Final exam study guide
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Dear EXCI 252 students, The Final Exam
is scheduled for Wednesday, December 6, 2023,
from 9:00 to
11:00 AM
in classrooms
MB-3.430
, MB-3.435
, and MB-3.445
of the John Molson
School of Business (JMSB) building
located at the Sir George Williams campus
.
Please visit your personalized final exam schedule by logging in to the
Student
Hub
with your netname
and then go to My CU Account > Academic > View exam
schedule to find your classroom. ACSD students are expected to
write the final exam
in one of the downtown ACSD classrooms.
You will have 2 hours
to complete the exam, which will be composed of
multiple-choice questions
. Each question will have 4 choices (
A, B, C, or D) with
only one correct answer
. The final exam
is worth 30%
of your final grade. To write
the final exam, you must present your valid Concordia University student
identification card to the invigilators. Furthermore, you only
need a pencil
, an eraser
,
a nonprogrammable or ENCS-approved calculator for the final exam. Cell phones
,
and electronic dictionaries
cannot
be used during the exam. However, a printed
(hard copy) translation dictionary
(English to French, English to Spanish, English to
Chinese, etc.) may be used during the exam. You are responsible for material from the textbook chapters
indicated in the
table below, the PowerPoint slides
corresponding to these chapters, and any
information covered in class lectures
. If you notice a difference in content between the
course textbook and the PowerPoint slides, the slides will take precedence
because
they have been updated to account for some errors or outdated information contained in
the course textbook. It is recommended that you use the PowerPoint slides as your
template
for studying. If you do not understand some of the material in the slides, you
can refer to the textbook. Chapte
r
Textbook Title
Pages
6
Assessing Muscular Fitness
159-187
7
Designing Resistance Training Programs
189-227
8
Assessing Body Composition
229-279
9
Designing Weight Management & Body Composition Programs
281-308
10
Assessing Flexibility
309-329
11
Designing Programs for Flexibility & Low Back Care
331-347
Section
CSEP-PATH Title
Pages
3
Behaviour Change (CSEP-PATH 2021)
3-21
4
Musculoskeletal Fitness Assessment (CSEP-PATH 2021)
41-55
4
Sit and Reach (CSEP-PATH, 2021) 48-49
4
Physical Activity Training for Health (CSEP-PATH 2021)
65-87
Please note that pages 67
to 71
in Chapter 3
of the course textbook authored by
Gibson, Wagner, and Heyward (2019)
contains some information about behaviour
change
. Please refer to the following pages for the specifics of this study content guide.
1
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Chapter 6
Assessment of Muscular Fitness
(Pages 159 to 187)
You are responsible to study most of the material in this chapter.
Use the PowerPoint slides as your guide for this chapter.
Please refer to the course textbook if you need clarification related to some of
the content in the PowerPoint slides.
Muscle fitness (
see page 72
): characteristics of strength, hypotrophy, and local muscular
endurance. Through resistance training (free weights, machines, body weight, bands…) where
exert force against resistance.
-
Sources of measurement error in muscular fitness testing: client factors (experience,
familiarity, motivation, maximal effort, restricted drugs and medications…) equipment
(most of the dynamic strength and muscular endurance protocols and norms uses constant
resistance exercise machines, calibration, inspection, maintenance…), technician skill
(qualified, trained, explanation, demonstration…), environmental factors (room °C,
humidity, clean). Muscular Endurance: muscle group exert a submaximal force, a given force, maintain a specific
% of the max voluntary contraction, execute repeated contractions (to cause fatigue), sustain a
static contraction (without fatigue) for extended periods. -
Dynamic muscular endurance testing
: repetitions to failure
at a given % of body weight
of 1 RM. YMCA bench press test
uses a flat bench and barbell. As many of rep as
possible. Cadence set a 30 reps/min. stopped when client can’t maintain the exercise
cadence. 80 lb male and 35 lb female. Use a test battery
, lift a % of client’s body mass
up to max 15 reps. Muscular strength: maximal force generated in a single contraction at a specific velocity. Muscle
group or specific muscle generate a maximal contractile force against a resistance in a single
contraction. Peak force of torque developed in a max voluntary contraction. Absolute (MVC) or
relative (MVC/Body Mass)
Muscular Power: skill-related component. Muscle’s ability to exert force per unit of time (exert
force rapidly). Rate of the mechanical work. Maximal amount of force for the least amount of
time. Muscle imbalance: may compromise joint stability. Increase the risk of musculoskeletal injury.
