EXERCISE PRESCRIPTION FINAL
Use cognitive restructuring to correct the following statement to promote a healthier mindset for your client: I've been exercising for several months. At first I did much better, but now it doesn't seem like I am getting any more fit.
The good news is you are much more fit than you were when you started, and as long as you keep exercising you will have a much lower chance of experiencing a bad event like a heart attack. We will just need to retest your fitness and adjust your exercise prescription.
Use cognitive restructuring to correct the following statement to promote a healthier mindset for your client: I'm too tired to exercise most nights.
The hardest part of exercise is getting started. Once started, most people actually feel more energized.
Tammy is a single mother who works very hard. Unfortunately she doesn't take care of herself the way she should. She is in her 30's so she doesn't see how her lack of physical activity and poor eating habits will affect her long term. What model suggests that Tammy will not change until she is educated on the consequences of her poor lifestyle choices? What do you need to do as the exercise professional in her employer's worksite wellness program?
The health belief model of behavior change. You need to offer her education on both the good things exercise can do for her in the short term and long term, as well as, educate her on the many diseases linked to poor health choices and sedentarism. It might be a good idea to do a cardiovascular risk factor assessment with her to help her understand her risks for future cardiovascular disease.
What is wrong (or missing) with this goal: Tom wants to have more energy and improve his health. He does not currently exercise at all. I want to meet the minimum criterion for cardiorespiratory fitness in 8 weeks' time.
This isn't quite specific. Yes, there is a measurable criterion for completion of the goal, but there is not an exact action described that will meet the criterion. There isn't even an action mentioned. Also, with no action described, it is hard to call this action-oriented. It is realistic, timely (8 weeks), and self-determined though.
The first T in FITT-VP stands for:
Time(duration of exercise)
The "T" in "SMARTS" stands for:
Timely
Adam is a type 1 diabetic. He is cleared to exercise with you, and you have been working with him for quite some time. Today was an especially busy day at work for Adam. He took his mid-morning insulin like normal, but accidentally missed his lunch. Now his blood sugar levels are very low, too low to exercise safely. What does insulin do? If you do not know then look it up online. How low is too low, in regards to blood glucose, to exercise safely? Also, how much is too much to exercise safely?
Insulin activates GLUT4, the main cellular transporter that brings glucose into the cell from the blood. Because he took insulin and did not eat this caused him to become hypoglycemic. Exercise could make his blood glucose levels drop even further. It is critical for all types of diabetics to test their blood glucose levels prior to an exercise session. This can be life threatening very quick. For people who are insulin users, if blood glucose is ≤100 mg/dL (5.6 mmol/L) your blood glucose may be too low to exercise safely. Eat a small snack containing 15 to 30 grams of carbohydrates, such as fruit juice, fruit, crackers or even glucose tablets before you begin your workout. For everyone, including insulin users, <70 mg/dL (3.9 mmol/L) is a relative contraindication for exercise. You should probably delay exercise until blood glucose increases. This will require eating carbohydrates like those already listed. 100 to 250 mg/dL (5.6 to 13.9 mmol/L). You're good to go. For most people, this is a safe pre-exercise blood sugar range. ≥250 mg/dL (13.9 mmol/L). This is a caution zone — Your blood sugar may be too high to exercise safely. Before exercising, test your urine for ketones — substances made when your body breaks down fat for energy. The presence of ketones indicates that your body doesn't have enough insulin to control your blood sugar. You should probably postpone exercise if blood glucose goes this high.
The I in FITT-VP stands for:
Intensity of exercise
What is better, extrinsic motivation or intrinsic motivation, for the ability to maintain a lifestyle incorporating exercise.
Intrinsic
When oxygen demand of a tissue is greater than the oxygen supply of that tissue.
Ischemia
Angie was prescribed 2 sets of 10 repetitions of the bench press using 100lbs as the resistance. After a couple of weeks of training she has two consecutive workouts where she completes 12 repetitions per set of the bench press. The next time she does a bench press during her workout you should increase her resistance. What should you increase the weight to for her next workout (give a range of potential weights that are considered reasonable for her progression).
