KIN 119 Personal Training Exam 2 Study Guide PDF

**[KIN 119 Personal Training]** **[Exam 2 Study Guide ]** 1. Deficiencies in ROM as identified by the shoulder flexion and abduction screens would suggest that tightness in the latissimus dorsi exists, since the lats serve to extend and adduct the shoulder. Therefore, proper performan...

**[KIN 119 Personal Training]** **[Exam 2 Study Guide ]** 1. Deficiencies in ROM as identified by the shoulder flexion and abduction screens would suggest that tightness in the latissimus dorsi exists, since the lats serve to extend and adduct the shoulder. Therefore, proper performance of the overhead shoulder press would not be attainable. The press exercise requires the arm to be extended over the shoulder through the frontal plane (arm abduction) which, in this case, would be limited by tightness in the latissimus dorsi. Therefore, flexibility programming for the latissimus dorsi should be targeted for functional ROM prior to programming the overhead shoulder press, and an exercise such as side raises should be used for strengthening in the meantime. 2. The recovery period refers to the amount of time between exercise bouts. Recovery allows for the necessary replenishment of energy sources and for cellular adaptations to occur. Rest interval refers to the amount of time taken between exercise sets. Training volume refers to the total amount of work completed during a training bout. Training volume is calculated by multiplying the total number of sets and repetitions performed and loads lifted. Duration refers to the amount of time the actual exercise is being performed. In a typical one-hour resistance training program, the duration of work may only be 15-20 minutes. 3. A push-up off a bench will load the upper body musculature and spinal stabilizers since the movement requires a stiff body segment maintained by spinal stability throughout the range of motion. Exercises with increased support, such as the bench press or various seated exercises, can help to isolate the prime mover but demand only limited stability from the trunk. 4. Range of motion screens involve placing various muscles in the position opposite to their concentric actions by contracting the antagonistic muscles. Therefore, the Apley back scratch test for shoulder rotation measures the internal and external capabilities of the rotator cuff along with the triceps and latissimus dorsi of the upward-raised arm. The spinal extension test is used to evaluate the range of motion in the rectus abdominis, and the hip extension screen is used to evaluate range of motion in the hip flexors. Tightness in these areas requires attention as this may lead to additional functional decline or injury. Keep in mind that with flexibility screening, the movement that is difficult to perform is related to tightness in the opposite muscle group (i.e., difficulty with hip extension = tight hip flexors). 5. The correct intensity is necessary to elicit the intended physiological stress perception and hormonal response, making the appropriate training intensity necessary for physiological adaptations to occur in the body as a result of exercise. High intensity resistance training utilizes low numbers of repetitions with near maximal intensities (85%-95% of 1RM), whereas endurance training utilizes higher repetition schemes with much lower intensities (45%-55% of 1RM is common). Training frequency refers to how often an exercise bout is performed (once a week vs. twice a week), while training volume is calculated by combining sets, reps, and loads lifted. Duration refers to the amount of time that work is actually performed. 6. Due to the fact that dynamic flexibility requires movement for proper execution, it is the only technique that can be used during a warm-up. Static flexibility and PNF stretching do not encourage increased blood flow, so those techniques should be performed following a warm-up. Cold tissue should not be stretched. In addition, if resistance training will be performed, static stretching should never occur prior to training since stretching will cause a relaxation state in the tissues and decrease the force production capabilities of the musculature, particularly in the legs. 7. Using the Heart Rate Reserve (HRR) Method (Karvonen Formula) or VO~2~max, the recommended training range is 60-80%. Although health attainment can occur at lower intensities (\>50%), fitness attainment requires higher intensities. If the heart rate max formula is used, the appropriate intensity range is 75-90% of HRmax. This heart rate range needs to be maintained throughout the aerobic training bout so that cardiovascular adaptation responses such as increased stroke volume, increased capillary density, increased mitochondrial density, and increased aerobic enzyme concentration can occur. 8. To improve functional activities of daily living, integrated, multiple-joint and multi-planar exercises performed at functional speeds are more task-specific than exercises that are isolative and single-joint. Essentially you want to create environments in which the body may find itself during tasks of daily living. Traditional training is very linear and does not assist coordinated actions due to tissue isolation. 9. In the initial phases of an exercise program, most strength gains are attributed to improved motor skill performance. Therefore, beginners should focus on proprioception and proper skill performance so the movements are learned correctly and motor patterning is retained. Exercises learned while using resistance are often prone to compensatory adjustments, potentially reducing the mastery of correct biomechanical form from the beginning. **Learn More: Advanced Concepts of Personal Training Textbook, Chapters 15, 19 -- Exercise Programming Components, Resistance Training Technique, pages 315-316, 404-405** 10. Research indicates that upon volitional fatigue while weight training, the individual still has not maximally recruited all of the primary motor units. The drop set (or strip set) technique is a high intensity technique designed to recruit remaining motor units, by lowering the weight immediately upon fatigue, followed by continued repetitions to volitional fatigue. Even though 30 total repetitions completed in a short amount of time (3 consecutive sets of 10 repetitions using successively less weight) seems like endurance training, each individual set is performed at near maximal intensity. 