement of attaining a goal reinforces commitment to the program and encourages the client to continue exercising. Attaining goals is also a testimony to the personal trainer's effectiveness. Relevant - Goals must be relevant to the particular interests, needs, and abilities of the individual client. Time-bound - Goals must contain estimated timelines for completion. Clients should be evaluated regularly to monitor progress toward goals.

SAID Principle in Cardiorespiratory Progression

Specific Adaptations to Imposed Demands

How to calculate goal weight through the use of body composition values

Step 1: 100% - Body fat percentage = Lean mass percentage Step 2: Body weight x Lean mass percentage = Lean mass Step 3: 100% - Desired body fat percentage = Desired lean mass percent Step 4: Lean body mass / Desired lean body mass percentage = Desired body weight

SOAP Note

Subjective; Objective; Assessment; Plan - many clinicians use this format to document a visit with a patient, progress note that focuses on a single patient problem and includes subjective and objective data, analysis, and planning; most often used in the POMR

How to give clients a sense of contextual motivation (overall outlook on exercise)

Teach the client, not control

Tell - Show - Do Method

Tell - Begin with a very short explanation of what he or she is going to do and why Show - Is often combined with the "tell" phase. Physically show the client how to do the given exercise Do - Client is ready to try the movement. Rather than distracting the client by talking to them, observe their practice and prepare to give helpful feedback once they complete it.

Tendinitis

Tendinitis is inflammation or irritation of a tendon — the thick fibrous cords that attach muscle to bone. The condition causes pain and tenderness just outside a joint. While tendinitis can occur in any of your tendons, it's most common around your shoulders, elbows, wrists, knees and heels.

cardiorespiratory fitness

Term that describes how efficiently the cardiovascular and respiratory systems deliver oxygen to the muscles during prolonged physical activity

Low-density lipoprotein

The "bad" cholesterol. Makes up most of your body's cholesterol. High levels of LDL cholesterol raise your risk for heart disease and stroke.

Transient hypertrophy

The "pumping up" of muscle that happens during a single exercise bout, resulting mainly from fluid accumulation in the interstitial and intracellular spaces of the muscle. However, it quickly diminishes after exercise as fluid balance between the various tissues and compartments returns to normal.

Activities of Daily Living (ADL)

The activities usually done during a normal day in a person's life

Tidal volume

The amount of air inhaled and exhaled per breath.

Stroke volume

The amount of blood ejected from the heart in one contraction.

self-efficacy

The belief in one's own capabilities to successfully engage in a physical-activity program. Influences thought patterns, emotional responses, and behavior.

Warmth

The essential attribute of successful relationships that is described as "the ability to respect another person regardless of his or her uniqueness"

Type II Muscle Fibers

The fast-twitch muscle fibers. Used for quick, powerful movements such as sprinting or weightlifting.

Absolute strength

The greatest amount of weight that can be lifted one time (1RM).

Agonist and antagonist muscles

The muscle that is contracting is called the agonist and the muscle that is relaxing or lengthening is called the antagonist. One way to remember which muscle is the agonist - it's the one that's in 'agony' when you are doing the movement as it is the one that is doing all the work.

Vasoconstriction

The narrowing (constriction) of blood vessels by small muscles in their walls. When blood vessels constrict, blood flow is slowed or blocked

diastolic pressure

The number on the bottom. Measures the pressure in your arteries when your heart rests between beats.

systolic blood pressure

The number on top. Measures the pressure in your arteries when your heart beats.

Agreement and release of liability waiver

This form does not necessarily protect the trainer from being sued for negligence. This form represents the client's voluntary abandonment of the right to file a lawsuit from injuries during exercise.

coronary revascularization

The procedure used to treat coronary artery disease when the coronary arteries become severely blocked.

METs

The product of metabolic equivalents (METs) and minutes of exercise. - 1 MET = 3.5 mL / Kg / minute

Type I Muscle Fibers

The slow twitch muscle fibers, found normally in postural skeletal muscles. Used for lower-intensity, long-term, endurance-oriented activities like walking, running, swimming, cycling or standing for extended periods of time.

Knowledge of results

The type of feedback that provides information on progress.

Residual volume

The volume of air remaining in lungs after maximum exhalation.

Fartlek training

This type of training allows an athlete to run at varying speeds, over unmeasured distances, on different terrain. Different from interval training because there are no set times or measured segments. More unstructured.

Contraindicated exercises

Those that carry higher risks to joint structure, soft tissue, or other risks. Because the risks typically outweigh the benefits, these exercises are inappropriate for most individuals.

Inversion of foot

Turning the sole of the foot inward

Eversion of foot

Turning the sole of the foot outward

How many days per week of moderate to high intensity muscle-strengthening activities containing all muscle groups does the United States Department of Health and Human Services recommend?

Two or more days per week

Type I and Type II Muscle Fibers

Type I - "slow-twitch" muscle fibers. Enhance a stabilizer muscle's capacity for endurance, which allows the muscle to efficiently stabilize the joint for prolonged periods without undue fatigue (higher-volume, lower intensity). Core muscles have higher concentrations of type I fibers. Type II - "fast-twitch" muscle fibers. Responsible for joint movement and generating larger forces. These muscles are better suited for strength and power-type training (higher intensity, lower volume).

BMI Classification Categories

Underweight: <18.5 Normal weight: 18.5 - 24.9 Overweight: 25.0 - 29.9 Grade I Obesity: 30.0 - 34.9 Grade II Obesity: 35.0 - 39.9 Grade III Obesity: >40

When does OBLA occur? (4 mmol/L)

VT2

Peripheral vascular disease

Vascular disease affecting blood vessels outside of the heart and especially those vessels supplying the extremities.

Disuse atrophy

When prolonged inactivity results in the muscles getting smaller in size.

Neuromuscular efficiency (NME)

Your ability to activate your central nervous system and recruit muscles to complete a task. A higher NME means that you are better at activating your central nervous system to recruit muscles and generate force.

Hernia

a bulge or protrusion of the abdominal contents into the groin or through the abdominal wall, respectively. Pain is usually present, but may not be in some cases.

hot button

a subject or issue that people have strong feelings about and argue about a lot

Greater Trochanteric Bursitis

an inflammation of the bursa sac that lies over the greater trochanter of the femur. Often due to acute trauma, repetitive stress, muscle imbalance, or muscle tightness.

aerobic exercise

cardiorespiratory endurance-based (e.g. running)

High-density lipoprotein (HDL)

good cholesterol. Absorbs cholesterol and carries it back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke.

Infrapatellar Tendinitis

inflammation of the patellar tendon at the insertion into the proximal tibia. "jumper's knee"

anaerobic exercise

muscle-strengthening (resistance training)

PPE

personal protective equipment

Undulating Periodization Model

refers to using different loads, reps, and sets in a resistance training program on different days of the week. The purpose behind daily undulating periodization is to get your body to respond to a variety of different challenges rather than focusing on only one challenge at a time

RICE Acronym

rest, ice, compression, elevation

Difference between a strain and sprain

sTrain = muscle or Tendon Sprain = ligament

transient ischemic attack

temporary interruption in the blood supply to the brain

vasodilation

widening of blood vessels

How many calories per liter of O2 consumed are produced?

~5 kcal