It is typically recommended to increase weight by 2-10%. So this means going from 100lbs to something between 102-110lbs.
John comes to you and asks you to help him lose 50lbs in a month and a half. He wants to look good at his wedding. How do you respond? What about his desired outcome conflicts with the SMARTS goal model?
John is asking for a nearly impossible and unsafe weight loss regimen. Healthfully it is recommended to lose 1-2lbs per week maximum. This means John should require a minimum of 25 weeks to lose this much weight, and a year is more reasonable. Therefore, his desired outcome would require writing a behavioral goal that is not realistic (violates the R in SMARTS).
John (from question 2) changes his mind to losing 10lbs in 5 weeks. Given that he is willing to cut down on what he eats by 500kcal per day (he will work with a nutritionist at your facility do design meal plans), and there are 3500kcals of energy in one pound of body fat, develop a SMART goal that will allow him to lose the rest of the weight through exercise. Prescribe the exercise in kcal/day (e.g. will exercise four days per week performing 900 kcals worth of exercise). Use the SMARTS model to write the goal. Show all of the calculations you do. Make it the same recommendation for each week (meaning do not worry about progression here).
John wants to lose 10lbs in 5 weeks meaning 2lbs per week. 2 lbs * 3500 kcals/lbs =7000 kcals of deficit per week are required to lose 2 lbs He will reduce his calorie intake by 500 kcal/day * 7 days per week = 3500kcal lost per week from dieting alone. 7000 kcals - 3500 kcals = means you need to produce a 3500 kcal/week of deficit from exercise. I (John) will exercise 7 days per week using a variety of aerobic exercise equipment. Each time I work out I will exercise continuously until I reach ≈700kcal of energy expenditure. To insure this I will only use equipment with kcal's burned listed on the screen (we will eventually go over how to do these calculations by hand so this does not matter). I will do this for 5 straight weeks. This is a decent goal given the situation. However, this is a lot of exercise, and would not be a good recommendation for most people. He will likely either drop out part way through because it is too intense, or he will not make this a permanent part of his life.
Karen has noticed chest pain at rest and during mild physical activity for the last couple of days. It is not constant and is not predictable. What is she likely experiencing, and what should you have her do?
Karen may be experiencing unstable angina. This is extremely dangerous. It means she may be having a heart attack, or a heart attack is about to happen. You need to stop her from exercising and get her to the ER immediately. Unstable angina is often caused by blood clots that completely or partially block the coronary arteries of the heart causing pain. They can be broken up by natural processes, but will likely keep happening.
A goal that takes an extended time frame to achieve (e.g. several months or more).
Long Term Goal
The "M" in "SMARTS" stands for:
Measurable
Exercise training involving motor skills, such as balance, coordination, gait, and agility, and proprioceptive training.
Neuromotor Exercise Training
Ann-Marie takes a beta blocker to help control her hypertension. Look up online the effects of beta blockers on exercising heart rate. Do you think you can use a typical heart rate based VO2max estimation test to assess Ann-Marie's cardiorespiratory fitness? Why or why not?
No. Beta blockers significantly decrease the increase of heart rate during exercise. So any test that depends on a linear relationship between heart rate and exercise intensity will be invalid. This includes most estimate-based step tests, cycle ergometer tests, and treadmill tests. You will likely need to assess exercise intensity using subjective assessments like ratings of perceived exertion and the talk test.
What are the stages of the transtheoretical model? Check all that apply.
Precontemplation, Contemplation, Preparation, Action, Maintenance
John decided to join your gym again, and he comes to you for an exercise prescription. What stage of the transtheoretical behavior change model is he in now?
Preparation
The P in FITT-VP stands for:
Progression of Exercise
James did 4 sets of squats and 3 sets of leg extensions. He also did 5 sets of pushups and 3 sets of arm extensions. How many sets did he work his quadriceps? How many sets did he work his triceps? How many sets did he work is pectoral muscles?
Quadriceps: 7 sets Triceps: 8 sets Pectoral: 5 sets
The "R" in "SMARTS" stands for:
Realistic
Arthritis caused by an autoimmune disease.
