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163 Cards in this Set

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What type of clothing should be worn during exercise?
- Clothing should fit comfortably and allow free movement

- Select according to temperature, humidity, and exercise intensity

- Avoid nylon and rubberized materials and tight clothes

- Choose fabrics that wicks moisture away from the skin

- Clothing should be lightweight, light-colored, loose-fitting, airy, and absorbent
Why are good shoes a must during exercise?
- They prevent injuries to lower limbs and low back

- Shoes should be specific to your activity

- Consider tendency to pronation or supination, and exercise surfaces

- Old shoes are freqently responsible for injuries
When should you get new shoes?
Every 300-500 miles or approximately every 6 months
What is exercise intolerance?
Inability to function during exercise because of excessive fatigue or extreme feelings of discomfort
What are signs of exercise intolerance?
Rapid or irregular heart rate
Difficulty breathing
Nausea
Vomiting
Lightheadedness
Headache
Dizziness
Unusually flushed or pale skin
Extreme weakness
Lack of energy
Shakiness
Sore muscles
Cramps
Tightness in chest
What are the percent HR max target zones for beginners, intermediate, and advanced exercisers?
Beginner: 60%

Intermediate: 70%

Advanced: 75-85%
At which of these levels can you gain cardiovascular exercise?
All of them
After how many minutes should heart rate be under 120 bpm?
5 minutes after exercise
What can be used as an indicator of overexertion?
Recovery heart rate

(The higher your respiratory fitness level, the faster your heart rate will decrease following exercise)
What are the vital signs that should be checked?
- Check HR
- Assess color
- Check body temperature
- Alertness
- Blood pressure
- Breathing rate
- Diabetic Acidosis
What is diabetic acidosis?
It happens when a lack of insulin leads to:

* high blood sugar levels
* the presence of ketones in urine and blood
* certain acids (known as ketoacids) in the blood.

characterized by a sweet of fruity breath odor
What time of the day is best for exercise?
Any time of the day

- Except during the hottest part of the day (summer)
- Except during the coldest part of the day (winter)

- When its best for you
- Short bouts throughout the day
How long should you wait to exercise after a heavy meal?
Approx. 2 hours
Is exercising in hot or humid conditions unsafe?
If the weather is too hot or the relative humidity is too high, body heat increases and can cause heat rleated injuries, even death
The ACSM recommended avoiding strenuous activity when the wet-bulb globe thermometer exceeds?
82.4°F
What are heat cramps?
Muscle spasms caused by heat-induced changes in electrolyte balance in muslce cells
What are the symptoms of heat cramps?
Cramps, spasms, and muscle twitching
How do you relieve heat cramps?
- Stop exercising
- Get out of the heat
- Massage the painful area
- Stretch slowly
- Drink plenty of fluids
(water, fruit drinks, electrolyte beverages)
What are the symptoms of heat illness?
- Decreased perspiration
- Cramping
- Weakness
- Flushed skin
-Throbbing head
- Nausea/vomitting
- Diarrhea
- Numbness in the extremities
- Blurred vision
- Unsteadiness
- Disorientation
- Incoherency
Heat Exhaustion
Symptoms include: fainting, dizziness, profuse sweating, cold and clammy skin, weakness, headache, rapid weak pulse
How do you relieve heat exhaustion?
- Stop and find a cold place to rest the person

- If conscious provide cool water to drink
(do NOT give water to an unconscious person)

- Loosen or remove clothing and rub skin with a coll, wet towel, or ice packs

- Place person in supine position with the legs elevated 8 to 12 inches
You should seek immediate medical attention if a person isn't recovered from heat exhaustion in how long?
30 minutes
What is a heat stroke?
Emergency situation resulting from the body being exposed to high temperatures

Symptoms include serious disorientation; warm, dry skin; NO SWEATING; rapid; full pulse; vomiting; diarrhea; unconscious; and high body temps
When the body reaches 104-105°F
Person may feel a cold sensation in the trunk of the body, goose bumps, nausea, throbbing in the temples, and numbness in the extremities
When the body reaches 105-107°F
Disorientation, loss of fine-motor control, and muscular weakness set in
When body reaches 106°F and above
Serious neurological injury and death may be imminent
What is the most important factor in preventing heat disorders?
Adequate water replacement
Why is it important to replace fluid during prolonged exercise?
Helps maintain blood volume so circulation and sweating can continue at normal levels
How much water should you drink to prevent dehydration?
6-8 oz. of cool water every 15-20 minutes during exercise
When are sports drinks recommended?
When exercise will be strenuous and greater than 1 hour

