ACSM Exercise Programming: A Comprehensive Guide, Exams of Public Health

A comprehensive guide to acsm (american college of sports medicine) exercise programming recommendations. It covers cardiovascular, resistance, and flexibility training guidelines for adults, children, and adolescents. It also details energy expenditure recommendations and physiological changes during warm-up and cool-down. Furthermore, the document outlines modifications of exercise programs for individuals with specific conditions such as osteoporosis, hypertension, diabetes mellitus, obesity, pregnancy, and arthritis, as well as considerations for older adults. It also includes a list of high-risk exercises and alternate exercises. This guide is useful for students and professionals in exercise science, physical therapy, and related fields, offering a structured approach to exercise prescription and adaptation for diverse populations and health conditions.

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2024/2025

Available from 08/19/2025

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ACSM Exercise Programming –
Complete Guide
Cardiovascular Training Recommendations Ans - Adults
should engage in moderate intensity physical activities for at
least 30 minutes on 5 or more days of the week.
Adults should engage in vigorous intensity physical activities for
at least 20 minutes on 3 or more days of the week
Children and adolescents should participate in at least 60
minutes of moderate intensity physical activity most days of the
week, preferably daily
Resistance Training Recommendations Ans - Adults
should participate in resistance training 2-3 times per week,
performing a minimum of 8-10 different exercises, 3-20
repetitions, and 1-3 sets that train all major muscle groups.
Flexibility Training Recommendations Ans -
Recommendations state that stretching be preceded by a warm-
up and be performed a minimum of 2-3 days per week, ideally 5-
7 days per week, stretching to the point of tightness at the end of
the range of motion and holding each stretch for 15-30 seconds
with 2-4 repetitions for each stretch.
Energy Expenditure Recommendations Ans - ACSM
recommends a target range of 150-400 kcal of energy
expenditure per day.
The lower end of this range (1,000 kcal/week) is associated with
a significant health benefit.
The upper end of this range (2,000 kcal/week) has been shown to
be successful for short and long term weight control as well as
for primary and secondary prevention of chronic disease.
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ACSM Exercise Programming –

Complete Guide

Cardiovascular Training Recommendations ✔Ans - Adults should engage in moderate intensity physical activities for at least 30 minutes on 5 or more days of the week. Adults should engage in vigorous intensity physical activities for at least 20 minutes on 3 or more days of the week Children and adolescents should participate in at least 60 minutes of moderate intensity physical activity most days of the week, preferably daily Resistance Training Recommendations ✔Ans - Adults should participate in resistance training 2-3 times per week, performing a minimum of 8-10 different exercises, 3- repetitions, and 1-3 sets that train all major muscle groups. Flexibility Training Recommendations ✔Ans - Recommendations state that stretching be preceded by a warm- up and be performed a minimum of 2-3 days per week, ideally 5- 7 days per week, stretching to the point of tightness at the end of the range of motion and holding each stretch for 15-30 seconds with 2-4 repetitions for each stretch. Energy Expenditure Recommendations ✔Ans - ACSM recommends a target range of 150-400 kcal of energy expenditure per day. The lower end of this range (1,000 kcal/week) is associated with a significant health benefit. The upper end of this range (2,000 kcal/week) has been shown to be successful for short and long term weight control as well as for primary and secondary prevention of chronic disease.

Physiological Changes During Warm-Up ✔Ans - 1. Increased muscle temperature

  1. Increased muscle blood flow
  2. Increase ease of dissociation of oxygen
  3. Increase muscle enzyme activity
  4. Increased elasticity of muscle and connective tissue
  5. Decreased muscle viscosity Physiological Changes During Cool-Down ✔Ans - 1. Enhanced venous return
  6. Enhanced transport of metabolic byproducts away from skeletal muscle
  7. Gradual return of HR and BP to pre-exercise levels
  8. Skeletal muscle and connective tissue may be less viscous and more pliable after the exercise stimulus; therefore, the cool-down period may be an appropriate time to enhance flexibility through stretching. Modifications of Exercise for Osteoporosis ✔Ans - There is an increased risk of fractures of the wrists, hips, and lumbosacral regions. Weight-bearing exercise is most effective in maintaining or increasing bone density, but such exercise may be harmful in those with advanced osteoporosis. Resistance Training: Include exercises that direct the load over the long axis of the bone (ex., leg press, shoulder press) Frequency: 2 or 3 times/week Repetitions: 8- Intensity: RPE 13- Aerobic Exercise: Mode: aquatic, walking, cycling Frequency: 3-5 days/week Duration: 20-60 minutes Intensity: 40%-70% of HRR

