Exercise Testing

This is the leading cause of pain and disability in the US with approximately 22.2 % of individuals having one of the 100 forms of the disease

arthritis

When does atrial repolarization occur?

at the same time as ventricular depolarization (QRS complex); doesn't show up

What does the P-wave represent

atrial depolarization

This population should be cleared by a medical physician prior to exercise testing to assess these conditions: peripheral neuropothies, musculoskeletal morbidities, fracture risk, cardiac conditions, arm/shoulder morbidity, lower leg lymphadema

cancer

What type of test is recommended before initiating Vigorous intensity exercise for older or high risk individuals?

maximal exercise testing (less commonly used than submaximal)

What is a dissecting aneurysm?

the splitting or dissection of an arterial wall by blood entering through a tear of the inner lining or by interstitial hemmorhage

How quickly should the BP cuff be released?

2-5 mm HG/second

Body Fat ideal for males and females?

20-32 percent for women and 10-22 percent for men

How are the center of gravity and base of support related to balance?

-Base of support-> relates to the surface supporting the body and the points of contact with that surface -Center of gravity-> the body's center of mass, or balance point. typically located in the torso region, but can also be outside the body depending on its position in space. -Stability increases by balancing the COG directly over the base of support.

Name all field tests we talked about in class and in ACSM.

-Cooper 12 minute test for time-> cover the greatest distance in the allotted time period (submax) -1.5 mile test fro time->walk or run the distance in the shortest period of time (submax) -Rockport One Mile Fitness Walk Test-> Subject walks one mile as fast as possible preferably on a track/level surface and HR is obtained in the final minute or after client has stopped moving. For low to moderate risk individuals (Submax) -6 minute walk test-> evaluates CRF in older and clinical patient population -Harvard Step Test-> step onto box for 5 minutes and take the HR right after (submaximal) -Queen's College Step Test (submaximal)

What are recommended lab tests for someone who is high risk for developing CVD?

-Do all the same tests for low to moderate risk plus pertinent previous cardiovacular lab tests (e.g. resting 12 lead ECG, holter monitoring, coronary angiography, radionuclide, previous exercise tests, carotid ultrasound, and other peripheral vascular studies. -Consider measures of lipoprotein (a), high sensitivity C-reactive protein, LDL particle size and #, HDL subspecies (especially in young individuals with a strong family history of premature CVD and in those without traditional CVD risk factors. -chest radiograph -comprehensive blood chemistry panel and complete blood count as indicated by history and physical examination

What is dynamic balance? What is functional balance?

-Dynamic balance is a measure of the torque or resistance developed during stretching throughout ROM -Alternate definition: The ability to maintain your equilibrium while moving through space (e.g.balancing while running) -Functional balance involves maintaining both static and dynamic balance during activities of daily living.

What are recommended lab tests for an individual who is at low to moderate risk of developing CVD?

-Fasting serum total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides -Fasting plasma glucose, especially individual's greater than or equal to 45 years and younger individuals who are overweight (BMI = or > than 25), and have one or more of the risk factors for diabetes. -Thyroid function, as a screening evaluation especially if dyslipidemia is present

What are the advantages and disadvantages of using a maximal versus a submaximal test (what's the difference)?

-Maximal tests require participants to exercise to the point of volitional fatigue which might entail the need for medical supervision. -Maximal testing offers increased sensitivity in the diagnosis of CVD in asymptomatic individuals and provides a better estimate of VO2max -Practitioners commonly rely on submaximal exercise tests to assess CRF because maximal testing is not always feasible in the health/fitness setting -Submaximal exercise testing is also recommended in stable patients 4 to 7 days post myocardial infarction to assess efficacyof medical therapy prior to hospital discharge among other clinical indices -basic aim= determine the HR response to one or more submaximal measures of HR, BP, workload, RPE, and other subjective indices as valuable info regarding one's functional response to exercise.\ > this info can be used to evaluate submaximal exercise responses over time in a controlled environment and appropriately determine the exercise prescription/

What does the BIA (Biolectrical Impedence measurement do?

-Measures resistance to the electrical signal as it travels through water found in muscle and fat. -About equivalent with skinfold measurements as far as accuracy.

What are the test termination criteria?

-Physical/ Verbal manifestation of severe fatigue -Noticeable change in heart rhythm by palpation/auscultation -Onset of angina, or angina like symptoms -Drop in SBP of equal to or greater than 10 mm Hg with an increase of work rate, or if SBP decreases below the value obtained in same position prior to testing -Excessive Rise in Blood Pressure: -SBP greater to or equal to 125 mm Hg and or DBP of greater than 115 mm Hg -Shortness of breath and wheezing -Leg cramps or claudication Signs of poor perfusion -Failure of heart rate to increase with an increased exercise intensity -Subject requests to stop -Failure of exercise equipment -Technical difficulties -ST segment elevation -Increasing nervous system symptoms -Client desires to stop -Signs of poor perfusion

What does muscular strength refer to? How is it measured? What is MVC? What does it mean for muscular strength to be measured statically and dynamically?

-Refers to the external force that can be generated by a specific muscle/muscle group; commonly expressed in terms of resistance met or overcome. -From powerpoint: Ability of muscle group to develop maximal force against a resistance in a single contraction - Can be measured with cable tensiomters, handgrip dynamometers, strain guages, load cells -Peak force development in such tests-> commonly referred to as maximum voluntary contraction (MVC)

What do you do if a risk factor is not disclosed/isn't available? What is the exception for prediabetes when assessing risk category for CVD? What is the one negative risk factor and what does this allow one to do? What are the cardiovascular risk factor classifications?

-That risk factor is counted as risk factor, except for pre-diabetes. -Prediabetes should be counted as a risk factor for those 45 years and older if missing or unknown, especially for those with a BMI of equal to or greater than 25 and those less than 45 years old with a BMI of equal to or greater than 25, and additional risk factors for diabetes. -HDL = 1 negative risk factor if it is greater than or equal to 60 mg/dl > One positive risk factor is subracted from the sum of risk factors Risk Factors-> Disease risk factor classification: High= known CV, pulmonary, or metabolic disease Moderate= greater than or equal to 2 risk factors for CVD Low= less than 2 CVD Risk factors

How do you manipulate the workload on a cycle ergometer? What is the distance of the flywheel and what does this indicate? When do you use the cycle ergometer? What is the formula for workload?

-You manipulate the workload through the cadence (how fast you are going, measured in rpm, and resistance, measured in kg or Watts) - Distance of the flywheel= 6 meters (for every turn, you go 6 meters) - You use the cycle ergometer if balance deficits or pain exists. - Formula for workload: kg* rpm * m >kg= resistance >rpm= cadence >m= flywheel distance

Ranges for HDL Cholesterol

< 40 = Low > or equal to 60 = High

Describe how test organization should be accomplished before the patient arrives?

-all forms, score sheets, tables, graphs, and other testing documents are organize in the client's or patient's file and availabe for the test's administration -calibrate all equipment at least monthly, or more frequently based on use -document equipment calibration in a designated folder -organize equipment so that test can follow in sequence without stressing the same muscle group repeatedly -provide an informed consent form and allow time for the individual undergoing assessment to have all questions adequately addressed. -maintain room temperature between 68 degrees ferenheit and 72 degrees ferenheit and humidity of less than 60 percent with adequate airflow

Lab tests for patients with pulmonary disease?

-chest radiograph -pulmonary function test -carbon monoxide diffusing capacity -other specialized pulmonary studies (e.g. oximetry or blood gas analysis)

Is a medical exam required before exercise for moderate/vigorous exercise for those at low, moderate, and high risk?

-low risk= no for moderate and vigorous -moderate risk= no for moderate and yes for vigorous -high risk= yes for moderate and yes for vigorous

Is MD supervision of an exercise test required for those at low, moderate, and high risk? (for submaximal and maximal)

-low risk= no for submaxmial and maximal -moderate risk= no for submaximal and no for maximal -high risk= yes for submaximal and yes for maximal

Is an exercise test required for moderate/vigorous exercise for those at low, moderate, and high risk?

-low= no for moderate and no for vigorous -moderate- no for moderate and no for vigorous -high= yes for moderate exercise and yes for vigorous

Explain the dose response relationship between the amount of calories burned per day and health benefits associated?

1,000 kcal/week -sufficient to reduce disease risk -insufficient to maintain health body weight -insufficient to experience full health benefits 2,000 kcal/week -sufficient to maintain health body weight -sufficient to prevent weight gain -sufficient to provide additional health benefits 3,000 kcal/week -maxed out on health benefits

Explain the dose response relationship between the amount of calories burned and health benefits associated?

