Subscapular: kids/certain female "ethnic" groups
2 cm below inferior angle of scapula. diagonal fold.
Midaxilary: female ethnic groups
raise right arm. landmark-mid armpit to zyphoid process.
vertical fold.
Circumference:
Commonly used for pre/post testing. Wrap tape around body part. Hold spring until it pulls to the red indentation. Reading in cm. Minimum of 2 readings. Readings must be within 5 mm of each other.
Arm & Calf same landmarks as SKF.
See book for sites as Tom had some trouble explaining them without it :)
Use waist to hip ratio to find risk factor for CVD.
Waist/hip = > or = .95 for males, > or = .86 for females
means that you store more fat androidally and thus increase your risk for CVD.
ACSM norms for waist circ.
>102 (~40 in.) for males
>85 cm (35.5 in.) for females
BMI
> or = 30
[(BW in kg)/ (height in m)^2]
See pkt. pages for different ethnic SKF equations.
For a white female you need tricept, superiliac, and thigh measurements.
Density of fat: .901
Density of FFM: 1.10
Density of H2O: 1.0
Monday, March 24, 2008
Monday, March 17, 2008
3.15.08 Body Composition
Testing Order
1. Resting measurements- BP, HR, Gender, height, weight, age
2. BC-body comp. -a lot of sweating can increase margin of error.
3. CRF-GXT-warms you up
4. Muscular endurance- not if #3 was intense
5. Flex-flexibility (because you are warmed up
Body Composition (BC)
Our poor attempt to differentiate the makeup of the human body into two components.
Assumptions of Hydrostatic Weighing
Best way to estimate body comp. Can easily do it in a pool. Considered, arguably, the Gold Standard in estimating % body fat.
Criterion measure
skin fold calipers are the best Field test.
Valid-measures what it is supposed to. HSW is really estimating body density (Db)
To be valid, we have to take for granted certain assumptions:
1. Body weight can be divided into 2 components
a. fat mass (FM
-includes essential fat (need to live)
b. fat free mass (FFM)
-water(72%), protein(21%), mineral(7%)
-older adults-total body water decreases with age.
% H2O may be good for 18 yo but in a 70 yo their %H2O could be 68%.
-Bloating (retaining water) during cycle affects this too.
-ethnicity-African American muscle density is slightly higher than in whites.
difference in muscled vs. deconditioned
-osteoporosis, gender, age, AA and Hispanic have increased BMD while Asians have decreased BMD
2. The relative portion of H2O, protein, and mineral are constant between all individuals.
3. Density of FM= .901g/ml - this is a good assumption, fat is fat
4. Density of FFM = 1.10 g/ml
-differs specifically over ethnicity, higher in Native Americans
#s based on dissection of 4 white people
3 males, 1 female
young-within 20 years of each other
all died in traumatic car accidents
the woman's #s were so far off the males' that they threw her data out.
DEXA
Theory of Hydrostatic Weighing
1. Body density= Db = body weight on land/ body volume
-scale to measure BW
-hydrostatic weighting to measure BV.
2. BV=(wt. in air)-(wt. in water)
Archimedes Principle
reflection of H2O displacement
But muscle sinks, fat floats
therefore:
Db= wt. in air/[(wt. in air)-(wt. in water)]
RV: residual volume: always a certain amount of air in lungs after you exhale as much as you can. air wil make you float, making you less dense, thus seem to have a higher % body fat.
Skin fold technique (SKF)
Lange calipers: $200-250.
Estimating total fat mass
FM: visceral/ adipose: 2/3 of total body fat
subcutaneous: 1/3
SKF estimates subcutaneous fat stores so that you can extrapolate visceral also.
younger people store fat visceral fat differently than subcutaneous than older adults do. must take into consideration age.
Margin of error: + OR - 3-3.5%
ACSM pg. 62 box 42
Thigh- used commonly in both men and women.
find inguinal crease is the 0 mark
measure to the top of the patella
mark half way between.
grip above cross hairs 3in. apart perpendicular to fold. Reach from above.
Bicep/Tricep
common for females
0 mark on the chromium process-shoulder ridge end
measure to point of elbow
tri: mark bottom of tape measure
bi: mark above tape measure
Calf
from medial process of knee, let tape measure fall to 90 degrees. plum line down, measure at largest part of calf.
Abdomen
common site for all men, ethnic minority females
0 mark is all the bottom right corner of belly button, 2com over, 1cm down
finger is in the belly button
Superiliac (pelvic crest)
45 degree angle fold
ASIS (anterior superior iliac spine)
find hip pointer bone
measure from armpit straight over ASIS mark
Chest
o mark at armpit
measure to nipple
1/3 distance in females
1/2 distance in males
45 degree angle fold
1. Resting measurements- BP, HR, Gender, height, weight, age
2. BC-body comp. -a lot of sweating can increase margin of error.
3. CRF-GXT-warms you up
4. Muscular endurance- not if #3 was intense
5. Flex-flexibility (because you are warmed up
Body Composition (BC)
Our poor attempt to differentiate the makeup of the human body into two components.
Assumptions of Hydrostatic Weighing
Best way to estimate body comp. Can easily do it in a pool. Considered, arguably, the Gold Standard in estimating % body fat.
Criterion measure
skin fold calipers are the best Field test.
Valid-measures what it is supposed to. HSW is really estimating body density (Db)
To be valid, we have to take for granted certain assumptions:
1. Body weight can be divided into 2 components
a. fat mass (FM
-includes essential fat (need to live)
b. fat free mass (FFM)
-water(72%), protein(21%), mineral(7%)
-older adults-total body water decreases with age.
% H2O may be good for 18 yo but in a 70 yo their %H2O could be 68%.
-Bloating (retaining water) during cycle affects this too.
-ethnicity-African American muscle density is slightly higher than in whites.
difference in muscled vs. deconditioned
-osteoporosis, gender, age, AA and Hispanic have increased BMD while Asians have decreased BMD
2. The relative portion of H2O, protein, and mineral are constant between all individuals.
3. Density of FM= .901g/ml - this is a good assumption, fat is fat
4. Density of FFM = 1.10 g/ml
-differs specifically over ethnicity, higher in Native Americans
#s based on dissection of 4 white people
3 males, 1 female
young-within 20 years of each other
all died in traumatic car accidents
the woman's #s were so far off the males' that they threw her data out.
DEXA
Theory of Hydrostatic Weighing
1. Body density= Db = body weight on land/ body volume
-scale to measure BW
-hydrostatic weighting to measure BV.
