APK4125 Exam 1 Review UF
General assumptions for max test
Exercising until "volitional fatigue", most protocols use the treadmill or leg cycle ergometer (more likely to result in peak), max tests can either use air collection for precise measurement or estimation, vo2 max can be estimated with nomogram or regression equations (indirect estimates) 1. have to see a plateau in vo2 with an increased intensity OR -post exercise blood lactate >8mmol/L -RER > 1.15 -reach age predicted HR max (220-age) +- 10bpm -RPE >17 if no plateau need two of the preceding criteria
A client is performing a VO2 max test, they report their Borg RPE as 16. Their HR at the time of the RPE measurement is 100. Based on these values you can assume that the exertion the client is experiencing is completely due to cardiovascular exertion
False
A handgrip dynamometer can only be used to measure muscular strength and not muscular endurance.
False
If a client had a myocardial infarction, but it occurred over 5 years ago , then it does not count as a cardiovascular disease.
False
The valsalva maneuver increases a lifters ability to lift without increasing their blood pressure
False
When performing VO2 testing closed-circuit spirometry is used more often than open-circuit spirometry
False
When performing a 1-RM test on a constant resistance exercise machine a spotter is recommended for all lifts.
False
Assumed body densities 2-compartment model
Fat mass- 0.9 Fat free mass- 1.1 Water- 1
5 components of health related fitness
Global- cardiovascular endurance, body composition Joint specific- muscular strength, muscular endurance, muscular flexibility
Absolute VO2
L/min, directly related to body size, used to express energy expenditure in weight-bearing exercises or non-weight-bearing exercises To convert from absolute to relative multiply by 1000 and divide by body weight
If you're performing a 1-RM for lower body strength which exercise would be the best for following ACSM recommendations?
Leg press
Exercise intensity and correlating METS
Light <3 METs Moderate 3-5.9 METs Vigorous >6METs
Bruce protocol
Maximal graded treadmill laboratory test, most commonly used protocol each stage is 3 minutes, beginning workload 1.7mph, 10% grade, no plateau in vo2 commonly seen -monitor hr every minute, take bP prior to every 3rd minute, ask RPE prior to every 3rd minute, terminate test at volitional fatigue or any indication to stop, if gas is not collected nomograms can be used -open spirometry and indirect calorimetry grade increases by 2%
Static test options
Measure MVC Isometric dynamometers- forearm is places at any angle between 90-180 degrees of the upper arm, wrist and forearm are in mid-prone position, complete two to three trials alternatively with each hand, 30 sec to 1 min rest STRENGTH -1 min mvc- squeeze as hard as possible for 1 minute, measures % decline in force, higher endurance= less decline ENDURANCE -50% mvc, squeeze at 50% mvc for as long as possible ENDURANCE Cable tensiometers- measure static strength on 38 different muscle groups
Which of the following skin fold sites isn't listed correctly?
Midaxillary- Diagonal fold on the midaxillary line at the level of the xiphoid process of the sternum to correct this it would be a vertical fold
What is the one measurement that the PAR-Q recommends that the client measure before participating in an exercise program even if they say no to all of the questions on the form?
Resting blood pressure
Whats the most common mode used for VO2 testing?
Running/walking
YMCA cycle ergometer results
Take the two HR above 110 bpm but below 85% HR max and plot them versus the work rate they were recorded at. Draw a line between them and connect it with the HR max line from 220-age. Then based on the given maximal work rate calculate VO2 max. work rate= rpm x resistance x distance of the flywheel (6m) rpm is constantly 50, so workrate= resistance x 300 the resistance is the kp that the person is cycling at during the HR over 110 bpm
An increase in mitochondrion will increase ________ which will in turn increase VO2 max
(a-v) O2 difference
dual energy x-ray absorptiometry (DEXA)
**gold standard** originally for the diagnosis of osteoporosis and the measure of bone mineral density, very accurate, works by the transmission of photons at two energy levels, high cost and low doses of radiation +-1.5% error
You have a new male client that's 44 years old. The client has blood pressure of 136/78, and a fasting blood sugar of 116mg/dL. Their BMI is 24 and their waist girth is 31inches. Lastly they have total blood cholesterol of 204mg/dL. Out of the items listed how many risk factors does this client have?
1
Estimating 1-RM
1- weight lifted (lb)/[1.0278-(reps to fatigue x 0.0278) 2- [(RM1-RM2)/(REP2-REP1)] x (REP1-1) + RM1 3-males (1.55 x ymca bench press test reps) + 37.9 females (0.31 x ymca bench press test reps) + 19.2
A female client that weighs 60kg performs a leg press 1-rm and achieved a max weight of 200 pounds. What is this clients strength ratio?