(For exercise less than 1 hour, water is effective)
What percent of glucose in sports drinks provides optimal fluid absorption and performance?
6% - 8%
Why are drink high in fructose or glucose not recommended?
Becayse they slow water absorption during exercise in the heat

(Most sodas and fruit drink have too much glucose)
Why should we not over hydrate with water?
During very long-distance events it can lead to hypoatremia, or low sodium concentration in the blood

Hyponatemia creates serious health problems, including seizures and coma in severe cases
What are the two factors to consider when exercising in the cold?
Hypothermia and Frostbite
Clothing for cold weather exercise
- Wear several layers of lightweight clothing
(warm air is trapped between layers)

- The first layer should wick moisture away from the skin

- Next wear a layer or wool, dacron, or polyester fleece

- Outerlayer should be waterproof, wind-resistant, and breathable

- Use a ski or face mask to protect the face
In extreme cold, what should you insulate the skin with?
Petroleum Jelly
What are the signs of hypothermia?
-Chills, fatigue, pain in the extremities

- Euphoria, slurred speech, weak pulse
shivering, unconsciousness
How do you treat hypothermia?
- Move to warm area
- Remove wet clothing
- Administer warm liquids
- Transport to hopsital
What are the signs of frostbite?
Sign: burning, numbness, itching or pain

Skin turns white or gray, yellow-reddish-black, and/or blisters
How do you treat frostbite?
- Move to warm area
- Remove wet clothing
- Drink carbohydrate containing fluid at warm temperature
- Treat as burn
- Get to hospital
You can exercise with the cold or flu if symptoms include:
Runny nose, sneezing or scratchy throat

Exercise program should include low to moderate intense exercises
You should NOT exercise with the cold or flu if symptoms include:
Fever, muscle aches, vomiting, diarrhea, or hacking cough
Greater than 50% of all new exercisers incur injuries during?
The first 6 months
What are the mos common cause of injuries?
- High impact activities
- Rapid conditioning programs
- Improper shoes or training surfaces

* Many of these injuries can be prevented through a gradual and correct conditioning program (low-impact)
RICE
R = rest
I = ice
C = compression
E = elevation


-Ice acts as a pain reliever and slows bleeding of the tissue
- An elastic bandage or wrap can be used for compression
- Elevating the body part decreases blood flow and swelling
Ice should be applied how often?
3-5 times a day for 15 minutes at a time
How should head injuries, fractures, dislocations, or partial dislocations be treated?
By specialized medical personnel
Personal Protective Equipment
(PPE)
- Gloves
- Mask
- Proper signs
- Clean gym
- Emergency Policies (AED)
- Regular procedural review
- Knowledge of your clientele
side stitch or side cramp
- Occurs in unconditioned beginners and in trained individuals when they increase exercise intensity

- Could be lack of blood flow to the respiratory muscles during strenuous activity
How do you treat side cramps?
- Slow down or stop exercise altogether
- Lie down on you back and bring knees to
the chest holding that position for 30-60 seconds
- Drink fluids 1-2 hours before exercise
Shin splints are usually from?
- Lack of proper and gradual conditioning
- Doing physical activity on hard surfaces
- Fallen arches
- Chronic overuse
- Muscle fatigue
- Faulty posture
- Improper shoes
- Participating in weight-bearing activities
when excessively overweight
How can you help shin splints?
- Warm up properly
- Slowly increase speed, duration, and intensity of workouts
- Inspect shoes and exercise surfaces
- Stretch before and after physical activity
- Use supportive taping during physical activity
Which muscles should you strengthen to prevent shin splints?
Strengthen the anterior tibialis and the calf muscles
What are muscle cramps?
The body's depletion of essential electrolytes or a breakdown between opposing muscle groups
How do you help muscle cramps?
- Try to stretch the muscles involved
- Rub the muscle gently
- Do warm up exercises
- Rest and replace fluids
Delayed Onset Muscle Soreness
Due to micro tears in the muscle tissue, increase of fluid retention, and overstretching or tearing of connective tissue in and around muscles and joints
DOMS onset is when?
Anywhere from 12 hours to 2-4 days after exercise
How can you prevent DOMS?
- Mild stretching before and adequate stretching after exercise may help prevent soreness