1,000 kcal/week-> sufficient to reduce disease risk, insufficient to maintain healthy body weight, insufficient to experience full health benefits 2,000 kcal/week-> sufficient to maintain a healthy body weight, prevent weight gain, and provide additional health benefits 3,000 kcal/ week-> maxed out on health benefits

What are the risk factors and defining criteria for Cardiovascular Disease? (8 total)

1. Age: men= greater than or equal to 45 years and women= greater than or equal to 55 years 2. Family History-> myocardial infarction, coronary revascularization or sudden death before 55 in father or 65 years in mother, or other male/female first degree relative. 3. cigarette smoking- current smoker, or those who quit within previous 6 months, or exposer toenvironmental cigarette smoke 4. sedentary lifestyle-> not participating in at least 30 minutes of moderate intensity physical activity (40-60 percent VO2) on at least 3 days a week for at least 3 months. 5. Obesity-> BMI of greater than or equal to 30 or waist girth >102 cm for men and > 88 cm for women 6. Hypertension-> SBP greater than or equal to 140 mm Hg and/ or diastolic BP greater than or equal to 90 mm Hg confirmed by measurements on at least two occasions. 7. Dyslipidemia-> LDL (Low Density Lipoprotein) greater than or equal to 130 mg/dL or High Density Lipoprotein less than 40 mg/dl or on lipid lowering medication If total cholesterol is all that's available greater than or equal to 200 mg/dL 8. Prediabetes-> Impaired Fasting Glucose (IFG) greater than or equal to 100 mg/dL and less than or equal to 125 mg/dl or Impaired GLucose Tolerance (IGT) = 2 hour value in Oral Glucose Test > 140 mg/dL and < 199 mg/dL confirmed on 2 seperate occasions

Skinfold Procedures

1. All measurements made on right side of the body with the subject standing upright. 2. Caliper placed directly on skin surface 1 cm below thumb and forefinger, perpendicular to the skinfold, and halfway between crest and base of fold. 3. Pinch should be maintained while reading the caliper. 4. Wait 1-2 seconds before reading caliper. 5. Take duplicate measurements at each site, or allow time for skin to regain normal texture and thickness.

Procedures for circumference measurements?

1. All measurements made with a flexible, yet inelastic tape measure. 2. Tape should be placed on skin surface, not over clothes without compressing adipose tissue. 3. Take duplicate measures at each site and retest if not within 5 mm (.5 cm) 4. Rotate through each site, or allow time for skin to re-gain normal texture before taking duplicate measures.

What is the procedure for the Queen's College Step Test?

1. Athlete warms up for 10 minutes and athletes step up and down on a platform at a rate of 22 steps/minute for females and 24 steps per minute for males 2.Subjects uses a 4 step cadence, "up up, down down" for 3 minutes. 3. Athlete stops immediately on completion of the test and heart beats are counted for 15 seconds 4. multiply this 15 second reading by 4 which will give you the BPM value to be used in calculation or vo2max

List the components of the symptom limited exercise test physical examination (box 3.2, p. 43 in ACSM)

1. Body weight (in many cases BMI, waist girth, and/or body comp/percent body fat is desirable) 2. Apical pulse rate and rhythm (at the apex of heart) 3. Resting BP (seated, supine, standing) 4. Auscultation of lungs with special attention to uniformity of breathing sounds in all areas 5. Palpation of the cardiac apical impulse and the point of maximal impulse 6. Evaluation of bowel sounds, masses, visceromegaly, and tenderness 7. Absense or presence of skin and tendon xanthoma 8. tests of neurologic function including reflexes and cognition 9.inspection of skin especially of the lower extremities in known patients with diabetes mellitus 10. Palpation auscultation of carotid, abdominal, and femoral arteries.

List components of medical history (Box 3.1, p. 42)

1. Medical diagnosis. 2. Previous physical examination findings. 3. History of symptoms. 4. Recent illness, hospitilization, new medical diagnosis, or surgical procedures 5. Medication use and drug allergies 6. Exercise history- info on readiness for change and habitual level of activity: frequency, duration, type, time and intensity 7. Work historywith emphasis on current or expected physical exams 8. Family history of cardiac, pulmonary, or metabolic disease, stroke or sudden death.

Push Up Test Procedure?

1. Men start at the standard "down" position and women in the modified "knee push-up" position 2. Client must raise body by straightening the elbows and return to "down" position, until chin touches the mat (stomach cannot touch) 3. Both men and women-> subject's back must be straight at all times and the subject must push up into a straight arm position 4. Max number of push ups performed consecutively without rest is counted as the score. 5. Test stopped when client strains forcefully or is unable to maintain appropriate technique with two reps. ** can use a box or a fist

What factors affect the reliability of a goniometer?

1. Not stabilizing the stationary portion of the body-> part of the body that is proximal (closer to the midline of the body) to the join you are testing. 2. Accuracy of readings on goniometer could be slightly off. 3. Consistency of using the same stationary and movable landmarks on the body when measuring each time.

What do you do if there is NOT a biphasic wave?

1. Pick one with the largest magnitude (III, II, I, AVF, AVR, or AVL) 2. Look at coordinate axesi and pick side which matches up with signs of I and AVF Ex: I= + and AVF = - & Biphasic is n/a but III is the one with the biggest magnitude. Could either have been 120 degrees or 90 degrees, but because I is positive and AVF is negative, we are in the left quadrant axis.

Chair stand procedures and scoring?

1. Place the chair against the wall, or otherwise stabilize it for safety. 2. The subject sits in the middle of the seat with feet shoulder width apart, flat on the floor, and arms crossed at the wrists and held closely to chest. 3. From sitting position, subject stands completely up and completely back down. This is repeated for 30 seconds. 3. Count total number of complete chair stands (up and down) 4. if subject has completed a full stand from sitting position when time is elapsed, final stand is counted in total. Scoring: The score is the total # of completed chair stands in 30 seconds.

Procedures and scoring for 8 foot get up and go test?

1. Place the chair next to the wall for safety and the marker 8 feet in front of the chair 2. Clear the the path between the chair and the marker. 3. Subject starts fully seated (hands resting on knees and feet flat on the ground) 4. On command "go" timing is begun and subject stands and walks as quickly as possible to and around cone, returning to chair to sit down. 5. Timing stops as they sit down. Perform 2 trials. Scoring: Take the best time of the two trials two the nearest 1/10th of a second

What is the proper order in which you should conduct an exercise test and what exactly is involved in each step?

1. Resting BP and HR 2. Balance and Body Composition (waist circumference, skinfold assesment) 3. Cardiorespiratory Endurance (submaximal or maximal test typcically on a cycle ergometer or treadmill) 4. Muscular Fitness- Muscular strength: 1 to multiple RM upper body (bench press) and lower body (leg press) and Muscular endurance: curl up test, push up test, specific motions using appropriate equipment to fatigue (e.g. bench press) 5. Flexibility- sit and reach or goniometric measurements of isolated anatomical joints

What are absolute contraindications to muscular fitness tests?

1. Unstable CHD 2. Decompensated HF 3. Uncontrolled dysrhythmias 4. Uncontrolled hypertension (SBP >180mmHG and/or DBP >110mmHG) 5. pulmonary hypertension (MAP >55mmHg) 6. Acute myocarditis, endocarditis, pericarditis 7. Aortic dissection 8. Marfan syndrome 9. Severe and symptomatic aortic stenosis 10. High intensity resistance training (80 % to 100 % of 1RM) in patients with active proliferative retinopathy or moderate or worse nonproliferative diabetic retinopothy

Relative Contraindications to performing aerobic exercise tests?

1. Ventricular aneurysm 2. Left main coronary stenosis 3. moderate stenotci valvular disease 4. elecroyte abnormalities 5. Sever arterial hypertension , defined as SBP >200 mmHg, DBP >110 mmHg 6. tachydysrthmaias (HR > 100_ or 7.Bradydysrhythmia (HR less than 60 BPM) 8. Hypertrophic cardiomyopothy or other forms of outflow tract obstruction 9.Neuromotor, musculoskeletal, or rheumatoid disorders that are exacerbated by exercise 10.High degree AV Block 11.uncontrolled metabolic disease.

What are the absolute contraindications to aerobic exercise testing

1. acute myocariditis or pericarditis 2. recent, significant change in resting ECG suggesting significant ischemia, recent myocardial infarction (within two days), or other acute cardiac events 3. unstable angina 4. uncontrolled cardiac dysrythmias causing symptoms of hemodynamic compromise 5.symptomatic severe aortic stenosis 6.uncontrolled symptomatic heart failure 7. acute pulmonary embolus/pulmonary infarction 8. acute systematic infection accompanied by fever, body aches, or swollen lymph glands 9. Dissecting aneurysm

List the major signs and symptoms suggestive of cardiovascular, pulmonary, or metabolic disease?