1.52 max weight/body weight
PA Guidelines
150 min moderate or 75 min vigorous aerobic PA, minimum 10 min increments more benefits 300 min moderate or 150 min vigorous at least two days a week or resistance training at mod or vig intensity 1 MET= 3.5 ml/kg/min oxygen consumed
When performing a skin fold measurement what's the maximum amount of time that you would want to wait before reading the measurement?
2 seconds
cm to in
2.54 cm = 1 in
When generally performing a 1-rm assessment how many warm up trials are given?
3
On average, for every person what is resting VO2 assumed to be?
3.5ml/kg/min
If a 50kg client has a relative VO2 of 60ml/kg/min, what is their absolute VO2?
3L/min
You have a new female client that's 64 years old. The client has blood pressure of 140/78, and a fasting blood sugar of 128mg/dL. Their waist girth is 37inches. Lastly they have total blood cholesterol of 190mg/dL. Out of the items listed how many risk factors does this client have?
4
How many questions does the original Physical Activity Readiness Questionnaire (PAR-Q) have?
7
When performing an isometric handgrip strength test what should the angle of the elbow joint be?
90-180 degrees
Which of the following isn't an indirect method of body composition?
BMI
BMI calculation and categories
BMI= weight (kg)/ height^2 (m^2) <18.5 underweight 18-25 normal weight 25-30 overweight >30 obese
Which body composition technique relies on Boyle's Law to calculate body density and then estimate body composition?
BODPOD (Air displacement plethysmography) thing Boyles and Bodpod- double indirect measurement
Resting HR
between 60 and 100 bpm
Waist circumference measurement
correlates well with abdominal fat content, horizontal measure at the narrowest part of the torso (between bottom of ribs and top of hip), waist between the top of the hip and the bottom of the butt, the thickest part tells between android (apple) and gynoid (pear) shape whether fat is held in the hips (good) or the stomach (bad).
Valsalva maneuver
expiration against a closed glottis, 4 stages -initial pressure rise -reduced venous return and compensation -pressure release -return of cardiac output stabilizes and increases effectiveness of trunk muscles, initial rise in bp can cause hiatal hernias, cardiac arrest, valsalva retinopathy, meant to increase the amount of weight we lift NCSA valsalva is effective to increase intra-abdominal pressure and health risks are not confirmed ACSM valsalva should be avoided during any lifts
BodPod Air displacement plethysmography
similar to hydrostatic weighing but uses air displacement to measure body volume, high cost and needs to be calibrated +- 3.5% error
FMS protocol- shoulder mobility test
stand with arms hanging to either side, make a fist around your thumbs, in one motion reach the right fist over the head and down back as far as possible while also reaching left fist up back as far as possible, graded hand is the top hand 3- hands within one hand length (hand length determined by the dominant hand) 2- fists within one and a half hand lengths 1- firsts not within one and a half hand lengths 0-pain
ACSM recommended lifts
Upper body- bench press or military (shoulder) press, constant resistance machine Lower body- leg press or leg extension, constant resistance machine
Fick equation
VO2= CO x a-v O2 diff , VO2 increases with an increase in either HR, SV, or a-v O2 difference
You have a new client who had a coronary artery stent surgically place a year ago, this client has been physically active for the past 2 months. However they have 4 cardiovascular risk factors, while showing no signs or symptoms of a CMR . Do they need to see a physician before starting an moderate intensity exercise program?
Yes
You have a new client who had a heart attack 2 years ago, this client has been physically active for the past 4 months. However they have 4 cardiovascular risk factors, while showing no signs or symptoms of a CMR . Do they need to see a physician before starting an vigorous intensity exercise program?
Yes
You have a new client who has no known diseases, this client has been physically active for the past year, but they show 1 sign or of a CMR . Do they need to see a physician before starting a vigorous intensity exercise program?
