ACE Personal Trainer Exam
high altitude
an altitude of 3500m(11500ft) is considered
very high altitude
an altitude of 4500m(14800ft) is considered
extreme altitude
an altitude of 5800m(19000ft) is considered
death zone
an altitude of 8000m(26000ft) is considered
a conditioning routine that incorporates squats, lunges, multidirectional arm reaches, and overhead press
an example of a program that develops functional strength and ROM ideal to enhance an older adult's everyday activities
air displacement plethysmography (ADP)
an example of this is the Bod Pod, an egg-shaped chamber that measures the amount of air that is displaced when a person sits in the machine. 2 values are needed to determine body fat: air displacement and body weight; high accuracy rate but equipment is expensive
medical clearance
approval from a health care professional to engage in exercise
carotid artery
artery located on the neck, lateral to the trachea more easily palpated when neck is extended
radial artery
artery on the ventral aspect of the wrist on the side of the thumb; can be assessed by both PT and client for more accurate result
72 to 80
average bpm for females
60 to 70
average bpm in males
skinfold measurement
calipers are used to "pinch" a fold of skin and fat. several sites on the body are typically measured. the measurements are plugged into an equation that calculates body-fat percentage
HR x SV
cardiac output equation
Cardiovascular disease
cardiac, peripheral vascular, or cerebrovascular disease
true
changes in fitness are more sensitive to changes in intensity than to changes in duration or frequency of training. (T or F)
with the client standing upright with arms hanging freely at the sides and the hands facing the thighs, a horizontal measure is taken midway between the acromion and olecranon process
location and technique for biceps circumference
with the client standing upright with arms at the sides, feet together, and abdomen relaxed, a horizontal measure is taken at the height of the iliac crest, typically level with the umbilicus
location and technique for abdominal circumference
with the client standing erect and feet together, a horizontal measure is taken at the maximal circumference of the buttocks
location and technique for hip circumference
with the client standing upright with 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)
location and technique for waist circumference
Bioelectrical impedence analysis (BIA)
measures electrical signals as they pass through fat, lean mass, and water in the body. this method assesses leanness, but calculations can be made based on this information; accuracy based primarily on the sophistication of the machine and the validity of the prediction algorithms many fitness centers utilize this method due to simplicity of use. optimal hydration is necessary for accurate results
-HR [%MHR; % heart-rate reserve (HRR)] -rating of perceived exertion (RPE) -VO2 or metabolic equivalents (METs) -caloric expenditure -talk test and HR at VT1 -Blood lactate and HR at the second ventilatory threshold (VT2)
methods by which the trainer can program and monitor exercise intensity
with the client standing with one foot on a bench so the knee is flexed at 90 degrees, a measure is taken midway between the inguinal crease (i.e., the crease between the torso and the thigh) and the proximal border of the patella, perpendicular to the tibia
midthigh circumference
zone 1
moderate; below VT1; (HR <VT1); talk test: can talk comfortably or can talk but not sing; RPE: very, very weak to light
karvonen formula
more appropriate formula for monitoring training intensity is
slow twitch
the gastrocnemius is made up primarily of which muscle fiber type?
radial and carotid arter
the most common sites for assessing heart rate
genetics, hormones, and the activity and exercise habits of the individual
the percentage of specific fiber types contained in skeletal muscle may be influenced by ?
Joint mobility
the range of uninhibited movement around a joint or body segment
fast twitch
the soleus is made up primarily of which muscle fiber type?
unipennate
these muscles have a tendon that runs the entire length of the muscle, with all the muscle fibers inserting diagonally onto one side the tendon (example:anterior tibialis)
bipennate
these muscles have a tendon that runs the entire length of the muscle, with the muscle fibers inserting obliquely onto each side of the tendon (example: rectus femoris)
Lifestyle and health-history questionnaire
this form collects more detailed medical and health information beyond the preparticipation health screening, including the following: -past and present exercise and physical-activity information -medications and supplements -recent or current illnesses or injuries, including chronic or acute pain -surgery and injury history -family medical history -lifestyle information (related to nutrition, stress, work, sleep, etc)
PAR-Q+
this form is evidence-based and was developed with a goal of reducing unnecessary barriers to exercise; can be used as either a self-guided screening tool or as an additional element of screening for use by personal trainers seeking additional client information
medical release
this form provides the PT with the client's medical information and explains physical activity limitations and/or guidelines as outlined by their physician. Deviation from these guidelines must be approved by the client's personal physician
hydrostatic weighing (i.e. underwater weighing)
this method measures the amount of water a person displaces when completely submerged, thereby indirectly measuring body fat via body density. generally not practical in a fitness center setting due to the sixe of the apparatus and the complexity of the technique required for accurate measurements, which involves the individual going to the bottom of a tank, exhaling all air from the lunges (expiratory reserve volume), and then holding the breath until the scale settles and records an accurate weight, the assessment must then be repeated to ensure reliability; the GOLD STANDARD
opposition
thumb movement unique to humans and primates
below zone 1
2-2.9 METs is where on the three zone intensity model?
kinesthetic
"I feel that" and "This does not feel right" would be said by a client with what learning style?
visual
"Oh I see" and "Let me see that again" would be said by a client with what learning style?
auditory
"Yeah, I hear you" and "Say that one more time" would be said by a client with what learning style?
True
(T or F) A muscle's fiber-type composition is typically a mixture of both fast and slow twitch fibers, though some muscle groups are known to be made up of primarily fast-twitch or slow-twitch fibers.
moderate-intensity exercise
40-59% HRR or VO2R, 3-5.9 METs, RPE 12-13, an intensity that causes noticeable increases in HR and breathing
zone 1
40-59% of HRR is what zone of intensity?
physiological or baseline assessment
-identify areas of health/injury risk for potential referral to the appropriate healthcare professional(s) -collect baseline date that can be used to develop a personalized cardiorespiratory and muscular training program and allow for comparison of subsequent evaluations -educate clients about their present physical condition and health risks by comparing their results to normative data for age and sex -motivate clients by helping them establish realistic goals These are the purpose of a what?