1. anginal symptoms in neck, chest, jaw , arms, or other areas that may result from ischemia 2. shortness of breath t rest or with mild exertion 3. dizziness or syncope 4. orthopnea or paroxysmal nocturnal dyspnea 5. ankle edema 6. palpitations/tachycardia 7.intermittent claudication 8. known heart murmur 9. unusual fatigue or shortness of breath with usual activities.

What are relative contraindications to muscular fitness test?

1. major risk factors for CHD 2. diabetes at any age 3. uncontrolled hypertension (>160/100) 4. musculoskeletal limitations 5. individuals who have pacemakers or defibrillators

What points should be considered for patient preliminary instructions? (8 total)

1. no caffeine, alcohol, tobacco products, or food should be ingested within 3 hours of testing. 2. participants should be rested for the assessment, avoiding significant exercise or exertion on the day of the assessment. 3. clothing should allow for freedom of movement and include walking/running shoes. Women should wear button down blouse that is short sleeved and avoid restrictive undergarments. 4. If evaluation is on an outpatient basis, participants should be made clear that the exercise test may be fatiguing, and may want someone to come with them to the appointment to accompany them home. -Clients taking B blocking agents may be asked to taper their medications over a 2 to 4 day period to minimize hyperadrenergic withdrawal responses. 5. If exercise test for diagnostic purposes-> may be helpful to discontinue prescribed cardiovascular medications, but only with a physician's approval 6. If exercise for exercise prescription purposes, patients should continue their medication regimen on their usual schedule so that the exercise response will be consistent with responses expected during exercise testing 7. Participants should bring a list of their medications including dosage and frequency of administration to the assessment and should report the last actual dose taken. (or bring medication with them for the exercise testing staff to record) 8. Drink ample fluids over 24 hour period before the exercise test to ensure normal hydration before testing (EU state)

Most accurate estimate of VO2 max achieved from the HR response to submaximal exercise tests if all of these assumptions are achieved.

1. steady state HR obtained for each exercise work rate 2. a linear relationship exists between HR and work rate 3. Difference between actual and predicted maximal HR= minimal 4.mechanical efficiency (VO2 at a given work rate = same for everyone) 5. Subject not on meds, using high quantities of caffeine under a lot of stress, ill, or in a high temp environment -> all could alter HR

What are the Center for Disease Control physical activity recommendations?

150 minutes per week of moderate activity 75 minutes per week of vigorous activity Resistance training 2 + days/week 30 minutes on 5 days a week (spread out) Dose response relationship-> additional= better

What are the Surgeon General physical activity recommendations?

150 minutes per week of moderate-intense (total) 30 minutes per day, 5 days a week of moderate PA 60 minutes per day= children

What is the formula for the Small Box Method?

1500/ # of small boxes between R waves

What equipment is required for the Queen's College Step Test?

16.25 inch step, stopwatch, metronome, and heart rate monitor

Steps to calculate BMI?

1st: change pounds to kilograms-> divide pounds by 2.2 lbs to get to kilograms 2nd: convert inches to meters squared-> multiply inches by .0254, and then square the meters value 3rd: Divide weight in kilograms by meters squared and you will obtain BMI

Difference between 2 component and 3 component model of body comp?

2 component: just measure FFM and Fat mass 3 compenent: measuers FFM, Fat mass, and Bone

What are the AHA and ACSM definitions for moderate intensity exercise? What is RPE? What is 1 MET equivalent to (ml/kg/min)

3-6 METS or 5-6 on a 10 point Ratings of Perceived Exertion (RPE scale) and it shows how hard you are working during exercise; 40-60 % VO2max MET= 3.5 ml/kg/min ; shows that there is a certain amount of oxygen being consumed at a higher MET- a higher amount of oxygen being consumed.

How do you calculate SM for the cycle test?

3.5 + 3.5 + (1.8 * work rate)/ (body mass) work rate should be in kpm and body mass should be in kg

What are the American Heart Association/American College of Sports Medicine PA recommendations?

30 minutes, 5 days per week of moderate activity 20 minutes, 3 days per week of vigorous activity minimum of 2 days per week resistance training (2-4 sets)

What is the formula for the Large Box Method?

300/ # of large boxes between R waves

What are two of the most common prediction equations for the two component model that allow one to convert body density to percent body fat?

5 fat = 457/ Body density-414.2 % fat = 495/ Body density-450

How long should the client rest before Blood Pressure is assessed?

5-10 minutes, but a minimum of 5

What is considered an acceptable fasting glucose? Not acceptable an fits criteria for pre-diabetes for IFG and OGT (oral glucose test)

60 to 90 mg/dl = acceptable fasting glucose greater than 100 mg/dl but less than 126 mg/dl or Impaired OGT > 140 mg/dl but <200 mg/dl

How much of the upper arm should the cuff circle?

80 percent of the client's arm-> if it doesn't, you should either get a smaller cuff or a larger cuff

Describe monitoring during CRF testing and why CRF testing is important. (what benefits come of it?)

:30 HR1 1:30 HR2 2:00 BP 2:30 RPE 2:40 HR 3 HR should level off by two minutes Purpose : 1. prdicts cardiorepspiratory fitness 2.customize design of exercise prescrition 3. evaluate effectiveness of an exercise program 4. monitors hr and bp and perceived exertion response HR monitored each minute, and BP monitored each stage, RPE measured once each stage.

Ranges for total cholesterol?

< 200- Desirable 200-239- Borderline high > or = to 240- High

What are the ranges for LDL cholesterol?

<100 = optimal 100-129= near optimal/above optimal 130-159 = borderline high 160-189= high greater than or equal to 190 = very high

What are normal, borderline high, high, and very high triglyceride numbers?

<150 normal 150-199 borderline high 200-499 high > or = to 500

What is the AHA and ACSM's definition for vigorous intensity exercise?

>6 METS or 7 to 8 on a 10 point RPE Scale, > 60 percent VO2max

What is the 8 Foot Get Up and Go Test for Seniors? What is its purpose? What equipment is needed?

A coordination and agility test for elderly that is part of senior fitness test protocol. Purpose: measures speed, agility, and balance while moving Equipment: stopwatch, straight back folding chair (17 inches/ 44 cm high), cone marker, measuring tape, area clear of obstacles

What is a goniometer? How is it used?

A device used to measure the range of motion around a joint in the body. 1st: place goniometer axis over the fulcrum of teh joint. Place the stationary arm along the stationary line o the body and the movable arm on the moving part of the body. 2nd: Patient moves the joint a certain direction with the stationary arm remaining straight. 3rd: Look at the reading on the goniometer.

What is syncope?

A faint, temporary loss of consciousness due to generalized cerebral ischemia (insufficient supply of blood to an organ usually due to a blocked artery).

What is intermittent claudication?

A pain in the leg that a person experiences when walking or exercising. The pain is intermittent and goes away when the person rests. Due to poor circulation of blood in the legs.

What is a goniometer? What are other methods for measuring ROM?

A protractor -like device with two arms that measures the joint angle at the extremes of ROM Flexometers/Inclinometers, tape measures, electrogoniometers

What is palpitation?

A subjective sensation of an unruly rapid or irregular heartbeat

What is the chair sit and reach? What is its purpose? What equipment is needed?

A test designed to test functional fitness of seniors. Purpose: measures lower body flexibility Equipment: ruler, straight back or folding chair (about 17 in. high)

What is the back scratch test? What is its purpose? What equipment is needed?

A test that measures how close the hands can be brought together behind the back. Purpose: test measures general shoulder ROM Equipment Required: ruler or yardstick

What is high degree atrioventricular block?

AV block occurs when atrial depolarizations fail to reach teh ventricles or when atrilal depolarization is conducted with delay. High degree= consists of multiple P waves in a row that should conduct, but do not.

List all of the uniplar limb leads in an ekg.

AVF, AVL, AVR, Ground

Normal Axis Deviation?

AVF= Positive and Lead 1 = Positive

What is muscular endurance? What are absolute and relative muscular endurance? What are examples of muscular endurance field tests?

Ability The ability of a muscle group to exert submaximal force for extended time periods. Absolute-> Total # of reps at a give amount of resistance is measured. Ex: Partial Curl Up test, Push Up Test Relative-> # of reps performed at a percentage of the 1-RM (e.g. 70 %) used pretesting and posttesting

What is absolute VO2 and relative VO2? Which is better?

Absolute VO2 is directly related to body size, so larger people will have a greater VO2. However, relative VO2 is expressed relative to an individual's bod weight.

Difference between active and passive cool down and when is the only time you would use a passive cool down?

Active means you continue exercise at a work rate equivalent to that of the first stage of the exercise test protocol or lower and gradually decrease resistance until HR returns close to the initial Heart Rates attained. Passive means that you abruptly end the test without a progressive cool down. Only do this if the subject experiences signs of discomfort or an emergency situation occurs.