Rheumatoid Arthritis
Ruth gets a cramp in her leg every time she increases the treadmill speed beyond 3 MPH at 0% grade. The cramp goes away slowly after decreasing the speed again. It is very predictable and happens every time. What might Ruth be experiencing, and what should you do.
Ruth is likely experiencing intermittent claudication. This is atherosclerosis in her leg causing an inability to get enough blood into the lower limb to supply oxygen for exercise more intense than 3 MPH. It does not hurt below 3 MPH because the artery is still open enough to provide adequate amounts of oxygenated blood to the lower limb to supply exercise at that intensity. Ruth likely has peripheral arterial disease (PAD), a type of cardiovascular disease. You need to stop her from exercising and have her see a doctor prior to allowing her to exercise again. While PAD is not typically life threatening by its self, this means she likely has atherosclerosis in more dangerous areas like the heart and brain. She needs to be cleared by a doctor prior to exercise.
A term that means a persons's confidence in their ability to adopt a specific behavior.
Self Efficacy
The second "S" in "SMARTS" stands for:
Self-determined
Elizabeth wants to meet the minimum aerobic exercise requirements set forth by the ACSM for health-related outcomes. She likes thinking of her exercise in terms of kilocalories burned. What is the minimum kcals she needs to accumulate throughout the week to meet the health recommendations? If she wants to exercise as few days per week as possible, what would her "frequency" be (keeping minimum frequency requirements in mind)? How many kcals would she need to expend per exercise bout for this to work? After doing the work to calculate all of this, Elizabeth changes her mind and wants to think of her exercise "volume" in terms of MET-minutes per week. What is the minimum volume recommendation in terms of MET-minutes/week? How many MET-minutes would she need to accumulate per exercise bout to meet this goal using as few days as possible (keeping minimum frequency requirements in mind)? You determine she can handle a moderate intensity physical activity of about 5 METs. So you look at a MET activity table (many of these exist, but I suggest going here: https://sites.google.com/site/compendiumofphysicalactivities/home (Links to an external site.) then click activity categories, choose a category and look up the METS of the various activities in that category) and pick an activity to prescribe that is equal to 5 METS. Tell me the activity you choose. How long will she need to do this activity to accumulate the MET-minutes she needs during a single exercise bout? Does this meet the minimum recommendation for "time" spent exercising at a moderate intensity (tell me the range that is recommended in your answer and tell me if you prescribed something in that range)?
She needs to burn 1000 kcals per week with exercise to meet volume recommendations. She would need to exercise a minimum of 3 days per week to meet frequency recommendations. 1000kcals / 3 days per week = 333 kcals per exercise bout After she changed her mind: 500 MET-minutes of physical activity per week meets the minimum volume recommendations. She still needs to exercise a minimum of 3 days per week to meet frequency recommendations. 500 MET-minutes / 3 days per week = 167 MET-minutes per exercise bout. Unicycling is 5 METS. I could also pick many others. 167 MET-minutes per bout / 5 METS from unicycling = She needs to unicycle for 33.4 minutes 3 days a week to meet her volume goal. For moderate intensity exercise the recommended range of time spent per day is 30-60 minutes. This client will be spending 33.4 minutes exercising each bout. So we are good here.
Joan is a 48 year old woman who recently became post-menopausal. Bone mineral density is now a major concern of hers. Her doctor tells her that her running routine is not enough to maintain her bone mass, especially for her upper body. What type of exercise should you encourage her to start?
She should start a whole body resistance training routine. The weight loading that occurs with resistance exercise when combined with proper nutrition is the best plan for maintaining bone mass.
What typically defines a good client goal in the exercise profession?
Something you aim to do
Applying stress during exercise training in as similar a way as possible to the stress that will be applied to the individual during activities of daily life, their occupation, recreation, and/or sport.
Specificity
List at least two interventional approaches for each stage of the transtheoretical model.
