ACSM-CEP - chapter 3, 100% Accurate. Latest Update. Rated A+

ACSM-CEP - chapter 3, 100% Accurate. Latest Update. Rated A+ information from health related physical fitness testing, and individuals medical and exercise history is used for... - -- collecting baseline data and educating individuals about their present health/fitness status relative to health related standards and age and sex matched norms - providing data that are helpful in the development of individualized exercise programs to address all health/fitness components - collecting follow up data that allow evaluation of short and long term progress following an exercise prescription - motivating individuals by establishing reasonable and attainable health/fitness goals steps that should be taken to ensure individual safety and comfort before administering physical fitness tests - -- make the informed consent document available to allow ample time for the individual undergoing assessment to have all questions adequately addressed - perform a preparticipation screening evaluation to determine the need for medical evaluation based on s/s of CV, metabolic, and/or renal disease. at minimum individuals should complete a self guided questionnaire like PAR-Q+ - follow the list of preliminary testing instructions for all individuals, may be modified to meet specific needs and circumstances organizing the fitness test - -- ensure all consent and screening forms, data recording sheets, and any related testing documents are available in the individuals file prior to test administration. - ensure that selected testing equipment has been calibrated according to manufacturers recommendation or more frequently based on use, and document all equipment calibration. skinfold calipers should be regularly checked for accuracy and sent to the manufacturer for calibration when needed. - ensure a room temperature between 68-72 and humidity of less than 60% w/ adequate airflow measurements to be obtained first in a fitness test - -resting measurements like HR, BP, height, weight, and body composition use of medications that affect physical fitness test results should be noted test environment - -important for validity and reliability things to control: - test anxiety - procedures should be explained and not be rushed, environment should be quiet and private. room should have comfortable seat for resting measurements. relaxed confident demeanor of staff and staff should know emergency plan. - emotions - room temperature - ventilation comprehensive health/fitness assessment - -1. informed consent, exercise pre-participation health screening, pre-exercise evaluation 2. resting measurements 3. circumference measurements, body composition 4. CRF measurement 5. muscular fitness measurement 6. flexibility measurement optional - static and dynamic balance resting HR and BP - -pt should rest for 5 minutes before HR or BP are measured to give them time to stabilize HR - pulse palpitation, auscultation w/stethoscope, HR monitor, ECG aging health related body composition changes - -- increased BF - decreased BMD - loss of muscle mass assessing resting BP - -1. sit quietly for 5 minutes, arms supported at heart level, no smoking or caffeine for 30 minutes prior. 2. supine and standing values measured under special circumstances 3. align cuff w/brachial artery, wrap cuff firmly around upper arm at heart level 4. bladder in cuff should cover 80% of pts arm, many adults require large cuff 5. stethoscope placed over brachial artery in anticubital space 6. quickly inflate to 20 mmHg above 1st karotkoff sound 7. slowly release at a rate of 2-3mmHg/sec 8. SBP = first karotkoff sound, DBP = disappearance of sound 9. 2 measurements at least 1 minute apart and take the average 10. BP should be measured in both arms at first examination 11. give individuals their BP verbally and in writing sources of error in BP measurement - -- inaccurate sphygmomanometer - improper cuff size - auditory acuity of technician - rate of inflation/deflation of cuff pressure - experience of technician - faulty equipment - improper stethoscope placement or pressure - not having cuff at heart level - physiologic abnormalities - reaction time of technician - background noise - pts holdint BMI - -kg/m^2 18.5 = underweight 18.5-24.9 = normal 25-29.9 = overweight 30+ = obese BMI 30+ - -increased risk of diseases and mortality BMI 25-29.9 - -increased risk of T2DM, dyslipidemia, hypertension, cancer BMI 18.5 - -may indicate malnutrition, eating disorder, osteoporosis, metabolic abnormalities android obesity - -more abdominal fat increases risk of HTN, metabolic syndrome, T2DM, dyslipidemia, CVD, and premature death gynoid/gynecoid obesity - -more hip and thigh fat visceral fat - -fat within and surrounding thoracic and abdominal cavities duplicate measurements - -obtained in a rotational order, not consecutive average of 2 measures is used, should not differ more than 5mm WHR - -circumference of waist divided by circumference of hip increased risk - under 60: men 0.95+, women 0.86+ 60-69: men 1.03+, women 0.90+ waist circumference - -may be used as indicator of obesity related health risk because central obesity is the primary health issue risk criteria WC - -very low - women 70cm - men 80cm low - women 70-89cm - men 80-99cm high - women 90-110cm - men 100-120cm very high - women 110cm - men 120cm skinfold measurements - -estimates BF% by determining thickness of several folds of skin across the body, the amount of subcutaneous fat is proportional to the total amount of body fat. accuracy of predicted BF% is +/-3.5% skinfold measurement procedure - -- all measurements should be made on the right side of the body w/individual standing upright - caliper should be placed directly on skin surface, 1 cm away from the thumb and finger, perpendicular to the skinfold, and halfway between the crest and base of the fold - pinch should be maintained while reading the caliper - wait 1-2s before reading caliper - take more that 2 measurements if first 2 are not within 1-2mm - rotate through measurement sites or allow time for skin to regain normal texture and thickness skinfold measurement error factors - -poor anatomical landmark identification, poor measurement technique, inexperienced evaluator, extremely obese or lean person, improperly calibrated caliper densitometry - -the estimate of total body fat percentage can be derived from a measurement of whole-body density using the ratio of body mass to body volume body density to body composition - -[(4.95/Db) - 4.50] x 100 DXA - -limited applicability due to cost, specialized equipment, and need for highly trained personnel BIA - -accuracy similar to skinfolds as long as protocols are followed and equations are valid for population tested ultrasound - -noninvasive direct measure of subcutaneous fat thickness cardiorespiratory fitness - -related to the ability to perform large-muscle, dynamic, moderate-to-high intensity exercise for prolonged periods of time considered a health related component of physical fitness because 1. low levels are associated w/ increased risk of premature death from all causes and CVD 2. increases in CRF associated w/ reduction in death 3. high levels of CRF are associated w/ higher levels of habitual PA VO2max - -criterion measure of CRF relative - ml/kg/min absolute - ml/min the product of the maximal cardiac output and a-v oxygen difference, closely related to the functional capacity of the heart. a plateau in HR (/=2 bpm) in the final minute of data collection is reported to hold promise as a singular method for confirming VO2max w/o need for verification trial. peak VO2 - -used when leveling off VO2 does not occur, or maximum performance appears limited by local muscular factors rather than central circulatory dynamics. commonly used to describe CRF in these and other populations with chronic disease and health conditions indirect calorimetry - -open circuit spirometry used to measure VO2max during graded incremental or ramp exercise test to exhaustion. pulmonary ventilation and expired fractions of O2 and CO2 are measured. allows for the accurate assessment of anaerobic/ventilatory threshold and direct measurement of VO2max/VO2peak estimating VO2max - -can be estimated by using a variety of maximal and submaximal exercise tests. tests have been validated by examining: 1. correlation between directly measured VO2max and the VO2max estimated from physiological response to submax exercise 2. correlation between directly measured VO2max