11. Aerobic training would be the best recommendation due to the need for increased VO~2~ and a decrease in cholesterol. Aerobic training increases HDL-C, which is a cardioprotective lipoprotein. Other forms of exercise should be included, but an emphasis on a sustained elevated heart rate is the most important for health in this individual. 12. Circuit training is continuous resistance training which uses multiple muscle groups. Due to the high oxygen demand and duration of time under load, the work output is significant. Heavy resistance training burns the largest number of calories per minute of work, but the actual amount of work accomplished in a 30-minute training session is low due to short bursts of activity and long rest periods. Pilates has a similar issue. Flexibility training (stretching) has a minimal oxygen demand and does not result in high amounts of caloric expenditure. Although aerobic training will continually burn calories at low intensities, the caloric expenditure is not as high as during circuit resistance training. 13. The optimal training range for hypertrophy is between eight and twelve repetitions. When combined with 30-60 second rest periods and high volumes of training, this rep range optimizes anabolic hormone concentrations which lead to more dramatic changes in muscle remodeling. Power/Strength training utilizes repetition ranges often below 6; endurance training uses repetition ranges such as 15-20. 14. Warm-ups for intense training: One of the primary contributors to performance is increased intramuscular cellular respiration, which can be achieved by reaching steady state with a minimum of 3-10 minutes of moderate activity. This time also allows for increased blood flow and oxygen delivery and diffusion time, increased temperature, neural conduction and enzyme activity. 15. The highest attainable training intensities have the greatest caloric expenditure for weightloss during aerobic training. The fat- burning zone is a low intensity training zone that does not burn many calories, making it ineffective for weight loss. In the fat-burning zone, the percentage of total calories burned from fat is high, but total calories expended is minimal. At higher intensities, the percentage of fat calories contributed may decrease, but the total number of calories burned is much greater than that those burned when training in the fat burning zone. When a client is concerned with weight loss, the primary concern is maximizing total caloric expenditure; where those calories come from (fat vs. carbohydrates) doesn't really matter. In fact, the optimal fat burning zone occurs during sleep. Walking can contribute to caloric expenditure, but at 80 calories per mile would require more than 6 miles per day for a pound of weight loss in a week. 16. Muscle tone is associated with electrical activity that stimulates calcium to leak out of the sarcoplasmic reticulum, causing twitch without summation. This is stimulated from routine force production requirements of the muscle cells. Although many training stimuli can contribute to some muscle tone, moderate contractile duration under elevated loads seems to be most effective. 17. Specificity is the principle that defines the outcome of the exercise. The result is specific to its demand. Programming using incorrect stimulus or incorrect training factors related to the goal will lead to an inability to attain the desired results. For example, lifting moderate to heavy resistance for hypertrophy only works when the rest periods are short (30-60 seconds). If they are longer, the training is more specific to moderate intensity strength training which will reduce the hypertrophic effect. 18. After a period of training, a person may need to have his target heart rate range readjusted due to a decrease in resting heart rate (increased stroke volume). Changes in resting heart rate will cause an intensity shift so more demand is applied for progressive overload. Ideally, a well-trained subject who regularly performs vigorous exercise should obtain his true max heart rate via a maximal aerobic test so he can most accurately determine his respective training zones. 19. The negative set system of training uses training intensities that are greater than an individual's 1 RM in an effort to maximize strength gains. The performance of the exercise requires a spot since the weight used is greater than what can be concentrically lifted. Although not typically used in personal training settings, an example such as the spot-assisted pull-up, where the trainer assists the client through the concentric phase and then allows the client to lower himself in a slow, controlled manner (eccentrically) would be beneficial and elicit strength gains. 20. Traditional weight training performed for one hour generally burns between 150-300 kcals (7-11 kcal/minute). The reason for the low calorie expenditure with the work is the duration of time the work is actually performed. Traditional weight training generally uses rest periods of 90-120 seconds. This suggests that in a one hour training bout, the amount of rest is generally twice the amount of work performed. A client working out twice a week should be using every minute of a one hour session rather than the 17-24 minutes commonly used in traditional training. 21. Power training requires velocity specific overload. Supersets performed with minimal rest using a pre-load followed by ballistic or plyometric jumps increases power output compared to ballistics alone. This is called a contrast superset. During the performance of the second exercise, the body recruits high velocity motor units which encourage power. 