Stage of Change Interventional Strategy Precontemplation Implement an exercise promotion media campaign, educate about personal benefits of exercise, foster positive values, clarify misconceptions, conduct health risk appraisals Contemplation Market benefits of exercise, foster self- and environmental reevaluation, provide clear guidelines for starting an exercise program (not an exercise prescription), be a positive role model, identify social support for exercise Preparation Conduct psychosocial and fitness assessments, evaluate supports/benefits and barriers/costs, design personalized exercise prescription, set goals, develop behavioral contracts, teach time management skills Action Identify social support for maintaining exercise, set up stimulus control (e.g. don't buy junk food), teach self reinforcement, implement self-efficacy enhancement strategies, set goals, teach self monitoring, employ relapse prevention strategies Maintenance Encourage new activities with others, reinforce self-regulatory skills, review and revise goals, introduce cross-training, conduct periodic fitness testing
Abe is hypertensive and did not take his medicine in the last couple of days because he has had a cold. He is taking Sudafed for his cold. Look up the effects of Sudafed (pseudoephedrine is the active ingredient) on blood pressure online. What are the effects? Is it a good idea to have Abe do a near maximal running workout today? Why or why not?
Sudafed is the name brand cold medication containing pseudoephedrine. Many over the counter medications have pseudoephedrine or other drugs with similar effects on blood pressure. This drug increases blood pressure. To summarize, Abe is not feeling well, is not taking his blood pressure medication, and is on an over the counter drug that increases his blood pressure. It is likely a bad idea to have him perform a vigorous intensity aerobic exercise session that will raise his blood pressure to potentially dangerous levels. If he is still feeling very sick you should send him home to rest until he is no longer sick and back on his blood pressure medication. If he is feeling okay and wants to exercise, you can try to exercise with him at a low intensity. You should at the very least measure his blood pressure before and after exercise to make sure he is in a safe range. It is probably not a terrible idea to measure it during exercise too. Avoid doing intense resistance training as well.
What is the minimal number of repetitions required in a test of muscular endurance for the test to be a true test of muscular endurance?
15
Jacky wants to continue to meet the minimum aerobic exercise requirements set forth by the ACSM, but her work requirements have just gotten more demanding and she needs to cut back on the time spent exercising. She has been exercising for 150 minutes per week at a 40% of her HRR. What could she do to still meet maintain the ACSM recommendations while reducing her time spent on exercise?
40% of HRR reserve is moderate intensity exercise. Each minute of vigorous exercise is worth approximately 2 minutes of moderate exercise. So she could increase her intensity to 60% of HRR and decrease her time spent per week from 150 to about 75 minutes without significant losses in health outcomes. In fact, moderate intensity exercise does little to increase fitness. It is more a benefit towards health outcomes than fitness outcomes. So she would likely maintain her health status while increasing her fitness capabilities by doing this.
How many hours should be between resistance training sessions that work the same muscle group?
48 or more
A week later John comes in for his first personal training visit. Now what stage of the transtheoretical model is he in?
Action
The "A" in "SMARTS" stands for:
Action-oriented
The word used to describe short term effects of exercise.
Acute
Rebecca is in her second trimester of her pregnancy. Rebecca has always enjoyed resistance training especially the barbell bench press. Should Rebecca keep doing the barbell bench press? Why or why not? If not, what can she replace it with?
After the end of the first trimester pregnant women should not exercise on their back (supine) or on their stomach (prone). Because of this she should stop doing the barbell bench press. You also want to avoid anything that could potentially cause trauma to the abdomen. This means free weights above the torso would be a bad idea. She can replace the barbell bench press with a machine chest press that has the body sitting upright.
Muscles that are a primary movers of a joint.
Agonists
Now Tammy wants to resistance train in as few days as possible but using a split routine. Give an example of a sensible split and which days per week she could perform her resistance exercises for each part of the "split"
An example of a split routine could be upper body/lower body, or push exercises/pull exercises. She could do upper body on Monday and Thursday and lower body on Tuesday and Friday. Again, the key is preventing her from working the same muscle group twice without at least 48 hours in between. Given that she seemed interesting in doing as few sessions per week you might want to remind her that doing a split routine will at least double the number of sessions she has in a week.
Chest pain from myocardial Ischemia.
Angina
Jayden has exercise induced asthma and forgot his inhaler today. What do you do?
Asthma attacks can be dangerous. Given that exercise is Jayden's main trigger for his asthma, it is not wise to allow him to exercise without his inhaler. Send him home to get it, or reschedule the session.