2. BV=(wt. in air)-(wt. in water)
Archimedes Principle
reflection of H2O displacement
But muscle sinks, fat floats
therefore:
Db= wt. in air/[(wt. in air)-(wt. in water)]
RV: residual volume: always a certain amount of air in lungs after you exhale as much as you can. air wil make you float, making you less dense, thus seem to have a higher % body fat.
Skin fold technique (SKF)
Lange calipers: $200-250.
Estimating total fat mass
FM: visceral/ adipose: 2/3 of total body fat
subcutaneous: 1/3
SKF estimates subcutaneous fat stores so that you can extrapolate visceral also.
younger people store fat visceral fat differently than subcutaneous than older adults do. must take into consideration age.
Margin of error: + OR - 3-3.5%
ACSM pg. 62 box 42
Thigh- used commonly in both men and women.
find inguinal crease is the 0 mark
measure to the top of the patella
mark half way between.
grip above cross hairs 3in. apart perpendicular to fold. Reach from above.
Bicep/Tricep
common for females
0 mark on the chromium process-shoulder ridge end
measure to point of elbow
tri: mark bottom of tape measure
bi: mark above tape measure
Calf
from medial process of knee, let tape measure fall to 90 degrees. plum line down, measure at largest part of calf.
Abdomen
common site for all men, ethnic minority females
0 mark is all the bottom right corner of belly button, 2com over, 1cm down
finger is in the belly button
Superiliac (pelvic crest)
45 degree angle fold
ASIS (anterior superior iliac spine)
find hip pointer bone
measure from armpit straight over ASIS mark
Chest
o mark at armpit
measure to nipple
1/3 distance in females
1/2 distance in males
45 degree angle fold
3.8.08 Fitness Tests
Canadian sit and Reach
-not modified for arm length so people with short arms don't do as well. Canadian- (cm), YMCA-(inches), (ACSM pg. 89-90 Norms).
Box that doesn't move- add 3cm to score to compare to norms
If person cannot do sit and reach star position-do back saver sit and reach in the hurdler position. Can't use norms but at least you have a base line to work from
Get average American to the 50% of the norms.
There is a relationship between poor sit and reach values and low back injury.
Bench Press Test
measures muscle endurance for most people
Ability of a muscle or muscle group to perform repeated consecutive contractions
Practice with client, then test them.
Push up Test
supposed to be a muscle endurance test also but usually more of a strength test for most Americans. easy assessment, no special equipment.
Curl up Test
people with long arms benefit from this protocol
10cm from top to top of yard sticks
start with fingers touching first then curl up to top of second
No holding feet
read modifications
Define Muscle Fitness Types
1. Muscle strength: the maximum amount of force that can be exerted by a muscle or muscle group.
-1 RM: heaviest weight that can be lifted 1 time through a Full Range of Motion with proper technique.
-high weight/low reps.
2. Muscle endurance: ability of muscle or muscle group to perform repeated, consecutive contractions
-low weight/high reps.
Muscle Contraction Types
1. Isometric/Static: muscle generates force or tension with no change in the muscle's length.
2. Isotonic/Dynamic constant external resistance (DCER)
Muscle generates force while the muscle changes length.
-concentric: muscle contracts (shortens)
-eccentric-muscle lengthens 70% of running is eccentric, causes most of DOMS
3.Isokinetic/Accomidating resistance-muscle generates near max force throughout Full range of motion while contracting at a constant speed. swimming is the closest without the expensive machines.
Program Characteristics
ACSM
Isotonic/DCER programs:
1set
8-12 reps (best of endurance and strength)
2-3 days per week of same muscle group
8-10 large muscle group exercises
pkt pg. 50
people who are of a greater training age.
training age is different than chronological age.
Endurance 12-20 RM 20-30sec rest best
70-20% 1RM <60sec rest.
Chart of 1-20RM (%) is best for large muscle groups and better for lower RM ranges. Fine for free bar or machine. Have to have good technique.
Program Characteristics
Isometric Programs
sticking points
musculo-skeletal injury/rehab
5-10 contractions (max or near max)
6 sec. contractions
(product must be 30) eg. 5 contractions with a 6 sec. hold (5x6=30)
3 days per week
joint angle specificity (+ or - 20)
Indications: can be performed anywhere
minimal time requirements
rehabilitation
sticking point (functional isometrics)
Contraindications: increased acute blood pressure
few practical uses (this is not necessarily true)
Program Characteristics
Isokinetic Program
Expensive machine
PT
3sets
8-15 reps
2-4 days per week
speeds from 1degree per sec to 600degrees per sec. (use intermediate speeds of 179degrees because there is a 20degree carry over)
Indications: Rehabilitation (machine stops when you stop)
maximal effort throughout ROM
Contraindications: cost, find them in hospitals, PT clinics.
-not modified for arm length so people with short arms don't do as well. Canadian- (cm), YMCA-(inches), (ACSM pg. 89-90 Norms).
Box that doesn't move- add 3cm to score to compare to norms
If person cannot do sit and reach star position-do back saver sit and reach in the hurdler position. Can't use norms but at least you have a base line to work from
Get average American to the 50% of the norms.
There is a relationship between poor sit and reach values and low back injury.
Bench Press Test
measures muscle endurance for most people
Ability of a muscle or muscle group to perform repeated consecutive contractions
Practice with client, then test them.
Push up Test
supposed to be a muscle endurance test also but usually more of a strength test for most Americans. easy assessment, no special equipment.
Curl up Test
people with long arms benefit from this protocol
10cm from top to top of yard sticks
start with fingers touching first then curl up to top of second
No holding feet
read modifications
Define Muscle Fitness Types
1. Muscle strength: the maximum amount of force that can be exerted by a muscle or muscle group.
-1 RM: heaviest weight that can be lifted 1 time through a Full Range of Motion with proper technique.
-high weight/low reps.
2. Muscle endurance: ability of muscle or muscle group to perform repeated, consecutive contractions
-low weight/high reps.
Muscle Contraction Types
1. Isometric/Static: muscle generates force or tension with no change in the muscle's length.
2. Isotonic/Dynamic constant external resistance (DCER)
Muscle generates force while the muscle changes length.
-concentric: muscle contracts (shortens)
-eccentric-muscle lengthens 70% of running is eccentric, causes most of DOMS
3.Isokinetic/Accomidating resistance-muscle generates near max force throughout Full range of motion while contracting at a constant speed. swimming is the closest without the expensive machines.
Program Characteristics
ACSM
Isotonic/DCER programs:
1set
8-12 reps (best of endurance and strength)
2-3 days per week of same muscle group
8-10 large muscle group exercises
pkt pg. 50
people who are of a greater training age.
training age is different than chronological age.
Endurance 12-20 RM 20-30sec rest best
70-20% 1RM <60sec rest.
Chart of 1-20RM (%) is best for large muscle groups and better for lower RM ranges. Fine for free bar or machine. Have to have good technique.