-
Ratios: The difference in strength between contralateral muscle groups should not be
more than 15%, upper body should be at least 40% of lower body relative strength.
Isokinetic dynamometers have been used to assess muscle imbalances of
agonist/antagonist (
see page 67
)
2
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Purpose of strength and muscular endurance assessment: establish baseline, monitor progress,
asses overall effectiveness of resistance training and exercise rehabilitation programs. -
Tests that asses them are specific to the: type of muscle action (static or dynamic),
velocity of muscle movement (slow or fast movement), type of test (strength or
endurance, type of equipment, ROM (static or dynamic)
Type of muscle:
-
Static or isometric: isometric dynamometers, spring loaded dynamometers (external force
applied to the dynamometers compresses a steel spring and moves an indicator needle or
pointer). Same muscle length. No visible movement of joint. Maximum force exerted in a
single contraction against an immovable resistance, limb not rotation (0 velocity)
Handgrip strength testing: indicator of total body strength. Predictor of limitations and
stability in a person. Procedures
Protocol 1 (ASHT, 1982)
Protocol 2 (CSEP, 2021)
Seated or stand. Shoulder adducted and
neutrally rotated. Elbow flexed 90°. 3
trials per hand. Forearm neutral, wrist
extension 0 to 30°. Record mean of the 3
trials.
Stand erect. Arm slightly abducted in
neutral position. Test arm straight. 2 trials
per hand, alternating. Combine the max
scores from the left and right hands.
Leg and back strength testing procedures Leg strength
Back strength
Stand on platform, erect trunk, flexed
knees, pronated grip. Exert as much force
while extending the knees w/o using back.
2 or 3 trials. 1 min rest between. Choose
MAX score and convert in kg
Stand on platform, head and trunk erect,
knees full extended. Alternated grip (right
= pronated, left =supinated). Pull straight
up using back muscles. 2 trials, 1 min rest.
Choose MAX score and convert in kg
Handgrip Endurance testing: Maximal force (MVC)
Submaximal force (% MVC)
Squeeze the handle maximally for 1min.
Record initial and final forces. Relative
endurance score = (final force/initial force
x 100)
Squeeze the handle at a submaximal force
for as long as possible. Relative endurance
score = time the %MVC is maintained
Hydraulic dynamometers: alternative to spring-loaded dynamometers. Have a sealed
hydraulic system that measures force on a gauge dial. Ex: Jamar handgrip dynamometer
(validity and reliability. Gold standard for handgrip dynamometers. May not be
appropriate for isometric strength of people w/ weak MVC bc resolution of the device is
too large to detect small changes)
Myogrip Dynamometer: recommended for clients w/ weak MVC. 3
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Cable Tensiometer: goniometer. provides the advantage of versatility for recording
force measurements at virtually all angles about a specific joint’s ROM (assess strength
impairment, monitor progress during rehabilitation). Strength in 38 muscle groups.
Digital Handheld Dynamometry: upper and lower body musculature. 11 muscle
groups.
Clinical methods: v-sit test (trunk reclined 60°, angle of flexion (knee and hips
90°), Sorensen test (bench height = 25 cm, side bridge test, novel side-support test (feet
are elevated on a 15 cm padded stool). -
Dynamic: all concentric and eccentric. Muscle length changes. Visible joint movement.