Yes
Health related component free response
-cardiovascular (VO2) -body comp -muscular strength (1 RM) -muscular endurance (handgrip dynamometer 50% mvc) -muscular flexibility (sit and reach) No singular measures to describe overall muscular strength, endurance and flexibility, health related fitness is what ACSM recommends assessing, highly related to longevity and healthy life outcomes
Dynamic testing equipment
-free weight, require more neuromuscular coordination to stabilize body parts and maintain balance, spotters may be needed -constant resistance exercise machines, no spotters needed, limit joint rom and plane of movement, large weight increments... potentially less accurate, not useful for individuals with very short limbs or very large limbs -1RM max weight lifted for one complete rep through the full ROM, strict posture, consistent movement speed, full ROM, spotters, equipment familiarization, proper warm up 3 warm up trials- 1. 5-10 reps with a load considered "easy" then 1 minute break with 30 seconds active flexibility movements 2. 3-5 reps at 60-80% estimated 1 rm 2 minute rest of active recovery 3. 2-3 reps at 90-95% estimated 1 rm rest 2-4 minutes with active recovery then weight equivalent to 1rm estimation equation is loaded, addition of 2.5-5% increase or decreased based on the clients success or unsuccessful attempt
General indications for stopping an Exercise test
-onset on angina -drop in SBP of >10 mm Hg with an increase in workrate -excessive rise in BP, SBP >250mm Hg or DBP >115 mm Hg -shortness of breath, wheezing, leg cramps, claudication -signs of poor perfusion -failure of HR to increase with increased intensity -noticeable changes in heart rhythm -subject requests to stop -physical or verbal signs of severe fatigue -failure of the testing equipment
If all of the following movements of the FMS are deficient which should be corrected first?
ASLR (mobility--> stability --> dynamic)
Which of the following is considered a mobility assessment in the FMS?
Active straight leg raise
8 cardiovascular risk factors
Age: men >45 women >55 Family history: MI, coronary revascularization, sudden death before 55 for father or 65 for mother Cigarette smoking: current smoker or quit within 6 months or exposure to environmental smoke Physical inactivity: not at least 30 min mod intensity 40-59% vo2 on 3 days of the week for 3 months Obesity: BMI >30, waist girth .102cm (40in) for men or 88cm (35in) for women Hypertension: SBP >140 mm Hg DBP > 90 MM hg or on antihypertensive medication Dyslipidemia: LDL >130 or HDL <40 mg*dl or on lipid lowering medication, total serum cholesterol >200 Diabetes: fasting plasma glucose >126 or 2 hour glucose >200 or HbA1C >6.5% NEGATIVE risk factor- HDL-C: >60 mg*dl
Which of the following methods doesn't use body density to calculate body composition?
All use body density- DXA, hydrostatic weighing, BodPod
Which researcher was the first to use body mass index as a tool to measure overall body fatness in a population?
Ancel Keys
In the average client which mode is going to result in the lowest VO2 max?
Arm ergometers
Which test traditionally uses a nomogram to estimate VO2?
Astrand and Rhyming cycle ergometer test
Using the recommended order to perform the FMS which movement would you assess first?
Deep squat
General assumptions for sub maximal test
Doesn't allow the client to go to maximal intensities, estimate maximal effort from submax load, estimation is a comparison of workload, size, age, and heart rate, any submax that reaches above 85% of a clients HR max is terminated because it is no longer considered submax 1. Linear relationship between HR and VO2 (work) between 110-150bpm 2. HR from two workloads can be plotted against VO2 and used to extrapolate HR max 3. HR max is similar for individuals of similar age 4. Steady state HR can be achieved in 3-4min at the same workload 5. Equal mechanical efficiency for everyone at a given workload
A client is performing a VO2 max test, they report their modified-Bord RPE as 9. Based on this values what would you expect the clients HR to be?
HR isn't typically compared to the modified Borg RPE
Out of the following methods of measuring body composition, which would be the MOST accurate?
Hydrostatic weighing over BMI, skinfold, BIA
When to refer pt to the physician:
If currently physically active with CMR disease: yes if ss, yes no ss for vig, with no CMR disease, yes if SS If not currently physically active with CMR yes for no SS and for SS, if no CMR yes for ss no if no ss
If you are performing a muscular fitness test that has the client perform 15 repetitions, which component of muscular fitness would this test best evaluate?
Muscular endurance
You have a new client who has a respiratory disease, this client has been physically active for the past 4 months, they show no signs or symptoms of a CMR . Do they need to see a physician before starting a moderate intensity exercise program?
No
What leg is scored during the hurdle step FMS test?
The stepping leg
HR max estimation equations
Traditional- 220-age Revised- 208- (0.7xage)
Any submax test that reaches above 85% of the clients %HR max is terminated because values above 85% can no longer be considered submax.
True
If a client has a deficiency in mobility this could influence their stability and dynamic movement
True
The ACSM recommends that the Valsalva maneuver be avoided during any resistance exercises.