Program Characteristics
Isometric Programs
sticking points
musculo-skeletal injury/rehab
5-10 contractions (max or near max)
6 sec. contractions
(product must be 30) eg. 5 contractions with a 6 sec. hold (5x6=30)
3 days per week
joint angle specificity (+ or - 20)
Indications: can be performed anywhere
minimal time requirements
rehabilitation
sticking point (functional isometrics)
Contraindications: increased acute blood pressure
few practical uses (this is not necessarily true)
Program Characteristics
Isokinetic Program
Expensive machine
PT
3sets
8-15 reps
2-4 days per week
speeds from 1degree per sec to 600degrees per sec. (use intermediate speeds of 179degrees because there is a 20degree carry over)
Indications: Rehabilitation (machine stops when you stop)
maximal effort throughout ROM
Contraindications: cost, find them in hospitals, PT clinics.
Wednesday, March 5, 2008
3.1.08 Cardiorespiratory Fittness Program Design
To improve VO2max:
F: frequency- 3-5 days/week
I: Intensity
T: Time- 20-60 min. related to Intensity
T: Type- aerobic exercise
People can improve metabolic health w/o improving VO2max.
I:Intensity- how hard you must work out. HR- most commonly used to measure I.
7 ways to measure I.
1&2: % VO2mas or HRR or Karvonen Method
3. VO2R
4. % HRmax- classical, least useful, most common for group exercise
5. METs
6. RPE
7. kcals
Fitness classification dictates I they need to work out at. Dependant on VO2max and norms on pg. 46.
Karvonen Method
pg. 47
How do you take % VO2max or % HRR and put it into a HR you can use? Karvonen formula.
THR= % I(HRmax- HRrest) + HRrest
HRrest is the average of 3 morning full minute HR counts.
VO2R
VO2R = % I (VO2max -VO2rest) + VO2rest
VO2rest= 3.5
pg. 289
Example: Maryann-
50% = 13.25
60% = 15.2
Back calculate for speed
13.25 = (.1)(s) + 0 + 3.5
13.25-3.5 = (.1)(s)
9.75/.1 = s
s = 97.5 m/min x 26.8 = 3.6 mph
METs
VO2---> METs
VO2/METs = VO2/3.5
Maryann-
23ml/kg/min.=VO2max
23/3.5 = 6.57 METs
pg. 34+ pkt.
You can easily convert METs into kcals
kcals/min. =[(METs)(3.5)(BW in kg)]/200
or [VO2max(BW)]/200
[4 (3.5)(205/2.2)]/200 = 6.5 kcals/min.
PRE
Rule of thumb- add a zero to PRE (6-20 scale) to get HR. give or take (~30)
Intensity should be from 12-16 on RPE
Borg Scales were originally only for aerobic training.
1-10 is the revised Borg Scale
% HRmax
Classical
THR = %I (HRmax)
Underestimates % needed to work out @ to elicit a training effect. pg 30 pkt.
low-below average is 63-69%, not 40-50%
THR = %I(200-age)
Rate of Progression
Initial Conditioning Stage
1. Low level aerobic activity
2. Minimize muscle soreness
3. Avoid injury
4. Develop orthopedic tolerance
5. Include 10-15 min. warm up and cool down
6. Intensity of 40-60% HRR
7. 3-4 DPW
9 Stage should last 1-6 weeks (depending on initial fitness level and adaptation rate)
Improvement Conditioning Stage
1. Progressive increase in D of no more than 20% per week
2. Once target frequency/D is achieved, increase I by 5% HRR every sixth session as tolerated.
3. Progressive increase in I from 50-85% HRR
4. Stage should last 4-8 months
Maintenance Stage
1. Once goal fitness level is established maintain at this level.
minimum of 50th percentile in all health related fitness parameters.
2. Introduce other activities to alleviate boredom.
3. Stage last for lifetime
Rate of Improvement in VO2max
1. 3% per week increase during 1st 4 weeks
2. 2% per week increase during 2nd 4 weeks
3. 1% per week increase thereafter
Maryann-
How much improvement in VO2max should she see in 12 weeks?
23 x .12 = 25.76 x 1.08 = 27.82 x 1.04 = 28.93 she would increase to the above average category.
Training Bout
1. Warm-up
historically static stretches- now they are at the end
2. Training session
3. Cool down- static stretches.
F: frequency- 3-5 days/week
I: Intensity
T: Time- 20-60 min. related to Intensity
T: Type- aerobic exercise
People can improve metabolic health w/o improving VO2max.
I:Intensity- how hard you must work out. HR- most commonly used to measure I.
7 ways to measure I.
1&2: % VO2mas or HRR or Karvonen Method
3. VO2R
4. % HRmax- classical, least useful, most common for group exercise
5. METs
6. RPE
7. kcals
Fitness classification dictates I they need to work out at. Dependant on VO2max and norms on pg. 46.
Karvonen Method
pg. 47
How do you take % VO2max or % HRR and put it into a HR you can use? Karvonen formula.
THR= % I(HRmax- HRrest) + HRrest
HRrest is the average of 3 morning full minute HR counts.
VO2R
VO2R = % I (VO2max -VO2rest) + VO2rest
VO2rest= 3.5
pg. 289
Example: Maryann-
50% = 13.25
60% = 15.2
Back calculate for speed
13.25 = (.1)(s) + 0 + 3.5
13.25-3.5 = (.1)(s)
9.75/.1 = s
s = 97.5 m/min x 26.8 = 3.6 mph
METs
VO2---> METs
VO2/METs = VO2/3.5
Maryann-
23ml/kg/min.=VO2max
23/3.5 = 6.57 METs
pg. 34+ pkt.
You can easily convert METs into kcals
kcals/min. =[(METs)(3.5)(BW in kg)]/200
or [VO2max(BW)]/200
[4 (3.5)(205/2.2)]/200 = 6.5 kcals/min.
PRE
Rule of thumb- add a zero to PRE (6-20 scale) to get HR. give or take (~30)
Intensity should be from 12-16 on RPE
Borg Scales were originally only for aerobic training.
1-10 is the revised Borg Scale
% HRmax
Classical
THR = %I (HRmax)
Underestimates % needed to work out @ to elicit a training effect. pg 30 pkt.
low-below average is 63-69%, not 40-50%
THR = %I(200-age)
Rate of Progression
Initial Conditioning Stage
1. Low level aerobic activity
2. Minimize muscle soreness
3. Avoid injury
4. Develop orthopedic tolerance
5. Include 10-15 min. warm up and cool down
6. Intensity of 40-60% HRR
7. 3-4 DPW
9 Stage should last 1-6 weeks (depending on initial fitness level and adaptation rate)
Improvement Conditioning Stage
1. Progressive increase in D of no more than 20% per week
2. Once target frequency/D is achieved, increase I by 5% HRR every sixth session as tolerated.
3. Progressive increase in I from 50-85% HRR
4. Stage should last 4-8 months
Maintenance Stage
1. Once goal fitness level is established maintain at this level.
minimum of 50th percentile in all health related fitness parameters.