Free weight (dynamic muscular strength and endurance), constant-resistance exercise
machines (dynamic muscular strength and endurance), variable-resistance exercise
machines (
not
for dynamic muscular strength and endurance), free-motion exercise
machines, isokinetic-resistance exercise machines, calisthenic-type exercise tests. o
Advantages and disadvantages of constant-resistance exercise machines compared
to free weights: CREMs require less neuromuscular coordination to stabilize body
parts and maintain balance and no spotting. However, limit an individual’s ROM
and plane of movement, have large weight plate increments, can’t accommodate
people w/ short limbs, long limbs, large body and large limb circumferences.
auxotonic: free weight. Before called isotonic (tension fluctuates greatly even tho the
resistance is constant throughout the ROM). Now (variable muscle tensions caused by
changing velocities and joint action). Can be called dynamic constant external resistance
exercise. The muscle group does not contract maximally throughout the ROM. o
Major disadvantage: measure dynamic strength only at the weakest point in the
ROM. The resistance can’t be varied to account for fluctuations in muscular force
caused by the changing mechanical (angle of muscle pull) and physiological
(muscle length advantage) of the musculoskeletal system during the movement. Concentric: resistance < force by muscle group. Muscle shortens during tension. Eccentric: resistance > force by muscle group. Muscle lengthens during tension. Resist
gravity. o
Force plates and linear transducers: used to obtain direct measures of muscular
force and power. Gold standard of measuring dynamic strength and power.
Expensive due to cost of equipment.
o
Tendo weightlifting analyzer system: linear transducer that can be attached to the
end of a barbell. Reliable and valid device to evaluate lifting movement velocity,
muscle force and power during dynamic resistance exercise in field setting.
o
Myotest accelerometer: measure force production in 3 different planes of
movement. High validity and reliability for measuring dynamic muscular strength
and power. Practical device to evaluate lifting movement velocity, muscle force
and power in field setting.
4
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
o
1-RM: most common in clinical setting. obtained through trials and errors. Used
to rate health status, establish exercise prescription workloads and/or monitor
resistance training programs. The heaviest weight that can be moved only once
through full ROM. One complete rep. Time consuming. May be underestimated
for clients with little or no resistance exercise experience. Outside scope of
practice of a CSEP-CPT. Warm-up: 5-10 reps 40%-60% of estimated 1 RM, rest
1 min, 3-5 reps at 60-80% estimated 1 RM, rest 2 min. Attempt 1-RM lift. Rest 2-
4 min between attempts. If successful, increase weight (5-10% upper body, 10-
20% lower body). Until failure (usually within 3 to 5 trials).
relative strength: 1 RM/body mass. Six test items: bench press, arm curl, lat
pull, leg press, leg extension, leg curl.
estimation of 1 RM: submaximal muscular endurance tests (YMCA), 1 RM
prediction equations, prediction tables. Use the average # of reps corresponding
to various percentages of 1 RM. Estimated 1 RM = Weight lifted / (% 1 RM/100).
isokinetic: isokinetic dynamometer (matches the force exerted to keep the same
velocity = different resistance). Maximal contraction of a muscle group at a constant
velocity throughout the entire ROM. o
Cybex II Isokinetic Dynamometer: involves the assessment of maximal muscle
tension throughout a ROM set at a constant angular velocity. Maximally loaded
for the complete ROM by an isokinetic resistance exercise machine. Provides an
accurate and reliable assessment of strength, endurance and power of muscle
groups. The speed of limb is kept at a constant preselected velocity. The
resistance counteracting the individuals force production is called accommodating
resistance. Peak torque (puissance), total work and power can be evaluated. o
Protocols
Isokinetic tests
Speed Protocol
Measure
Strength
30 or 60
2 submax practice
trials and 3 max
trials
Peak torque
Endurance
120 to 180
1 max trial
# reps until
torque reaches
50%
initial
torque value
Power
120 to 300
2 submax practice
trials and 3 max
trials
Peak torque
o
Limitation: expensive. Only permits angular motion. No isokinetic muscle
actions occur in real-life movements.
