ACSM EP-C

FITT recommendations for Dyslipidemia

**Aerobic focused, goal to maximize caloric expenditure - Frequency: at least 5d/wk - Intensity: 40-75% VO2R/HRR - Time: 30-60min/day; 50-60min/day for weight loss - Type: aerobic exercises involving large muscle groups

FITT recommendations for Type I & II Diabetes Mellitus

**Aerobic training focused - Frequency: 3-7d/wk - Intensity: 40-60% VO2R; 11-13 RPE (6-20 scale) - Time: at least 150min/wk; 300min/wk added benefits - Type: large muscle groups, rhythmic & continuous fashion

FITT recommendations for Osteoperosis

**Goal to preserve bone health/prevent disease progression - Frequency: weight-bearing aerobic exercises 3-5d/wk; Resistance training 2-3d/wk - Intensity: Moderate to vigorous aerobic training; resistance training of 8-12 reps @ 60-80% 1RM - Time: 30-60min/day combining aerobic and resistance - Type: weight bearing aerobics and resistance training

FITT recommendations for Metabolic Syndrome

**consistent with FITT for healthy adults - Frequency: at least 5d/wk moderate; or 3d/wk vigorous - Intensity: moderate &/or vigorous intensityes - Time: 30-60min/dy moderate; 20-60min/dy vigourous; OR at least 150min/wk moderate or at least 75min/wk vigourous - Type: rhythmic, continous in nature exercises involving large muscle groups - Volume: 500-1000 METS a week

FITT recommendations for Overweight/Obese

**focus on maximizing caloric expenditure - Frequency: at least 5d/wk - Intensity: 40-60% VO2R/HRR progressing to >/= 60% VO2R/HRR - Time: at least 30min/day (150min/wk) progressing to 60min/day (300min/wk) - Type: emphasize aerobic exercises, incorporate resistance and flexibility

FITT recommendations for pregnant women

- Frequency: 3-4d/wk - Intensity: Moderate intensity for wmn with BMI <25, light intensity for wmn with BMI >/=25 - Time: >/=15min/day, progressing to 30min/dy; add up to 120min/week - Type: dynamic, rhythmic exercises involving large muscle groups

FITT recommendations for wight loss

- Frequency: 5-7d/wk - Intensity: moderate-vigorous intensity - Time: at least 250min/wk - Type: emphasize aerobic exercises

FITT recommendations for Hypertension

- Frequency: Aerobic training most/all days; resistance training 2-3d/wk - Intensity: 40-60% VO2R/HRR or 11-13 RPE (6-20 scale) for aerobic; 60-80% 1RM for resistance - Time: 30-60min/day continuous aerobic; or 10min bouts adding up to. Resistance is 1 set 8-12 reps for major muscle groups - Type: emphasize aerobic exercises, supplemented by resistance exercises

FITT recommendations for individuals 65yrs and older

- Frequency: Aerobic; >/=5d/wk moderate intensity, or >/=3d/wk vigorous intensity. Resistance; 2d/wk - Intensity: Aerobic; RPE scale 1-10 moderate (5-6 RPE) or vigorous (7-8 RPE). Resistance; light-moderate (40-70% 1RM) - Time: 30-60min/d (150-300min/wk) moderate intensity or 20-30min/d (75-100min/wk) vigorous intensity. Stretches held 30-60s - Type: any aerobic exercise that doesn't cause orthopedic stress

FITT recommendations for cancer

- Frequency: aerobic 3-5d/wk; resistance 2-3d/wk; flexibility daily - Intensity: as tolerated (40-60% VO2R if okay) - Time: 75min/wk vigorous or 150min/wk moderate - Type: prolonged rhytmic aerobic exercises

FITT recommendations for Arthritis

- Frequency: aerobic 3-5d/wk; resistance 2-5d/wk; flexibility daily - Intensity: 40-60% VO2R - Time: goal of >/= 150min/wk - Type: exercises with low joint stress

FITT recommendations for children & adolescence

- Frequency: aerobic training; daily. Resistance training; >/=3d/wk - Intensity: aerobic; moderate-vigorous (moderate = noticed increase in breathing & HR; vigorous = substantial increase in breating & HR) - Time: >/=60min/dy for aerobic; Resistance a part of it - Type: aerobic; anything they enjoy. Resistance; bone-strengthening (weight-bearing)

FITT recommendations for COPD

- Frequency: at least 3-5d/wk - Intensity: Light (30-<40% peak work rate) and vigorous (60-80% peak work rate) intensities - Time: intermittent bouts as tolerated; shorter periods if at vigorous intensities - Type: Walking &/or cycling

FITT recommendations for Fibromyalgia

- Frequency: start @ 2-3d/wk, progress to 3-4d/wk - Intensity: start @ </=30% VO2R/HRR, prog to <60% VO2R/HRR - Time: start @ 10min bout adding to 30min/dy, prog to 60min/dy - Type: low impact/non-weight-bearing exercises

Metabolic syndrome diagnostic criteria

- at least 3 of the following: 1. Insulin resistance (>/= 110 mg/dL FBG) 2. Abdominal obesity (Men >102cm; Wmn >88cm) 3. Dyslipidemia (HDL Men <40; Wmn <50. Or Triglycerides >/= 150 mg/dL) 4. Elevated blood pressure (SBP >/= 130 or DBP >/= 85)

Social-cognitive theory of behavior depends on what?