2. Introduce other activities to alleviate boredom.
3. Stage last for lifetime
Rate of Improvement in VO2max
1. 3% per week increase during 1st 4 weeks
2. 2% per week increase during 2nd 4 weeks
3. 1% per week increase thereafter
Maryann-
How much improvement in VO2max should she see in 12 weeks?
23 x .12 = 25.76 x 1.08 = 27.82 x 1.04 = 28.93 she would increase to the above average category.
Training Bout
1. Warm-up
historically static stretches- now they are at the end
2. Training session
3. Cool down- static stretches.
Wednesday, February 13, 2008
2.9.08 Math Math and yes, More Math
Day of the in class demonstration of the bike ergometer GXT.
As stated in the title, this is a lot of math. If you weren't there, I would suggest getting together with Tom or someone else. Pretty in-depth lecture.
ACSM pg. 289 pkt. pg. 14 VO2
How much oxygen is a person taking in and consuming at a given level of submaximal exercise?
Walking test: Usually on a treadmill-must control speed
Stationary bike: cannot be used on just any stationary bike-must provide info on workload. Ergometer (work measure)- can measure workload.
Arm ergometer:arm cranking- generally for people who cannot use bike, lower extremity problems.
Stepping test: Macartyl Step test
We use these equations to estimate submax VO2. There is a linear relationship between HR & VO2. Relationship begins over 110HR.
GRAPH
Our major goal is to get two data points to estimate VO2max. Need age to estimate HRmax.
Say we have two people who are 30 years old. They both should be able to get to a HR of 190 (200-30).
Walking:
Best used at speeds from 1.9 mph-3.7 mph as long as they are truly walking.
VO2= (.1)(s)+(1.8)(s)(g)+3.5
Where s=speed of treadmill (reported in meters/min.)
g=grade or incline (1% = .01)
miles per hour x 26.8 = meters per min.
mpm/26.8 = miles per hour
VO2 = HC + VC + RC
HR is horizontal component (distance or speed)
VC is vertical component (incline or grade)
RC is the rest component (VO2rest)
VO2rest is .1m/kg/min to get 1m in 1 min. (for everyone)
The difference is the HR it takes to do this.
Say we get on the treadmill going 4mph.
VO2 = .1(4x26.8)+0+3.5= 10.72+3.5= 14.22 ml/kg/min (pg. 289-all units are ml/kg/min)
What about 4mph with a 12% grade?
VO2= .1(107.2)+1.8(107.2)(.12)+3.5= 37.3752 ml/kg/min.
Running: Best used at speeds of 5mph but can be used with validity from 3-5mph.
VO2= (.2)(s)+(.9)(s)(g)+3.5
.2 is because it takes twice as much oxygen to run at the same speed as it does to walk.
La Luz Trail: 12% grade 9 miles long 1hr.: 45min. (105 min.)
9/105min. x 60min./hr. = 540 (5..14 mph)
.2(137.752)+.9(137.752)(.12)+3.5= 45.93ml/kg/min.
pkt. pg. 16 MEMORIZE kcals/min.
METS x 3.5= VO2 so VO2 x BW(in kg)/ 200
(45.93 x 71kg)/200 = 16.39 kcals/min. x 105 min. = 1720.8 kcals burned going up LLT.
Bike Ergometer:
VO2 =1.8 (workrate/BW in kg) +3.5+3.5
workrate is resistance & cadence (Friction is measured in kg or kp (kiloponds))
kg and kp are THE SAME
Workrate = kg x m/rev. x rev./min.
kg is the friction
m/rev is dependent on the bike ergometer type: Monarch =6, Bodyguard & Tunturi =3
rev/min is the cadence (dictated by the protocol being used)
Pg. 74 ACSM
Pg. 27 pkt.
Example: Monarch, 90rpm, 1.5 kp
1.5x6x (90/min)=(810 kgm/min)/ 6 = 135 Watts (power a lightbulb for one min.)
Maryann's Bike Ergometer Test YMCA Protocol
Pg. 84 pkt.
I 0-1 nothing
1-2 15 HR, 7RPE
2-3 145/80, 16HR, 7RPE
Pg. 74 (1.5 kg @ 50rpm)
II 3-4 nothing
4-5 18HR, 8RPE
5-6 155/80, 18HR, 9RPE
III 6-7 nothing
7-8 20HR, 14RPE
8-9 165/78, 22HR, 14RPE
9-10 175/80, 22, 15RPE
HRmax =220-54
70%= 116 (19HR)
85% = 141 (23HR)
Weight 205/ 2.2= 93.18 kg
Cool down is 4 min. (collect everything for all 4 min.)
10-11 175/80, 19HR, 12RPE
11-12 170/70, 17HR, 11RPE
12-13 165/75, 16HR, 11RPE
VO2= 1.8 (1.5x6x50)/93.18+3.5+3.5= 15.69 ml/kg/min.
Mathmatical formula to extrapolate HRmax
b=slope= (SM2 - SM)/ (HR2 - HR)
VO2max = SM2 + b (HRmax - HR2)
b= (18.59 - 15.69)/ (132 - 108) = .12
VO2 max = 18.59 + .12 (166-132)
VO2 max = 22.67 VO2 peak probably
pg. 46 pkt. Average Category
pg. 47 For biking program 50-60% of VO2max
Fat loss-closer to 50
Interval 60-50-60-50 etc.
Assign Homework 1
As stated in the title, this is a lot of math. If you weren't there, I would suggest getting together with Tom or someone else. Pretty in-depth lecture.
ACSM pg. 289 pkt. pg. 14 VO2
How much oxygen is a person taking in and consuming at a given level of submaximal exercise?
Walking test: Usually on a treadmill-must control speed
Stationary bike: cannot be used on just any stationary bike-must provide info on workload. Ergometer (work measure)- can measure workload.
Arm ergometer:arm cranking- generally for people who cannot use bike, lower extremity problems.
Stepping test: Macartyl Step test
We use these equations to estimate submax VO2. There is a linear relationship between HR & VO2. Relationship begins over 110HR.
GRAPH
Our major goal is to get two data points to estimate VO2max. Need age to estimate HRmax.
Say we have two people who are 30 years old. They both should be able to get to a HR of 190 (200-30).