True
The amount of residual volume of air in the lungs can decrease the accuracy of hydrostatic weighing.
True
The number of times that a person participates in vigorous physical activity greatly influences their risk of having an acute myocardial infarction
True
When looking at a population of people, their collective BMI average can indicate their mortality risk.
True
When performing the Valsalva maneuver during an exercise the client typically experiences a rise in blood pressure at the start of the maneuver and then a second increase as reflexive response after the cessation of the maneuver.
True
When using skin fold testing we must assume that the sum of the skin folds and body density have a linear relationship.
True
9 skin fold sites
abdominal- 2 inches to the right of the umbilicus, vertical biceps (not used in 7 site)- anterior aspect of the arm over the belly of the biceps 1cm above marking, vertical chest/pectoral- 1/2 distance between anterior axillary and nipple for men, 1/3 distance between anterior axillary and nipple for women, diagonal medial calf (not used in 7 site)- max circumference of the calf on midline of medial border, vertical midaxillary- midaxillary line level with xiphoid, vertical sub scapular- 1-2cm below inferior aspect of the scapular, diagonal suprailiac- in line with angle of iliac crest in the anterior axillary line, immediately superior, diagonal thigh- anterior midline midway between proximal border of the patella and the increase crease of the hip, vertical
Skill related components of fitness
agility, balance, coordination, speed, power, reaction time Considered more closely connected with sports ability
kg to lb
kg x 2.2 = lb
FMS protocol- trunk stability push-up
lie face down with arms overhead, pull thumbs down in line with (forehead for men, chin for women), keeps legs together and toes toward shins, extend knees and lift elbows slightly off the ground, maintain a rigid torso, push body into push-up position 3- body lifts with no lag in the spine, men thumbs in life with top of head, women with chin 2- body lifts with no lag in spine, men with thumbs aligned with chin, women with clavicle 1- unable to perform the rep with hands with chin for men or clavicle for women 0- pain
FMS protocol- active straight leg raise
lie flat with back of knees against the board, toes pointing up and feet together, both arms next to body with palms facing up, keep the scoring leg straight and the opposite knee in contact with the board, raise the scoring leg as high as possible 3-vertical line of malleolus resides between mid-thigh and ASIS, non moving limb in neutral position 2- malleolus between mid-thigh and joint line, non moving remains in neutral 1- vertical line of malleolus resides below joint line, non moving limb in neutral position 0-pain
Relative VO2
mL/kg/min, compare across individuals, used to express energy expenditure in weight-bearing exercises To convert from relative to absolute divide by 1000 and multiply by body weight Mets to relative multiply by 3.5 because 1 Met = 3.5ml/kg/min
Cooper 1.5 mile run/walk test
maximal field estimation test -2 minute warm up -run 1.5 miles as fast as possible -run time is recorded and used for calculation VO2max)= 3.5 + (483/time)
Pacer test
maximal field estimation test, 20m area, it is a maximal test and no HR is required for estimation of VO2, -at the sounds of the beep subject runs to 20m mark before next beep -wait until another beep and return to the starting position -subject runs until they are no longer to keep up with the beeps or they stop
12 minute test (Cooper test)
maximal field estimation test, created for military use, estimation of VO2 based on distance covered in 12 minutes, use the equation for VO2 max (22.351 x distance covered in km) - 11.288
Multi-frequency BIA
measures are made (right arm, left arm, right leg, left leg, trunk, right side of the body, left side of the body), uses regression equation from 4 compartment model to adjust fat-free mass estimation, not very accurate, high cost +- 1.5% error
Single-frequency BIA (bioelectrical impedance analysis)
measures impedance, resistance, and reactance, sends current through the body at 50kHz, does not measure total body impedance, permits estimate of fat-free mass and total body water, cannot determine intra-cellular water, low reliability, inability to measure dehydrated individuals, low accuracy +- 10% error
Skinfold testing
measures the amount of subcutaneous fat and assumes that subcutaneous fat is proportional to total body fat, proportion of subcutaneous fat to total fat varies with gender, age and ethnicity, 9 standardized test sites, calipers deliver 12 g/mm^2 of force, drawbacks of accuracy and difficult to master technique +- 3.5-5% error 3 assumptions- skin fold is a good measure of subcutaneous fat, distribution of fat is similar for all individuals within each sex, there is a linear relationship between sum of skin folds and body density all measures on the right side of the body, grasp the skin fold with thumb and index finger approx 1.5 inches to each side of the site, read the thickness after 2 seconds, 2 measurements should be taken at each site, if >2mm difference than a third should be taken, measurements should be taken in sequential order, do them all first before taking second