Variable resistance: machines w/ cams and pulleys. The muscle contracts maximally
throughout the entire ROM by varying the resistance to match the exercise strength
curve. Provide proportionally less resistance in weaker segments of ROM and more
resistance in stronger segments of the ROM. Overcomes the main limitation of auxotonic
resistance exercise. Have a moving connection between the resistance and the point of
force of application. o
Cam: ellipse connected to the movement arm of the machine on which the cable
or belt travels. Each joint movement has an associated strength curve. Limitation
5
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
the cams of many machines are incorrectly designed and fail to match the strength
curves of different muscle groups. Difficult to assess maximal muscle force or
strength.
Calisthenic-type strength and muscular endurance test: o
Dynamic muscular strength test: determining max weight, in excess of body mass,
that can be lifted for 1 rep of the movement. For each test, attach weight plates to
the person. Pull-up, dip-strength, sit-up, push-up, bench squat.
o
Dynamic muscular endurance tests: max # of reps of a calisthenic exercise. Pull-
ups, sit-ups, trunk curls, partial curl-ups, push-ups.
Modified pull-up (Baumgartner, 1978). Flexed arms hang test. Measures
isometric endurance of arm and shoulder girdle muscles. Scored as the amount of
time that is maintained in the flexed arm hanging position. o
Dynamic muscular power testing: vertical jump or standing long jump.
Do not memorize information in the following tables:
Table 6.2: Static Strength Norms
Table 6.3: Percentile Scores for the Forearm Plank
Table 6.4: Age-Gender Norms for 1-RM Bench Press
Table 6.5: Age-Gender Norms for 1-RM Leg Press
Table 6.6: Strength-to-Body-Mass Ratios for Selected 1-RM Tests
Table 6.7: Muscular Endurance Norms for Bench Press
Table 6.8: Dynamic Muscular Endurance Test Battery
Table 6.10: Age-Gender Norms for Push-Up Test
Table 6.11: Sahrmann Core Stability Test
Table 6.12: Age-Gender Norms for Countermovement Vertical Jump
Table 6.13: Average Number of Repetitions and %1-RM Values
Table 6.14: Muscle Balance Ratios
Table 6.15: Arm Curl Test Norms for Older Adults
Table 6.16: 30 Sec Chair Stand Test Norms for Older Adults
However, you should know how to use most of these tables in the event you
are given practical problems on the final exam. I would have to provide you
with these tables.
You must know how to use Tables 6.6, 6.8, and 6.13, which correspond to slides 47,
60, and 51, respectively.
You do NOT need to know
anything about the tests for older adults
in this chapter,
which includes tables 6.15 and 6.16.
Also, do NOT study
any information in Table 6.11. 6
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Do NOT study MUSCULAR FITNESS TESTING OF OLDER ADULTS &
CHILDREN on pages 181 to 186.
7
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Chapter 7
Designing Resistance Training Programs (Pages 189 to 227)
You are responsible to study most of the material in this chapter.
Use the PowerPoint slides as your guide for this chapter.
Please refer to the course textbook if you need clarification related to some of
the content in the PowerPoint slides.
Resistance training: systematic program of exercise for the development of the muscular
system. Health benefits: Improved and maintained muscular endurance, strength, power,
hypotrophy. Builds mass (bone density and strength, counteracts loss of bone minerals,
decrease the risk of falls w/ age). Increase in size and strength of ligaments and tendon.
Lower BP. Increase in FFM, decrease fat mass and relative body fat. Muscle fiber: single muscle cell. Classified by color, speed of contraction, strength, fatigue
resistance, energy source. Composed of myofibrils (protein structures). Slow-twitch fibers
(type I), intermediate fibers (Type IIA), fast twitch fibers (Type IIX).