- Gradually progress into an exercise program

- To relieve pain: mild stretching, low-intensity exercise to stimulate blood flow, and a warm bath are recommended
What is acute muscle soreness that sets in after a few hours attributed to?
General fatigue of the exercised muscles
What should a first aid kit prepare for?
- Orthopedic injury (ice)
- Cardiac episode (CPR kit)
- Diabetic hypoglycemia (Juice)
- Hypertension
- Irregular heart beat
- Minor cut
- Asthma
What did the Surgeon General's Report of 1996 say?
Physical activity is a major risk factor for cardiovascular, respiratory, and metabolic diseases
As VO2 max increases, what happens to all-cause mortality?
It decreases
What is considered a GOOD vo2?
15-30
F: >40 M: >45

35-50
F: >35 M: >40

55-70
F: > 30 M: >35
What is considered an ADEQUATE vo2?
15-30
F: 35 M: 40

35-50
F: 30 M: 35

55-70
F: 25 M: 30
What is considered a BORDERLINE vo2?
15-30
F: 30 M: 35

35-50
F: 25 M: 30

55-70
F: 20 M: 25
What is considered NEEDS EXTRA WORK vo2?
15-30
F: <25 M: <30

35-50
F: <20 M: <25

55-70
F: <15 M: <20
More physical activity does what to disease?
Decreases the risk

- CVD
- CHD
- Type 2 Diabetes
- Overweight
- Colon CA
- Breast CA
- Osteoporosis
Small amounts of physical activity make big changes to what things?
- Blood pressure
- Stokes
- Type 2 Diabetes
- Blood cholesterol
- Abdominal and visceral fat
- Depression
- Anxiety
- Independent living in older adults
The response of aerobic training is?
Delayed
2-4 weeks of aerobic training improves?
Depression and anxiety
12 weeks or 3 months of aerobic training improve what?
endurance
cardiovascular health
lowers BP and HR
3-6 months of aerobic training improves what?
Cholesterol
ACSM says that every one should receive how much PA?
Every adult should accumulate 30 minutes or more of moderate intensity exercise on most, preferably all, days of the week
What are the MET levels?
Intense: >6 METS
Moderate: 3-6 METS
Less Intense: <3 METS
Lowest death rates occur when?
- VO2 max is above average
- Expend more than 2000 kcal/week
- Aerobic exercise
What are the three goals of exercise perscription?
1. Health
2. Fitness
3. Performance
Health
* Lower risk of health problems
- moderate intensity
- 5 to 7 days per week
- minimum of 30 minutes/day
With is the overall goal for health?
30 mins per day most days of the week
Fitness
* Cardiovascular Fitness
- 60% to 80% HRR
- 3 to 5 days/week
- 20 to 60 minutes/session
What is the overall goal for fitness?
About 3 miles 3 times a week
Performance
* Running
- >80% HRR
- 7+ days/week
- > 60 min/session
What is the overall goal of performance?
50-90 miles per week
How should unsupervised exercise be conducted?
- Start at a low intensity
- Increase duration and frequency
- Establish lifestyle
- Fitness Professional should occasionally adjust and review program
- Patient in charge of record keeping
How should supervised exercise be conducted?
- Establish Rx by a GXT
- Monitor HR during several activities to ensure THR
- Ability to decrease duration and intensity base on cardio factors
- Communication with physicians
- Determine how medications are affecting patients exercise tolerance
What the the frequency of exercise for CV fitness?
3 - 5 days/week

At least 4 days/week

One day on one day off has shown to benefit cardiovascular health
Things to consider when choosing frequency of exercise
If choosing 2 days/wk exercise at a higher intensity and longer duration

If choosing 4 days/wk moderate intensity and duration can be used

If choosing 6-7 days a week, watch for injuries and signs of overtraining
How long should the warm-up and cool-down be?
5-10 minutes
How long do you have to be at your target heart rate to maintain and gain improvements in VO2?
Minimum of 20 minutes
How long do you have to exercise for weight management and fitness gains?
60 minutes
How long for weight loss and performance increases?
90 minutes
What are the recommendations for calorie burn?
150 kcal/day minimum

Up to 400 kcal/day
What are examples of weight bearing vs. non-weight bearing?
Weight: Running

Non-weight: Swimming, Cycling
Intensity for Cardiorespiratory Fitness for the majority of the population
60% - 80% of VO2 max, HRR, and VO2R

75% - 90% HRmax
What is the recommended RPE ratings for improvements?
12-16 on the BORG scale
In 1998 the ACSM recommended what ranges of VO2 to achieve CR fitness?
40-50% to 85%