Cardiovascular disease initiated by fatty streaks inside of blood vessels.
Atherosclerosis
During the Korean War autopsy's performed on American solders found that 70% of them had fatty streaks in their coronary arteries. The average age of the soldiers was only 22 years old. What disease is initiated by these fatty streaks?
Atherosclerosis, which is the most common type of coronary artery disease. This means that even young apparently healthy people are likely already developing the early stages of heart disease. So what you do when you are young does affect your cardiovascular health long term.
The word used to describe long term effects of exercise.
Chronic
What is the most common cardiovascular disease?
Coronary Artery Disease (CAD)
Thinking about John and Tammy from the previous case studies, what part of the motivational continuum (self determination theory) do they likely reside (currently)? What type of motivation do you want to eventually instill in them?
Currently = Amotivated. You would like to get them to a state of intrinsic motivation.
Again thinking about John and Tammy from the previous case studies, what stage of change (transtheoretical model) are they currently? Hopefully with some education what stage would you hope them to reach?
Currently they are in "precontemplation". If you are lucky and good at what you do, you may be able to get them into the "contemplation" phase.
What are the key factors of the social cognitive theory? Check all that apply.
Environment, Personal, and Behaviors
Use cognitive restructuring to correct the following statement to promote a healthier mindset for your client: Every time I lose weight I just gain it all back. It's pointless.
Even if you gain the weight back there is a benefit to having a period of time where your weight is lower. However, if you use a more modest approach to weight loss you may be able to reduce your weight and maintain the weight loss.
The ability of exercise to bring about a certain result
Exercise Potency
Matt is 19 years old and has been having some issues with his form while going over hurdles on the track. He finds he is not as flexible as he needs to be in order to effortlessly perform the proper hurdling technique. He knows what stretches to do, but he is unsure on everything else. Tell him what he needs to do by filling in the flexibility FITT-VP principle for him.
F: Because he needs to increase flexibility, he should probably perform flexibility exercises daily or almost daily (5-7 days per week [pick 5, 6, or 7 days to recommend rather than giving a range]). I: All stretches should be performed to the point of discomfort but not pain after some aerobic exercise performed as a warmup. T: 10-30s per repetition [pick one, do not give a range]. Shorter or longer than this is not going to be helpful for him. T: He already has exercises in mind that are good for his particular sport. I would assume they are a mix of static and dynamic stretches. They should not include ballistic stretching and probably do not include proprioceptive neuromuscular facilitation stretches because they require a partner. V: He needs to get 60s of stretching per muscle group. E.g. doing repetitions of 30s means he needs to perform each stretch twice to accumulate 60s in total. P: As a highly fit individual it is likely ok to dive right in to doing stretches daily. So the only real progression will be lengthening the muscle more as he becomes more flexible. This is essentially just a matter of maintaining the "intensity" of the stretches as he improves.
A short term goal is often defined as anything that can happen in less than one year.
False
Breaking up exercise into 3x10 minute sessions in a day is not acceptable.
False
Children do a better job of thermoregulating than adults.
False
Doing a cool down will likely result in decreased soreness in the following days.
False
Exercise prescription does not need to be altered when exercising outside on very hot or very cold days.
False
Exercise recommendations for health are much lower for old adults.
False
Stretching repetitions should be 120s in length for all people stretching to improve their range of motion.
False
Stretching will likely result in fewer injuries during an exercise bout.
False
The ACSM metabolic equations are designed to be used with trained runners. Therefore they provide accurate assessments of VO2 for trained runners and the average adult has over inflated values.
False
The ACSM running and walking equations use treadmill speed in miles per hour.
False
John is a football linemen, and Anne is a ballerina. You should prescribe flexibility training differently between these two individuals. Think specifically about the frequency per week. Tell John and Anne how many days per week they should work on flexibility.
Flexibility is a minimal part of John's sport and a huge part of Anne's chosen medium of performance art. John can get by with doing the minimal of 2-3 days per week. Anne should probably perform flexibility exercises every day. Also, John's sport is power intensive. This means he should perform any static and PNF stretches exercises during his cool-down, and use dynamic stretches during his warmup. The same recommendation MAY make sense for Anne too, but it may be less critical given the relative importance of flexibility vs power for a ballerina.