Walking:
Best used at speeds from 1.9 mph-3.7 mph as long as they are truly walking.
VO2= (.1)(s)+(1.8)(s)(g)+3.5
Where s=speed of treadmill (reported in meters/min.)
g=grade or incline (1% = .01)
miles per hour x 26.8 = meters per min.
mpm/26.8 = miles per hour
VO2 = HC + VC + RC
HR is horizontal component (distance or speed)
VC is vertical component (incline or grade)
RC is the rest component (VO2rest)
VO2rest is .1m/kg/min to get 1m in 1 min. (for everyone)
The difference is the HR it takes to do this.
Say we get on the treadmill going 4mph.
VO2 = .1(4x26.8)+0+3.5= 10.72+3.5= 14.22 ml/kg/min (pg. 289-all units are ml/kg/min)
What about 4mph with a 12% grade?
VO2= .1(107.2)+1.8(107.2)(.12)+3.5= 37.3752 ml/kg/min.
Running: Best used at speeds of 5mph but can be used with validity from 3-5mph.
VO2= (.2)(s)+(.9)(s)(g)+3.5
.2 is because it takes twice as much oxygen to run at the same speed as it does to walk.
La Luz Trail: 12% grade 9 miles long 1hr.: 45min. (105 min.)
9/105min. x 60min./hr. = 540 (5..14 mph)
.2(137.752)+.9(137.752)(.12)+3.5= 45.93ml/kg/min.
pkt. pg. 16 MEMORIZE kcals/min.
METS x 3.5= VO2 so VO2 x BW(in kg)/ 200
(45.93 x 71kg)/200 = 16.39 kcals/min. x 105 min. = 1720.8 kcals burned going up LLT.
Bike Ergometer:
VO2 =1.8 (workrate/BW in kg) +3.5+3.5
workrate is resistance & cadence (Friction is measured in kg or kp (kiloponds))
kg and kp are THE SAME
Workrate = kg x m/rev. x rev./min.
kg is the friction
m/rev is dependent on the bike ergometer type: Monarch =6, Bodyguard & Tunturi =3
rev/min is the cadence (dictated by the protocol being used)
Pg. 74 ACSM
Pg. 27 pkt.
Example: Monarch, 90rpm, 1.5 kp
1.5x6x (90/min)=(810 kgm/min)/ 6 = 135 Watts (power a lightbulb for one min.)
Maryann's Bike Ergometer Test YMCA Protocol
Pg. 84 pkt.
I 0-1 nothing
1-2 15 HR, 7RPE
2-3 145/80, 16HR, 7RPE
Pg. 74 (1.5 kg @ 50rpm)
II 3-4 nothing
4-5 18HR, 8RPE
5-6 155/80, 18HR, 9RPE
III 6-7 nothing
7-8 20HR, 14RPE
8-9 165/78, 22HR, 14RPE
9-10 175/80, 22, 15RPE
HRmax =220-54
70%= 116 (19HR)
85% = 141 (23HR)
Weight 205/ 2.2= 93.18 kg
Cool down is 4 min. (collect everything for all 4 min.)
10-11 175/80, 19HR, 12RPE
11-12 170/70, 17HR, 11RPE
12-13 165/75, 16HR, 11RPE
VO2= 1.8 (1.5x6x50)/93.18+3.5+3.5= 15.69 ml/kg/min.
Mathmatical formula to extrapolate HRmax
b=slope= (SM2 - SM)/ (HR2 - HR)
VO2max = SM2 + b (HRmax - HR2)
b= (18.59 - 15.69)/ (132 - 108) = .12
VO2 max = 18.59 + .12 (166-132)
VO2 max = 22.67 VO2 peak probably
pg. 46 pkt. Average Category
pg. 47 For biking program 50-60% of VO2max
Fat loss-closer to 50
Interval 60-50-60-50 etc.
Assign Homework 1
Monday, February 4, 2008
2-2-08 Assessing Cardio Respiratory Fitness
CRF: Refers to body's ability to deliver oxygen to & carbon dioxide from working muscles.
Measured by VO2max (Maximal Oxygen Consumption)
Higher VO2max, the better shape you are in.
VO2max can be reported in two ways:
1. Relative to weight 10-90ml kg^-1 min^-1 (relative terms)
OR
2. Absolute terms (based on absolute difference between people)
pkt. pg. 32-33
Before you can improve someone's cardiorespiratory fitness, you have to know their present fitness level.
3 major types of tests to extimate VO2max.
1.Feild tests-many of these
Does not require expensive equipment. Most commonly used- Rockport 1 mile walk test.
2. Maximal
3. Sub-maximal Graded Exercise Tests (GXT)
The difference between 2&3 is when you terminate the test.
Max: Until athlete is completely fatigued. Ideally @HRmax (220-age) but max test HRmax is mode specific.
HRpeak
VO2peak > not able to get VO2max or HRmax with some modes eg smaller muscle groups, etc.
Submax: terminated @70-85 % of HRmax
Example: 220-46= 174
.7(174)=122
.85(174)=148- the closer you get to 85% the better the data you collect.
Submax (& max) Test Procedures:
Stage 1 warm up
Stage 2 and up - increase intensity (incline and speed) progressively
typically a stage lasts 2-3 min. based on what protocol you use (YMCA=3min., ACSM=2min.)
YMCA Test
Stage 1 Min. 0-1: no physiological data collected
min. 1-2 collect in order: 10sec HR, RPE, Signs/Symptoms
min. 2-3 collect in order: BP, HR, RPE, S/S
Do I graduate the person to stage 2? Must have a steady state HR.
Steady State= HR within +or-1 bpm (10sec HR) or +or-5 bpm (60sec HR)
Extend stage one if +or-2 bpm. and collect in order BP, HR, RPE, S/S
If any of the HRs are within +or-1 bpm (not just consecutive ones) you can graduate them.
Stage 2: Tell them you are going to increase intensity
min. 4-5 no data collected
5-6 HR, RPE, S/S
6-7 BP, HR, RPE, S/S
Steady state to graduate
Terminate test between .7-.85 HRmax
Good data: > or = 110bpm minimum HR
ideally 85% HRmax
Steady state is the average of 2 HRs. Data is unreliable under 110 bpm. Must use data above 110 bpm.
GXT
1. Informed consent pkt pg. 17-18, ACSM 52-54
7 parts
a. explaination
b. risk
c. responsibilities
d. benefits
e questions
f. medical records
g. consent
2. Record
a. age
b. weight
c. height-hands on waist, inhalation, 5 point contact on wall
d. gender
e. estimated HRmax
f. HRrest-full min HR
g. BPrest- 70-85% HRmax (regardless of mode)
3. Instructions and PRACTICE-let the client get used to the machine.
4. Initiate test
a. warm up usually included in protocol
b. gradually increase in speed or grade/resistance or both ever 2-3 min. Allow for steady state HR.
c. FOLLOW STANDARDIZED PROCEDURE PROTOCOL: - HR,S/S @ end of 2nd min. - BP, HR, RPE, S/S @ end of 3rd min.
