Exam 1 - Test Review Topics PTOT6606 PDF

Exam 1 – Test Review Topics – 2023 PTOT6606 1. Apply ACSMs Risk Algorithm to identify risk of an adverse exercise event. ​ Participates in regular exercise? ​ No/Known/Signs&Symptoms of CVD ​ Is medical clearance needed? ​ If medical clearance is n...

Exam 1 – Test Review Topics – 2023 PTOT6606 1. Apply ACSMs Risk Algorithm to identify risk of an adverse exercise event. ​ Participates in regular exercise? ​ No/Known/Signs&Symptoms of CVD ​ Is medical clearance needed? ​ If medical clearance is needed receive it, and figure out the intensity of the exercise for the individual 2. Recognize and identify risk factors for developing CVD. ​ Age: Men ≥ 45 years, Women ≥ 55 years ​ Family History: Myocardial infarction, coronary revascularization, or sudden death before 55 years of age in father of other 1st degree male relative or before 65 years of age in mother or other 1st degree female relative ​ Cigarette Smoking: Current cigarette smoker or those who quit within the previous six months, or exposure to environmental tobacco smoke (i.e., secondhand smoke) ​ Physical inactivity: Not meeting the min of 500-1000 METS-min of moderate to vigorous physical activity or 75-150 min-wk of moderate to vigorous intensity of physical activity ​ Obesity: Body mass index ≥30 kg/m2 or waist girth >40 inches for men 35 inches for women ​ Blood pressure: SBP > 130mm Hg and/or DBP >80 mm Hg ​ Dyslipidemia: LDL cholesterol ≥ 130mg/dL; HDL cholesterol 5.7% ​ +1 High HDL Cholesterol: ≥60 mg/dL 3. Identify benefits of exercises ​ Cardiovascular health ○​ Improved heart health ○​ Reduce the risk of CVD ○​ Enhanced vascular health ​ Musculoskeletal health ○​ Increase muscle strength and endurance ○​ Improved bone and joint health ​ Metabolic health ○​ Weight management ○​ Improved insulin sensitivity ○​ Better cholesterol levels ​ Mental and Emotional wellbeing ○​ Improved mood and reduced stressed ○​ Reduced symptoms of depression ○​ Improved cognitive function ​ Enhanced immune function ​ Improved sleep quality  ​ Enhanced Functional Capacity ○​ Improved flexibility and balance ○​ Better physical performance ​ Decreased Morbidity and Mortality 4. Identify and recognize red-flag symptoms and signs that would jeopardize a person’s safety in performing an exercise program. – i.e. what S&S would prevent the starting of exercises; and what S&S would warrant stopping exercise ​ Absolute Contraindications: ​ A recent significant change in the resting electrocardiogram suggesting significant ischemia, ​ recent myocardial infarction (within 2 d), or other acute cardiac event ​ Unstable angina ​ Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise ​ Symptomatic severe aortic stenosis ​ Uncontrolled symptomatic heart failure ​ Acute pulmonary embolus or pulmonary infarction ​ Acute myocarditis or pericarditis ​ Suspected or known dissecting aneurysm ​ Acute systemic infection, accompanied by fever, body aches, or swollen lymph glands ​ Relative Contraindications ​ Left main coronary stenosis ​ Moderate stenotic valvular heart disease ​ Electrolyte abnormalities (e.g., hypokalemia, hypomagnesemia) ​ Severe arterial hypertension (i.e., systolic blood pressure of >200 mm Hg and/or a diastolic ​ blood pressure of >110 mm Hg) at rest ​ Tachydysrhythmia or bradydysrhythmia ​ Hypertrophic cardiomyopathy and other forms of outflow tract obstruction ​ Neuromotor, musculoskeletal, or rheumatoid disorders that are exacerbated by exercise ​ High-degree atrioventricular block ​ Ventricular aneurysm ​ Uncontrolled metabolic disease (e.g., diabetes, thyrotoxicosis, myxedema) ​ Chronic infectious disease (e.g., HIV) ​ Mental or physical impairment leading to inability to exercise adequately 5. According to the ACSM, clearly instruct a client on how to measure their exercise intensity. ​ Target Heart Rate Zone (THR) Method ○​ HRmax = 220 - age ○​ Target HR = (HRmax - Resting HR) × % intensity + Resting HR. ​ For Moderate Intensity: Aim for 50% to 70% of HRmax. ​ For Vigorous Intensity: Aim for 70% to 85% of HRmax. ​ Rating of Perceived Exertion (RPE) Method  ○​ Borg Rating of Perceived Exertion (RPE) Scale 6-20 ​ 6 = No exertion at all ​ 20 = Maximal exertion ​ For moderate intensity, clients should aim for an RPE of 12-14 ​ For vigorous intensity, aim for an RPE of 15-17 ​ Talk Test Method ○​ At moderate intensity, the client should be able to talk, but not sing comfortably during exercise ○​ At vigorous intensity, the client should find it difficult to hold a conversation due to heavy breathing ​ Metabolic Equivalents (METs) Method ○​ Use energy expenditure values to determine intensity. 