- Lower end (40-50%): very unfit people
- 50% and above for average population
How do you determine VO2 max?
Sub max chart
% Heart Rate Reserve
aka Karvonen Method

220 - age = max HR

Max HR - Resting HR = HRR

HRR * intensity + RHR = %HRR

[60-80% intensity is typically range used for prescribing exercise to an average adult]

+/- 10% error
Moderate activity starts at what percent HRR?
70%
%HR max and %VO2 max have what kind of relationship?
A linear one
What RPEs do we generally use for 60, 70, and 80 year-olds
6 = 60
7 = 70
8 = 80
When starting an exercise program during pregnancy?
- Always get prior approval from physician
- Never perform exercise teting
- Be cautious if patient was sedentary previously
What intensity should you keep them at?
Moderate, NO vigorous

Stay on same program you were before pregnant
Physiological changes during exercise
Oxygen uptake during weight bearing exercise decreases

HR increases at rest and with activity

No change, or a decrease, in SBP and DBP
Exercise Prescription for Pregnancy:
Frequency
At least 3 times/week, if not all days
Exercise Prescription for Pregnancy:
Intensity
Moderate (40-60% VO2R)

RPE: 12-14, talk test
Exercise Prescription for Pregnancy:
Time
>15 mins

Increasing to at least 30 mins

Goal is 150 mins per week
Exercise Prescription for Pregnancy:
Type
Rythmic PA, large muscle groups, walking, cycling

* important b/c it keeps blood flowing
What are some cautions during pregnancy?
- If morbidly obese, they're at a higher risk for
gestational diabetes and hypertension

- Avoid all contact sports, do not start new balance exercises, no vigorous activity

- No horseback riding or rollercoaster

- No yoga or feet over head maneuvers
Reasons to terminate activity during pregnancy
Vaginal bleeding
shortness of breath
dizziness
headache
chest pain
weakness
calf pain or swelling
amniotic fluid leakage
For children <13 years old and
adolescents 13-18 years old
- Most are not meeting recommendation for activity per day

- Exercise testing is not recommended unless needed to clarify health concerns

- Encourage all types of aerobic activity

- Encourage some vigorous and moderate each day

- Discourage hours watching TV, games, and internet use
What happens to relative VO2 and HR during youth?
They increase
What happens to SBP and DBP during youth?
they decrease
What happens to respiratory rate during youth?
It increases
Exercise Prescription for Youth:
Frequency
3-4 days/wk, preferably all days of the week
Exercise Prescription for Youth:
Intensity
Moderate to Vigorous (noticeable increase in breathing and sweating)
Exercise Prescription for Youth:
Time
30 min of moderate and 30 min vigorous per day

* you want a mix of both
Exercise Prescription for Youth:
Type
A variety: sports, individual, recreational, leagues
Considerations for Youth
* Do not perform max resistance exercises
- 8 to 15 reps should be performed to moderate fatigue
- Good mechanical form

* Encourage proper hydration and exercise behavior

* Form habits of 60 mins a day

* Manage disease or disabilities: asthma, diabetes, obesity, cerebral palsy
Older Adults ≥ 65 years old
* Or 50-64 years old with clinically significant conditions or limitations to movement

-Encourage a lifestyle of physical activities
- Look at total time spent during physical activities not intensity
(30 minutes total)
- Encourage maintenance of independent living
Overwhelming evidence supports that exercise:
1. Slows loss of aerobic capacity
2. Improves age related body composition changes
3. Psychological and mental well-being
4. Management of chronic disease
5. Reduces disability
6. Increases longevity
Physiological changes of older adults
- HR max decreases

- Resting BP and exercise BP increase

- Muscular strength, flexibility, bone mass,
reaction time all decrease
Exercise Prescription for Older Adults:
Frequency
Aerobic: minimum of 5 days/weel

Other: 2-3 times/week

(other can include strength, balance, flexibility)
Exercise Prescription for Older Adults:
Intensity
If using 0-10 scale: 5-6 is moderate

If using 6-20 scale: 12-14 is moderate
Exercise Prescription for Older Adults:
Time
at least 30 minutes work, up to 60 minutes
Exercise Prescription for Older Adults:
Type
Aerobic, muscular strength and endurance, flexibility and balance
What are the two types of arthritis?
Osteoarthritis and Rheumatoid Arthritis
Osteoarthritis
- Local degenerative joint disease

- Hands, hips, spine, and knees

- Usually comes with age or injury

- Also associate with obesity
Rheumatoid Arthritis
- Chronic, systemic inflammatory disease