What is wrong (or missing) with this goal: You will perform 2 sets of 10 repetitions for 8 resistance exercises encompassing the full body 3 days per week. The sets will be performed to volitional fatigue using the 2 by 2 rule for increasing the resistance intensity. This is done to meet health standards for resistance training.
Given the language of "you", I assume this was not self-determined. It is specific, measurable, and realistic (sets, reps, # of exercises, and days/week given to meet/surpass resistance training standards for health). This is action-oriented. There is no time component though. When will it be achieved, or if it is done from week one, how long will it be maintained?
How often should you perform flexibility training?
Greater than or equal to 2-3 days/week
Judith has osteoarthritis in her knees and elbows. She comes to you as a new client asking for you to help her get in shape. Her goal is to lose some weight so she has less impact on her knees when she is walking around. Judith takes her pain medication every morning at 8AM and it hits its peak effect around lunch (12noon). When should you exercise her? What types of exercise should she focus on?
Have Judith come in during her lunch break at work when her medication is at its peak effectiveness. You should focus on low impact exercise that burns a lot of calories like water aerobics, cycling, and the elliptical machine. This will decrease the likelihood of further damaging her joints while increasing the likelihood of her reaching her weight loss desired outcomes.
What model states that a person must perceive risk of their bad health behaviors for them to change?
Health Believe Model
Sue is a 28 year old and weighs 136lbs. Her resting heart rate is 74 bpm. Her VO2max was estimated from the Astrand bicycle test at 3.1L/min. What is her VO2max in relative terms? What is her METmax? What is the lowest intensity exercise she can perform and be considered working at a vigorous intensity (vigorous begins where the moderate range ends) as calculated from VO2R in relative terms, VO2max in relative terms, MET reserve, HRR, HRmax, and RPE. I am looking for exact numbers that are specific to Sue, not the criterion. This means for VO2R you will give me a number in mL/kg/min (e.g. 21.3 mL/kg/min). You will not simply tell me 40% of VO2R. Please ask if this does not make sense.
I would probably start by converting her weight to kilograms. 136lbs / 2.2 = 61.8 kg Then I would convert her VO2max from absolute to relative terms. 3.1L/min *1000 / 61.8kg = 50.2 mL/kg/min Her METmax calculation would be: 50.2mL/kg/min / 3.5mL/kg/min = 14.3 METs The low cut off for vigorous intensity for VO2R is 60%. The calculation is as follows. (50.2mL/kg/min - 3.5mL/kg/min) * 0.6 + 3.5= 31.5 mL/kg/min The low cut off for vigorous intensity for VO2max is 64%. The calculation is as follows. 50.2mL/kg/min * 0.64 = 32.1 mL/kg/min The low cut off for vigorous intensity for MET reserve is 60%. The calculation is as follows. (14.3METs - 1) * 0.6 + 1= 8.98 METs I would calculate her age predicted maximal heart rate as: Estimated HRmax = 208 - (0.7*age) = 208 - (0.7*28) = 188.4 ≈ 188 bpm or Estimated HRmax = 220 - (age) = 220 - (28) = 192 bpm The low cut off for vigorous intensity for HRR is 60%. The calculation is as follows. (188bpm - 74bpm) *0.6 + 74bpm = 142bpm Or (192bpm - 74bpm) *0.6 + 74bpm = 144.8bpm The low cut off for vigorous intensity for %HRmax is 77%. The calculation is as follows. 188bpm * 0.77 = 145bpm Or 192bpm * 0.77 = 147.8bpm The vigorous intensity range for RPE is 14-16. The low cut point is 14. No calculations are required here.
Joe is a 22 year old and weighs 162lbs. His resting heart rate is 62 bpm. His VO2max was estimated from the YMCA bicycle test at 4.1L/min. What is his VO2max in relative terms? What is his METmax? What is the lowest intensity exercise he can perform and be considered working at a moderate intensity as calculated from VO2R in relative terms, VO2max in relative terms, MET reserve, HRR, HRmax, and RPE. I am looking for exact numbers that are specific to Joe, not the criterion. This means for VO2R you will give me a number in mL/kg/min (e.g. 21.3 mL/kg/min). You will not simply tell me 40% of VO2R. Please ask if this does not make sense.