1. Individual 2. Behavior itself 3. interaction with the environment

Relative contraindications to GXT (12)

1. Left main coronary artery stenosis 2. Moderate stenotic valvular heart disease 3. electrolyte abnormalities 4. severe arterial hypertension (SBP>200 or DBP>100) 5. tachy or brady 6. hypertrophic cardiomyopathy 7. neuromotor, muscolosekeltal, or rheumatoid disorder worsened with exercise 8. high degree AV block 9. uncontrolled metabolic disease 10. chronic infectious disease 11. ventricular aneurysm 12. mental or physical impairment

7 components of an Informed Consent document

1. Purpose/explanation of test 2. potential risks/discomforts of test 3. responsibilities of participant (to report any unusual sensations/pain/etc.) 4. Benefits that can be expected 5. Inquiries (ask them) 6. use of medical records 7. freedom of consent

Two types of Self-efficacy in the Self-efficacy behavioral theory and which is important to establish 1st?

1. Task self-efficacy, established first 2. barriers self-efficacy

9 major signs and symptoms of CV/Pulmonary/metabolic diseases

1. anginal pain 2. SOB with mild exertion 3. dizziness/syncope 4. orthopnea (SOB while lying flat) or paroxysmal nocturnal dyspnea 5. ankle edema 6. palpitations or tachycardia 7. intermittent claudication (muscle pain due to inadequate bloodflow) 8. known heart murmur 9. unusual fatigue during ADL's

10 indications to stop a GXT

1. onset of anginal pain 2. drop in SBP of 10mmHg (or more) with increased work rate 3. excessive rise in BP (SBP>/=250 or DBP>/= 115) 4. SOB, wheezing, leg cramp, claudication 5. signs of poor perfusion (ataxia, pallor, cyanosis) 6. failure of HR to increase with increased intensity 7. Arrythmias 8. subject asks to stop 9. signs of severe fatigue (physical/verbal) 10. equipment failure

5 stages of Transtheoretical model

1. precontemplation 2. contemplation 3. preparation 4. action (<6mos) 5. maintenance (>6mos) **Action stage has greatest risk of relapse

Absolute contraindications to GXT (9)

1. recent significant change in resting ECG 2. unstable angina 3. uncontrolled cardiac dysrhythmia 4. symptomatic severe aortic stenosis 5. uncontrolled symptomatic heart failure 6. acute pulmonary embolus/infarction 7. acute myocarditis or pericarditis 8. suspected/known dissecting aneurysm 9. acute systemic infection

kg/m/min to Watts conversion factor

1W = 6.12kg/m/min; kg/m/min/6.12 = W; W x 6.12 = kg/m/min

Feet to meters conversion factor

1ft = .3048m; ft x .3048 = m

Inches to centimeters conversion factor

1in = 2.54cm; in x 2.54 = cm

miles to kilometers conversion factor

1mile = 1.6km; miles x 1.6 = km

mph to m/min conversion factor

1mph = 26.8m/min; mph x 26.8 = m/min

What percent changes in Q come from HR and from SV?

60% from HR 40% from SV

AVO2Diff =

Arterial O2 - Venous O2

Mean arterial pressure (MAP) =

DBP + 1/3(SBP - DBP)

Stroke volume =

EDV - ESV

FITT-RS recommendations for Resistance training

Frequency: 2-3dys/week, 48 hours between each Intensity: 60-70%, or 80% 1RM for strength Time: N/A Type: involve major muscle groups Reps & Sets: 2-4 sets of 8-12 reps for most, 10-15 reps for elderly, 15-20 reps for endurance

FITT-V recommendations for flexibility training

Frequency: 2-3dys/week, daily preferred Intensity: until you feel tightness/slight discomfort Time: hold each stretch for 10-30s, 30-60s for elderly; for PNF a 3-6s contraction followed by 10-30s hold Type: Static, dynamic, ballistic, PNF Volume: 60s. for each exercise

Muscle with greatest amount of Fast twitch fibers

Gastrocnemius

Muscle with greatest surface area

Gluteus Maximus

What parts of the sarcomere shorten with muscle contraction?

H-zone and A-band

isometric contraction defintion

Muscle contraction without movement of any joints or shortening/lengthening of muscles

Orthopnea definition

SOB while lying flat

Cardiac Output (Q) =

SV x HR

Longest muscle in the body

Sartorius

Type I fibers vs Type IIa and Type IIx fibers

Type I = slow twitch Type IIa = "middle" fast twitch Type IIx = fast twitch

cyanosis definition

blue/purple skin coloration due to lack of skin blood flow

Ataxia definition

lack of voluntary control due to reduced perfusion

Claudication definition

muscular pain caused by inadequate blood flow to the muscle

pallor definition

pale appearance due to lack of skin blood flow