22. Since there are 3,500 calories in a pound of fat, a daily net reduction of 500 calories could produce a pound of fat lost in a week (500 x 7 = 3500). Dietary strategies suggest not restricting diet too significantly (\~300 kcals per day). Using diet alone to lose weight has been shown to have an extremely high failure rate (98% regain in \ 23. Circuit weight training typically involves resistance and aerobic activities with transitional rest periods from one exercise to the next. This encourages a high amount of work per hour compared to other resistance training systems *(best way to lose weight and gain strength*). Aerobic exercise is sometimes placed between resistance exercises to further increase caloric expenditure of the session. Circuit training can also include stability, core, flexibility, and power activities. 24. Optimal recovery for hypertrophy training (an increase in muscle size) has been shown to range between 30 and 60 seconds. The duration is intensity specific. A basic rule of thumb is to employ thirty seconds of rest with intensities of 70-75% 1RM, sixty seconds when working at 75-80% 1RM, and up to ninety seconds for 80-85% of 1RM. Hypertrophy training does not require complete replenishment of anaerobic phosphate stores the way power and strength training do. The shorter recovery interval allows a greater volume of work to be performed in less time and increases the release of anabolic hormones, including testosterone and HGH-driven insulin-like growth factor. 25. For weight loss to occur, a negative caloric balance must be attained. This suggests that the aim of any program for weight loss should be to maximize caloric expenditure. Continuous movement is usually preferred over short bouts of moderate to intense actions (traditional weight training) due to the total net caloric cost of the activity. Maximizing the duration of work during each training bout will assist in increasing the oxygen demands of the training and the associated caloric expenditure. 26. Closed-chain activities with coordinated prime mover emphasis for total muscle balance at the beginning of the training cycle are important for performance. Once muscle balance and basic strength have been established, more complex environments should be added. They will generally involve movement patterns in multiple planes (i.e., more stabilizer recruitment) that duplicate the sport performance requirements. Various resistance training exercises and systems can be combined to improve athletic performance based on a safe and logical progression and emphasis on sport specificity. Speed of movement and acceleration emphasis (weighted squat jumps) is more desirable than heavy decelerated movements (heavy back squat) commonly used with traditional weight training. 27. Supersets involve performing one exercise immediately followed by another exercise with only transitional rest. In some cases, the supersets combine exercises for different muscle groups not involved in the first movement, such as alternating upper and lower body movements (lunges and pull-ups) or agonist/antagonist supersets (bench press and seated row) to aid in recovery. In other cases, supersets for the same muscle group can be used for hypertrophy outcomes (shoulder press and side raise). Whatever the combinations, supersets of two or more exercises permit a higher volume of work to be performed in less time. 28. The Heart Rate Reserve Method (Karvonen formula) begins by calculating the age-predicted max heart rate (MHR; 220-age). It then takes that number and subtracts resting heart rate (RHR) to get heart rate reserve (HRR). The HRR is multiplied by the training intensity and, lastly, the RHR is added back into the equation to get a training heart rate zone. Example: You have a 44-year old male client with a resting heart rate of 68 bpm. The optimal training intensity is recommended to be 60-80% of heart rate reserve for improvements in cardiovascular fitness*. If you were to carry out the formula it would be: 220-44 = MHR of 176bpm; 176 -- RHR of 68 = a HRR of 108; 108 x.60 = 64.8; 108 x.8 = 86.4; 64.8 plus RHR of 68 = **[132.8]** and 86.4 plus RHR of 68 = **[154.4]**. Training zone: 133-154 beats ∙ min*. **Learn More: Advanced Concepts of Personal Training Textbook, Chapter 17 -- Programming for Cardiovascular Fitness, pages 356-357** 29. A body fat percentage of 25% indicates the starting point of obesity in males and predisposes one to an increased risk of cardiovascular and metabolic disease. Therefore, the primary goal for this individual should be decreased body fat percentage using an appropriate weight loss program. Additionally, the flexibility and muscle weaknesses should be addressed to avoid low back problems. 30. Performance-based fitness components are: 1) coordination, 2) balance, 3) agility, 4) speed, and 5) power. Foam rollers, closed-chain exercises, and physioballs require more balance and coordination, making them effective in increasing the difficulty of the movement and coordinated effort of multiple systems of the body. Traditional movements can be combined with different environments created by the equipment to challenge the nervous system and facilitate improved efficiency. If one choice has to be made, closed- chain exercises would be the best selection because they are ground based and use reaction forces. 31. When developing a resistance training program, it is ideal to begin a session with exercises that use the greatest amount of musculature and finish with those that require the least. Other considerations are the amount of resistance, which exercises require the greatest neuromuscular coordination, the activities requiring the most speed, and cross joint actions. If the order is incorrect, stabilizers and assistive movers often become fatigued, reducing the application of overload. 32. Alternating toe touch march is a dynamic flexibility exercise for the hip extensors of the raised leg when performed at a controlled speed. Performing the chest press through only a partial ROM will not benefit the pectoralis muscles with regard to maximizing flexibility since they are not stretched through a full ROM. Complete shoulder flexion with a resisted 5-second contraction of the latissimus dorsi is proprioceptive neuromuscular facilitation designed to elicit increased stretch tolerance through Golgi tendon organ inhibition. A trainer pulling a client's arm backward into horizontal abduction is an example of passive stretching, which can be dangerous to shoulder ligaments. 