-
Motor unit: makes the functional unit of movement. Made up of a nerve cell (alpha motor
neuron) connected to a # of muscle fibers. All the muscle fibers in the muscle unit will
contract to their maximum capacity when a nerve cell calls on its muscle fibers to
contract. + motor units = + force. Slow twitch MU = - force than fast-twitch MU. Slow
recruited first for most dynamic movements. Muscles: mix of slow and fast twitch fibers. Type of fiber that acts is dependent of the type
of work required. Slow (endurance), fast (strength and power)
Resistance training adaptations: increase size of fast and slow twitch muscle fibers, not
increase the # of muscle fibers. -
First 2 to 8 weeks: rapid increase in strength due to neural adaptations (muscle learning). -
8 to 10 weeks: muscle hypertrophy contributes more than neural adaptation to strength
gains. -
> 6 months: increase strength w/o hypertrophy. Secondary phase of neural adaptation. Hypertrophy: increase in the size of cell or tissue. Process of making larger muscle fibers.
Increase of muscle fiber size, amount of connective tissue, cell content of enzymes and energy
storage.
8
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Type of resistance training: -
Isometric: static. Can be performed anywhere, anytime, little to no equipment.
Disadvantage: strength gains are specific to the joint angle. + intrathoracic pressure
-
venous return to the heart
+ work of the heart
+ BP.
-
Dynamic: concentric and eccentric. At least 8 to 10 exercises. Full ROM. Stabilized body
position. Inhale during eccentric phase. Exhale during the concentric phase. Multi joints
(larger muscles) before single joint (smaller muscles) exercises. Rest 48 to 72 hours
between RT workouts. Spot for free weight workouts. Warm up and cool down. -
Isokinetic: same velocity and speed. Combines the advantages of dynamic (full ROM)
and static (max force). Involves dynamic concentric against an accommodating
resistance. Used to increase muscular strength, power and endurance. Little to no muscle
soreness because muscles do not contract eccentrically. Not best choice to increase
muscle size and for hypertrophy. Relative hemodynamic responses to dynamic and isometric exertion: Variable
Dynamic
Isometric
Cardiac output
++++
+
HR
++
+
Stroke volume
++
0
Peripheral resistance (thickness of blood)
-
+++
SBP
+++
++++
DBP
0 or -
++++
Mean arterial BP
0 or +
++++
Left ventricular work Volume load
Pressure load Valsalva maneuver: holding breath = + SB and + DB. Could happen in dynamic. Happens in
isometric.
Steps for developing a resistance exercise training program: 1.
Identify the primary goal.
2.
Determine the type based on the client’s goal, time commitment and access to equipment.
3.
Identify muscle weaknesses and muscle strength. 4.
Select resistance exercises. 5.
Order the resistance exercises. 6.
Determine the appropriate starting loads, sets, and reps.
7.
Set guidelines for progressively overloading each muscle group. 8.
Novice: whole body workout. Intermediate: whole body workout. Advanced: split
workout.
Guidelines for resistance training:
-
Frequency: novices each major muscle group at least 2 nonconsecutive days per week.
Experienced based on their weekly training volume (increase by increase the # of
exercises, load of each exercise, # of reps, # of sets
Volume = load x sets x reps
). -
Intensity: o
Improved muscular fitness: Novices 60-70% of the 1 RM
9
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
o
Improved muscular strength: loads > 60% 1 RM. Novices 40-85% 1 RM.
Experienced 80-100% 1 RM. o
Improved muscular power: upper body 30-60% 1 RM. Lower body 0-60% 1 RM. -
Time: depend on set and reps
o
Improved muscular fitness: novice at least 1 set, 8-12 reps.
o
Improved muscular strength: novices at least 1 set, 8-12 reps. Experienced
multiple sets, 1-12 reps.
o
Improved muscular power: 1 to 3 sets, 3-6 reps. o
Rest intervals: 1-2 min or > 2 min between each set. -
Type: different types of equipment and body weight exercises. Program for clients who don’t have time: split routine, agonist vs antagonist, upper body vs
lower body, push vs pull, compound exercises. Periodization: systematic variation of intensity and volume of resistance training. To maximize
the response of the neuromuscular system. To minimize overtraining and injury. Variation of
training volumes (# of sets, reps, exercises), training intensity (resistance), type of muscle
contraction (concentric, eccentric, isometric) and training frequency.