What are the advantages and disadvantages of step testing?

Advantages: It is an inexpensive modality for predicting CRF by measuring HR response to stepping at a fixed rate and/or a fixed step height, or by measuring post-exercise recovery HR Requires little or no equipments, steps are easily transportable Stepping skills require little practice Test is usually short and duration and stepping is advantageous for mass testing Easy to explain Disadvantages: Excessive fatigue, not keeping to the cadence, special attention needed of those with balance problems, or those who are deconditioned -Doesn't take into account height of client, or their leg length.

Motor Driven Treadmills Advantages and Disadvantages?

Advantages: can be used for submaximal and maximal testing and are often employed for diagnostic testing in the US. Provides a familiar form of exercise if correct protocol is chosen, can accommodate the least physically fit, to the fittest, across a continuum of walking and running speeds. Disadvantages; treadmills are usually expensive, not easily transportable, make measurements harder to obtain (BP, HR, ECG) difficult while running; treadmills must be calibrated;holding onto support rails can skew metabolic work output (overestimation)

What is the target population for the 8 foot get up and go test? How many times should the test be practiced and performed? Can a can or walker be used? Is a push off from a chair allowed?

Aged population, which may not be able to do a traditional fitness test. For best results, practice test once and then perform twice, A cane/walker may be used if usual mode of walking. Push off from chair is allowed.

What are some of the skill related components of physical fitness?

Agility-the ability to change the position of the body in space with speed and accuracy Coordination-the ability to use the senses, such as sight and hearing, together body parts, in performing tasks smoothly and accurately Balance-The maintenace of equilibrium while stationary or moving Power-the ability or rate at which one can perform work Reaction time-the time elapsed between stimulation and the beginning of the reaction to it Speed-the ability to perform a movement within a short period of time.

Procedures/Aim for Arm Curl Test? Scoring for Arm Curl Test

Aim= do as many arm curls as possible in 30 seconds. -test conducted on dominant arm side (or stronger side) -subject sits on the chair, holding the weight in the hand using a suitcase grip with the arm vertically down position beside the chair. -Brace upper arm against the body so that only the lower arm is moving. -Curl the arm up through full range of motion, gradually turning palm up. -As arm is lowered through full ROM, gradually returning to the starting position. -The arm must be fully bent and then fully straightened at the elbow. -The protocol for the AAHPERD test describes the administrator's hand being placed on the biceps and the lower arm must touch the tester's hand for a full bicep curl to be counted. -Repeat action as many times as possible within 30 seconds. Scoring: Score= total number of controlled arm curls performed in 30 seconds

What happens on the vertical axes of an ECG?

Amplitude is measured in millivolts. 1 small box= .1 millivolts (mv) 1 large box= .5 millivolts (mv)

What is tachycardia?

An abnormally rapid heart beat.

Define an electrocardiogram.

An electrocardiogram is a test that checks for problems with the electrical activity of your heart. It translate s the heart's electrical activity into line tracings on paper. The spikes and dips in the line tracings are called waves.

Define balance.

An even distribution of weight-> enabling someone to remain upright and steady in whatever posture he or she is trying to maintain

What is an isokinetic contraction? It is considered dynamic or static?

An isokinetic contraction involves a movement that is the same speed throughout the movement; You need specialized equipment that is expensive. It is considered to be a dynamic contraction. Ex: cycle ergometer

What is a cardiac arrhythmia?

Any disturbance or irregularity of the heartbeat.

Affects nearly 76 million Americans and leads to a higher risk of CVD, stroke, heart failure, and peripheral artery disease

Arthritis

What is being assessed with the Romberg Test? What are the procedures? Variations for testing?

Assesses static balance Equipment: clean, open area, a stopwatch Procedures: 1. take shoes off and put feet together as close as possible cross arms across chest (posture throughout test) 3. stand a still as possible 4. stand as long as possible and maintain posture without swaying (max =60 seconds), or without altered stance. Variations: eyes closed, tandem stance (one foot in front of the other)

What is being assessed with the Functional Reach Test? What are the procedures for the Functional Reach Test? What is the test termination criteria for the Functional Reach Test? What is the computation of the final score?

Assesses: Dynamic balance and the risk of falling Equipment needed: Piece of tape and a wall, flexible tape measure (measured to shoulder height) Procedures: 1. stand shoulder width, finger tip to finger tip 2. fingers at about 0 cm to start 3. reach out as far as possible 4. see how far out you can reach in centimeters (heels can come off the ground and do not alter the base of support) Test termination criteria-> stumble forward, fall coming back, loss of contact with the ground Computation of final score-> average of three trials of how far you can lean

Procedures for Harvard Step Test?

Athlete steps up an down on platform at a rate of 30 steps per minute for 5 minutes until exhaustion Exhaustion-> Defined as when the athlete cannot maintain stepping rate for 15 seconds. Athlete immediately sits down on completion of the test and the total number of heart beats are counted between 1 to 1.5 minutes after completion of test (long form of test) > For long form of test: additional heart rates being measured between 2 and 2.5 minutes and between 3 and 3.5 minutes

What is the axis, static arm, and moving arm of the goniometer when measuring shoulder girdle flexion? Should the subject be supine or prone?

Axis: Acromion process Static Arm: Midaxillary Line Moving Arm: Lateral epicondyle of humerus Measured while supine (facing up)

What is the axis, static arm, and moving arm of the goniometer when measuring shoulder girdle extension? Should the subject be supine or prone?

Axis: Acromion process Static Arm: Midaxillary Line Moving Arm: Lateral epicondyle of the humerus The subject should be prone (face down)

What is the axis, static arm, and moving arm of elbow flexion?

Axis: lateral epicondyle of humerus Static Arm: Laeral midline of humerus Moving Arm: Lateral midline of radial head and styloid process Measured while supine.

Do benefits of physical activity generally outweigh the risks? What is the risk of sudden cardiac death in young adults during vigorous activity? What is the risk of sudden cardiac death in healthy adults? Nonfatal complications during cardiac rehab? (risk in hours) Fatal complications during cardiac rehab? (risk in hours)

Benefits outweigh the risks. 1 : 133,000 men and 1: 769,000 women 1 in 15,000- 18,000 young adults Non-fatal complications during cardiac rehab: 1 in 34, 673 hours Fatal complications during cardiac rehab: 1 in 116, 402 hours

What is a bipolar lead defined as? A unipolar lead?

Bipolar= utilizes a single positive and a signle negative electrode between which potentials are measured and a single negative electrode between which potentials are measured Unipolar leads= have a single positive recording electrode and utilize combinations of the other electrodes to serve as a "composite" negative electrode

What is a pulmonary embolus?

Blockage of an artery of the lung by foreign matter such as fat, a tumor, tissue, or a clot originating from a vein

What are some health related components of physical fitness?

Cardiorespiratory endurance-> the ability of the circulatory and respiratory system to supply oxygen during sustained physical activity. Body composition-> the relative amount of muscle, fat, bone, and other vital parts of the body Muscular strength-> the ability of the muscle to exert force Muscular endurance-> the ability of the muscle to continue to perform without fatigue Flexibility-> the range of motion of a joint

What are the various types of cardiovascular, pulmonary, and metabolic diseases that can be classified as "Known CV, Pulmonary and Metabolic Disease" when classifying people based on risk factors?

Cardiovascular: Cardiac, peripheral vascular, or cerebrovascular disease. Pulmonary: COPD, asthma, interstital lung disese, or cystic fibrosis Metabolic: Diabetes mellitus (types 1 and 2) or renal disease.

What are the different methods one can use to obtain HR? What is the most common way to measure HR?

Carotid palpation, femoral palpation, abdominal palpation (not common), Radial palpation, brachial, palpitation, auscultation with stethescope, radio telemetry HR monitor Radial HR (use two fingers on thumb side of wrist)

Name the three sites for skinfold assessments in males.

Chest, Abdomen, and Thigh

What are the pre-test recommendations for sit and reach assessment?

Clients should perform a short warm up before the test and include stretches. The participant should refrain from fast, jerky movements which may increase the possibility of an injury. Shoes should be removed. Breathing is important-> inform client to exhale normally while performing the reach.

What is a ventricular aneurysm?

Complication of a heart attack. Ballooning of a section of a blood vessel in the heart that 1st appears several days or weeks after an acute myocardial infarction.

What happens with concentric and eccentric contractions? Exhale on concentric or eccentric contraction? Example?

Concentric- Joint angle and musculature are both shortening (weight of barbell overcomes strength of the arm) Eccentric- Joint angle and musculature both lengthening and increasing. Exhale on concentric. Example is the bench press-> when you push weights above you exhale because this is concentric phase and when you bring weights back down you inhale because its eccentric.

