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ACSM CERTIFIED EXERCISE PHYSIOLOGIST
EXAM STUDY GUIDE
Physical Activity - ANSWER Any bodily movement produced by contracting skeletal muscles, with an increase in energy expenditure. Exercise - ANSWER Planned, purposeful, repetitive Physical Fitness - ANSWER Attributes or characteristics that individuals have achieved that related to their ability to perform physical activity 3 metabolic pathways the body uses to creates ATP - ANSWER 1. Creatine Phosphate
- anaerobic glycolysis
- 0xidative system Claudication - ANSWER pain in the leg is induced by exercise, usually because of an artery obstruction. Creatine Phosphate system - ANSWER Small amounts of CP are stored within each cell. Simple one-to-one trade off that allows for the rapid production of ATP. ONLY for use during short bouts of exercise. less that 10 seconds. Anaerobic glycolysis - ANSWER No oxygen required. NExt most immediate energy source. break down carbs (glucose or glycogen) into pyruvate. Used during medium- duration exercise. no more than about 90 seconds. Aerobic glycolysis (oxidative system) - ANSWER Oxygen dependent. As exercise intensity decreases allowing for longer duration activities, use of the oxidative system increases. (Krebs cycle and ETC). Produce ATP in the mitochondria of the cell--requires oxygen. Lasts longer than 1-2 minutes. What is VO2? - ANSWER The volume of oxygen the body consumes. VO2 max is the highest volume of oxygen the body can consume. Define Stroke Volume - ANSWER the volume of blood the heart ejects with each beat. How does SV increase with workload? - ANSWER Similar to HR, it increases as workload increases but only up to ~40% to 60% of VO2max. The percentages can be decreases in sedentary individuals and increased with training. What happens to resting HR as stroke volume increases? - ANSWER it decreases, as more blood being pumped per beat allows the heart to beat less often.
What is cardiac output? - ANSWER a measure of blood pumped per minute. The product of stroke volume and heart rate. What does Diastolic Blood pressure do during exercise? - ANSWER Remains stable or decreases slightly. What is rate pressure product? - ANSWER serves as an estimate of myocardial oxygen demand. Product of HR and Systolic BP. HR X SBP What is the Fick equation used to determine VO2 max? - ANSWER VO2max = HRmax X SVmax X a-VO2 difference max (arteriovenous oxygen difference) What is the gold standard to measure Cardiorespiratory fitness? - ANSWER VO2 max during open circuit spirometry. How does a submaximal exercise test work? - ANSWER It estimates VO2 max from the HR response to submaximal single stage or graded exercise. absolute oxygen consumption vs. relative oxygen consumption - ANSWER absolute is the raw volume of O2 consumed by the body. Relative is the volume of O2 consumed relative to body weight. Useful to compare fitness levels between individuals. What is one of the largest components of PA-related energy expenditure? - ANSWER Occupational Physical Ativity 5 Health related physical fitness components - ANSWER Cardiorespiratory endurance, body composition, muscular strength, muscular endurance, and flexibility 6 Skill (performance) related physical fitness components - ANSWER Agility, coordination, balance, power, reaction time, and speed cardiorespiratory endurance - ANSWER ability of circulatory system and respiratory system to supply o2 during sustained physical activity Body composition - ANSWER relative amounts of muscle, fat, bone, and other vital parts of the body Muscular strength - ANSWER Ability of muscle to exert force muscular endurance - ANSWER ability of muscle to continue to perform without fatigue flexibility - ANSWER ROM at a joint. as per the skeletal muscles and not any external forces. Agility - ANSWER ability to change position of the body in space with speed and accuracy