33. The human body can adapt to most stresses, but the physiological adaptation process is relatively slow compared to the desire to improve. Increasing overload above 5% per week will likely lead to poor training technique, overstraining, overtraining, and eventually injury. A more reasonable approach is increasing overload no more than 5% and allowing the body to recover and improve *(principle of Progression).* 34. A functional warm-up is an activity that involves light resistance training using coordinated movements to target muscles used in everyday activities. These often include postural muscle stabilizers and muscles specific to the performance needs of the individual. A functional warm-up is most often designed in a circuit to increase activity of the tissue and subsequently its temperature. It is desirable to warm up regions of the body which will be used in some part of the exercise session. A specific warm-up is different; an example would be push-ups before using the chest press machine with heavy resistance. 35. The correct exercise order for these lower body exercises is the squat, Romanian deadlift, seated leg extension, and the seated calf raise. The exercise order principles state that larger muscle groups should be trained before smaller muscle groups, that multi-joint movements should be performed prior to single-joint movements, and more complex exercises should be completed prior to simpler exercises. The squat should be first since is uses a large amount of muscle mass (hamstring, glutes, quads) and is multi-joint. Next will be the Romanian deadlift since it uses the glutes and hamstrings and is a more complex exercise than the seated leg extension (free weight vs. machine). Third is the seated leg extension. The client has now moved into a stable (seated) environment and the exercise only requires a single joint movement (knee extension). The seated calf raise is last, since it is a single joint movement in a stable environment using the smallest amount of muscle mass. 36. The single leg squat (or Bulgarian squat) simultaneously improves lower body strength and flexibility. When the front leg performs hip/knee flexion the contralateral limb extends at the hip; dynamically stretching the hip flexors. Specifically, the rectus femoris and iliopsoas can benefit from range of motion improvements via the single leg squat while the other limb is strengthened. 37. Excess post-exercise oxygen consumption (EPOC) is responsible for the temporary increase in the metabolic rate experienced after an anaerobic training session. This increase creates a higher caloric expenditure throughout the day, and is a potential contributor in to weight loss when training intensities are elevated. Low intensity work promotes a limited EPOC response. 38. If a client experiences a significant increase in diastolic blood pressure during steady-state aerobic exercise it would be cause for concern. Diastolic blood pressure indicates the pressure in the arteries when the heart is in recovery. Systolic blood pressure on the other hand increases with exercise based on the heart rate, and is a normal response to exercise. 39. 70-85% is the ideal training intensity for lifts used to promote protein synthesis. The goal of adding lean mass requires significant muscle recruitment and anabolic hormone release, which is best achieved with sets of 8-12 repetitions. Clients looking to add lean mass and gain significant strength may benefit from 6-10 repetitions. 40. When a constant heart rate is achieved during aerobic training, it is classified as steady state training. Steady state is defined by a change in heart rate by less than 5 beats per minute. 41. The proper procedure if a client hurts their hamstring (or any other body part) would be to immediately stop the training session, provide basic first aid if necessary and write up an incident report. Early management of a muscle strain can greatly improve recovery time; in this case use the PRICE formula: Protection, Rest, Ice, Compression, and Elevation. However, further evaluation and diagnosis should be left to medical practitioners. 42. The goniometer is a device used to directly measure joint angles. Goniometric measurements help identify ROM deficits which can potentially contribute to injury. While valid and reliable as a form of assessment, successful readings are determined by protocol strictness and technician expertise. 43. Age-predicated maximal heart rate for males using the heart rate max formula is determined by subtracting the client's age from 220. Maximal heart rate of a 60 year old: 220 - 60 = 160 beats/min. 44. A DB step-up followed by a DB incline press would be an appropriate superset to improve total body strength. Each addresses central and peripheral stability while adding load to prime movers. Strength supersets should be comprised of two compound exercises performed at higher intensities using two different muscles groups. Muscle groups can be chosen using push/pull or upper/lower body combinations. Utilizing different musculature will allow for greater loads to be used during each respective exercise. The RDL superset with a barbell good morning may seem to fit this criterion, but would place excessive stress upon the low back. 45. An appropriate cool down will help minimize blood pooling after a high-intensity training session. A proper cool down should include full range-of-motion movements that mimic the exercises included in the resistance training bout to bring the body back to a pre-exercise state. The emphasis should be on fluid movements that are continuous enough to mobilize circulating blood in venous structures. 46. Performing sets of 12-15 repetitions (65-70% 1RM) is consistent with training for anaerobic endurance; indicating that a rest interval of 30-45 seconds would be appropriate. If 75-85% 1RM is used, the value will rise to at least 60 seconds of rest between sets. Training over 85% 1RM requires phosphagen system recovery and a rest period \2 minutes. 