Is the Bruce Treadmill test considered submaximal or maximal?

Could be either. 3 minute stages increased speed until max is attained.

Describe what you do for the 6 Second Method HR?

Count cycles in a 6 second interval and multiply by 10. Always begin with zero and start with the most prominent point and count boxes to the next prominent point. -5 Large Boxes in 6 seconds (5 *6) = 30 -Ex: 6 cycles * 10 = 60 BPM

What does DEXA stand for and what is it? Disadvantages?

DEXA= one of the most accurate ways to measure bone density. 2 x-ray beams with different energy levels are aimed at the person's bones. Also measures muscle mass, fat mass and body water. Disadvantage= cannot be used very much in a routine health setting because it is extremely expensive and requires trained personnel.

Naughton Treadmill aimed at what population?

Deconditioned older people/cardiac rehab coronary health test 2 minute stages starts at 2 mph

What happens if I or AVF are biphasic?

Go straight to where I or AVF is on the cardinal axis and count 90 degrees positive or negative from that point.

What is depolarization? What occurs with depolarization?

Depolarization is the act of losing internal polarity. The positive ions flood inside the cell and are channeled from cell to cell across the heart.

What are the benefits of assessing muscular strength and endurance in children and adolescents?

Developing proper posture, reducing the risk of injury, improving body composition, enhancing motor skills like jumping and sprinting, and enhancing self confidence and self esteem

Carbohydrate intake and/or medications should be adjusted prior to exercise testing

Diabetes mellitus

Population is more predisposed to autonomic neuropothy, peripheral neuropothy, nephropathy, macrovascular complications, microvascular complications. The effects of these conditions need to be considered prior to exercise testing.

Diabetes mellitus

Suprailiac Skinfold Assessment

Diagonal Fold: in line with the natural angle of the iliac crest taken in the anterior axillary line immediately superior to the iliac crest

Subscapular Skinfold Site

Diagonal fold (at a 45 degree angle) 1-2 cm below the inferior angle of the scapula

Chest/ Pectoral

Diagonal fold-> One half the distance between the anterior axillary line and the nipple (men) or one third of the distance between the anterior axillary line and the nipple (men)

What are the advantages and disadvantages in using anthropometric measurements measurements? What are examples of anthropometric measurements?

Disadvantages: Anthropometric measurements are limited in their ability to provide highly precise estimates of percent body fat. Advantages: Provide valuable information on general health and risk stratification. Examples: BMI, WHR, waist circumference, and skinfolds

What variables does flexibility depend on physiologically?

Distensibility of the joint capsule, warm-up, and muscle viscosity, and compliance of various other tissues such as ligaments and tendons that affect ROM, body temp (should be warm), girth (the larger the girth the less flexible), too much focus on the concentric phase (eccentric phase needs attention as well)

For individuals aged 40 to 70 years, each increment of 20 mm Hg in SBP or 10 mm Hg in DBP does what to the risk of CVD across what BP range?

Doubles the risk across the range from 115/75 mm Hg to 185/115 mmg Hg

Recommendations for supervision of exercise testing for those at moderate risk?

Exercise testing for individuals at high risk can be supervised by non-physican health care professionals if the professional is specially trained in clinical exercise testing with a physician immediately available if needed.

What is being assessed with the Star Excursion Test? What equipment is needed? Procedures? Variations? Test Termination Criteria? Computation of final score?

Dynamic balance is being assessed with the Star Excursion Test. Equipment: A clear area, flexible tape measure, masking tape, goniometer OR a star excursion mat and clean open area Procedures: 1. One piece of tape placed horizontally. Use goniometer to measure 45 degrees from horizontal tape. 2. 6 practice trials in 8 directions are required.5 minute trials on each leg (24 on each leg) with 10 seconds in between each trial. 3. 3 real trials allowed Test Termination? Actual transfer of weight; ball of foot should be in the middle, hands on the hips, and reach out as far as possible. Computation of final score? 1. Take the average of three trials on both legs. 2. Take the reach length and divide by the leg length in centimeters and you will get a ratio you can compare to norms.

Describe the standard sit and reach protocol?

Equipment needed: standard sit and reach box or modified sit and reach box Procedures: 1. Silver lever pulled close to them. 2. inhale and exhale while pushing silver lever as far as they can forward. 3. tuck head, knees flat, and hands over each other with middle fingers over each other. 4. Hold 2 to 3 seconds, extended, and sit back up to start.

What does body composition help us to determine and do?

Estimate healthy body weight Formulate nutritional recommendations Formulate exercise prescriptions Estimate competitive weight for athletes Monitor growth Identify those at risk of under- or overfatness Assess changes with aging, malnutrition, and disease Assess effectiveness of nutrition/exercise programs

What are the recommendations for supervision of exercise testing for those at moderate risk?

Exercise testing of individuals at moderate risk can be supervised by non-physician health care professions if the professional is specially trained in clinical exercise testing, but whether or not a physician must be immediately available for exercise testing is dependent on local policies and circumstances, the health care of the patient, and the training and experience of the laboratory staff.

Prior to exercise testing-> perform a comprehensive review of the symptoms to determine severity and location of an individual's pain. During testing continuously monitor the pain levels. After testing educate the individuals on difference between post exercise soreness and fatigue and normal fluctuations in pain/fatigue as a result

Fibromyalgia

Define flexibility and why it is important. What are different pieces of equipment that can measure flexibility? What does flexibility usually estimate?

Flexibility is the ability to move a joint through its complete ROM. It is important in athletic performance and in ability to carry out Activities of Daily Living.

What populations are free weights, constant resistance, and variable resistances used for?

Free weights most commonly used during testing. All of these could be used depending on the individual. Constant resistance-older people Variable resistance- someone who has spasticity issues like Parkinson's disease.

Mechanically Braked Cycle Ergometers

Frequently used for diagnostic testing, particularly in European laboratories Advantages: lower equipment expense, transportability, and greater ease in obtaining BP and ECG (if appopriate) measurements -provide non-weight bearing test modality in which work rates are easily adjusted in small increments Disadvantages: less familiar mode of exercise to individuals in the US, often resulting in localized muscle fatigue and underestimation of VO2 -must be calibrated -subject must maintain proper cadence

How is cardiac output measured?

HR X SV

What is the significance of HRs between 110 and 150 BPM?

HR and )2 consumption rates have a direct and linear relationship between 110 and 150 BPM.

Does the sit and reach test measure hamstring or lower back flexibility better? What other type of flexibility does it measure?

Hamstring> low back Gastroc/soleus flexibility

What are the test termination criteria for the Romberg Test?

Hands come uncrossed, base of support is altered, visible sway; if doing eyes closed variation, if eyes open.

What are the 2 main components of fitness?

Health related and skill related physical fitness

Describe Hydrostatic Weighing (underwater weighing) and Plethysmography

Hydrostatic weighing is the gold standard of body composition measurements; Relies on Archimedes principle that states when a body is immersed in water it is buoyed by a counterforce equal to the weight of the water displaced. Muscle weighs more in water than fat and is more dense, so a person with more FFM will weigh more and have a lower percentage body fat. Plethysmography utilizes air displacement of air within a closed chamber. Less time is required than with hydrostatic weighing. Requires less technical skill than hydrostatic weighing. Client wears minimal clothing during the test and steps inside a "Bod Pod"

Does hyper-hydration and dehydration reduce or increase resistance and what happens with the current in regards to BIA?

Hyper hydration reduces resistance and current moves easily Dehydration increases resistane and slows the current Obesity may skew results because of differences in body water distribution.

Usually prescribed Beta blockers to treat the condition. These drugs adversely affect thermoregulatory function and in some cases may predispose an individual to hypoglycemia. These drugs may also lower submaximal exercise capacity and attenuate HR response. RPE should be used.

Hypertension

List all bibolar leads in an 12 lead EKG.

I -> voltage difference between AVL and AVR II-> voltage difference between AVR and AVF III-> voltage difference between AVL and AVF

Computation of final score for sit and reach?

If at 23 cm to start-> add 3 cm to final score to compare to norm values in ACSM If at 26 cm to start-> simply compare to norm values in ACSM

Scoring of Chair Sit and Reach Test?

If fingertips touch toes-> Score= zero Fingertips don't touch-> measure the distance between fingers and toes (negative score) If they overlap-> measure by how much (positive score). Perform two trials Score recorded as the nearest .5 inch or 1 cm as the distance reached, either positive or negative score. Record which leg used for measurement.

What is a field test and what are the advantages and disadvantages?

