ACE CPT Chapter 8 – Physiological Assessments

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Important things to know:

Be able to identify symptoms and signs that deserve an immediate termination of assessment

The onset of chest pain/discomfort, angina, or similar symptoms

A drop of systolic blood pressure of 10mmHg or more with an intensity increase

An increase in blood pressure (over 115mmHg for diastolic or over 250mmHg for systolic)

Symptoms of excessive fatigue

Pallor (paleness), Cyanosis (coloration by mouth), Lightheadedness, clammy/cold skin, and nausea

Ataxia, confusion, syncope, and dizziness

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Claudication or leg cramping

A request from your client to stop

Physical and verbal signs of extreme fatigue

Failure in equipment

Anthropometrics and body composition

Fat tissue and lean tissue

Lean tissue (body mass): Bones, connective tissue, muscles, nervous tissue, blood, organs, and skin

Essential body fat levels for women: 10% to 13%

Essential body fat levels for men: 2% to 5%

Hydrostatic weighing

Also called underwater weighing

The best way/benchmark for determining body composition

Has approximately a 1.5% to 2% error margin

Skinfold measurements

Is done by measuring subcutaneous body fat

Has eight errors between 6% and 8%, especially for inexperienced or untrained personal trainers

Is usually between 2% and 3.5% of the underwater weighing measurements

Jackson and Pollick 3 site locations

• For women: Thigh, triceps, and suprailium
• For men: thigh, abdominal, and chest

Evaluation of body composition

Considerations for programming

Additional anthropometric measurements

Body mass index (BMI)

• Under 18.5 = underweight
• Between 18.5 in 24.9 = Normal
• Between 25 and 29.9 = Overweight
• Between 30 and 34.9 = level I obesity
• Between 35 and 39.9 = level II obesity
• Over 40 = Level III obesity

Measurements of girth (circumference)

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• Locations: Arm, calf, forearm, waist, upper thigh, mid thigh, hips, glutes, and abdomen
• This is helpful for clients who have hypertrophy goals

The hip to waist ratio

• Gynoid (pear-shaped) and Android (Apple shaped)
• Risk factors
• Over .95 for men
• Over .86 women

Waist Circumference Risk Factors:

• 100 to 120 cm (39.5 to 47 inches) for men
• 90 to 109 cm (35.5 to 43 inches) for women

Fitness testing: Cardiorespiratory testing

Lab assessment or fitness centers

GXT (graded exercise test)

VO2 maximum

Max heart rate

• 220 – age fox, Naughton & Haskell (+/- 12 bpm)
• 208 – (.7 x age) Tanaka, Monahan, and Seals (+/- 7 bpm)
• 9 – (.67 x age) Gellish et al (+/- 7 bpm)

Cycle ergometer testing

Sub Max VO2

Ventilator threshold testing

Title volume: The amount of air that is exhaled and inhaled per breath

Minute ventilation: The volume of air that is breathed in a minute

Anaerobic glycolysis: an energy system that relies on carbohydrates

VT1 (first ventilator threshold): When lactate builds up faster than it can be cleared out.

Faster breathing

VT2 (Second ventilator threshold): also known as the lactate threshold (LT): This happens when lactate increases at such a rate that hyperventilation (fast breathing) is not enough to maintain the increased acidity happening during more and more intense exercise.

The submaximal talking test for VT1

This is better performed with a heart rate strap/watch (telemetry)

The threshold test for VT2

OBLA (Onset blood lactate accumulation): The exact moment that blood lactate is accumulating at a faster rate than the body can remove it (usually >4mmol/L)

This is also referred to as the lactate threshold or the anaerobic threshold

Field testing:

Deconditioned clients should not perform a running test

The one-mile Rockport walk test

1 1/2 mile run test

Step tests

Should not be done with clients that:

• Have balance problems
• Are severely overweight
• Are very deconditioned
• Have orthopedic problems
• Are very short and have difficulty with stepping height

Testing for muscular fitness

Testing for muscular endurance:

Curl up test

Push up test

Squat test with body weight

Testing for muscular strength

One rep maximum (absolute strength): The most amount of weight a client can lift for one repetition

Relative strength: The overall absolute strength of one’s body weight

The one rep maximum bench press test, squat test, and leg press test

Only perform muscular strength tests for clients in either phase 3 or phase 4 of the IFT ACE model

Sports/skill assessments

Power assessments

• Only perform power assessments if the client is in phase 4 of the IFT ACE model.
• Vertical jumping test
• The standing long jump test

SAQ

• Only perform if a client is in phase 4 of the IFT ACE model.
• The 40-yard dash test
• The pro-agility test

Fitness testing accuracy

Typical causes of inaccuracy

• Client factors: Lack of hydration, food intake before the test, the lack of quality sleep, overall fatigue
• Personal trainer factors: Inexperience with administering tests, attempting to influence results for encouragement
• Equipment factors: Bad calibration, failure of equipment, not matched well to the subject
• Environmental factors: Privacy, conditions of weather, distractions, temperature

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