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
Go over case studies.