What is the PAR-Q? Limitation? - ANSWER A minimal standard for entry into Moderate- intensity exercise programs. allows individuals to gauge their own medical readiness to participate. does not screen well for those at low to moderate risk. What is a pre-participation screening questionnaire? - ANSWER Also useful for clients to assess their health readiness. More comprehensive and recognizes signs and symptoms of CVD and other risk-factor thresholds. What are the ACSM Coronary Artery Risk factors? - ANSWER Age (Men 45 and older women 55 and older), Family History (MI, coronary revascularization or sudden death before 55 in father and 65 in mother or first degree relative), Smoker (current or quit within the last 6 months), Sedentary (no PA in at least 30 minutes of MPA at least 3 days per week for the last 3 months), Obesity (BMI 30 or over, or waist girth >40in for men and >35in for women), Hypertension (SBP 140 or more and/or DBP 90 or more confirmed on 2 seperate occasions), Dyslipidemia (LDL 130 or more OR HDL <40. OR on lipid lowering meds), Prediabetes (Impaired FBG between 100 and 125.) What is the negative risk factor? - ANSWER HDL value of greater than or equal to 60. (this is reverse cholesterol transport and reduces the risk of CVD) Dyspnea - ANSWER Shortness of breath Orthopnea - ANSWER trouble breathing while lying down paroxysmal nocturnal dyspnea - ANSWER difficulty breathing while asleep What classifies as low, moderate, and high risk clients? - ANSWER Low: <2 risk factors and asymptomatic Moderate: 2 or more risk factors and Asymptomatic High: Symptomatic OR known CVD, CPD, renal or metabolic disease What is the exception to missing risk factor information? - ANSWER Prediabetes is counted as a positive risk factor ONLY if the person is 45 or older OR The BMI is 25 or more (and have additional risk factor for prediabetes) What is a contraindication - ANSWER individual's characteristic that make PA more risky Absolute contraindications to exercise - ANSWER Absolute cannot participate in andy PA program and/or assessment and should consult with their doctor first. Relative contraindications to exercise - ANSWER the benefit of exercise outweighs the risk of testing. Left main coronary stenosis, moderate stenotic valvular heart disease, Electrolyte abnormalities, severe atrial hypertension, tachy or bradydysrhythmia, hypertrophic
myopathy, most disorders exacerbated by exercise, uncontrolled metabolic disease, chronic infectious disease, Mental impairment, AV block. Exercise testing is recommended for individuals at ____ risk - ANSWER High risk. What is prehypertension? - ANSWER 120-139 SBP and/or 80-89 DBP Normal BP? - ANSWER <120 and < Stage 1 hypertension? - ANSWER 140-159 SBP and 90-99 DBP Stage 2 hypertension? - ANSWER 160 + SBP 100+ DBP Optimal LDL, total cholesterol, HDL, and triglyceride levels? - ANSWER LDL: < HDL: < Triglyceride: < TOTAL: < 3 assesments for muscular endurance - ANSWER 1. Bench press
- Curl up
- push up twitch - ANSWER When a motor unit is stimulated by a single nerve impulse tetanus - ANSWER motor unit stimulated constantly summation - ANSWER motor unit has more than 1 stimulus What is the SAID principle? What is it dependent on? - ANSWER The specificity principle. Specific exercise elicits specific adaptations, creating specific training effects. (Specific Adaptations to Imposed Demands). Dependent on the TYPE and MODE of exercise. Example: a client wants to improve their time in an endurance run, you select training stimulus that is appropriate. (eg. endurance activities, not swimming. 7 ways of determining exercise intensity - ANSWER 1. Heart rate reserve method.
- Peak HR method
- Peak VO2. method
- Peak METs method
- VO2 reserve method
- Talk test method
- RPE method (HRR) Heart rate reserve method KARVONEN FORMULA - ANSWER The difference between max HR and resting HR. Target HR = [(max HR - resting HR) X %intensity desired] + Resting HR.