Pre-exercise snack
-relatively high in carbohydrate to maximize blood glucose availability (most credible sources recommend 1-4.5 g of carbohydrate per kg of body weight, depending on type of food and time of exercise/event) -relatively low in fat and fiber to minimize gastrointestinal distress and facilitate gastric emptying -moderate in protein -approximately 400 to 800 calories- an amount that should fuel the exercise without causing noticeable sluggishness or fullness -well tolerated by the individual This is an example of?
fairly light
11 on the Borg RPE scale is:
somewhat hard
13 on the Borg RPE scale is:
hard
15 on the Borg RPE scale is:
very hard
17 on the Borg RPE scale is:
very, very hard
19 on the Borg RPE scale is:
-any amount of physical activity is more desirable when compared to none. Additionally, a concerted effort should be made to sit less throughout the day -perform 150 to 300 minutes per week of moderate-intensity cardiorespiratory physical activity or 75 to 150 minutes per week of vigorous-intensity cardiorespiratory physical activity, or a combination of both. Additional health benefits are obtained from performing greater amounts of activity than these quantities. -participate in muscle-strengthening activities involving all major muscle groups at least two days per week.
2018 physical activity guidelines for americans (for adults aged 18-64)
zone 1
3 to 5.9 METs is where on the three zone intensity model?
light-intensity exercise
30-39% HRR or VO2R, 2-2.9 METs, RPE 9-11, an intensity that causes slight increases in HR and breathing
below zone 1
30-39% of %HRR and 57-63% of MHR is where on the three zone intensity model?
below zone 1
30-39% of VO2r is where on the three zone intensity model?
below zone 1
37-45% of VO2max is where on the three zone intensity model?
zone 1
40 to 59% of VO2r is where on the three zone intensity model?
zone 1
46-63% of VO2max is where on the three zone intensity model?
zone 2
6 to 8.7 METs is where on the three zone intensity model?
normal synus rhythm
60-100 bpm
zone 2
60-89% of HRR is what zone of intensity?
zone 2
60-89% of VO2r is where on the three zone intensity model?
zone 1
64-76% of MHR is what zone of intensity?
zone 2
64-90% of VO2max is where on the three zone intensity model?
very, very light
7 on the Borg RPE scale is:
zone 2
77-95% of MHR is what zone of intensity?
very light
9 on the Borg RPE scale is:
-Ask open-ended questions -Break down barriers -Collaborate
ACE ABC Mover Method
ACSM guidelines
ACSM's Guidelines for Exercise Testing and Prescription, 10th edition
-based on measured VT1 and VT2 -ideally, VT1 and VT2 are measured in a lab with a metabolic cart and blood lactate -field assessments are relatively easy to administer, require minimal equipment, and provide accurate corresponding HRs at VT1 and VT2 -programming with metabolic markers allows for personalized programming
Advantages/Limitations of Metabolic Markers:VT1 and VT2 and HR relative to VT1 and VT2
-good subjective intensity marker -correlates well with talk test, metabolic markers, and measured %VO2max -easy to teach to clients
Advantages/Limitations of RPE (terminology)
-based on actual changes in ventilation due to physiological adaptations to increasing exercise intensities -very easy for practical measurement -no equipment required -can easily be taught to clients -allows for personalized programming
Advantages/Limitations of Talk Test
Signs and symptoms
At rest or during activity. Includes pain, discomfort in the chest, neck, jaw, arms, or other areas that may result from ischemia; shortness of breath at rest or with mild exertion; dizziness or syncope; orthopnea or paraoxysmal nocturnal dyspnea; ankle edema; palpitations or tachycardia; intermittent claudication; known heart murmur; unusual fatigue or shortness of breath with usual activities
weight (kg) / height (m^2) or weight (lb)/height(m^2)(in) x 703
BMI formula
-Academy of Nutrition and Dietetics -Canada's Dietary Guidelines for Health Professionals and Policy Makers -Harvard University's Healthy Eating Plate
Besides the Dietary Guidelines for Americans and MyPlate, what are three credible sources of nutrition information?
Evocation
Component of the "Spirit" of Motivational Interviewing in which the PT elicits the client's own motivation for a particular change, instead of telling the client why they should change
Collaboration
Component of the "Spirit" of Motivational Interviewing in which the PT functions as a partner in collaboration with the client based on the recognition that people are the undisputed experts on themselves; allows the clients ideas to be integrated into how the behavior change should occur
Acceptance
Component of the "Spirit" of Motivational Interviewing in which the PT values the inherent worth and potential of every client through empathy, honoring individual autonomy and affirming a person's strength and efforts; involves respecting the client's decisions about whether and how the behavior change should occur
Compassion
Component of the"Spirit" of Motivational Interviewing in which the PT demonstrates compassion when they deliberately pursue the welfare and best interests of the client, giving priority to the client's needs
Self-liberation
Deciding to change and experiencing a new belief in the ability to change(one of the processes of change)
-initially, increase the number of minutes per session (duration) and the number of days a week (frequency) of moderate-intensity activity prior to an increase in the exercise intensity -be mindful of the magnitude increase in physical activity each week, as this can be predictive of injury risk. for instance, a 20-minute increase per week is safer for a client who already does 200 minutes a week of jogging (a 10% increase) relative to a client who does 40 minutes per week (50% increase) -high volumes of moderate-to-vigorous physical activity appear to remove the excess risk of all-cause mortality that is associated with high volumes of sitting -decreased sedentary time reduces, but does not eliminate, the risks related to a lack of physical activity throughout the week
Exercise duration guidelines related to duration call for the following:
Dramatic relief
Experiencing negative emotions because the negative behavior (e.g., being physically inactive or eating fast food) is perceived to be problematic, then feeling relief from deciding to change(one of the processes of change)
Consciousness raising
Finding and learning new facts, ideas, and tips that support the healthy behavior change (one of the processes of change)
1. Voice quality - inspire confidence, don't sound weak or hesitant 2. Eye contact - direct and friendly 3. Facial expressions - try to convey genuine emotion 4. Hand gestures - too much is distracting, keep hands quiet 5. Body position - exhibit good posture
Five important components of verbal and non-verbal cues during rapport stage
-consumption of normal meals and beverages will resotre euhydration -if rapid recovery is needed, drink 1.5 L/kg (23 oz/lb) of body weight lost
Fluid Replacement Recommendations for After Exercise
-Drink 5-7 ml/kg (.08-.11 oz/lb) at least 4 hours before exercise
Fluid Replacement Recommendations for Before Exercise
-Monitor individual body-weight changed ruing exercise to estimate sweat loss -composition of fluid should include 20-30 mEq/L of sodium, 2-5 mEq/L of potassium, and 5-10% of carbohydrate)
Fluid Replacement Recommendations for During Exercise
-BP increases by 10% -blood cholesterol level increases by 8% -high-density lipoprotein (HDL) decrease by 15% -triglycerides increase by 18% -metabolic syndrome risk increases by 18%
For every 1 (2.5 cm)inch increase in waist circumference in men, what health risks are associated?