- Autoimmune disease against joint tissues

- Can happen at any age
What are some other common rheumatic diseases?
Fibromyalgia (muscular pain)

Systemic Lupus

Gout

Bursitis
Exercise Prescription for Arthritis:
Frequency
3-5 days/week for aerobic

2-3 days/week for resistance on non-consecutive days

Flexibility and Range of Motion should be done at least once per day
Exercise Prescription for Arthritis:
Intensity
Low to moderate, adjust according to pain scale
Exercise Prescription for Arthritis:
Time
Up to 30 mins per day

Resistance 10-15 reps
Exercise Prescription for Arthritis:
Type
Low joint stress

(swimming, exercise bike)
Borg Pain Scale
Ranges from 0-10

0 being no pain, 10 being maximal
Lifetime prevalence of cancer
Men: 1 in 2
(lung, prostate, colon)

Women: 1 in 3
(lung, breast, colon)
Cancer Treatments
Surgery, radiation, chemotherapy, hormones, and immunotherapy
Side effects of Cancer
Loss of aerobic capacity
Decrease in muscle tissue
Decreased range of motion
Exercise Prescription for Cancer:
Frequency
Aerobics: 3-5 days/week

Resistance: 2-3 days/week

Flexibility: 2-7 times/week
helps with stress management
Exercise Prescription for Cancer:
Intensity
Low to moderate
40% - 60% VO2R
Exercise Prescription for Cancer:
Time
20-60 mins

8-12 reps
Exercise Prescription for Cancer:
Type
Prolonged, rhythmic activities with large muscle groups
For someone who is currently undergoing cancer treatment you must have?
A doctor's permission to exercise
What are the fasting glucose levels for diabetes?
Normal: < 100
Pre-Diabetic: 100-125
Diabetic: ≥126
What are some important consideration for diabetic exercisers?
There is increased chance of cardiac disease

Watch out for glucose spikes or drops

Pre, during, and post exercise blood glucose tests
Exercise Prescription for Diabetics:
Frequency
3-7 days/week
Exercise Prescription for Diabetics:
Intensity
50-80% VO2R

or

12-16 RPE
Exercise Prescription for Diabetics:
Time
20-60 continuous or accumulated

Goal is 300 minutes per week
Exercise Prescription for Diabetics:
Type
Rhytmic large muscle groups
Metabolic Syndrome Risk Factors
ABDOMINAL OBESITY:
waist circumference ≥ 102 cm (men)
waist circumference ≥ 88 cm (women)

HIGH TRIGLYCERIDES:
≥ 150 mg/dL, or drug treatment

LOW HDL-C:
< 40 mg/dL (men) or < 50 mg/dL (women)
or drug treatment

ELEVATED BLOOD PRESSURE:
≥130/≥85 mmHg or drug treatment

ELEVATED FASTING GLUCOSE:
≥ 100 mg/dL or drug treatment
How many risk factors designate metabolic syndrome?
3 or more

(27% of people have it)
What is the best intervention for Metabolic Syndrome?
Medication, because people find it easiest to stick to
Primary Intervention for people with Syndrome X
1. Moderate restriction of calories
- goal is to acheive 5-10% weight loss in 1 yr

2. Increase PA, at least 30 mins most days

3. Change macronutrient intake
- Decrease total fats <30% total calories
- Decrease sat fat <7% of total calories
- Increase whole grains > 3 oz per day
- Increase fiber
- Increase vegetables and fruits (5 a day)
Exercise Prescription for Metabolic Syndrome:
Frequency
Increase to all days of the week
Exercise Prescription for Metabolic Syndrome:
Intensity
Moderate increasing to vigorous
Exercise Prescription for Metabolic Syndrome:
Time
Increasing to 60 minutes 5 times a week
Exercise Prescription for Metabolic Syndrome:
Type
Continuous and Rhythmic
Overweight and Obese BMIs
Overweight: 25-29.9

Obese: >30
What percent weight loss can significantly reduce chronic diseases?
5-10%
Exercise Prescription for Overweight and Obese:
Frequency
more than 5 days/week

(want to maximize caloric expenditure)
Exercise Prescription for Overweight and Obese:
Intensity
Moderate to vigorous
Exercise Prescription for Overweight and Obese:
Time
30-60 mins

work up to 60 mins each day
Exercise Prescription for Overweight and Obese:
Type
Primarily aerobic, add in resistance and flexibility
By how much do we want to reduce caloric intake a day by?
500 - 1000 per day