6. Apply the concepts of METS – recognize light, moderate, and vigorous exercise levels ​ Metabolic Equivalents (METs) Values of Common PhysicalActivities ○​ Light (1.6-2.9 METs) ​ Walking slowly around home ​ Making the bed/washing the dishes ​ Arts/crafts, playing cards, Fishing ○​ Moderate (3.0–5.9 METs) ​ Walking at very brisk pace ​ Walking 3.0 mi ∙ h −1 = 3.0 a ​ Cleaning, heavy — washing windows, car, clean garage = 3.0 ​ Basketball — shooting around = 4.5 ○​ Vigorous (≥6.0 METs) ​ Walking at very, very brisk pace (4.5 mi ∙ h −1 ) = 6.3 a ​ Carrying heavy loads, such as bricks = 7.5 ​ Tennis singles = 8.0 7. Know the definition of exercise, physical activity, physical fitness ​ Exercise: Planned, purposeful, and progressive; physical activity that is planned, structured, and repetitive and has a final or intermediate objective ​ Physical activity: any bodily movement produced by skeletal muscles that results in energy expenditure ​ Physical fitness: attributes/characteristics that relate to the ability to perform physical activity with vigor and alertness ​ Physical function: ability to perform activities of daily living, improved by physical fitness, predictor of independence and disability ​ T or F: Exercise is physical activity, but physical activity is not exercise ○​ True: Exercise is a subset of physical activity. While physical activity includes any movement of the body that requires energy expenditure (such as walking, household chores, or even fidgeting), exercise refers to structured, planned, and repetitive physical activity that is specifically performed to improve or maintain physical fitness. 8. Know normal BP and HR responses to aerobic exercise ​ During exercise:  ○​ Systolic BP (SBP) increases during exercise as the heart pumps more blood to meet the demand of working muscles ○​ Diastolic BP (DBP) typically remains unchanged or decreasing slightly, depending on the intensity of the exercise ○​ Systolic BP increases in a linear fashion with exercise intensity, while Diastolic BP usually remains relatively stable. ○​ HR: HR increases linearly with exercise intensity, typically increasing by approximately 10 bpm per MET of exercise ○​ Recovery HR: After exercise, HR should return to resting levels relatively quickly 9. Know the response of the cardiovascular system to an aerobic training program. ​ Resting HR: Decreases. ​ Submaximal HR: Decreases. ​ Maximal HR: No significant change. ​ Stroke Volume: Increases. ​ Cardiac Output: Increases during exercise due to both higher stroke volume and maintained HR. ​ Blood Pressure: Systolic BP increases during exercise, while diastolic BP remains stable or slightly decreases at rest. ​ Blood Volume: Increases due to enhanced plasma volume and red blood cell mass. ​ Capillary Density: Increases in muscle tissue for better oxygen delivery. ​ VO2 Max: Increases, reflecting improved aerobic capacity. ​ Arterial-Venous Oxygen Difference: Increases, allowing muscles to extract more oxygen. 10. Apply the concept of optimal loading for physiologic adaptations ​ The Overload Principle states that for a body to adapt, it must be exposed to a workload that exceeds its usual capacity. Over time, this increased demand forces the body to make physiological adjustments. ○​ To apply the principle effectively, the intensity, volume, or frequency of exercise must be gradually increased to ensure continuous improvement. ​ Progressive overload involves gradually increasing the intensity, duration, or frequency of exercise to allow the body to adapt over time. ○​ For example, increasing the weight in resistance training or the duration of aerobic activity ensures that the body continues to adapt and improve. ​ The Specificity Principle states that adaptations are specific to the type of exercise performed. For example, if you want to improve endurance, you need to perform exercises that specifically target aerobic capacity, like running or cycling. ○​ This principle emphasizes the importance of aligning your training program with your goals (e.g., strength, endurance, flexibility). ​ Periodization involves structuring the training program in cycles of varying intensity and volume to prevent plateaus and reduce the risk of overtraining. 