Intrinsic risk factors to injury - ANSWER History of previous injury Inadequate fitness/conditioning Body composition Bony alignment abnormalities Flexibility/strength imbalances Joint laxity Musculoskeletal disease Extrinsic risk factors to injury - ANSWER Excessive load on the body Type or speed of movement number of reps footwear surface training errors excessive distances fast progression high intensity running on hills poor technique fatigue environment conditions Exercise in heat yields? (relate to HR as well) - ANSWER Dehydration risk, increased blood flow to the skin (away from working muscles), HIGHER HR values. Exercise in the cold yields? - ANSWER Vasoconstriction of blood vessels in the skin, HR and cardiac output are similar to thermoneutral environment, wearing bulky clothing is a barrier, Respiratory rate is higher and VO2 max may be slightly lower. Some individuals may perceive exercise to be more difficult in the cold Exercise in high altitude - ANSWER "thin air" same amount of oxygen in the air at ALL elevations. It is the change in barometric pressure that causes the PO2 to decrease. SV decreases and HR increases during first initial days. Safe to assume that there will need to be a significant reduction in intensity and duration of activities. acclimatization vs. acclimation - ANSWER acclimatization - Physiological adaptation that occurs in response to a change in the "natural" environment. acclimation - physiological adaptation that occurs in response to EXPERIMENTALLY induced changes in climate. Heat acclimatization, cold acclimatization, altitude acclimatization benefits - ANSWER Heat- lower core body temp, skin temp, high sweat rate, lower HR, lower perception of effort, improved conservation of sodium. (recommended 10 consecutive days in heat) cold- maintain heat production by means beside shivering, maintenance of hand and feet temperatures.
altitude- Increases O2 carrying capacity in the blood. (Erythropoiesis, production of additional RBC) "live high" "train low" Benefits last up to 3 weeks. Smallest contractile unit of a muscle - ANSWER Sarcomere Type I fibers - ANSWER Slow twitch fibers. Lower contractile force. better for endurance activities Type II fibers - ANSWER Fast twitch fibers. Higher contractile force. better for strength and power activities. Which type of muscle fibers are recruited first? - ANSWER Type I then Type II. as force production increases. initial simple assessment of muscular strength and change in muscular strength between clients (calculation) - ANSWER (kg) weight lifted / (kg) body weight What is a 1RM? Multiple RM? What equipment should be used? - ANSWER 1RM is the heaviest weight that can be lifted in 1 rep. using proper form and technique. STANDARD muscular strength assessment. multiple RM can provide an index of change over time. Performance is significantly greater on weight machines than free weights. Allow 3 to 5 minutes between trials. Obtain 1RM within 4 sets. Muscular endurance assessments. How do you determine which test to use based on each client? - ANSWER Curl-up and push up test. Based on the needs of the client. (poor ab strength is thought to contribute to low back pain. What are the PROS principle of designing a resistance training program? What do they mean? - ANSWER Progression- Regularity Overload Specificity Progression - ANSWER demands placed on the body must be continually and progressively increased over time. Increase at 5% to 10% per week and decrease the reps by 2 to 4 when a given load can be performed for the desired number of reps. Frequency - ANSWER Resistance training must be performed on a regular basis several times per week to make gains. 2-3 per week. Overload - ANSWER to enhance muscular fitness, the body must exercise at a level beyond that at which it is normally stressed. Manipulated by changing the INTENSITY, DURATION, or FREQUENCY
Explain myotatic reflex reciprocal inhibition. - ANSWER Myotatic reflex "stretch reflex" occurs in the stretched muscle by attempting to resist the stretch. Muscle spindles monitor muscle length. Helps keep us upright. What is reciprocal inhibition? - ANSWER *The antagonist muscle responds with reciprocal inhibition. Causes antagonist to contract less as the agonist contracts. Flexibility assesments - ANSWER Goniometers sit and reach tests- most commonly used for flexibility in lower back and hip joint. functional movement screens Flexibility program designs - ANSWER Flexibility gains are lost within 4 to 6 weeks of quitting exercises. 2-3 x per week for at least 3-4 weeks may be required. Do these exercises when the body is warm. hold to mild discomfort. NO link between ROM training and prevention of lowback pain or muscle soreness. Central abdominal obesity is associated with.. - ANSWER metabolic syndrome. what is metabolic syndrome? - ANSWER a clustering of metabolic factors that increase the risk of cardiorespiratory disease. What are anthropometric measures? - ANSWER noninvasive and quantitative techniques for determining body size by measuring specific body dimensions. Anthropometric methods for measuring body composition - ANSWER BMI- measure of weight in relation to height. Waist circumference Skinfolds WHR How to calculate BMI. Limitations of BMI? - ANSWER divide weight (kg) by height (meters squared). 1kg = 2.2 lbs 1in = 2.54cm 1m = 100cm Does not differentiate between fat and fat free mass. Not a true measure of body fatness. what is BMI classifications of: Underweight Normal Overweight Obesity class I Obesity class II Obesity class III - ANSWER Underweight <18.