In a 2 min. stage, you collect data from 0-1 min of each stage. (need two HRs)
pg. 27 pkt
pg 74 ACSM
Termination of GXT
1. VO2max is reached/submax HR is reached
2. Abnormal signs/symptoms
- terminate the test:
dizziness, mental confusion, staggering, unsteadiness
angina or claudication
nausea
marked/abnormal dyspnea
cyanosis or pallor
severe fatigue
severe facial distress
3. Subject Asks to Stop
4. Abnormal BP response - SBP decreases by >or=20mmHg with increased intensity
MEMORIZE: SBP > 260mmHg (not during resistance training)
DBP: >115 mmHg
5. 70-85% of HRmax is acheived (during submax)
6.Malfunction of equipment - don't restart test that day
7. Various EKG responses
Walking Feild Test- Rockport 1 mile walk test
Most commonly used to estimate VO2max in general population
All field usually able to test many ppl @ same time
Ideally on a flat track
Loop
During this test-tell them to walk 1 mile as fast as tehy can (1 part of 1 ft. is always in contact with the ground)
1. Time to the closest second.
2. within 5sec of stopping take 10sec. HR
3. Gender
4. Age
5. Body weight
pkt pg. 21-23
Example 50 year old female, 155 lbs., HR 25, time 15:15
27.4 if you use charts
28.3 =132.853-0.1692(155/2.2)-0.3877(50)+6.315 (0)-3.2649(15.25)-0.1565(150) if you use the equation.
Measured by VO2max (Maximal Oxygen Consumption)
Higher VO2max, the better shape you are in.
VO2max can be reported in two ways:
1. Relative to weight 10-90ml kg^-1 min^-1 (relative terms)
OR
2. Absolute terms (based on absolute difference between people)
pkt. pg. 32-33
Before you can improve someone's cardiorespiratory fitness, you have to know their present fitness level.
3 major types of tests to extimate VO2max.
1.Feild tests-many of these
Does not require expensive equipment. Most commonly used- Rockport 1 mile walk test.
2. Maximal
3. Sub-maximal Graded Exercise Tests (GXT)
The difference between 2&3 is when you terminate the test.
Max: Until athlete is completely fatigued. Ideally @HRmax (220-age) but max test HRmax is mode specific.
HRpeak
VO2peak > not able to get VO2max or HRmax with some modes eg smaller muscle groups, etc.
Submax: terminated @70-85 % of HRmax
Example: 220-46= 174
.7(174)=122
.85(174)=148- the closer you get to 85% the better the data you collect.
Submax (& max) Test Procedures:
Stage 1 warm up
Stage 2 and up - increase intensity (incline and speed) progressively
typically a stage lasts 2-3 min. based on what protocol you use (YMCA=3min., ACSM=2min.)
YMCA Test
Stage 1 Min. 0-1: no physiological data collected
min. 1-2 collect in order: 10sec HR, RPE, Signs/Symptoms
min. 2-3 collect in order: BP, HR, RPE, S/S
Do I graduate the person to stage 2? Must have a steady state HR.
Steady State= HR within +or-1 bpm (10sec HR) or +or-5 bpm (60sec HR)
Extend stage one if +or-2 bpm. and collect in order BP, HR, RPE, S/S
If any of the HRs are within +or-1 bpm (not just consecutive ones) you can graduate them.
Stage 2: Tell them you are going to increase intensity
min. 4-5 no data collected
5-6 HR, RPE, S/S
6-7 BP, HR, RPE, S/S
Steady state to graduate
Terminate test between .7-.85 HRmax
Good data: > or = 110bpm minimum HR
ideally 85% HRmax
Steady state is the average of 2 HRs. Data is unreliable under 110 bpm. Must use data above 110 bpm.
GXT
1. Informed consent pkt pg. 17-18, ACSM 52-54
7 parts
a. explaination
b. risk
c. responsibilities
d. benefits
e questions
f. medical records
g. consent
2. Record
a. age
b. weight
c. height-hands on waist, inhalation, 5 point contact on wall
d. gender
e. estimated HRmax
f. HRrest-full min HR
g. BPrest- 70-85% HRmax (regardless of mode)
3. Instructions and PRACTICE-let the client get used to the machine.
4. Initiate test
a. warm up usually included in protocol
b. gradually increase in speed or grade/resistance or both ever 2-3 min. Allow for steady state HR.
c. FOLLOW STANDARDIZED PROCEDURE PROTOCOL: - HR,S/S @ end of 2nd min. - BP, HR, RPE, S/S @ end of 3rd min.
In a 2 min. stage, you collect data from 0-1 min of each stage. (need two HRs)
pg. 27 pkt
pg 74 ACSM
Termination of GXT
1. VO2max is reached/submax HR is reached
2. Abnormal signs/symptoms
- terminate the test:
dizziness, mental confusion, staggering, unsteadiness
angina or claudication
nausea
marked/abnormal dyspnea
cyanosis or pallor
severe fatigue
severe facial distress
3. Subject Asks to Stop
4. Abnormal BP response - SBP decreases by >or=20mmHg with increased intensity
MEMORIZE: SBP > 260mmHg (not during resistance training)
DBP: >115 mmHg
5. 70-85% of HRmax is acheived (during submax)
6.Malfunction of equipment - don't restart test that day
7. Various EKG responses
Walking Feild Test- Rockport 1 mile walk test
Most commonly used to estimate VO2max in general population
All field usually able to test many ppl @ same time
Ideally on a flat track
Loop
During this test-tell them to walk 1 mile as fast as tehy can (1 part of 1 ft. is always in contact with the ground)
1. Time to the closest second.
2. within 5sec of stopping take 10sec. HR
3. Gender
4. Age
5. Body weight
pkt pg. 21-23
Example 50 year old female, 155 lbs., HR 25, time 15:15
27.4 if you use charts
28.3 =132.853-0.1692(155/2.2)-0.3877(50)+6.315 (0)-3.2649(15.25)-0.1565(150) if you use the equation.
Wednesday, January 30, 2008
1.26.08 Blood Pressure (sphigmomanometers :))
Get handout for health questionairres.
Blood Pressure
Systolic/Diastolic (sbp/dbp) Risk strat is >or = 140/ >or = 90
Norms
ACSM pg. 44
Prehypertension is 120-139/ 80-90 Red flag
Resting BP: 5 min. seated in a chair, using the back, feet on the ground (legs uncrossed) arms at side or on lap.