take breaks from sedentary time every 60 to 120 minutes
Frequency recommendations for reducing sedentary time according to FITT
206.9 - (0.67 x age)
Gellish et al formula for MHR
refueling should begin within 30 minutes after exercise and be followed by a high-carbohydrate meal within 2 hours. A carbohydrate intake of 1.5 kg of body weight in the first 30 min after exercise and then every 2 hours for 4 to 6 hours is recommended.
Guidelines for refueling after exercise:
distributing zone 1 training time across warm ups, cool downs , moderate intensity workouts focused on increasing distance and/or exercise time recovery intervals following zone 2 and 3 workouts on days following higher intensity workouts. By completing adequate zone 1 training time, clients will have the mental and physical energy required to perform their zone 2 and 3 intervals as planned.
How can a pt help a client reduce the risk of overtraining syndrome in cardiorespiratory training?
Honest, straightforward expression of thoughts, feelings, and beliefs
How does a PT maintain client motivation through assertiveness?
Teach clients to take control over their behavior instead of doing it for them
How does a PT maintain client motivation through self-regulation?
Teach clients to be prepared for barriers and relapses and have a plan of action for when high-risk situations occur. Give them coping strategies and more education
How does a PT manage high-risk situations?
1. Encourage 2. Paraphrase 3. Ask open-ended questions 4. Reflect 5. Summarize 6. respond to difficult disclosures
How does a trainer exhibit effective listening skills in investigation stage
Discussing proper techniques for performing light, dynamic stretching for the affected area
How might a personal trainer help a client who has soreness following a weekend tennis tournament?
Listening to the client with empathy and maintaining confidentiality
How might a personal trainer manage a client telling them that they are depressed due to problems with their spouse?
The personal trainer can make the individual's BOS narrower to stimulate adaptation to the imposed demand
How might a personal trainer work on balance with a client?
Implementing exercises to improve shoulder stability and building on the work done in physical therapy
How would a personal trainer help a client who is cleared for exercise following physical therapy for rotator cuff impingement?
Helping the client make more healthful choices using the Dietary Guidelines and tools on MyPlate
How would a personal trainer help a client who wants to lose weight by trying the latest commercial diet?
implementing a core conditioning progeam to improve strength and flexibility imbalances in muscles acting on the hips and spine
How would a personal trainer manage a client's exaggerated lordotic posture that is within their scope of practice?
Teaching the client self-myofascial release techniques for the IT bands using a foam roller
How would the personal trainer help a client who has tight iliotibial (IT) bands?
6-12 months
Improvements in VO2 max may continue for up to ___________________ after the beginning of a regular exercise program?
investigation
In what stage of the client-PT relationship does one review clients' health and fitness data, any available test results, medical clearance information, and clients' goals and exercise history
Planning stage
In what stage of the client-PT relationship does the trainer design workout program with client and the client is ready to work out
rapport stage
In what stage of the client-personal trainer relationship does the PT focus on mutual understanding and trust in a relationship both verbal and nonverbal
Reinforcement management
Increasing rewards for healthy behavior change and decreasing rewards for unhealthy behavior(one of the processes of change)
-light-intensity activities are recommended for sedentary-break activities -light intensity equates to <25 to 50% VO2max, >1.5 to<3 METs, or below VT1
Intensity recommendations for reducing sedentary time according to FITT
medical clearance recommended; following medical clearance, light-to moderate intensity exercise recommended; may gradually progress as tolerated following ACSM guidelines
Is medical clearance necessary for a client who: -does not participate in regular exercise -has any signs or symptoms of suggestive CV, metabolic, or renal disease (regardless of disease status) If exercise is recommended, what are the general guidelines?
medical clearance recommended; following medical clearance, light to moderate-intensity exercise recommended, may gradually progress as tolerated following ACSM guidelines
Is medical clearance necessary for a client who: -does not participate in regular exercise -has known CV, metabolic, or renal disease AND asymptomatic If exercise is recommended, what are the general guidelines?
medical clearance not necessary; may gradually progress to vigorous-intensity exercise following ACSM guidelines
Is medical clearance necessary for a client who: -does not participate in regular exercise -has no CV, metabolic, and renal disease -no signs or symptoms suggestive of CV, metabolic, or renal disease If exercise is recommended, what are the general guidelines?
medical clearance for moderate-intensity exercise not necessary medical clearance (within the past 12 months if no change in signs/symptoms) recommended before engaging in vigorous-intensity exercise continue with moderate-intensity exercise Following medical clearance, may gradually progress as tolerated following ACSM guidelines
Is medical clearance necessary for a client who: -participates in regular exercise -Has known CV, metabolic, or renal disease -asymptomatic If exercise is recommended, what are the general guidelines?
medical clearance not necessary; continue moderate or vigorous-intensity exercise, may gradually progress following ACSM guidelines
Is medical clearance necessary for a client who: -participates in regular exercise -No CV, metabolic, or renal disease -No sign or symptoms suggestive of CV, metabolic, or renal disease If exercise is recommended, what are the general guidelines?
