Expand Your Knowledge
1. According to the Centers for Disease Control and Prevention, a reduction in what three factors would dramatically reduce the incidence of chronic disease?
a. Poor diet
b. Physical inactivity
c. Smoking
2. Fill in the blanks.
a. An ACE-certified Personal Trainer is certified to work with clients that have health challenges only after they have been declared by their personal physicians.
b. Metabolic syndrome is characterized by abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, insulin resistance, prothombotic state, and proinflammatory state.
c. Malignant cells typically metastasize, while benign cells stay locally at the site of origin and do not spread throughout the body.
d. Many cancer patients are at increased risk of developing osteoporosis due to treatment side effects combined with inactivity during treatment. Thus, weightbearing exercise is an appropriate first step in the cardiovascular recovery phase for most cancer clients.
3. Consider the effect of aging on the following variables. Place an (I) next to the variables that tend to increase during the aging process, a (D) next to those that decrease, and an (NC) next to those that do not change.
a. Maximal heart rate D
b. Body-fat percentage I
c. Maximum oxygen uptake D
d. Basal metabolic rate D
e. Coordination D
4. Which of the following three types of exercise programs would you recommend for an obese client who wants to lose weight? Explain why you would recommend that program.
A combination of aerobic endurance and strength training. Aerobic endurance and weight training in combination has been shown to effectively burn calories and maintain fat-free mass and resting metabolic rate, producing the best long-term wright-loss results.
5. Match the health concern to the appropriate exercise recommendation. In some cases, the exercise recommendation may apply to more than one health concern.
1. Extend the warm-up and cool-down periods Low back pain, Osteoporosis, Asthma
2. In some cases, avoid upper-body exercises Asthma
3. Avoid extreme environmental conditions (high or low temperature) Asthma
4. Avoid forward-head positions in which the chin is tilted up Low back pain
5. Use isometric strengthening exercises Arthritis
6. List the types of movements that clients diagnosed with lower-back pain should avoid.
Unsupported forward flexion; twisting at the waist with turned feet, especially when carrying a load; lifting both legs simultaneously while in the prone or supine position; rapid movements such as twisting, forward flexion, or hyperextension
7. List the exercise guidelines for a low-risk client with stable cardiovascular artery disease who is initiating an exercise program
a. Mode: The initial mode should consist of low-intensity endurance exercise, gradually progressing to moderate-intensity exercise utilizing interval-type training. The resistance-training program should utilize one set of 12 to 15 repetitions of eight to 10 exercises.
b. Intensity: Begin at an intensity of 40 to 50% of heart-rate reserve, an RPE of 9 to 11 (6 to 20 scale), or a heart rate 20 to 30 beats over resting heart rate.
c. Duration: Total duration should be gradually increased to 30 minutes or more of continuous or interval training, plus additional time for warm-up and cool-down activities.
d. Frequency: Clients should perform three to five days per week of aerobic training and two days per week of resistance training.
8. Match the health concern to the appropriate exercise recommendations
1. Exercise at the same time each day for better control Diabetes
2. Avoid holding breath or straining during exercise (Valsalva maneuver) Hypertension
3. Avoid exercising in cold air or water to reduce the risk of vasoconstriction Peripheral vascular disease
4. Give special attention to foot care and hygiene Diabetes
5. No heavy lifting; keep resistance low to moderate and repetitions high Hypertension
6. Move slowly when changing positions Hypertension
9. Explain the major differences between the following pairs of words or phrases.
a. Osteoarthritis and rheumatoid arthritis: Osteoarthritis is a degenerative disease of the joint cartilage, while rheumatoid arthritis is a chronic and systemic inflammatory disease.
b. Type 1 diabetes and type 2 diabetes: Type 1 diabetes is caused by the destruction of insulin-producing cells, which occurs in childhood, while type 2 diabetes usually occurs during adulthood in overweight individuals and initially presents as insulin resistance. Increasing numbers of children are being diagnosed with type 2 diabetes.
c. Ischemic stroke and hemorrhagic stroke: An ischemic stroke occurs when blood supply to the brain is cut off, while a hemorrhagic stroke occurs when a blood vessel in the brain bursts.
d. Low-density lipoprotein (LDL) and high-density lipoprotein (HDL): LDL is the major carrier of cholesterol in the blood and is often called the “bad” cholesterol, while HDL is called the “good” cholesterol, as high HDL levels are associated with a reduced risk of coronary artery disease.
e. Fibromyalgia and chronic fatigue syndrome: Fibromyalgia is a syndrome characterized by long-lasting widespread pain and tenderness at specific points on the body, while chronic fatigue syndrome is a debilitating and complex illness characterized by profound, incapacitating fatigue lasting at least six months.