47. The partial pressure of oxygen in the air is reduced at high altitudes; causing increases in heart rate and respiratory rate to match the oxygen demands of working tissues. Athletes acclimated to higher altitudes attain higher concentrations of circulating hemoglobin as a specific adaptation. 48. Cessation of aerobic training can reverse positive adaptations within 7 days of detraining. To mitigate the loss of adaptations, increasing the training intensity to maximal tolerable levels (as little as twice a week) is recommended. Maintaining a volume of training (albeit reduced) will help maintain mitochondrial density, VO2max, stroke volume, cardiac output, (a-v)O2 difference and maximal heart rate. 49. The typical training period required for lean mass gains is 4-6 weeks. In detrained or previously sedentary individuals, hypertrophic responses may be seen earlier than 4 weeks. This can occur among individuals with a genetic predisposition for greater muscularity than they currently possess. Many people experience a small weight gain when they begin resistance training due to increased storage of water in muscle tissue. Continuing to add lean mass is a difficult task, with most research suggesting 5 lbs a year as an attainable goal. 50. Even if a client requires medical clearance prior to engaging in physical activity, assessments that do not require actual physical activity can still be performed. This could include body composition tests. If medical clearance is required, all other exercise-based tests cannot be performed until the client consults with his or her physician. 51. The purpose of the informed consent is to provide documentation of voluntary participation through an educational process that clarifies the activities to be performed. When signed using proper methodology, the document serves as a waiver of liability by the client. The informed consent provides information regarding predicted outcomes as well as the risks assumed with exercise. While the client assumes liability during exercise with proper signing of the document, it does not protect the trainer from negligent behavior. Specific and detailed care must be given at all times, regardless of signed documentation. 52. To reduce involvement of the hip flexors and prevent low back injury during trunk flexion while encouraging proper engagement of the transverse abdominis (TVA) and rectus abdominis, one should draw in the umbilicus before performing the posterior pelvic tilt during the execution of the abdominal curl-up exercise. 53. The psoas major is one of the primary hip flexors. When tight, the hip flexors pull on the pelvis and cause an anterior pelvic tilt, which can ultimately lead to the development of low back pain. The vastus lateralis and vastus medialis are two of the four muscles that comprise the quadriceps and only cross the knee joint (responsible for knee extension). The gastrocnemius is a primary plantar flexor found in the lower leg. 54. A common error when performing pulling exercises such as the bent-over row is a rounding of spinal segments, or kyphosis. This excessive flexion puts a lot of stress on the vertebral column. The client should be encouraged to retract his scapulae (stick his chest out) and cued to anteriorly tilt the pelvis slightly (from the picture shown) to re-establish a neutral spine and natural lordotic curvature. 55. This client is performing the exercise incorrectly, most likely due to too much resistance on the bar. He is compensating for the weight with poor form using excessive angular momentum with hip and spinal extension. Hip extension and flexion are two of the most common compensatory mechanisms used to create momentum during resistance training using too much load, often leading to poor biomechanics and increased risk for injury. 56. The rectus femoris of the left leg is performing a dynamic stretch during the walking lunge. The rectus femoris is the only quadriceps muscle that also contributes to hip flexion. It crosses not only the knee joint, but also the hip joint, so it experiences a stretch when the hip is extended, as in the case of the back leg during the lunge. 57. Many clients may instinctively hold their breath during the concentric phase of resistance training. This can lead to thoracic compression of the thoracic aorta and cause dramatic increases in both arterial blood pressure and afterload on the heart (called the Valsalva Maneuver). To reduce this effect, the client should exhale during the concentric contraction (positive velocity) and inhale during the eccentric phase. Slightly holding one's breath is appropriate during the transition between exercise movements for added stability, but complete breath holds are inappropriate. 58. Proper spotting during the squat consists of supporting the lateral anterior thorax (rib cage) below the pectoralis major and anterior to the mid-axillary line. Controlling the rib cage allows the trainer to control the spine, which will subsequently assist in client hip extension. Placing hands on the hips will not allow the trainer to control the spinal position and puts the trainer at a mechanical disadvantage in case of failure. Additionally, the trainer should be spotting the client, not the actual resistance as would be the case if the bar was spotted. When two spotters are used, the distal aspects of the bar become the assistance site. 59. During the one-arm row, it is important the client retracts the scapula to initiate the movement. This activates the rhomboids and middle fibers of the trapezius just prior to extension of the humerus and flexion of the arm during the concentric phase of the movement. Flexing the arm to initiate the movement reduces the use of the back musculature as the biceps increase their contribution to the movement. 60. During a traditional deadlift using a barbell, it is important to keep the bar as close to the body as possible so that the line of resistance (gravity) is close to the line of force. This increases stress on the hips, thereby reducing the risk of injury to the lower back during this exercise. Additionally, the natural curvature of the spine should be maintained through the movement, and the feet should be placed approximately shoulder-width. 