Discontinue exercise and seek medical clearance May return to exercise following medical clearance Gradually progress as tolerated following ACSM guidelines
Is medical clearance necessary for a client who: -participates in regular exercise -has any signs or symptoms suggestive of CV, metabolic, or renal disease (regardless of disease status) If exercise is recommended, what are the general guidelines?
mobility
Is the ankle an example of a mobility or a stability joint?
stability
Is the foot an example of a mobility or stability joint?
mobility
Is the glenohumeral joint an example of a mobility or stability joint?
mobility
Is the hip an example of a mobility or a stability joint?
stability
Is the knee an example of a mobility or a stability joint?
stability
Is the lumbar spine an example of a mobility or a stability joint?
stability
Is the scapulothoracic joint an example of a mobility or stability joint?
mobility
Is the thoracic spine an example of a mobility or stability joint?
Target HR (THR)=(HRRx%Intensity)+RHR Where: HRR=MHR-RHR
Karvonen formula
Walking walking slowly around home, store, or office=2.0 Household and Occupation standing while performing light work, such as making bed, washing dishes, ironing, preparing food, or store clerk =2-2.5 Leisure Time and Sports arts and crafts, playing cards=1.5 billiards=2.5 boating--power=2.5 croquet=2.5 darts=2.5 fishing--sitting=2.5 playing most musical instruments=2-2.5
Light (<3 METS) common physical activities
220-age
MHR formula devised by Fox, Naughton, and Haskell
Walking Walking 3.0 mph=3.0 Walking at very brisk pace (4 mph)=5.0 Household and Occupation cleaning, heavy--washing windows, car, clean garage=3.0 sweeping floors or carpet, vacuuming, mopping=3.0-3.5 carpentry--general=3.6 carrying and stacking wood=5.5 mowing lawn/walk power mower=5.5 Leisure Time and Sports Badminton-recreational=4.5 Basketball-shooting around=4.5 Dancing-ballroom slow=3.0;ballroom fast=4.5 dishing from riverbank and walking=4.0 fishing from riverbank and walking=4.0 golf-walking, pulling clubs=4.3 sailing boat, wind surfing=3.0 swimming leisurely=6.0 table tennis=4.0 tennis doubles=5.0 volleyball-noncompetitive=3.0-4.0
Moderate (3-5.9 METs) common physical activities
Exercise Participation
Performing planned, structured physical activity at least 30 min at moderate intensity on at least 3 d/wk for at least the last 3 months
Tension or trepidation
Potential meaning of biting lip
comforting habit
Potential meaning of cracking knuckles
anger, defiance, or disinterest (unless the client is cold)
Potential meaning of crossed arms
Bored or anxious to leave
Potential meaning of feet pointed toward the door
Bored or anxious to leave
Potential meaning of repeatedly looking at watch
personal space is being invaded
Potential meaning of use of a barrier (such as a purse, backpack, or briefcase)
Gellish et al formula Tanaka, Monaha, and Seals formula
Preferred MHR equations over the Fox, Naughton, and Haskell method because of standard deviations close to 7 bpm, according to ACSM guidelines
Helping relationships
Seeking and using social support for the healthy behavior change(one of the processes of change)
208 - (0.7 x age)
Tanaka, Monahan, and Seals formula
-Each professional interaction is client-centered, with a recognition that clients are the foremost experts on themselves -Powerful open-ended questions and active listening are utilized in every session with clients -Clients are genuinely viewed as resourceful and capable of change
The ACE Mover Method is founded on what tenets?
-limit overall discretionary sitting time to no more than 2 hours/day -each break in sedentary time should last 5 to 10 minutes
Time recommendations for reducing sedentary time according to FITT
Metabolic disease
Type 1 and 2 diabetes mellitus
-light-intensity activities include routine household/occupational tasks -substitute light-intensity activities for sedentary time whenever possible -modify household/occupational environment to limit sitting (e.g., remove chairs from TV area and position computers at a standing height).
Type recommendations for reducing sedentary time according to FITT
jogging, rowing, elliptical training, stepping, indoor cycling, fast-dancing
Vigorous-intensity endurance activities requiring minimal skill, recommended group-adults participating in regular exercise or having better than average fitness
near-infrared interactance (NIR)
Uses a fiber optic probe connected to a digital analyzer that indirectly measures tissue composition (fat and water) typically biceps are the assessment site calculations are then plugged into an equation that includes height, weight, frame, size, and level of activity this method is relatively inexpensive and fast, but generally not as accurate as other techniques
Health-behavior change; Postural(kinetic chain) stability; Kinetic chain mobility; Movement efficiency; Core Conditioning; Balance; Cardiorespiratory (aerobic and anaerobic) fitness; Metabolic Markers (ventilatory thresholds); Muscular endurance; Muscular strength; flexibility; agility, coordination, and reaction time; speed and power
What are examples of contemporary training parameters of personal training?
Cardiorespiratory(aerobic) fitness Muscular endurance Muscular strength Fleixibility
What are examples of traditional training parameters of personal training?
-exercise too intense -injury from workout
What are physical activity factors that might cause a client to not come back?
1. find a workout partner 2. ask friends and family to be encouraging, as well as asking them for reminders about goals or appointments 3. set up "fun" contests 4. add a social element 5. find an enjoyable activity
What are the strategies for building a social support system?