10. List the types of activities that clients with osteoporosis should avoid.
Spinal flexion, crunches, and rowing machines; jumping and high-impact aerobics; trampolines and step aerobics; abducting or adducting the legs against resistance; pulling on the neck with the hands behind the head
11. List the five warning signs of stroke of which a personal trainer must be aware.
a. Sudden numbness or weakness in the face, arms, or legs
b. Sudden confusion or trouble speaking or understanding others
c. Sudden trouble in seeing in one or both eyes
d. Sudden walking problems, dizziness, or loss of balance or coordination
e. Sudden severe headache with no known cause
QUIZ
1. You are working with a client who has osteoarthritis. He shows up to his latest session and tells you that he has been “experiencing soreness in his right knee since helping his daughter move into a new apartment over the weekend.” In which section of this client’s SOAP notes should this information be recorded?
SOAP: Subjective Objective Assessment Plan
Subjective.
2. You are working with a client who has hypertension and has been cleared by her physician for exercise. Which of the following would be MOST appropriate for her initial resistance-training program?
Circuit training consisting of 8-10 exercises using mostly tubing and bodyweight performed one time for 12-16 repetitions at 60-70% 1 RM
3. What effect does regular exercise have on dyslipidemia?
Regular exercise can increase HDL levels
4. You are working with a client who has type 1 diabetes and checks his blood glucose levels prior to each exercise session. Which of the following pre-exercise blood glucose levels would make you postpone the exercise session until his blood sugar is under control?
88 mg/dL
5. You are designing an exercise program for a new client who has type 2 diabetes and a physician’s release for exercise as tolerated to lower weight and improve blood glucose regulation. During the initial session, you learn that she has been sedentary for the past few years. What initial cardiorespiratory program would be most appropriate for her?
Walking 5-6 days per week for 10-20 minutes at an RPE of 11-13, working up to 40-60 minutes
6. Which of the clients described below meets the criteria for the metabolic syndrome?
42 Year old female
Waist circumference = 36 in (91.4 cm)
Triglycerides = 133 mg/dL
HDL cholesterol = 47 mg/dL
Blood pressure = 128/87 mmHg
Fasting blood glucose = 107 mg/dL
7. Which of the following steps would be MOST appropriate for personal trainers to take to reduce the risk of exercise-induced asthma (EIA) episodes when working with clients who have asthma?
Include an extended warm-up and cool-down
8. Which of the following repetition ranges is recommended to stimulate bone changes in clients who have osteopenia and/or osteoporosis?
6-8
9. Which of the following progressions is LEAST recommended for clients who have osteoarthritis?
Increasing the weight lifted instead of increasing the number of repetitions
10. Which of the following statements is CORRECT regarding exercise for people who have low-back pain?
Low-back exercises have the most beneficial effects when performed on a daily basis
SHOW WHAT YOU KNOW
1. Describe how you would gradually reduce the intensity, duration, and frequency of a pregnant client’s workout that consisted of high-impact aerobics three times per week and cycling outdoors 20 miles/day (75 minutes) two days per week.
a. Fist trimester: Reduce the outdoor ride to 60 minutes at a reduced intensity
b. Second trimester: Change high-impact to low-impact and cycle indoors in an air-conditioned environment
c. Third trimester: Reduce low-impact aerobics from three times per week to twice per week and cycle only 45 minutes
2. You have taken on a new client, IMA Young, who is an 11-year-old girl. Her parents hired you because the physical education program at her school has been dropped. Describe the general recommendations you would make for Ima in the following areas.
a. Mode: Sustained activities that use large muscle groups. Incorporate fun activities that develop other components of fitness. Encourage Ima to live an active lifestyle
b. Intensity: Being with low-intensity activity and gradually progress. As her conditioning improves, Ima should be encouraged to participate in moderate- and vigorous intensity activities. Activities that encompass all three intensity zones are an excellent choice.
c. Duration: Ima should accumulate 60 minutes or more of daily physical activity.
d. Frequency: Ima should be encouraged to exercise daily.
e. Strength training: Strength-training activities should be performed at least three days per week. They do not need to be structured and can be incorporated into games and other activities.
ACE Fitness notes 