In a field test you are walking and running in a predetermine time or distance (i.e 12 minute and 1.5 mile walk/run test, and one mile and 6 minute walk tests) Advantages: Easy to administer to large number of people at one time and little equipment is needed -Can predicted VO2 Max Disadvantages: Some tests are maximal for some and sub-maximal for others. -Individual's motivation and pacing ability can affect the testing results -All out run is inappropriate for musculature problems, sedentary clients, or cardiovascular patients

How should the client be positioned when you obtain resting BP?

In a straight back chair with feet flat on the ground and arm should be on a flat surface (either on a table or on your shoulder)

Free weights

Increase neuromuscular coordination Allow full ROM Spotter required

Describe the sit and reach test? What does it measure and is it an indirect or direct measure?

It evaluates static flexibility of the lower back and hamstring muscles. It is moderately related to hamstring flexibility and poorly related to lower back flexibility and may be representative of gastrocnemius flexibility.

What is an isotonic contraction and is it considered to be a static or dynamic contraction?

It is a concentric or eccentric contraction that is the same tension throughout the entire range of motion. A constant resistance and tension machine can be used. It is a dynamic contraction that involves the movement of an external limb. Ex: bicep curl or bench press

What is Static Balance?

It is a measure of the total ROM of the joint, limited by extensibility of the musculotendinous unit. -Ability to hold a position while stationary. Ex: Balancing while standing on one foot.

What is densitometry a ratio of? What is the limitation in the measurement of body density?

It is a ratio of body mass to body volume. Limiting factor is the accuracy of the body volume measurement because body mass is measured simply as weight.

Describe the Astrand-Ryhming Cycle Ergometer Test.

It is a single stage test, lasting 6 minutes Pedal rate is set at 50 RPM goal= obtain HR values between 125 and 170 BPM with HR measured during the 5th and 6th minute of work Avg of 2 HRs then used to estimate VO2max from a nomogram >value must then be adjusted for age b/c HRmax decreases with age by multiplying the VO2max value by the corrective factor. The corrective factor goes down as you age.

What is an isometric contraction and is it considered to be a static or dynamic contraction? What is an example?

It is a static contraction that means that the muscle contracts but does not shorten; the force does not overcome the opposing movement going against it. Ex: hand grip dynamometer

What is the Queen's College Step Test purpose?

It is a submaximal test which provides a measure of cardiorespiratory or endurance fitness.

What is the 6 minute walk test for seniors? What is the purpose? What equipment is required?

It is a test of functional fitness of seniors. It is an adaptation of Cooper 12 Run. For people who use orthopedic devices when walking, and for people who have difficulty balancing, there is an alternative 2 minute step in place test. Purpose: measures aerobic fitness Equipment: measuring tape to mark out track distance, stopwatch, chairs positioned for resting (if needed)

What is the arm curl (bicep) test? Purpose of test? Equipment required? term-65

It is a test of upper body strength designed to test the functional fitness of seniors. Purpose:measures upper body strength and endurance Equipment: 4 lb. weight (women, AAHPERD) and 5 lb. weight (women SFT), 8 lb. weight (men), a chair without arm rests, stopwatch)

What is the unipedal stance test? Variations?

It is a test that assesses static balance. Push client gently and they either fall on right or left leg-> whichever leg they fall on is the leg they stand on b/c it is dominant. Lift non-dominant leg to ankle and balance until you reach 45 seconds. Arms should be crossed across the chest. Switch legs and do the same thing on the other leg. Take best of three trials. Variations: Eyes closed-> if eyes open, if non-dominant leg touches ground, if dominant leg wobbles around

What is metabolic syndrome?

It is characterized by a constellation of metabolic risk factors in one individual. Abdominal obesity, atherogenic dylipidemia, elevated BP, insulin resistance, prothrombic state, and proinflammatory state

What is the Chair Stand test? What is its purpose? What equipment is needed for the Chair Stand Test?

It is similar to the squat test to measure leg strength and is designed to test functional fitness of seniors. Purpose: This test assesses leg strength and endurance. Equipment: A straight back/folding chair without arm rests. (seat 17 inches/44 cm high), stopwatch

What is 1-RM? What are the two methods for obtaining 1-RM values? Describe the procedures for the 1-RM.

It is the greatest resistance that can be moved through full ROM in a controlled manner with good posture. It is the standard for dynamic strength assessment with appropriate testing familiarization. 1 RM values for bench press or shoulder press/ leg press or leg extension. 1. Subject should warm up by completing a number of submaximal repetitions of the specific exercise that will be used. 2. Determine the 1 RM (or any multiple of 1-RM) within 4 trials with rest periods of 3- 5 minutes between trials. 3. Select an initial weight that is within the subject's perceived capacity ( about 50 percent to 70 percent capacity) 4. Resistance is the progressively increased by 2.5 to 20 kilograms until the subject cannot complete the selected repetitions. 5. Final weight lifted successfully is recorded as the 1-RM or multiple RM

What are some disadvantages to hydrostatic weighing?

It requires special equipment, the accurate measurement of residual volume, population-specific formulas, and significant cooperation by the subject.

What are the three sizes of BP cuffs?

Large, Pediatric, Extra Large

What are all the reach directions for the Star Excursion Balance Test What is the alternative/modification for the test? Why is there a limitation to this test?

Lasteral, Posterolateral, Anterolateral, Posteromedial, Medial, Anteromedial, Anterior (can use all) Alternative-> use only anteromedial, medial, posteromedial directions Limitation-> Time constraint -There are 48 practice trials (6 in 8 directions) -24 test trials for each leg

Extreme Right Axis Deviation?

Lead 1= Negative and AVF= Negative

Right Axis Deviation?

Lead 1= Negative and AVF= Positive

Left Axis Deviation?

Lead 1= Positive and AVF= Negative

List all limb leads.

Lead I, Lead II, Lead III, AVF, AVR, AVL, Ground

Resistance machine

Less increase in neuromuscular coordination ROM limited by machine No spotter required Weight increments may be limited Machines may not accommodate all body types

What is considered to be the cornerstone of antihypertensive therapy?

Lifestyle modificatiosn including physical activity, weight reduction, a Dietary Approaches to Stop Hypetension (DASH) eating plan (i.e. a diet rich in frutis, vegetables, low fat dairy products with a reduced content of saturated fat ), dietary sodium reduction (no more than 100 mmol or 2.4 g sodium/day), and moderation of alcohol consumption.

Submaximal testing is recommended before what type of exercise program is begun?

Low ro moderate risk individuals start a moderate intensity exercise program

MAP: Mean Arterial Pressure Direct and Indirect measurement equations?

MAP: The average pressure in the patient's arteries during one cardiac cycle. DBP: CO (cardiac output) X TPR (total peripheral resistance) Indirect: HR <100 BPM, then MAP= 1/3 (SBP-DBP) + DBP HR >100 BPM, then MAP = 1/2 (SBP-DBP) + DBP

What does MVIC stand for? What devices are used for static strength and endurance?

MVIC stands for Maximal Voluntary Isometric Contraction Devices used for static strength and endurance include: Dynamometers Cable Tensiometers Strain gauges Load Cells

Where should the manometer be placed?

Manometer should be placed at eye level (either on the cuff or ask patient to hold it at eye level.

Circumference purpose?

May be used to provide a general representation of body compostion and equations are available for both sexes and range of age groups Affected by fat mass, muscle mass, skeletal size; related to fat mass and lean body mass

What are all of the Bruce Treadmill Speeds and Grades and what are the times that the speeds and grades are increased throughout the test?

Minute 3-1.7 mph, 10 percent grade Minute 6-2.5 mph, 12 percent grade Minute 9-3.4 mph, 14 percent grade Minute 12- 4.2 mph, 16 percent grade Minute 15- 5.0 mph, 18 percent grade Minute 18- 5.5 mph, 20 percent grade Minute 21- 6.0 mph, 22 percent grade

What is being assessed with the YMCA Bench Press? Equipment needed for the YMCA Bench Press? Procedures for the YMCA Bench Press? Computation of final score?

Muscular endurance in upper body is being assessed. Men tested using 80 lb barbell and women tested using 35 lb barbell Procedures: 1. Each subject given either an 80 lb or 35 lb. barbell based on his/her gender. 2. Subject then performs standardized reps at a rate of 30 lifts/reps per minute. 3. Subject attempts to complete as many reps as possible. Final score-> Scored by the number of successful reps completed. Then, one can compare a client's score with normative data.

What must occur for data to be completed when conducting a test with a submaximal protocol?

Must complete greater than or equal to 1/3 of terminal stage of the test

What are the myocardial cells? What state are they in at rest? Where are the majority of the negative ions housed?

Myocardial cells are the contractile cells of the heart . At rest myocardial cells are polarized. Majority of the negative ions are housed inside the cells.

What is myocarditits and pericarditis?