1. Balance time with unsupportive people and supportive 2. Set limits on how much time is spent with unsupportive people 3. Mentally prepare 4. Mentally review 5. Explain to them why exercise is important for you
What are the strategies to fighting negative social influences?
individual health status, exercise tolerance, available time, and program goals
What does the rate of program progression depend on?
i. Access to facilities ii. Time iii. Social support
What environmental factors affect adherence and participation?
overhead press
What exercise might an ACE Certified Personal trainer include in a workout program for an older adult because of age-associated declines in upper body strength that might be making the simplest tasks, such as putting away groceries on a top shelf, a substantial effort?
participation for any benefit other than enjoyment such as weight loss, trying to be healthy, looking good, meeting new people. Feelings of tension, guilt, or pressure related to their participation
What is extrinsic motivation?
Balance
What is important for older adults to work on because these capabilities decline with age?
person truly enjoys exercise and the pleasure/emotions and experience that comes from engaging in it. Increases adherence
What is intrinsic motivation?
belief in personal control over health outcomes
What is locus of control?
belief in one's own capability to engage in a physical-activity program
What is self-efficacy?
Summarizing
What is the communication skill of motivational interviewing when a PT reflects two or more statements said by a client, a longer version of reflective listening
offering affirmations
What is the communication skill of motivational interviewing when the personal trainer makes a statement valuing a positive client attribute or behavior
asking open-ended questions
What is the communication skill of motivational interviewing where questions are asked in a way that allow a client to reflect and elaborate
Reflective Listening
What is the communication skill of motivational interviewing where the PT actively listens seeking to understand the client's feeling by offering reflections as guesses about the client's statements. Once a statement is given, the client has a chance to either confirm or correct what the personal trainer said
Reinforce what was done well, correct errors, motivate clients to continue practicing and improving
What is the correct way to offer feedback?
150 minutes a week of moderate intensity
What is the minimum amount of time needed for a client to receive the health benefits of exercise?
OARS -asking open-ended questions -offering affirmations -reflective listening -summarizing
What is the set of conversational skills that are a key aspect of motivational interviewing?
auditory
What learning style does a client prefer when they listen carefully and prefer hearing?
kinesthetic
What learning style does a client prefer when they touch or hold, or prefer to be spotted?
visual
What learning style does a client prefer when they watch intently and prefer reading?
demographic variables, health status, activity history, psychological traits, knowledge, attitudes, and beliefs
What personal attributes affect adherence and participation
Base Training
What phase of the Cardiorespiratory IFT Model is described below? -Focus on moderate-intensity cardiorespiratory exercise (RPE=3-4), while keeping an emphasis on enjoyment -Keep intensities below the Talk Test threshold (below VT1) Increase duration and frequency of exercise bouts
Fitness Training
What phase of the Cardiorespiratory IFT Model is described below? -Progress cardiorespiratory exercise duration and frequency based on the client's goals and available time -Integrate vigorous-intensity (RPE=5-6) cardiorespiratory exercise intervals with segments performed at intensities below,at, and above VT1 to just below VT2
Performance training
What phase of the Cardiorespiratory IFT Model is described below? -Progress moderate- and vigorous-intensity cardiorespiratory exercise -program sufficient volume for the client to achieve goals -integrate near-maximal and maximal intensity (RPE= 7-20)intervals performed at and above VT2 to increase aerobic capacity, speed, and performance -periodized training plans can be used to incorporate adequate training tie below VT1, from VT1 to just below VT2, and at or above VT2
Functional training
What phase of the Muscular Training IFT Model is described below? -Focus on establishing/reestablishing postural stability and kinetic chain mobility -exercise programs should improve muscular endurance, flexibility, core function, and static and dynamic balance -progress exercise volume and challenge as function improves
Load/speed training
What phase of the Muscular Training IFT Model is described below? -focus on application of external loads to movements to create increased force production to meet desired goals -integrate the five primary movement patterns through exercises that load them in different planes of motion and combinations -integrate functional training exercises to enhance postural stability and kinetic chain mobility to support increased workloads -programs should focus on adequate resistance-training loads to help clients reach muscular strength, endurance, and hypertrophy goals -clients with goals for athletic performance will integrate exercises and drills to build speed, agility, quickness, and power
movement training
What phase of the Muscular Training IFT Model is described below?-focus on developing good movement patterings without compromising postural or joint stability -programs should include exercise for all five primary movement patterns in varied planes of motion -integrate functional training exercises to help clients maintain and improve postural stability and kinetic chain mobility
-using coaching techniques to support clients through behavior change (e.g.) increasing physical activity and adopting healthy eating habits) -providing general health and wellness information -referring clients to appropriate healthcare professionals as needed
What should a PT do in place of counseling clients?
-follow accepted guidelines for exercise programming for diseases and disorders as presented by the appropriate governing body (e.g. American college of Obstreticians and Gynecolists and American Diabetes Association) -assessing for exercise limitations identifying potential risk factors through health screening and fitness assessments -referring clients to appropriate healthcare professional as needed -adhering to guidance and limitations outlines in a medical release form provided by a client's physician or other healthcare professional
What should a PT do in place of diagnosing disease or illness?
-documenting progress and reporting it to the appropriate healthcare professional or physician after receiving the client's permission to do so -Following recommendations from a physician, physical therapist, registered dietician, or other healthcare professional
What should a PT do in place of monitoring clinical progress for medically referred clients?
-referring clients to a registered dietician for meal planning or a specific diet plan -providing general information on healthy, evidence-based nutrition (e.g. Dietary Guidelines for Americans)
What should a PT do in place of prescribing diets or nutritional supplements?
-using exercise programming to help clients improve overall health -helping clients adhere to advice from a physician or physical therapist -designing an exercise program after a client has been release from rehabilitation -referring clients to appropriate healthcare professional as needed
What should a PT do in place of treating injury or disease or rehabilitating clients following injury?