Taking BP
1. Ask subject to relax arm
*maintain arm at heart level
*do not grasp handlebars or treadmill bar
2. Wrap cuff firmly
*lower edge of cuff about 1" above anticubital fossa
*cuff should cover 80% of the upper arm (3 cuff sizes)
(too small: overestimates bp)
(too big: underestimates bp)
3. Place bell of stethoscope on or jst below anticubital fossa on brachial artery (medial side of elbow)
4. Quickly inflate cufff to ~200 mmHg or 20 above estimated bp
5. Release pressure @ rate of 2-5 mmHg per sec.
6. Mentally record 1st Korotkoff sound (SBP-thud) and 5th Korotkoff sound (DBP-silence).
How Blood Pressure responds to exercise: what you should expect to see.
Go over case studies.
Linear increase with increasing exercise intensity for SBP and a relatively consistant line for DBP.
If you do not see a rise in SBP-STOP! Could be an impending cardiac event.
Blood Pressure
Systolic/Diastolic (sbp/dbp) Risk strat is >or = 140/ >or = 90
Norms
ACSM pg. 44
Prehypertension is 120-139/ 80-90 Red flag
Resting BP: 5 min. seated in a chair, using the back, feet on the ground (legs uncrossed) arms at side or on lap.
Taking BP
1. Ask subject to relax arm
*maintain arm at heart level
*do not grasp handlebars or treadmill bar
2. Wrap cuff firmly
*lower edge of cuff about 1" above anticubital fossa
*cuff should cover 80% of the upper arm (3 cuff sizes)
(too small: overestimates bp)
(too big: underestimates bp)
3. Place bell of stethoscope on or jst below anticubital fossa on brachial artery (medial side of elbow)
4. Quickly inflate cufff to ~200 mmHg or 20 above estimated bp
5. Release pressure @ rate of 2-5 mmHg per sec.
6. Mentally record 1st Korotkoff sound (SBP-thud) and 5th Korotkoff sound (DBP-silence).
How Blood Pressure responds to exercise: what you should expect to see.
Go over case studies.Linear increase with increasing exercise intensity for SBP and a relatively consistant line for DBP.
If you do not see a rise in SBP-STOP! Could be an impending cardiac event.
Friday, January 25, 2008
1.19.08 First Lecture - Definitions
ACSM book:
Tag pg. 289 D1 Metabolic Equations (Estimate VO2 max)
Read everything up to week three
Definitions:
Health: Lifestyle characterized by delaying premature death and avoiding preventable disease- secondary hypokinetic disease (sedentary lifestyle).
Hypo (under) kinetic (movement)
excludes type 2 diabetics who run marathons
Physical Activity: Any bodily movement produced by skeletal muscle that results in energy expenditure.
How much do you need to improve health? Moderate activity= 3-6 METS = 3-4 mph (brisk) walk (enough to burn 200 kcals)
Exercise: A subset of physical activity. Planned, structured, repetitive bodily movement done to improve or maintain one or more components of physical fitness (increased VO2 max, decreased FM). All exercise if physical activity but not all physical activity is exercise.
Muscle fitness: Increased 1 RM. CR VO2max
Body Comp, Decreased FM, Decreased BMI, flexibility-increased range of motion.
(balance, agility, etc.-not covered in this class)
Stress Management
Physical Fitness
A set of attributions that people have or achieve that relate to that ability to perform physical activity.
Performance: (Competitive Sport) Deals w/ optimizing success in sports to its highest level.
Good test of fitness assessment:
Valid
Reliable
Consistent
Validity: Does the test measure what it is supposed to measure? (or estimate)
-Determined by experts - criterion measure (we estimate body comp, not measure-subcutaneous fat is related to body density and FM, skin fold calipers are better at estimation than air pods or hydro.)
-Population Specific
Reliability: Does the test consistently measure what it's supposed to? Can be done by different ppl. w/same directions-all should get about the same results.
-test re-test: done every day-same results
-a test can be reliable w/o being valid. You can do the same test and get the same results but it doesn't mean that the test is valid or that it means anything.
-if a test is not reliable it is not valid
Objectivity/Consistency: -Can the test be administered by different testers w/the same results?
-Importance of standardized procedures. Steps involved (see pg. 52-53 of pkt.
Specificity of Training:
Testing must be specific to program mode. eg. Rockport one mile walk test for a walking program.
50% of all deaths:
1. Heart Disease
2. Cancer
3. Stroke
1 & 3 account for 50% of all deaths.
Pre-assessment of client (formalities):
Medical Form
hobbies
habits
kids
learn everything you can about that person
Risk Stratification process:
1. Gather as much info on: health, lifestyle, medical history
pg. 22 table 2
2. Identify if the person has coronary artery risk factors using this table. MEMORIZE TABLE
Family history: cardiovascular disease (including stroke) whether or not client is M/F if their biological father, brother, grandfather had, was diagnosed with, hospitalized for, died from before age 55.
&/or M/F if biological mother, sister, grandmother had, was diagnosed with, hospitalized for, died from before age 65.
Cigarette Smoking: what are you smoking? presently or quit within the last 6 months they have the risk factor.
High blood pressure: SBP/DBP (systolic/ diastolic): SBP is > or = 140, or DBP is > or = 90 OR is presently on anti-hypertensive medications. Take BP reading twice.
Dislipidemia: LDL: > or = 130, or HDL < 40 OR on cholesterol meds.
or total > or = 200
Pre-cursor to diabetes: > or = 100 resting
2 tests
Obesity ( good for average ppl.) BMI > or = 30
BMI= body weight (kg)/ height (m)^2
25-30 is overweight
OR waist girth (circumference) -much better indicator
Male > 102 cm (40in), Female > 88 cm (35.5)
Or waist to hip M (> or = .95, F > or = .86)
Waist circumference/hip circumference (includes butt)
Sedentary Lifestyle: must 30 or more of moderate physical activity on most, preferably all days of the week.
Negative Risk Factor; if HDL >or = 60 cancel out one of the + risk factors.
pg. 23-24 table 2.3 Step 3 Identify whether they have major signs or symptoms of CV, pulmonary disease, metabolic disease MEMORIZE
Pain
Ischemia: lack of blood flow in the heart
dipsnia: abnormally uncomfortable awareness of breathing
syncope: loss of consciousness
orthopnia: dipsnea occurring at rest when in recumbent position and relieved when sitting upright.
ankle edema: swelling -bilateral palpitation @ rest - uncomfortable awareness tachycardia: heart is beating fast RHR: > 100.
quadication: pain in legs w/ very mild activity-pain relieves one they sit down.
heart murmur
unusual fatigue/SOB w/unusual labor
Have them tell you about any symptoms they say they have.