61. By elevating the chest, the spine is repositioned from a kyphotic bend to a flattened position where the stress is redirected from the spine and low back and absorbed by the appropriate postural musculature. Additionally, emphasizing a neutral (preferred) or slight anterior pelvic tight will help maintain proper lifting posture. The hips and glutes should also be pushed backward to assist with maintaining a flat back position during the descent phase. 62. Progressions have several components which can affect the level of difficulty for an exerciser. When progressing through a particular exercise, it is important to start with and master lower skill requirements before adding the increased demands of stability and coordination. For each new progression factor, prime mover strength, balance, coordination, and stability requirements must be considered when evaluating an activities difficulty level. The progression for bridging starts with a focus on prime mover force outputs before increasing the requirements of stability (going to one leg at a time) and then balance (moving onto the physioball), and finally a combination of stability and balance (moving onto the physioball and completing the exercise unilaterally). 63. Periodization is an effective training technique utilizing training periods (cycles) designed to focus on specific objectives to reduce plateaus in performance via progressive overload. Variations in intensity and volume allow the body to better recover and encourage new perceived stresses for continued adaptation. Common periodization models use phases of movement mastery, hypertrophy, basic strength, power, and performance specificity. 64. The dumbbell chest press requires spotting at or near the client's wrists so that the dumbbells can be guided away from the head of the client in case he is unable to complete the lift. Spotting from the elbows does not give the trainer sufficient control of the dumbbells to prevent the weight from hitting the client's head or body. 65. The deadlift exercise uses the most muscle mass and resistance, crosses multiple joints, requires spinal stability and pelvic control, and is a closed-chain exercise, which dictates the need to perform it first in the exercise bout. The other activities do not place the same demands on the body, indicating they are best implemented later in the training bout. 66. A plyometric involves a rapid pre-stretch followed by an immediate powerful contraction using the muscle-spindle stretch-reflex mechanism (myotatic) and passive elastic force harnessed in the agonist muscles. Therefore, stepping off a box to elicit a dramatic pre-stretch on the ground, followed by a subsequent and powerful concentric contraction, is a more intense form of plyometric training. 67. The first 30 degrees of trunk flexion are primarily controlled by the rectus abdominis. Beyond 30 degrees, the hip flexors are engaged by pulling the spine upward from the femur. To properly perform the crunch exercise, the umbilicus should be drawn in with a concurrent posterior pelvic tilt, prior to abdominal flexion to 30 degrees. 68. Referencing the image, overly-flexed elbows would be the error that requires correction. This common miscue is caused by inadequate elbow-wrist alignment. It reduces the stress placed on the prime movers in a compensatory adjustment to use more arm musculature. 69. An AED is an essential piece of equipment for gyms or fitness facilities due their ability to defibrillate an individual in asystole. If an individual has a significant cardiac event and were to require defibrillation, the AED would be able to provide an electric stimulus which may eliminate arrhythmia and potentially restore a stable heart rate. 70. The correct course of action for a 72 year-old male client with kyphosis would be to increase pulling movements such as a variety of angled rows. It would also be recommended to stretch the chest and internal rotators. Kyphosis is an undesirable, exaggerated curvature of the thoracic spine associated with old age. It can become progressively worse with weakness, muscle imbalance and chronically bad posture. Restoring range of motion must be a primary focus in both the thoracic spine and shoulder joints before any significant loading is to take place. 71. Cable internal/external shoulder rotation exercises, performed either on a cable machine or with bands, are applicable exercises to strengthen the subscapularis (internal rotator) and infraspinatus (external rotator) muscles. Internal rotation, when performed correctly, will target the subscapularis; while external rotation will target the infraspinatus and teres minor. 72. For the situation presented in the picture, the appropriate course of action would be to instruct the client to pull the bar in front of their head instead of behind. Performing the lat pull-down behind the neck is contraindicated and increases the risk for a cervical spine injury as well as soft-tissue injuries within the shoulder joints. Furthermore, this form will actually reduce contribution from the latissimus dorsi muscles when compared to pulling in front of the head. 73. Choosing the seated dumbbell overhead press would be an ideal exercise to isolate the deltoids due to the stabilized nature of the torso during the lift. While the Kettlebell swings involve the performance of shoulder flexion, shoulder muscle isolation is reduced due to the added stability demands. 74. The prime movers responsible for scapular retraction are the rhomboids. Proper rhomboid activation is important for clients that have muscle imbalances at the shoulder; commonly seen with the upper-cross syndrome. Training the rhomboids is necessary as the internal rotators of the shoulder, including the pectoralis major, commonly become overactive. 75. If a client displays excessive dorsiflexion during a forward lunge, the appropriate verbal cue would be to instruct him or her to broaden their step and drop their trailing knee at the onset of the movement. This will help pull the pelvis downward. Encouraging this movement will reduce femoral movement in the sagittal plane and aid in avoiding tibial translation. 