Basic Functional Movements
What should a client who has difficulties performing ADL focus on when beginning training?
question and answer
What strategy would a PT adapt with a client who has a auditory learning style?
hands-on supervision
What strategy would a PT adapt with a client who has a kinesthetic learning style?
demonstrating
What strategy would a PT adapt with a client who has a visual learning style?
athletes should consum glucose-containing beverages and snacks; 30-60 g of carbohydrates per hour of training
When exercise lasts for more than one hour, what must one do maintain a ready energy supply during a prolonged, moderate-to-vigorous continuous exercise session?
when the client can compete at least 20 min of cardiorespiratory exercise below the talk-test threshold at least three times per week
When to progress from base training to fitness training on the cardiorespiratory IFT Model?
generally at the level of the second sacral vertebra, but it changes from person to person, depending on build
Where is the body's center of gravity, typically (if they are standing in neutral position)?
-individuals with certain breathing problems [asthma or chronic obstructive pulmonary disease (COPD)] individuals prone to panic/anxiety attacks, as the labored breathing may create discomfort or precipitate an attack -those recovering from a recent respiratory infection -individuals who are not fit enough to perform or benefit from the assessment
Who might a ventilatory assessment not be suitable for?
Such balanced, neutral alignment prevents excessive stress on muscles and ligaments
Why is it an important goal of exercise and training to stimulate and reinforce neutral, symmetrical alignment about the line of gravity (static balance)?
normal
a BMI of 18.5-24.9 is considered
grade I obesity
a BMI of 30-34.9 is considered
grade II obesity
a BMI of 35-39.9 is considered
underweight
a BMI of <18.5 is considered
grade III obesity (extreme obesity)
a BMI of grader than or equal to 40 is considered
overweight
a BMI of of 25-29.9 is considered
low altitude
an altitude of 1500m(4900ft) or less is considered
moderate altitude
an altitude of 2500m(8000ft) is considered
water exercise
a convenient alternative form of exercise that is pleasant, reduces orthopedic loading, and is capable of training different muscle groups than those used during ambulatory activities
Social Support
a network of family, friends, co-workers, etc who support one's involvement in exercise and acts as a coping strategy for relapse (returning to an unhealthy/inactive state) prevention
≥5 days/week of moderate exercise, or ≥4 days/week of vigorous exercise, or a combination of moderate and vigorous exercise on ≥3-5 days/week is recommended
aerobic (cardiovascular endurance) exercise evidence-based recommendations for frequency
moderate and/or vigorous intensity is recommended for most adults light-to moderate intensity exercise may be beneficial in deconditioned individuals
aerobic (cardiovascular endurance) exercise evidence-based recommendations for intensity
exercise may be performed in one continuous session, in one interval session, or in multiple sessions of ≥10 minutes to accumulate the desired duration and volume of exercise per day exercise bouts of <10 minutes may yield favorable adaptations in very deconditioned individuals
aerobic (cardiovascular endurance) exercise evidence-based recommendations for pattern
a gradual progression of exercise volume by adjusting exercise duration, frequency, and/or intensity is reasonable until the desired exercise goal (maintenance) is attained this approach of "start low and go slow" may enhance adherence and reduce risks of musculoskeletal injury and adverse cardiac events
aerobic (cardiovascular endurance) exercise evidence-based recommendations for progression
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 is recommended for most adults <20 minutes of exercise per day can be beneficial, especially in previously sedentary individuals
aerobic (cardiovascular endurance) exercise evidence-based recommendations for time
Regular, purposeful exercise that involves major muscle groups and is continuous and rhythmic in nature is recommended
aerobic (cardiovascular endurance) exercise evidence-based recommendations for type
a target volume of ≥500-1000 MET -minutes/week is recommended increasing pedometer step counts by ≥2000 steps/day to reach a daily step count ≥7000 steps/day is beneficial exercising below these volumes may still be beneficial for individuals unable or unwilling to reach this amount of exercise
aerobic (cardiovascular endurance) exercise evidence-based recommendations for volume
standard deviation of 12bpm overestimates MHR in younger adults underestimates MHR in older adults
concerns with the Fox, Naughton, and Haskell MHR formula
-client should be resting comfortably for several minutes or more in a quiet, restful environment before obtaining rhr -rhr may be measured indirectly by placing the fingertips on a pulse site (palpation) or directly by listening through a stethoscope (auscultation) -place the tips of the index and middle fingers (not the thumb, which has a pulse of its own) over the artery and apply pressure (to determine rhr, count the number of beats for 30 to 60 seconds and then correct that score to bpm if necessary) -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 -clients may also measure their own rhr before rising from bed in the morning and report it to the personal trainer
considerations for measuring rhr
flexion
decreasing the angle between two bones
Dietary Supplement Health and Education Act (DSHEA)
dictates supplement production, marketing, and safety guidelines?
swimming, cross-country, skiing
endurance activities requiring higher skill levels, recommended group-adults with acquired skill and higher fitness levels
walking, slow-dancing, recreational cycling or swimming
endurance activities requiring minimal skill or fitness, recommended group-older adults
convection
form of conduction wherein heat is transferred to or from air or water molecules in contact with the body. As water or air molecules are warmed or cooled and moved away from the skin (such as in forced connection when the wind from a fan blows over the skin), cooler molecules replace them
horizontal extension (abduction)
from a 90-degree (horizontally) flexed shoulder or hip position, the humerus or femur, respectively, is extended (abducted) out away from the midline of the body in the transverse plane
horizontal flexion (adduction)
from a 90-degree (horizontally) flexed shoulder or hip position, the humerus or femur, respectively, is extended (abducted) out away from the midline of the body in the transverse plane
abduction adduction elevation depression inversion eversion
fundamental movements of the frontal plane (from anatomical position)
circumduction, opposition
fundamental movements of the multiplanar plane (from anatomical position)
flexion extension dorsiflexion plantar flexion
fundamental movements of the sagittal plane (from anatomical position)
rotation pronation supination horizontal flexion (adduction) horizontal extension (abduction)
fundamental movements of the transverse plane (from anatomical position)
MHR-Rhr
heart rate reserve formula
radiation
heat lost or gained in the form of infrared rays, which involves the transfer of heat from the surface of one object to another without any physical contact (e.g. the sun's rays transferring heat to the earth's surface)
heat stroke
hot, dry skin bright red skin color rapid, strong pulse labored breathing elevated body core temp
standing or sitting positions elevate hr more than supine or prone positions due to the involvement of postural muscles and the effects of gravity
how does body position affect rhr
noise, as well as high and low temperatures, can place additional stress on the body, increasing HR as the body attempts to respond
how might environmental factors affect rhr?