Decreased intensity Avoid valsalva maneuvers such as holding the breath Modifications of Exercise for Children and Adolescents ✔Ans - Children ages 5-12 should:

  1. Engage in >60 minutes of age appropriate physical activity on all or most days of the week.
  2. Use a wide variety of physical activities
  3. Extended periods > 2 hours of inactivity are discouraged during daytime hours Resistance Training:
  4. Avoid overly intense or maximal resistance training.
  5. Training should be varied and appropriate to sized, strength, and maturity.
  6. Repetitions: 8-
  7. If a prepubescent child cannot perform a minimum of 8 repetitions in good form, the resistance is too heavy and should be reduced. Modifications of Exercise for Older Individuals ✔Ans - Aerobic Exercise:
  8. The exercise modes used for older individuals should be those that do not impose excessive orthopedic stress (ex., walking, stationary cycling, aquatic)
  9. Start at a very low intensity and gradually build up.
  10. Group exercise setting can provided needed social reinforcement enhancing adherence. Resistance Training:
  11. Exercise should be closely supervised.
  12. One set of 10-15 repetitions at a perceived exertion level of 12- 13 should be used on 8-10 exercises that use all major muscle groups.
  13. Use machines as opposed to free weights because balance is often an issue.
  14. Allow ample time during transition between exercises.

Modifications of Exercise for Arthritis ✔Ans - Aerobic Training: Mode: Walking, cycling, and especially aquatic exercises are preferred. Frequency: 3-5 days/week Duration: 20-60 minutes Intensity: 40% or 50%-80% of HRR or VO2R, 555 or 65%-90% of HRmax, 12-16 RPE Resistance Training: Frequency: 2-3 days/week Intensity: Volitional fatigue or stop two to three repetitions before volitional fatigue. Duration: 1 set of 3-20 repetitions, 8-10 exercises include all major muscle groups Flexibility Training: Frequency: Minimal 2-3 days/week; ideally, 5-7 days/week Intensity: Stretch to tightness at the end of the ROM but not to pain Duration: 15-30 seconds, repeat each stretch 2-4 times, static stretch all major muscle groups. Special Considerations for Osteoporosis ✔Ans - a. Pain is a contraindication to exercise b. Excessive trunk flexion and twisting activities increase compressive forces and may increase the risk of vertebral fracture. Special Considerations for Hypertension ✔Ans - a. Terminate a resistance training set when the RPE is between 13 and 15. b. Exercise is contraindicated if pre-exercise SPB is > 200 mm Hg or DBP is > 100 mm Hg c. Terminate an exercise session if exercise SBP is > 220 mm Hg or DBP is > 105 mm Hg d. for those on vasodilator medications, prolong cool-down and avoid abrupt postural change. e. B-blockers attenuate the HR and neccessitate use of the RPE.

f. Consume between 30 and 50 g of carbohydrate before exercise. High-Risk Exercises//Alternate Exercise ✔Ans - 1. Straight leg or full sit-ups//Crunches

  1. Double leg raises//Single leg raises
  2. Full squats//90 degree squats
  3. Hurdler's stretch//Seated hamstring stetch
  4. Plough//Double knee to chest
  5. Back Hyperextension//Back extension to normal standing lumbar lordosis
  6. Full neck rolls//Lateral neck stretches
  7. Flexion with rotation//Supine curl-ups with flexion followed
  8. Standing toe touch//Standing hamstring stretch, back flat