76. Women with a body composition score of \>40% must obtain clearance, while men with a body composition score of \>30% should obtain medical clearance before beginning an exercise program. These values represent morbid obesity and are associated with numerous health risks. At the other end of the scale, individuals with body fat levels that fall below the normal range are also more likely to experience health problems Essential fat values for females are 8-12%, although some women develop amenorrhea below 14%, whereas men generally require 3-5% body fat for healthy function. 77. The Health Status Questionnaire (HSQ) provides more specific information when screening clients during the initial consultation than the PAR-Q, Food Log, or informed consent. The four parts to the HSQ form are comprised of different sections of data that can be used when making exercise participation decisions and including programming components. The Par-Q asks seven questions which serve as red flag indicators and is a basic screening instrument practical for large groups. It requires little time or expertise to implement. The Food Log does not provide information pertaining to physical activity participation. The Informed Consent is not necessarily a screening form and provides no information pertaining to physical activity participation except that there exists an inherent risk. 78. The 30-second chair stand is a common test of lower body functional strength and power in the elderly. As people age, gravity often shifts downward (female gynoid storage) and forward (male android storage). These changes, combined with general deconditioning, make rising from a seated position more challenging. Functional strength is important to maintain independence and the ability to perform activities of daily living (ADLs). Low chair stand scores are associated with risk for loss of independence. **Learn More: Advanced Concepts of Personal Training Textbook, Chapter 14 -- Assessment of Physical Fitness, page 307; Chapter 22 -- Working with Special Populations, page 517** 79. The Body Mass Index (BMI) is a stature index of height and weight used to predict risk for disease development. Dividing the body weight in kilograms by height in meters squared provides a value which can aid in risk stratification. Ideally, a BMI value should be between 18 and 24, with 22 being most desirable. Values below 17 and above 27 are associated with elevated risk of health problems. The English equation for BMI is weight in pounds divided by height in inches squared and then multiplying the outcome by 703. 80. A resting systolic blood pressure equal to, or above 160mmHg and/or diastolic blood pressure equal to, or above 100mmHg requires medical referral, as does a resting heart rate equal to, or above 100 bpm. A medical referral is also required if male body fat is greater than 30% or female body fat is greater than 40%. 81. A client who cannot perform the full duration of an aerobic test should still have her heart rate assessed to provide some data regarding the performance and physiological demand experienced during the test. It is not uncommon for deconditioned clients to perform poorly on tests of physical measurement, and in some cases, they may not be able to perform the assessment at all. Although motivation can be a good thing, always let the client stop the test if he or she makes such a request. If the client has chest pain or other signs and symptoms of heart trauma, an emergency plan should be enacted, but in most cases it is due to general deconditioning and local muscle fatigue. 82. Rate of perceived exertion is defined as the self-reported perception of physical effort to perform a task. Although it provides some evidence of the physiological parameters experienced during exercise, it does not directly measure any component of physiology; it actually uses a psychological determination of intensity. Therefore, RPE should be used in conjunction with direct cardiovascular measures during assessment. The Borg scale uses a 6-20 point measure with descriptive verbiage quantifying each level of exertion. The six generally reflects a 60 beats ∙ min^-1^ heart rate, while the 20 equates to roughly 200 beats ∙ min^-1^. Moderate intensity exercise for adults is approximately equivalent to a perceived exertion of 12-14. New exercisers in particular have a tendency to overpredict their effort because they are not used to the body's reaction to exercise. 83. Stop test indicators during a fitness assessment include: 1) the subject no longer feels comfortable; 2) the subject becomes pale; 3) the subject is unable to focus his/her attention on the task; 4) the subject feels faint or dizzy; 5) the subject experiences stomach illness or vomiting; 6) the subject has unusual discomfort breathing beyond what is expected for the effort; 7) the subject experiences chest pain; 8) the subject experiences unusual or unexpected pain such as a side-stitch, cramp, or muscle fatigue; and 9) the subject no longer wants to continue. 84. A 45-year old, previously sedentary female would not require medical clearance prior to engaging in any level exercise program. A male with a body fat equal to or above 30% requires medical clearance, as does anyone with a systolic blood pressure greater than or equal to 160 mmHg. Pregnant females should always have physician clearance prior to engaging in an exercise program. 85. The recommended order of events during the initiation of an exercise program is informed consent, health screening including resting assessments, physical assessment and goal setting based on the findings. Informed consent explains what will be done with regard to screening and exercise testing. Screening determines if exercise testing is in fact safe for the client. Ideally, no physical activity should occur without the administration of the informed consent, the HSQ, and the resting test battery. Once all the screening and exercise test data is collected, goal setting can occur. 86. One adaptation of aerobic training is increased stroke volume (increased volume of blood ejected per beat of the heart), which results in a lower heart rate response to a given workload. Therefore, after a month of aerobic training, the client would be expected to have a heart rate lower than 150 bpm on a treadmill at 3.5 mph on a 4% grade, since this was the heart rate the client maintained prior to the training program. If no changes were seen, the client may not be appropriately stressing the cardiovascular system enough to warrant an adaptation response. 