density=mass/volume
hydrostatic weighing is based on the archimedes principle which provides which equation
METS
in cases where VO2 is not directly measured during either assessment or training, an alternative method for expressing exercise intensity is in terms of...
multipennate
in these muscles, the muscle fibers have a complex arrangement that involves the convergence of several tendons (example:deltoid muscle)
longitudinal muscle
in these muscles, the muscle fibers run parallel to the long axis of the muscle, forming a long, strap-like arrangement; although it is capable of producing considerable movement, it is relatively weak compared to other muscle-fiber arrangements (example: sartorius muscle)
extension
increasing the angle between two bones
rotation
internal (inward) or external (outward) turning about the vertical axis of a bone
-to provide a framework that ensures proper alignment of muscle fibers, blood vessels, and nerves -to enable the safe and effective transmission of forces throughout the whole muscle -to provide the necessary lubricated surfaces between muscle fibers that allow muscles to change shape during contraction and elongation
intramuscular fascia (deep fascia) is directly related to flexibility and ROM. Its 3 main functions are:
inversion
lifting at the medial border of the foot (only at the subtalar joint)
eversion
lifting the lateral border of the foot (only at the subtalar joing)
circumduction
motion that describes a "cone"; combines flexion, abduction, extension, and adduction in sequential order
adduction
motion toward the midline of the body (or body segment)
abduction
moving away from the midline of the body (or body segment)
plantar flexion
moving the sole of the foot downward; "pointing the toes" (only at the ankle)
dorsiflexion
moving the top of the foot toward the shin (only at the ankle joint)
elevation
moving to a superior position (only at the scapula)
depression
moving to an inferior position (only at the scapula)
fitness, fatigue, genetics, body composition, drugs and medication, alcohol, caffeine, and stress
name factors affecting rhr
zone 3
near maximal/maximal; VT2 and above; (HR ≥VT2); talk test:definitely cannot talk comfortably; RPE: "very strong to very, very hard/strong to maximal"
evaporation
occurs when heat is transferred from the body to water on the surface of the skin (e.g., sweat). when this water accumulates sufficient heat, it is convected to a gas (water vapor), removing heat from the body as it vaporizes
functional training ( or purposeful exercise) that takes advantage of closed-kinetic-chain activity and focuses on the body's stabilizing musculature
people who have weak stabilizer muscles (e.g. deep abdominals, hip stabilizers, and scapular retractors) exhibit problems with performing proper, efficient movement, which may lead to pain and/or injury. What should be incorporated in rehabilitation or post-rehabilitation programs for these individuals?
-assessments should be performed prior to exercise
should circumference assessments be performed prior to or after exercise?
-the pt should explain the procedure for each assessment and ensure that the client is comfortable with the proposed measurement sites -each measurement must be performed using the precise landmarks -the pt should record values on the assessment form and then evaluate and classify the client's measurements using normative date -pts should discuss health and fitness concerns related to abnormal readings and educate clients on strategies to reduce personal risk and improve overall health
protocol for anthropometric assessments
dual energy x-ray absorptiometry (DXA)
ranks among the most accurate and precise methods; whole-body scanning system that delivers a low-dose x-ray that reads bone and soft-tissue mass.has the ability to identify regional body-fat distribution
Self-reevaluation
realizing behavior change is an important part of one's identity as a person(one of the processes of change)
Environmental reevaluation
realizing how the behavior influences the environment, especially the person's social environment(one of the processes of change)
stop exercising move to a cool ventilated area lie down and elevate feet 12-18 inches (30-46 cm) give fluids monitor temperature
recommendations for heat exhaustion
stop exercising remove as much clothing as feasible try to cool the body immediately in any way possible (wet towels, ice packs/baths, fan, alcohol rubs) give fluids transport to emergency room immediately
recommendations for heat stroke
soccer, basketball, racquet sports
recreational sports, recommended group-adults participating in regular training with acquired fitness and skill levels
Stimulus control
removing reminders or cues to engage in the unhealthy behavior and adding cues or reminders to engage in the healthy behavior(one of the processes of change)
sinus brachycardia (slow hr)
rhr <60 bpm
sinus tachycardia (fast hr)
rhr > 100 bpm
low
risk categories associated with a waist circumference of 27.3-34.7 in (70-89 cm) in women and 31.2-38.6 in (80-99cm) in men
high
risk categories associated with a waist circumference of 35.1-42.5 in (90-109 cm) in women and 39.0-46.8 in (100-120 cm) in men
very low
risk categories associated with a waist circumference of <27.3 in (<70 cm) in women and <31.2 in (<80 cm) in men
very high
risk categories associated with a waist circumference of >42.9 in (>110 cm) in women and >46.8 in (>120 cm) in men
supination
rotating the hand and wrist laterally (palm up position)
pronation
rotating the hand and wrist medially (palm down position)
-onset of angina, chest-pain, or angina-like symptoms -significant drop (≥10 mmHg) in systolic blood pressure (SBP) despite an increase in exercise intensity or a decrease in SBP below the value obtained in the same position prior to assessment -excessive rise in BP:SBP reaches >250 mmHg and/or diastolic blood pressure (DBP) reaches >115 mmHg -shortness of breath, or wheezing (does not include heavy breathing due to intense exercise) -signs of poor perfusion:lightheadedness, confusion, ataxia, pallor (pale skin), cyanosis (bluish coloration, especially around the mouth), nausea, or cold and clammy skin -failure of heart rate to increase with increased exercise intensity -noticeable change in heart rhythm by palpation or auscultation -subject requests to stop -physical or verbal manifestations of severe fatigue -failure of assessment equipment