11. Apply the concept of specificity (SAID principles) to an exercise prescription ​ 12. Know the components of FITT (VP) ​ F = Frequency (how often)  ​ I = Intensity (how hard) ​ T = Time (duration or repetitions) ​ T = Type (muscle or mode of exercise) ​ V = Volume (overall expenditure) ​ P = Progression (how to continue to overload) 13. Apply the concept of MET/mins for overall weekly volume of exercise for different health Benefits ·​ EE quantifying amount of PA. Product is the number of METS associated with an activity and the number of minutes it was performed. Usually measured per week or per day as a measure of exercise volume. ·​ Total EE of greater than or equal to 500-1000 mets-min/week is consistently associated with lower rates of CVD and premature mortality. 14. Understand the relationship between VO2 / METs / RPE / HR ​ VO2 and METs (Paired Relationship): ○​ Relationship: 1 MET = 3.5 ml/kg/min of VO2. Therefore, METs are essentially a way to simplify the expression of VO2 in terms of the body's energy expenditure relative to rest. ○​ %VO2 and METs reflect the same concept/physiologic measure (workload) ​ RPE and HR (Paired Relationship): ○​ RPE and HR are closely linked because as the intensity of exercise increases, both the heart rate and the perceived exertion (RPE) also increase in a linear manner. As exercise intensity rises, individuals tend to perceive more effort and their heart rate typically increases accordingly. ○​ Scale: The most common scale is the Borg Scale, which ranges from 6 to 20, with higher numbers corresponding to greater perceived effort. ​ Moderate intensity (RPE of 12-14) usually corresponds to 50-70% of maximum heart rate. ​ Vigorous Exercise: RPE 15-17 is typically associated with 70-85% of HRmax. 15. Recognize changes in workload (MET) capacity with training and the changes in %VO2Max capability and the subsequent cardiovascular response with change in RPE and HR at set MET load 16. Understand purpose and use of basic aerobic field tests and the methods of monitoring workload tolerance. ·​ Field Tests are conducted outside of the lab to predict Cardiorespiratory fitness by measuring HR response. o Running, walking, or step tests can be timed/counted and used to estimate VO2 max following protocol and equations from specific tests. ·​ Methods of monitoring workload tolerance: o Talk test o RPE  o HR monitoring if possible (rapid increase in HR used as a tolerance moderator) o Identifying the following signs/symptoms: fatigue, dizziness, excessive sweating, chest pain, 17. Spinal Stabilization a. Know Characteristics of superficial/global spinal muscle and deep/segmental spinal muscles (cervical and lumbar) ​ Global Muscle: Characteristics: Superficial (further from the axis), Crosses multiple vertebral segments, produces larger movements and power through the spine ​ Deep segmental muscles: Characteristics: deep (closer to the axis of motion), attach to each vertebral segment, play a key role in stabilizing individual vertebrae and segments of the spine, greater percentage of Type 1 muscle fibers. b. Know Muscles that comprise the deep/segmental core muscles (cervical and lumbar) ​ Global: ○​ Lumbar region: Rectus abdominis, Obliques, QL, erector spinae and ilio psoas ○​ Cervical region: SCM, scalene, levator scapulae, Upper traps, and erector spinae ○​ CONTRACT 2ND ​ Deep ○​ Lumbar region :Transversus abdominis, multifidus, deep QL and deep rotators ○​ Cervical region: Rectus capitis anterior and lateralis and longus colli ○​ CONTRACT FIRST c. Know Methods of activation of the deep core muscles o (stabilizers) engaging TA, multifidus, QL, rectus capitis anterior/lateralis, and the longus colli o Patients with unilateral back pain often show decreased activation/atrophy in painful side when compared to unimpaired side. o Drawing in maneuver in thoracic trunk o deep cervical muscles are active when keeping the cervical spine in a neutral position (axial extension with mild lordosis) d. Progression and regression of limb loading for core stabilization exercises; if given one exercise be able to select an exercise that is training/emphasizing the same muscle group but is easier or harder than the original exercise e. Recognize how various positions alter the difficulty for stabilization exercises