Step 4. pg. 27 top right table 2.4 Stratify Risk
1 of 3 categories
Low, Moderate, High Risk
MEMORIZE
Low:
Men < 45
Women < 55
A-symptomatic 23-24 & meet no more than 1 from pg. 22 or 2 w/ high HDL
Moderate:
Men >or = 45
Women > or = 55
or younger & 2 or more & risk factor pg. 22
High:
Pg. 23-24 or a known cardiovascular, pulmonary, or metabolic disease
Step 5.
pg. 5 of pkt.
1. Moderate (40-60% VO2max) or vigorous (60% or higher) program
2. Is it recommended to get medical permission to participate?
3. Do we need a medical diagnosis (Dr. makes this decision) Clinical Assessment- max or submax test
pg 6-12 of pkt.
Know norms on pg. 4 or pkt.
Case Study #1 in pkt. Obese BMI 32.77 (over 30) BP 150/80 (SBP >or=140)
Cholesterol 245 (total > or = 200)
NEG HDL (take one away)
2 risk factors
smokes
2 or more from pg. 22
MODERATE RISK
Tag pg. 289 D1 Metabolic Equations (Estimate VO2 max)
Read everything up to week three
Definitions:
Health: Lifestyle characterized by delaying premature death and avoiding preventable disease- secondary hypokinetic disease (sedentary lifestyle).
Hypo (under) kinetic (movement)
excludes type 2 diabetics who run marathons
Physical Activity: Any bodily movement produced by skeletal muscle that results in energy expenditure.
How much do you need to improve health? Moderate activity= 3-6 METS = 3-4 mph (brisk) walk (enough to burn 200 kcals)
Exercise: A subset of physical activity. Planned, structured, repetitive bodily movement done to improve or maintain one or more components of physical fitness (increased VO2 max, decreased FM). All exercise if physical activity but not all physical activity is exercise.
Muscle fitness: Increased 1 RM. CR VO2max
Body Comp, Decreased FM, Decreased BMI, flexibility-increased range of motion.
(balance, agility, etc.-not covered in this class)
Stress Management
Physical Fitness
A set of attributions that people have or achieve that relate to that ability to perform physical activity.
Performance: (Competitive Sport) Deals w/ optimizing success in sports to its highest level.
Good test of fitness assessment:
Valid
Reliable
Consistent
Validity: Does the test measure what it is supposed to measure? (or estimate)
-Determined by experts - criterion measure (we estimate body comp, not measure-subcutaneous fat is related to body density and FM, skin fold calipers are better at estimation than air pods or hydro.)
-Population Specific
Reliability: Does the test consistently measure what it's supposed to? Can be done by different ppl. w/same directions-all should get about the same results.
-test re-test: done every day-same results
-a test can be reliable w/o being valid. You can do the same test and get the same results but it doesn't mean that the test is valid or that it means anything.
-if a test is not reliable it is not valid
Objectivity/Consistency: -Can the test be administered by different testers w/the same results?
-Importance of standardized procedures. Steps involved (see pg. 52-53 of pkt.
Specificity of Training:
Testing must be specific to program mode. eg. Rockport one mile walk test for a walking program.
50% of all deaths:
1. Heart Disease
2. Cancer
3. Stroke
1 & 3 account for 50% of all deaths.
Pre-assessment of client (formalities):
Medical Form
hobbies
habits
kids
learn everything you can about that person
Risk Stratification process:
1. Gather as much info on: health, lifestyle, medical history
pg. 22 table 2
2. Identify if the person has coronary artery risk factors using this table. MEMORIZE TABLE
Family history: cardiovascular disease (including stroke) whether or not client is M/F if their biological father, brother, grandfather had, was diagnosed with, hospitalized for, died from before age 55.
&/or M/F if biological mother, sister, grandmother had, was diagnosed with, hospitalized for, died from before age 65.
Cigarette Smoking: what are you smoking? presently or quit within the last 6 months they have the risk factor.
High blood pressure: SBP/DBP (systolic/ diastolic): SBP is > or = 140, or DBP is > or = 90 OR is presently on anti-hypertensive medications. Take BP reading twice.
Dislipidemia: LDL: > or = 130, or HDL < 40 OR on cholesterol meds.
or total > or = 200
Pre-cursor to diabetes: > or = 100 resting
2 tests
Obesity ( good for average ppl.) BMI > or = 30
BMI= body weight (kg)/ height (m)^2
25-30 is overweight
OR waist girth (circumference) -much better indicator
Male > 102 cm (40in), Female > 88 cm (35.5)
Or waist to hip M (> or = .95, F > or = .86)
Waist circumference/hip circumference (includes butt)
Sedentary Lifestyle: must 30 or more of moderate physical activity on most, preferably all days of the week.
Negative Risk Factor; if HDL >or = 60 cancel out one of the + risk factors.
pg. 23-24 table 2.3 Step 3 Identify whether they have major signs or symptoms of CV, pulmonary disease, metabolic disease MEMORIZE
Pain
Ischemia: lack of blood flow in the heart
dipsnia: abnormally uncomfortable awareness of breathing
syncope: loss of consciousness
orthopnia: dipsnea occurring at rest when in recumbent position and relieved when sitting upright.
ankle edema: swelling -bilateral palpitation @ rest - uncomfortable awareness tachycardia: heart is beating fast RHR: > 100.
quadication: pain in legs w/ very mild activity-pain relieves one they sit down.
heart murmur
unusual fatigue/SOB w/unusual labor
Have them tell you about any symptoms they say they have.
Step 4. pg. 27 top right table 2.4 Stratify Risk
1 of 3 categories
Low, Moderate, High Risk
MEMORIZE
Low:
Men < 45
Women < 55
A-symptomatic 23-24 & meet no more than 1 from pg. 22 or 2 w/ high HDL
Moderate:
Men >or = 45
Women > or = 55
or younger & 2 or more & risk factor pg. 22
High:
Pg. 23-24 or a known cardiovascular, pulmonary, or metabolic disease
Step 5.
pg. 5 of pkt.
1. Moderate (40-60% VO2max) or vigorous (60% or higher) program
2. Is it recommended to get medical permission to participate?
3. Do we need a medical diagnosis (Dr. makes this decision) Clinical Assessment- max or submax test
pg 6-12 of pkt.
Know norms on pg. 4 or pkt.
Case Study #1 in pkt. Obese BMI 32.77 (over 30) BP 150/80 (SBP >or=140)
Cholesterol 245 (total > or = 200)
NEG HDL (take one away)
2 risk factors
smokes
2 or more from pg. 22
MODERATE RISK
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