87. A large waist circumference is common with android obesity, the type of obesity associated with the greatest risk of cardiovascular and metabolic disease. A single circumference measure has been identified as a criterion reference for risk for disease. BMI also predicts disease, but it may be less accurate for muscular individuals and may be elevated from gynoid storage rather than android storage of fat. Waist to hip ratio has decreased predictive capabilities because a person may have a large hip and waist, which is indicative of disease risk, but a similar ratio to someone not at risk. 88. Prior to engaging in physical activity assessments of any kind, a client must be screened. Informed consent, questionnaires such as the Health Status Questionnaire (HSQ) or Health Risk Appraisal (HRA), as well as a resting battery of physical measurements, are part of the assessment process. 89. Exercise prescription for an obese client should include low-impact activities during aerobic exercise to minimize risk of injury. High-impact exercises such as treadmill running can cause severe DOMS or overuse injuries (e.g., shin splints). Likewise, obese individuals often prefer slower speeds and higher resistance over faster activities. 90. Clients with hypertension should avoid performing heavy resistance training sets under 12 repetitions as well as holding their breath. This is due to the increased stress placed upon the heart and vascular system during high-intensity resistance training. Resistance training for individuals with high blood pressure should not exceed intensities associated with 12-15 repetitions, nor include heavy compressive exercises such as the leg press. 91. All legitimate credentials require renewal over a designated period of time. Normally, reporting cycles require the completion of continuing education once a person earns certification. While continuing education is mandatory, a misrepresentation of knowledge attainment is considered unethical. Attending a weekend seminar does not make an attendee an expert in the field. It is designed to provide on-going learning and help maintain practical competency for consumer protection. 92. (The supplement industry is not tightly-regulated and the FDA does not evaluate product claims or contents. Thus, many claims made by supplement companies are not backed by research. Almost anything goes with supplement labelling, as long as a product does not make a medical claim or suggest it prevents or cures a disease. 93. The maintenance of a constant pattern of movement without rest is required in specific fitness assessments such as the curl-up and step test *(use of metronome during testing).* Consistent movement timing reduces the risk of poor pacing and injury as well as prevents the use of momentum to aid in additional repetitions. 94. The most appropriate assessment of aerobic fitness for a 14 year-old boy would be the one mile run test. Children can perform short bouts (10 minutes) of intense aerobic exercise on an intermittent basis. Care should be provided to ensure adequate thermoregulation, as youths have a greater tendency to overheat. When using running tests the participants should practice the distance to establish an appropriate pace. 95. Anaerobic endurance assessments require at least 10 repetitions to be performed for it to be considered useful in predicting muscle endurance. A common fault during anaerobic endurance assessments is for the client to perform too few repetitions; negating the test's validity. If adequate repetitions cannot be performed, test modifications may be necessary such as switching a push-up test to a modified push-up assessment. 96. Continuing education is a vital component of maintaining a professional credential, and is mandated by the governing body to maintain certification status. Ethically, trainers should focus on continued education in their deficient areas, and only represent the areas of knowledge for which they are competent. 97. Heavy resistance training should be avoided when training individuals with hypertension. Individuals who already have elevated blood pressure are at risk of negative vascular events, such as stroke or heart failure. Training should avoid heavy resistance activities and breath holding that can result in exercising blood pressures of 200/300 mmHg. One particular exercise contraindicated for hypertensive clients is the leg press, because it requires the activity of a large amount of muscle mass (legs) and generally utilizes heavy loads. Additionally, hypertensives should not consume energy drinks containing caffeine, as caffeine blocks the parasympathetic action of exercise. 98. Children do not regulate or dissipate heat as effectively as adults and therefore require more prudence with activity decisions when environmental stressors are present. Children do well with intermittent activities and should engage in activities that encourage motor development and fun but can also be challenging. 99. The general guidelines for exercise prescription for an individual with asthma include exercising in a well-ventilated area free of known allergens. The intensity of aerobic training should be approximately 60%-80% of Heart Rate Reserve (HRR), because intensities above this range can increase the likelihood of exercise-induced asthma (EIA) attacks. Due to the possibility of an asthma attack during exercise, a proper emergency plan should always be in place and the appropriate medication should be on site. 100. Pregnant clients beyond their first trimester should avoid the supine position for several reasons. The supine position causes changes in blood flow distribution that reduces blood flow to the fetus, increasing potential risk and possibly resulting in circulatory problems such as orthostatic intolerance and fainting. **Learn More: Advanced Concepts of Personal Training Textbook, Chapter 22 -- Working with Special Populations, pages 505-508**