Myocarditis= an inflammatory disease of the heart muscle (myocardium) that can result from a variety of causes. Most cases are from a viral infection, but an inflammation of the heart muscle may also be instigated by toxins, drugs, and hypersensitive immune reactions. Pericarditis= inflammation of the two layers of the thin, sac-like membrane that surrounds the heart (membrane called the pericardium).

When pressure in BP cuff is above 120 are any sounds heard? Is the brachial artery open or closed?

No Brachial artery is closed.

When pressure in cuff is below 70, are sounds audible?

No sounds are audible. Brachial artery is closed again.

What are the blood pressure classifications?

Normal BP: SBP <120 and DBP< 80 Prehypertension: SBP 120-139 or DBP 80-89 Stage 1 Hypertension: SBP 140-150 or DBP 90-99 Stage 2 Hypertension: SBP greater than or equal to 160 or a DBP greater than or equal to 100

Is constant resistance better for older or younger people?

Older people

Where should the BP cuff be positioned on the arm?

Over the brachial artery (pinky side).

What are the root causes of metabolic syndrome?

Overweight/ obesity, physical inactivity, insulin resistance, and genetic factors like high blood pressure, and dislypidemia

One is considered overweight and obese when BMI is in what ranges?

Overweight: 25.0-29.9 kg/m2 Obese: BMI > or = to 30 kg/m2

Describe all questionnaires / Screening Forms used before any fitness assessment can be conducted.

PAR-Q and You-> Used to determine client's readiness for physical activity. Signs and Symptoms of Disease and Medical Clearance-> To identify individuals in need of medical referral and to obtain evidence of physician approval for exercise testing and participation. Disease Risk Classification-> to determine the number of coronary risk factors for the client. Medical History-> To review client's past and present personal and family health history focusing on conditions requiring medical referral and clearance. Lifestyle Evaluation-> to obtain info about a client's living habits. Informed Consent-> to explain the purpose,risk, an benefits of physical fitness tests and to obtain client's consent for participation in these tests.

Name all of the intervals and segments they contain.

PR Interval -Start of P wave to start of Q wave (ventricular depolarization) -represents time taken for electrical activity to move between the atria and the ventricles (takes less than .2 seconds) QT interval- time between ventricular depolarization and re-polarization (contains ST segment)

List the 5 components of a clinical test and what constitutes each one.

Physical Examination-> to detect signs and symptoms of disease. Blood Chemistry Profile-> to determine if client has normal values for selected blood values; values of blood cholesterol are used in coronary risk factor analysis. 12 Lead ECG-> used to evaluate cardiac function and detect cardiac abnormalities due to exercise stress Additional Laboratory Tests (e.g. angiograms, echocardiograms, pulmonary tests)-> provide a more in depth assessment of client's health status, particularly those with known disease.

Describe the YMCA Sit and Reach.

Place a yardstick on the floor and a piece of tape is placed across it at a right angle to the 15 in mark. The client/ patient sits with yardstick between legs and with legs extended at right angles to the taped line on the floor. Heels of feet should touch the edge of the taped line and be about 10 to 12 inches apart. Client reaches forward with both hands as far as possible, holding this position about two seconds. The fingertips can be overlapped and should be in contact with the measuring portion of the yardstick. Score= most distant point (cm or inches) reached with fingertips. 1 practice trial is given and the best of 2 trials should be recorded. To assist with the best attempt, client should exhale and drop head between arms when reaching. Knees should be extended.

Tricep Skinfold Site

Posterior midline of the upper arm, halfway between acromion and olecronon processes, with arm held freely to the side of the body.

6 minute walk test for seniors-procedures/ aim of test, and scoring?

Procedures: walking course is laid out in a 50 yard rectangular area, with cones placed at regular intervals to indicate distance walked. Aim of test: to walk as quickly as possible for six minutes to cover as much ground as possible. Subjects set their own pace and are able to stop and rest if they want. Scoring: measures the distance walked in 6 minutes to the nearest meter. 2 regression equations are used

The Borg Scale Rating of perceived Dyspnea should be used throughout exercise testing and test should be terminated if Oxygen saturation drops below 80 %

Pulmonary Disease

What is the purpose of the preliminary health evaluation? What are the parts of a preliminary health evaluation?

Purpose of the preliminary health evaluation: 1. Detect the presence of disease. 2. Assess the initial disease risk of the client. Parts of preliminary health evaluation: 1. Administer informed consent. 2. Administer PAR-Q and You 3. Identify major signs and symptoms of disease 4. Determine the risk stratification of the client.

Harvard Step Test Purpose? What are the positive features of the test?

Purpose= a test of aerobic fitness; features = simple to conduct and requires minimal equipment.

What is the RPP and what kind of measurement is it?

Rate Pressure Product; It is an indirect measurement of myocardial oxygen consumption (AKA an indirect measurement of how hard the heart is working) -measures the stress put on the cardiac muscle based on the number of times it needs to beat per minute (HR) and the arterial Blood Pressure pumping against it. (SBP) RPP = HR x SBP / 100

Scoring of back scratch test?

Record the best score to the nearest cm or 1/2 inch.

How is pulse pressure measuerd?

SBP-DBP

What is the ST segment? What is the difference between a segment an interval?

ST segment is another time of pause between next big segment-- between ventricular depolarization and repolarization Interval-> contains a wave and segment and are sections of isolectric activity Segments are times of pause between waves of depolarizatation and repolarization

What is the Borg Ratings of Perceived Exertion Scale...goes from what to what and what do these values mean? What is a category RPE scale?

Scale from 6-20. 6= no exertion at all 13=somewhat hard 20=maximal exertion scale from 1-10. 1= no exertion at all 10= heavy exertion

Balke Treadmill aimed for what population?

Sedentary or moderately active population Grade is increased

Accuracy of skinfolds and circumference measurements? What type of fat does skinfold measurement measure?

Skinfolds: + or - 3.5 percent; comparable to hydrostatic weighing; measures subcutaneous fat Circumference: 2.5 to 4 percent accuracy

What is a heart murmur?

Sound during the heartbeat caused by a heart valve that doesn't close properly.

Equipment for Harvard Step Test?

Step/platform 20 inches/50.8 cm high, a stopwatch, a metronome

Procedures and scoring for chair sit and reach?

Subject sits on the edge of the chair, foot must remain on floor. Other leg extended forward with knee straight, heel on floor, and ankle bent at 90 degrees. Place one hand on top of other with tips of middle fingers even. Instruct the subject to inhale. As client exhales, reach forward toward toes by bending at hip. Keep back straight up and head up, and keep knee straight. Hold reach for 2 seconds. Distance measured between the tip of fingertips and toes.

Calculation of final score for the romberg and unipedal stance tests?

Take the maximum amount of seconds for each. Can pick the fitness ranking (above, average, or below)

Target population of the 6 minute walk test? Advantages/Disadvantages? When should the test be terminated?

Target population: aged population which may not be able to do traditional fitness tests Advantages: Minimal equipment and costs Disadvantages: Test too easy for highly fit person, one of the other running tests would be better suited. Test should be terminated if examined person reports dizziness, nausea, excessive fatigue, pain, or if examiner notices any other symptoms of concern.

Procedures for the back scratch test?

Test performed in standing position. Place one hand behind the head and back over the shoulder and reach as far as possible down the middle of your back. Your palm touching your body and fingers directed downwards. Place other arm behind back, palm facing outward and fingers upward and reach up as far as possible, attempting to touch or overlap the middle fingers of both hands. If fingertips touch-> score= zero Fingertips don't touch-> measure the distance between fingertips (negative) Fingertips overlap-> measure by how much (positive)

Midaxillary Skinfold

Vertical fold; on the midaxillary line at the level of the xiphoid process of the sternum.

Define flexibility, dynamic flexibility, and static flexibility.

The ability to move a joint through its complete ROM. Dynamic flexibility is measured by moving through motions by increasing your heart rate, raising your blood temperature, and sending extra blood to muscles Static stretching involves holding a stretch for an extended period of time. You relax the body part and let it stretch further on its own.

Target population for chair sit and reach test? Advantages/Disadvantages? Reliability? Retesting? Contraindications? Other comments?

The aged population which may not be able to do a traditional fitness test. Advantages-> does not require subject to get up and down from the floor as does the traditional test. Disadvantages-> Only one leg is measured which will not show any differences between sides. Reliability-> will depend on the amount of warm up before testing. If Retesting-> must ensure the same procedures are used each time and order of test should be standardized. Contraindication-> If severe osteoporosis, do not perform test Other comments->Variation of sit and reach test adapted for the elderly population.

What is the mean axis of the heart?

The average of all the instantaneous mean electrical vectors occuring sequentially during depolarization of the ventricles.

What occurs with Coronary Heart Disease (CHD)? What are the criteria? What is it attributed to? How do you combat it?