Normal 18.5-24. Overweight 25-29. Obesity class I 30-34. Obesity class II 35-39. Obesity class II 40+ Central obesity versus gynoid - ANSWER central (apple, or abdominal) vs. pear shaped (hips and thighs) Waist to hip ratio - ANSWER identify people with more central abdominal fat. Divide the circumference of the waist by the circumference of the hips (buttocks/hips) in inches. Using waist circumference alone - ANSWER describes abdominal fat measurement. health risks are higher when measurement is 35+ in for women and 40+ for men. risk category for waist circumference in male and female adults. (very low, low, high, very high) - ANSWER Women: very low <70cm Low 70-89cm High 90-110cm Very high > Men very low <80cm Low 80-9cm High 100-120cm Very high > standard circumference sites - ANSWER Abdomen Arm *Buttox/hip Calf Forearm Hips/thigh Mid-thigh *Waist % body fat methods. What is the % for men and women that is considered satisfactory for health? - ANSWER Skinfold measurements Bioelectrical Impedance Lab methods for measuring body composition - ANSWER Hydrostatic weighing- calculates body density from body volume Air displacement plethysmography- measures body volume. DEXA- x- ray to measure bone mineral content, body fat, and lean soft tissue.
define Total Energy Expenditure - ANSWER the total number of calories expended each day and reflects th amount of energy required to carry out all metabolic processes within the body 3 components of determining energy expenditure - ANSWER Resting energy expenditure (REE)- 60 - 70% TEE Thermic effect of food: 10% TEE Physical activity expenditure: 20-30% TEE define Resting energy expenditure what influences it the most? - ANSWER resting metabolism! energy required to maintain normal regulatory balance and body functions at rest. Also called basal energy expenditure. The amount of calories a person uses if they want to do no activity throughout the day. lean body mass influences it because it is more metabolically active than fat. define thermic effect of food - ANSWER energy required to eat and digest food. The more physically active, the more active their metabolism TEE recommended 1-2lbs/week weight loss in calories - ANSWER 1lb of weight loss is a calorie deficit of 3,500 calories. or 500 calories per day. nor recommended for an individual to consume less than ____ calories per day - ANSWER 1,200 calories ACSM postion stand indicates that engaging in _____ minutes per week of MVPA would result in better weight management - ANSWER 250 min/week. demonstration of exercise is especially important in _____ populations - ANSWER overweight or obese Behavioral strategies for weight loss - ANSWER Self monitoring goal setting stimulus control problem solving How many calories in 1 gram of: carb protein fat alcohol - ANSWER 1 g carbs- 4 calories 1 g protein- 4 calories 1g fat- 9 calories 1g alcohol- 7 calories
energy intake for carbs, protein and fat - ANSWER 45 - 65% of daily energy intake; 70% for athletes; 4 cal/gram 10 - 15% of daily intake; .8 g/kg of body wt.; athletes may need 1.2 - 1.4 for endurance and 1.6-1.7 for strength; 4 cal/gram 3 abnormal curves of the spine - ANSWER hyperkyphosis, hyperlordosis, scoliosis Pregnant women need an additional ____ calories per day - ANSWER 150 cal per day then 300cal in the 3rd trimester avoid exercising in the ______ position after week _____ - ANSWER Supine position