signs and symptoms that merit immediate assessment termination and possible referral to a qualified healthcare professional
Counter-conditioning
substituting healthier behaviors and cognitions for the unhealthy behavior(one of the processes of change)
Social liberation
taking advantage of opportunities to be with people who model the new behavior, noticing the social norms that reinforce the new behavior(one of the processes of change)
Joint stability
the ability to maintain or control joint movement or position
conduction
transfer of heat from the surface of the warmer object in contact with the surface of a cooler object (e.g. the transfer of heat from the body to a metal chair while a person is sitting on it)
Total body electrical conductivity (TOBEC)
uses an electromagnetic force field to assess relative body fat. much like the mri, it is impractical and too expensive for the fitness setting
magnetic resonance imaging (MRI)
uses magnetic fields to assess how much fat a person has and where it is deposited; located in clinical settings (using one solely for calculation of body fat is not practical)
-genetics -exercise modality(e.g. MHR varies between running and cycling due to the involvement of upper body musculature) -medications -body size: MHR is generally higher in smaller individuals who have smaller hearts, and hence lower stroke volumes -altitude: altitude can lower the MHR reached due to most individual's inability to train at higher intensities -age: MHR generally decreases by 1 bpm each year starting in a person's early 20s. However, there is considerable inter-individual variability in the age-associated reduction in MHR based on factors such as genetics, medications, and training status
variables impacting MHR
Walking, jogging, and running walking at very, very brisk pace (4.5 mph)=6.3 walking/hiking at moderate pace and grade with no or light pack (10 lb)=7.0 Hiking at steep grades and pack (10-42 lb)=7.5-9 jogging at 5 mph=8 jogging at 6 mph=10 running at 7 mph=11.5 household and occupation shoveling sand, coal, etc=7 carrying heavy loads such as bricks=7.5 heavy farming, such as bailing hay=8.0 shoveling, digging ditches=8.5 leisure time and sports bicycling on flat-light effort (10-12 mph)=6 basketball game=8 bicycling on flat-moderate effort (12-14 mph)=8, fast (14-16mph)=10 skiing cross country--slow 2.5 mph)=7, fast (5-7.9 mph)=9.0 soccer-casual=7, competitive=10 swimming leisurely=6; swimming-moderate/heard=8-11 tennis singles=8 volleyball-competitive at gym or beach=8
vigorous (≥6 METs) common physical activities
zone 2
vigorous; below VT1 to just below VT2; (HR ≥VT1 to <VT2); talk test: not sure if talking is comfortable, cannot say more than a few word without pausing for a breath; RPE: "hard/strong" to "very hard"
heat exhaustion
weak, rapid pulse low blood pressure headache nausea dizziness general weakness paleness cold, clammy skin profuse sweating
frequency, intensity, time, and type
what are the variables that pts manipulate to generally progress and pattern their client's programs?
frequency, intensity, time, type, volume, pattern, progression
what does FITT-VP stand for?
Combination of Moderate and Vigorous Intensity Cardiorespiratory Training
what is the cardiorespiratory recommendation for a healthy adult seeking to dedicate 3-5 days per week?
vigorous intensity -60-89% VO2R or HRR -VT1 to VT2 -not sure if speech is comfortable to definitely cannot speak
what is the cardiorespiratory recommendation for a healthy adult seeking to dedicate a minimum of 3 days per week?
moderate-intensity -40% to 59% VO2R or HRR -Below VT1 -Can speak comfortably
what is the cardiorespiratory recommendation for a healthy adult seeking to dedicate a minimum of 5 days per week?
2.7-5.9
what is the expected change for body fat percentage in 2-3 months?
1.9-3.3
what is the expected change in waist circumference (cm) in 2-3 months?
abstain from consuming non-prescription stimulants or depressants for a min of 12 hours prior to measuring rhr
what should a client do in terms of drugs, medications, and supplements preceding assessment of rhr
wear several layers of clothing, allow for adequate ventilation of sweat, wear breathable clothing, replace body fluids in the cold just as in the heat, monitor body weight
what tips should pts share with clients before they consider exercising in a cold environment
begin exercising in the heat gradually, always wear lightweight, well-ventilated clothing, never wear impermeable or nonbreathable garments, replace body fluids as they are lost
what tips should pts share with clients before they consider exercising in the heat
thin, form-fitting materials that allow for accurate measurments
what type of clothing should clients wear for circumference measurements?
non-elastic, flexible tape
what type of tape should be used for circumference measurements?
when the clent rises from bed in the morning
when is the client's true rhr measured?
important for training balance and postural control during dynamic activities
why are multidirectional arm reaches (i.e., reaching one or both arms in front of, to the side of, or behind the body) important in including in a program to enhance an older adult's everyday activities?
these tasks are required to stand up from a chair or stoop down to pick up a pair of shoes
why are squatting and lunging essential to human movement (very important in including in a program to enhance an older adult's everyday activities)?
may evoke a vasovagal response that slows down HR
why do pts and clients have to be careful not to push down too hard on the carotid artery?
physchological or emotional stress can affect rhr
why might sharing of personal information or thinking about stressful situations cause rhr to rise?
digestion increases rhr. absorption and digestion require energy, necessitating the delivery of additional blood to the gastrointestinal (GI) tract, while blood flow to the other parts of the body are not changed
why should a client not eat too closely to the assessing of rhr?
vigorous-intensity exercise
≥ 60% HRR or VO2R, ≥ 6 METs, RPE ≥ 14, an intensity that causes substantial increases in HR and breathing
zone 3
≥8.8 METs is where on the three zone intensity model?
zone 3
≥90% of VO2r is where on the three zone intensity model?
zone 3
≥90% oh HRR is what zone of intensity?
zone 3
≥91% of VO2max is where on the three zone intensity model?
zone 3
≥96% of MHR is what zone of intensity?