FMS protocol- rotary stability
on hands and knees over the board, thumbs knees and toes must contact the board, toes facing the shins, shift and lift right leg backward and hand outward, without touching down touch the right elbow to the right knee directly over the board, re-extend the arm and leg, return to the start position 3- performs a correct unilateral rep 2- performs correct diagonal rep 1-inability to perform diagonal rep (opposite hand and foot) 0- pain
FMS protocol- deep squat
stand with feet shoulder width apart, grasp the dowel overhead with shoulder and elbows at 90 degrees, press the dowel so it is directly above the head and descend into a squat, hold for a count of 1 and return to original position scoring-3 torso is parallel with tibia or toward vertical, femur below the horizontal, knees are aligned over feet, dowel aligned over feet 2 torso is parallel, femur is below horizontal, knees aligned over feet, dowel is aligned over feet, heels are elevated 1- thigh and torso not parallel, femur is not below horizontal, knees not aligned over feet, lumbar flexion 0-pain
FMS protocol- hurdle step
stand with feet together, grasp dowel with both hands on top of head with elbows at 90 degrees, lower the dowel to the base of the neck across the shoulders, raise the right leg and step over the hurdle, touch the floor with heel and return to starting position scoring leg is the stepping leg 3- hips, knees and ankles remain aligned, minimal to no movement in lumbar spine, dowel and hurdle parallel 2- alignment lost between hips, knees, and ankles, movement in lumbar spine. dowel and hurdle not parallel 1- contact between foot and hurdle, loss of balance 0- pain
FMS protocol- inline lunge
step on center of the board with right foot with toe at the zero mark, left heel should be placed according to tibia measurement, both toes pointing forward, dowel along the spine touching head, upper back and butt, grasp the dowel with the right hand on top and left in the curve of the lower back, descend into lunge so the right knee touched the center of the board, return to starting position 3- dowel contact maintained, dowel vertical, no torso movement, dowel and feet remain in sagittal plane, knee touches board behind front foot 2- dowel contact not maintained, dowel not vertical, movement in torso, dowel an feet not in sagittal plane, knee does not tack behind front foot 1- loss of balance 0- pain
Agonist-Antagonist pairs
strength imbalance between opposing muscle groups can affect joint health and stability muscular balance 1:1 hip extensors and flexors 1:1 elbow extensors and flexors 1:1 trunk extensors and flexors 1:1 ankle inverters and everters 1:1 should extensors and flexors 3:2 knee extensors and flexors 3:2 shoulder internal and external rotators 3;2 ankle plantar and dorsiflexors 3:1
Rockport walking test
sub maximal field estimation, subject walks as fast as possible for the duration of the test, at the end measure HR and plug into the equation for VO2 max
YMCA 3-minute step test
submax, single stage step estimation test, very portable and low amount of equipment needed, 12 inch step, -set metronome to 96 bpm -subject stands facing the step -start the stopwatch and begin stepping on and off the step to the metronome -take RPE at end of 1st and 3rd minute -once 3 minutes is reached, have the subject sit down and take their pulse MANUALLY for 60 seconds
YMCA Cycle ergometer test protocol
submaximal branching (graded) protocol, cycle ergometer vo2 max estimation test 2-4 three minute stages of continuous exercise to raise steady state hr, at least 2 consecutive HR measurements >110bpm and less than 85% max, estimation of max is made from the 2 stages measured (STEADY STATE HR IS OBTAINED DURING EACH STAGE OF THE TEST TO MOVE ON TO THE NEXT STAGE)
Astrand-Rhyming Cycle Ergometer Test
submaximal single stage cycle ergometer estimation test, all based on a nomogram, only 6 minutes long, goal is to obtain HR values between 125-170bpm, HR measured during the 5th and 6th minutes, average of the two HR is used to estimate vo2max. -adjust the height, set the initial workload, cycle at workload for 6 minutes, record the hr during the 5th and 6th minute, if avg is between 125 and 170 stop the test, is less than 125 increase the workload by .5kp and continue for another 3 minutes ( measure hr at 8 and 9 minutes), if hr is over 85% of estimated hr max the test should be terminated
Hydrostatic weighing
very accurate, uses an estimation equation, estimation of residual volume of air in the lungs and gastrointestinal tract can also create error, high cost and very high maintenance ~ +-1.5% error
Calculating relative strength
weight lifted / body mass