after week 16 pregnant women need as increase dietary need for.... - ANSWER folic acid (B vitamin to prevent serious birth defects) and iron. Vitamin D intake have increased for? what are the levels? - ANSWER all populations but particularly children and older adults (65+). children and adolescents 1-18 600 IU Older adults 800IU Coronary Artery disease - ANSWER accounts for the most cardiovascular deaths. The most prevalent types of CVD. Define athlerosclerosis - ANSWER process where fatty streaks develop, causing the artery wall the thicken while reducing the luminal diameter. begins with a focal injury to the lining of the artery and eventually causes damage to the endothelium. The endothelium then becomes more permeable to lipids , allowing LDL's to move easily through where they are oxidized by macrophages. creating fatty streaks and plaque formation begins. Define myocardial ischemia - ANSWER partial impairment of coronary artery artery blood flow reduces oxygen to cardiac tissue. Define myocardial infarction - ANSWER hEART ATTACK. results in heart tissue death. stable ischemia vs. unstable ischemia - ANSWER stable: result of increased O demand of the heart (as seen with exercise) increased chest pain (angina) and decreased exercise capacity because of reduced blood supply to the heart. unstable: more severe often seen at rest with time of little exertion and oxygen demand. May be a warning sign that a heart attack is imminent. Hypertension is also known as _____ - ANSWER The silent killer because the signs and symptoms go unnoticed.
acute pain, muscle pain and dysfunction usually becomes more apparent 1-2 days after the the injury because of DOMS. most common in the calf and thigh (quads and hamstrings) rates I to III. III is the worst RICE Sprian definition, signs and symptoms. most common sites, treatment - ANSWER injury to a ligament. most common is ankle due to inversion. RICE contusion - ANSWER soft-tissue hemorrhage and/or hematoma that occurs after the disruption of the muscle fibers. PRICE - ANSWER Protection Rest Ice Compression Elevation Phases of tissue healing - ANSWER inflammatory phase (2-3 days) (edema)-fluid in surrounding tissues that act as a brace. repair- 3 - 5 days after lasting up to 2 months. Exercise during this phase remodeling-weakened repaired tissue. Overuse injuries - ANSWER Tendinopathy (tendinitis-acute inflammatory,tendinosis- degenerative changes in the absence of inflammation) Plantar Fasciitis Low back pain Plantar fasciitis - ANSWER repeated trauma of the plantar fascia. common in running athletes. Stretching is incorporated Low back pain *drawing in maneuver - ANSWER endurance of core musculature is more critical than strength focus on bracing Arthritis. 2 types. - ANSWER inflammation of a joint. Rheumatoid - ANSWER autoimmune chronic inflammatory disease affecting the synovial lining of joints and other connective tissue. Slow progressive disease. osteoarthritis - ANSWER more prevalent with age. bone remodeling at the joint and overgrowth occurs. Thought to be the result of mechanical injury due to excessive loading or repeated low-force stressors. osteoporosis - ANSWER "silent disease". low bone density or bone mass. increases risk of fracture. largely preventable. Women are 3x more likely to develop it. osteopenia - ANSWER between normal and osteoporosis. describes those at risk for osteoporosis.