I would probably start by converting his weight to kilograms. 162lbs / 2.2 = 73.6 kg Then I would convert his VO2max from absolute to relative terms. 4.1L/min *1000 / 73.6kg = 55.7 mL/kg/min His METmax calculation would be: 55.7mL/kg/min / 3.5mL/kg/min = 15.9 METs The low cut off for moderate intensity for VO2R is 40%. The calculation is as follows. (55.7mL/kg/min - 3.5mL/kg/min) * 0.4 + 3.5= 24.4 mL/kg/min The low cut off for moderate intensity for VO2max is 46%. The calculation is as follows. 55.7mL/kg/min * 0.46 = 25.6 mL/kg/min The low cut off for moderate intensity for MET reserve is 40%. The calculation is as follows. (15.9METs - 1) * 0.4 + 1= 6.96 METs I would calculate his age predicted maximal heart rate as one of the following: Estimated HRmax = 208 - (0.7*age) = 208 - (0.7*22) = 192.6 ≈ 193 bpm or Estimated HRmax = 220 - (age) = 220 - (22) = 198 bpm The low cut off for moderate intensity for HRR is 40%. The calculation is as follows. (193bpm - 62bpm) *0.4 + 62bpm = 114.4bpm Or (198bpm - 62bpm) *0.4 + 62bpm = 116.4bpm The low cut off for moderate intensity for %HRmax is 64%. The calculation is as follows. 193bpm * 0.64 = 123.5bpm Or 198bpm * 0.64 = 126.7bpm The moderate intensity range for RPE is 12-13. The low cut point is 12. No calculations are required here.
Tammy wants to start resistance training, but she wants to do as few days per week as possible. What type of routine should she do (full body or split routine)? Give her an example of which days per week she could perform her resistance exercises.
If the goal is as few days as possible, then she should do a full body routine. The ACSM recommends 2-3 days per week for each major muscle group. So if she wants to meet the minimum requirement she would need to do a full body resistance training routine 2 days per week. You can tell her any days of the week you want as long as there are at least 48 hours between sessions (essentially a day off between training days. So for example: Monday and Wednesday, or Tuesday and Thursday, or Tuesday and Friday. It may also be a good idea to also minimize detraining between sessions. The National Strength and Conditioning Association (NSCA) recommends not taking off more than 3 days between sessions that work the same muscle group. This would suggest something like a Monday and Friday, Monday and Thursday, or Tuesday and Friday, etc. plan would be best.
Melanie wants to do a sprint triathlon in 6 months. She currently does not exercise. Assuming she is young and naturally athletic, do you think this is "Realistic"? Is performing the triathlon a training goal or a desired outcome? Support your answer with rational.
In a young healthy naturally gifted individual 6 months is likely enough time to perform a sprint triathlon (look this up if you do not know what it is). This is a subjective decision that I could see you arguing the other way with your answer. Performing the triathlon could be considered either the final step of the goal, or a desired outcome. I would lean more towards this being a desired outcome, and the goal would be the training program that led up to her being able to do the triathlon.
List three indoor activities and three outdoor activities that can be used in an exercise prescription for "type". Keep your answers focused on cardiorespiratory exercises.
Indoor: Treadmill, swimming, exercise bike, elliptical machine, aerobics classes, walking around a mall, etc. Outdoor: Running, Cycling, walking around the block, hiking, mountain climbing, etc.
Tina is coming to you and wants you to train her. You ask her what her goals are, and she says she doesn't know. What do you do/say next? What part of making SMARTS goals (think in terms of what the acronym means) with Tina is going to be especially hard?