There is an imbalance of coronary O2 supply and demand. -attributed to atherosclerosis, or hardening of the arteries. -angina pectoris (chest pain)-> can lead to a heart attack if left untreated. -combated with a high aerobic fitness level, which is associated with a physically active lifestyle.

What are the recommendations for supervision of exercise testing for those at low risk?

There is general agreement that testing in patients at low risk can be supervised by nonphysicians without a physician being immediately available.

Variable resistance best for what population?

Those with spasticity issues like Parkinson's Disease.

What occurs on the horizontal axes of an ECG? 1 small box on an ECG represents how many seconds? 1 large box on an ECG represents how many seconds?

Time is counted in seconds. 1 small box= .04 seconds 1 large box= .2 seconds

Name three sites for skinfold assessment in females.

Triceps, Suprailiac, and Thigh

What are the BMI classifications?

Underweight: Less than 18.5 Normal: 18.5-24.9 Overweight: 25.0-29.9 Obesity: 3 classes I: 30.0-34.9 II: 35.0-39.9 III: greater than or equal to 40

YMCA Protocol for the Cycle Ergometer?

Uses 2 to 4 minute, 3 minute stages of continuous exercise. Test is designed to raise steady state HR of the subject between 110 BPM and 70 percent HRR (or 85 percent of age predicted HR max) for at least 2 consecutive stages. 2 Consecutive HR measurements can be obtained within this HR range to predict VO2 Max. Each work rate is performed for at least 3 minutes and HR is recorded during the final 15 to 30 seconds of 2nd and 3rd minutes. HR should be obtained for an additional minute if the two heart rates vary by more than 5 Beats Per Minute

List all the ECG precordial (chest) leads, their location, and the order in which they are prepped.

V1-> 4th intercostal space on the right (prep 1st) V2-> 4th intercostal space on the left (prep 2nd) V3-> Between V2 and V4 in the fifth intercostal space (prep 4th) V4-> 5th intercostal space, midclavicular line (prep 3rd) V5-> Anterior Axillary line, on horizontal plane through v4 and v5 (prep 6th) V6-> Midaxillary Line, on horizontal plane through v4 (prep 5th)

List all of the uniplar leads n a 12 Lead EKG

V1-V6, AVR, AVL, AVF, Ground

Abdominal Skinfold Site

Vertical fold; 2 cm to the right of the umbilicus Measure 2 cm over and then bring down below belly button

What is considered the gold standard for assessing aerobic fitness?

Vo2max-> typically expressed clinically in relative (ml/kg/min) opposed to absolute terms (ml/min), allowing for meaningful comparisons between/among individuals with different body weights.

Waist Circumference and Hip Circumference procedures? What is the preferred method of waist circumference? What waist to hip ratio puts men/women at risk for adverse health risks? (young men and women, and those aged 60-69 for men and women)

Waist: measurement of waist circumference immediately above the iliac crest, as proposed by National Institute of Health guidelines, preferred method to assess healt risk. Hip-> with subject standing and legs about 10 cm apart,a horizontal measure is taken at the max circumference of the hip and proximal thigh just below the gluteal fold. WHR values >.95 for men an d>.86 for women Aged 60-69: >1.03 for men and >.90 for women

What are the metabolic Calculations for the Bruce Treadmill?

Walking: Vo2= 3.5 + (0.1 * Speed) + (1.8* Speed* Grade) Running: Vo2= 3.5 + (0.2 * Speed) + (0.9 * Speed* Grade)

Wat is the metronome set at for males and females for the Queen's College Step Test?

Women: 88 BPM Men: 96 BPM

Does blood pressure generically differ when supine and standing?

Yes, it is generally lower when supine than when standing.

Are sounds audible when pressure in cuff is below 120 and above 70? Is the brachial artery open or closed?

Yes. Brachial artery is open.

How do you calculate the final scores for the Functional reach test and Star Excursion Test?

You do three trials and average them. For star excursion balance test-> divide length reached by the length of your leg in centimeters and multiply by 100 % to get the "normalized score". Then, pick a fitness ranking (average, above, and below)

Describe what happens with Biolelectrical Impedence.

You enter the client's age, gender, weight, and height and hold the BIA out in front of the client and it will give you the percent body fat and BMI. Low levels of electrical current applied an tissue oppostion to the current estimates body composition Lean mass=more water= faster current Fat mass= minimal H20=slower current

How many readings of BP should you obtain and what do you do with the two readings?

You take 2 and wait 1 minute in between, then average them.

How many trials do you do for the romberg test, unipedal stance test, functional reach test, and star excursion test? Do you have to take three trials for all of them?

You take 3 of each. For the unipedal and romberg tests, if you get to 45 seconds (unipedal) and 60 seconds (romberg) in the 1st or 2nd trial, you do not have to move on to the 3rd trial.

Why should young people and older people be concerned with improving balance?

Young adults-> having proper balance could help one perform better in sports and have better sport specific skills -help prevent injuries from occuring in the future -help build muscle Older adults-> proper balance can prevent injuries from falls -could potentially increase fitness levels by allowing one to exercise more effectively

What is bradychardia?

a slowness of the heartbeat; under 60 beats per minute in adults

What is the essential fat for men?

about 10 to 13 %

What is the essential fat for men?

about 3 %

What are the methods for obtaining exercise Heart Rate?

count for 15 seconds and multiply by 4

What is the method for obtaining resting HR?

count for 30 seconds and multiply 2 count for 60 seconds

Characterized by an elevated blood glucose concentration as a result of insulin secretion or inability to use insulin

diabetes mellitus

What is nocturnal dyspnea?

dyspnea occuring at night, several hours after assuming a recumbent position. Occurs in heart failure and results from re absorption of water from dependent areas after removal of effects of gravity.

What is orthopnea?

dyspnea that is relieved in an upright position. Dyspnea= labored or difficulty breathing.

What are circumference measures affected by?

fat mass, muscle mass, and skeletal size; they are related to fat mass and lean body mass

Characterized by a widespread chronic non-articular musculoskeletal pain. Only 2-4 percent of the population is affected by the disease.

fybromyalgia

What is the term "older adult" defined as?

greater than or equal to 65 years old and individuals 50-64 years old with clinically significant conditions or physical limitations that affect movement, physical fitness, or physical activity.

A chronic inflammatory demyelinating disease of the CNS; affects an estimated 2.1 million people worldwide. The symptoms include visual disturbances, weakness, sensory loss, fatigue, pain, coordination, deficits, bowel/bladder dysfunction, and cognitive/emotional changes

multiple sclerosis

Testing should be performed in the morning due to severe fatigue this population has during the day. Testing should be avoided during acute exacerbation periods of the disease. Cycle ergometer is the preferred modality for CRF testing. The testing environment should be kept cool.

multiple sclerosis

How do you calculate the speed from mph to meters/min?

multiply the mph by 26.8 m/min

What is coronary stenosis

narrowing of the lumen of a coronary artery

What is a pulomnary infarction?

necrosis in a part of a lung caused by an obstruction in a branch of a pulmonary artery.

What is stenotic valvular disease?

occurs when a valve opening is smaller than normal due to stiff or fused leaflets. May make the heart work very hard to pump blood through it. Can lead to heart failure or valvular insufficiency ("leaky valve"- some blood leaks backward across the valve)

characterized by t-scores of lumbar spine, total hip and femoral neck = to or less than -2.5

osteoporosis

What is angina?

pain, discomfort, or pressure localized in the chest that is cause by an insufficient supply of blood (ischemia) to the heart muscle sometimes characterized by feeling of choking, suffocation, or a crushing heaviness

What is aortic stenosis?

pathological narrowing of the orifice of the aortic valve.

There is not much validity/benefit in performing an exercise test during this period of a woman's life

pregancy

What is hypertrophic cardiomyopathy?

primary disease of the myocardium in which a portion of the myocardium (muscle of the heart is thickened without any obvious cause)

May include but is not limited to asthma, COPD, cystic fibrosis, and pulmonary fibrosis

pulmonary disease

What are all the factors that the Senior Fitness Test measures?

strength, endurance, agility, and balance

Summarize the standardized conditions for submaximal testing.

strict posture, consistent repetition duration (movement speed), full ROM, use of a spotter (when needed) , equipment familiarization, and warm up

List all precordial/ chest leads?

v1, v2, v3, v4, v5, and v6

What does the QRS complex represent ? How long does it take?

ventricular depolarization Takes less than .1 second

What does the T-wave represent?

ventricular repolarization

Thigh skinfold?

vertical fold; on the anterior midline of the thigh, midway between the proximal border of the patella and the inguinal crease (hip)

How to you measure the bench press weight ratio?

weight pushed in lbs/ body weight in pounds