The female athlete triad. - ANSWER disordered eating amenorrhea osteoporosis age difference between children, adolescents, and older adults - ANSWER children: younger than 13 adolescents: 13- 18 older adults: 65+ accelerated periods of growth in childhood. When do they stop growing? - ANSWER 12 for girls and 14 for boys. girls stop growing in stature by 15, boys by 17. HR, strove volume, and cardiac output in children - ANSWER higher HR, lower stroke volume, higher cardiac output. Sweat rate production in children. and exercise in the heat - ANSWER Lower sweat rate production and lower tolerance to exercising in the heat. in general... drink ____ for every ____lbs of fluid lost - ANSWER 1 pint for every 1 pound lost define hyponatremia - ANSWER low blood sodium (drink too much water) In general, exercise recommendations for children - ANSWER exercise is safe as well as resistance training. just make it age appropriate. weight gained during pregnancy - ANSWER typically 26lbs. cardiac output, stroke volume, heart rate, resting O2 uptake for pregnant women. - ANSWER all increase. Why is the supine position avoided in pregnant women? - ANSWER because the expanded uterus compresses on the inferior vena cava and reduces venous blood flow back to the heart. Supine positions may exacerbate this situation. Exercise for pregnant women and recommendations - ANSWER highly encouraged. Those physically active before pregnancy can exercise at a higher level than those more sedentary. ensure proper hydration. exercise 30 minutes of moderate intensity exercise on most days of the week. During adulthood individuals tend to gain ___ and ___ and tend to lose____ - ANSWER fat mass and body weight and tend to lose fat-free mass.
Key to social cognitive theory - ANSWER focus on what they CAN do. not what they CAN'T do. What is the social ecological model - ANSWER comprehensive approach integrating multiple variables or layers that influence behavior. Each layer has an impact on the next. It helps identify opportunities to promote participation in PA by recognizing multiple variables that may influence a person's choices. what 6 factors (layers) are involved in the social ecological model - ANSWER Physical activity behavior personal factors social factors institutional factors community factors public policy What is the Health Belief model? - ANSWER As individuals take greater investment in their health they are more likely to make relevant and meaningful behavior changes. Must feel that the risks outweight the benefits. 4 main components of the health belief model - ANSWER 1. perception of risk
- perception of severity of threat
- perception of benefits
- perceptions of barriers to reduce health threat What is the theory of planned behavior? - ANSWER identifies intension as the primary influence determining behavior. intension + perceived behavioral control What is the self-determination theory? - ANSWER Individuals have 3 basic psychological needs that must be met in order to be motivated to engage behavior. Autonomy and competence are key with this theory. The person must feel that they have a sense of control. Must also feel challenged yet successful. what are those 3 psychological needs? - ANSWER 1. competence- feeling capable of mastering a task
- relatedness- need to be connected and involved with the social world
- autonomy- maintaining a perceived internal locus of control and a sense that behaviors are chosen freely. extrinsic vs. intrinsic motivation. - ANSWER intrinsic is more likely to maintain PA. Extrinsic is doing it for weight control, weight loss, and stress reduction. intrinsic rewards - ANSWER anything that is fulfilling because of the internal pleasure. more sustainable over time.
extrinsic rewards - ANSWER tangible things earned in response to completing a task. Help increase motivation in the initial stages of change. self-monitoring - ANSWER important in the initial days of adaptation to keep the person accountable and on track. Continue for entire adoption phase (up to 6 months) SMART goals - ANSWER Specific Measurable Attainable Realistic Time-bound- Short term goals are better than long term goals. Barriers to physical activity - ANSWER 1. lack of time
- environmental changes
- fear of injury
- lack of enjoyable activities Motivational Interviewing - ANSWER person-centered technique to strengthen motivation for change. *individuals become more committed to what they say to themselves than what they hear from others. goal of motivational interviewing - ANSWER generate change talk 4 principles motivational interviewing conversation - ANSWER 1. obervations, not evaluations
- express feelings, not thoughts
- identify needs, not strategies
- make requests, not demands. Visual imagery - ANSWER visualizing onesself performing the desired behavior. also used to improve muscle memory Exercise Imagery Questionnaire - ANSWER Energy imagery Appearance imagery Technique imagery define negligence - ANSWER one's failure to act. Overwhelming majority of cases against trainers are negligence. Statutory law (legislative law) - ANSWER enacted by federal and state governments. Imposes duties or restriction upon individuals. Case Law (common law) - ANSWER based on court descisions