Tina will be especially hard because she doesn't seem to know why she came to see me. This makes it difficult to create "self-determined" goals (the last S in SMARTS). There is no one correct way to proceed at this point, but there could be multiple ways of proceeding that are not correct. You SHOULD NOT make goals for her without her input. You SHOULD NOT belittle her for not knowing what she is doing. You SHOULD NOT turn her away. I hope you understand the "should not's" of this situation (there are others). What I would do is enter into a friendly interview style conversation. Ask her questions like: What do you already do for exercise? What inspires you to exercise? What made you decide you should get a personal trainer? What made you decide to join our fitness facility? What about your current health and fitness level are you happy and satisfied with, etc.? What about your current health and fitness level are you not happy with? Hopefully one of those questions spurs a conversation. From the conversation you would hope to find what motivates her and what she wants in terms of desired outcomes. That can be expanded on to make some good SMARTS goals. Often times people are intimidated by a fitness facility and/or the people who work out there. In those situations, it is a great goal to just get them informed on, and work on achieving, the general health recommendations for exercise as per the ACSM guidelines (covered in other sections of this course). You would also want to teach them how to use several pieces of equipment. These people are often terrified by the thought of looking "stupid" at the gym.
What is wrong (or missing) with this goal: Background information: Kelly wants to feel better and improve her cardiorespiratory fitness for health reasons. She does not currently exercise at all. I will start by walking twice a day for 10 minutes 3 days per week at a moderate intensity (week 1). Week 2, I will walk 3 times a day for 10 minutes at a moderate intensity 3 days per week. Week 3, I will walk 2 times a day for 15 minutes at a moderate intensity five days. Week 4, I will walk 1 time for 30 minutes at a moderate intensity 5 days. In doing all of this I will be able to meet the minimum standards for cardiorespiratory fitness for health in a single effort each day.
Trick question. This sounds like a pretty good SMARTS goal to me. What do you think?
150-300 minutes of moderate intensity physical activity is a good range for increasing health and fitness.
True
5 days per week of moderate intensity exercise or 3 days per week of vigorous intensity exercise is a generally recommended for improving health and fitness.
True
A decent example of a self determined goal is: I will run at a HR of 130 bpm for 30 minutes 4 days per week 4 weeks from now.
True
For health outcomes the focus during resistance training sessions should be on multi-joint exercises incorporating multiple muscle groups.
True
Kids have higher heart rates than adults at submaximal and maximal exercise intensities.
True
Moderate exercise intensity can be defined as 40-59.9% of VO2R of HRR.
True
Over the counter drugs, prescription medicines, and dietary supplements can effect exercise safety and normal exercise responses. Therefore, you should look up the effects of anything your client is taking if you are unfamiliar with the effects, side effects, and interactions with exercise.
True
The ACSM metabolic equations are good but not perfect. They have about a 7-9% standard deviation of error.
True
The ACSM metabolic equations give gross VO2 consumption estimates meaning the oxygen consumption at rest is incorporated into the VO2 calculated.
True
The ACSM metabolic equations use VO2 in relative terms.
True
Which type of diabetes is largely driven by lifestyle choices?
Type 2 Diabetes
The idea that not everyone will respond the same to exercise (even if starting from a similar fitness level).
Variability
The V in FITT-VP stands for:
Volume of exercise per week
Roseanne is 80 years old and has trouble walking for more than about 10 minutes at a time at a moderate intensity. How can you prescribe her exercise in regards to "time" per day that will allow her to still meet the minimum recommendation for health?
You can prescribe exercise in 3x10 minute work bouts spread throughout the day. Anything longer than 10 minutes is long enough to count towards your daily exercise in a cumulative fashion.
John, your neighbor, is clearly obese and performs no exercise. His spouse talks to you out of concern for his health, and asks for you to get him to exercise again. Clearly John has a good social environment given his spouse is encouraging him to exercise. Also, he has an exercise professional right next door, and you know he use to exercise at your gym (which is just down the street). What key factor in the social cognitive theory model for behavior change do you still need to address? What types of subfactors does this include?
You have a pretty good handle on John's behaviors (past and present) and environment. You really know very little about him as an individual (personal factors). You need to find out how he is doing emotionally. Although not discussed in the case study, I'm assuming if you are that close to his spouse you probably know a bit about his personality too. You could also do much better to learn about his cognition (knowledge regarding exercise and health), and his biology (current health status).
A self-determined goal cannot have any guidance from an exercise professional.
False