Macrocycle (9-12 months),
mesocycle (3-4 months), microcycle (1-4 weeks)
-
Classic linear periodization model: % 1-RM or #RM. Intensity increase, volume
decreases w/ weeks.
-
Reverse linear periodization model: % 1 RM or #RM. Intensity decrease, volume
increase w/ weeks. -
Undulating periodization model: #RM (volume). Decrease for cycle 1, increase for cycle
2.
Circuit resistance training: dynamic resistance training to increase strength, muscular endurance
and cardiorespiratory endurance. 40-55% 1 RM. Reps as many as possible for 30s. 15 sec of rest.
12 stations clockwise, 9 times, 3 sessions (27min). 3 days/week, 8 weeks. Core stability training: improve functional capacity and sport skills performance. The ability to
maintain the ideal alignment of the neck, spine, scapula, pelvis while performing an exercise.
Develops muscular endurance more than strength or power. Performed on unstable surfaces. Eccentric training: load is limited to eccentric muscle action only. Higher forces and velocities.
Improve strength, hypertrophy, performance and aid in tendon and muscle injury rehabilitation.
Increased risk for delayed onset muscle soreness. Functional training: 6-step approach by Yoke and Kennedy (2004). Difficulty level (strength)
and skill level (balance and coordination) of specific exercises are rated. All muscle groups.
Improve joint stability, neuromuscular control, flexibility, muscular fitness. 4 types of exercises
(spinal stabilization, proprioception and balance, resistance, flexibility exercises)
Extreme conditioning programs: high intensity functional training. Short recovery periods.
Multi-joint exercises, fictional movements, body resistance. CrossFit.
Study
the following guidelines
:
10
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
General Guidelines for Dynamic Resistance Exercise Training (
slides 32-33
)
Table 7.1: Guidelines for Designing Isometric Training Programs (
slide 26
)
ACSM (2022) Guidelines for Resistance Training of Healthy Adults (
slides 34-36
)
Table 7.8: Guidelines for Designing Isokinetic Resistance Training Programs
(
slide 77
)
Study
the isometric and dynamic resistance exercises on slides 27
and 52
,
respectively.
You need to know the advantages & disadvantages of the different types of
resistance training.
Do NOT memorize information in the following tables (understand the concepts
associated with these tables that affect the prescription of exercises when
designing resistance training programs)
:
Table 7.3: Guidelines for Resistance Training Programs for Novice Lifters
Table 7.4: Guidelines for Resistance Training Programs for Intermediate Lifters
Table 7.5: Guidelines for Resistance Training Programs for Advanced Lifters
CSEP’s Typical Resistance Training Variables for Novice-Intermediate Levels of
Training.
Do NOT study the resistance training guidelines for novice, intermediate, and
advanced lifters.
However, you should be able to identify which factors will influence your
selection of intensity, volume, frequency, and rest interval between sets
for a client.
For example, you must be aware that the intensity, volume, velocity,
frequency, and rest interval of a resistance training program are partly
dependent on the training status of your lifter (novice, intermediate, or
advanced).
Do NOT study Designing Resistance Training Programs for Children and Older
Adults on pages 209 to 211.
Do NOT study MUSCULAR SORENESS on pages 224 to 226.
11
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Chapter 8
Assessing Body Composition
(Pages 229 to 279)
You are responsible to study most of the material in this chapter.
Use the PowerPoint slides as your guide for this chapter.
Please refer to the course textbook if you need clarification related to some of
the content in the PowerPoint slides.
PART 1
Fat mass (FM): all the fat in the body. Fats that can be extracted from the fat tissues and other
tissues of the body. Also called Fat Weight. Estimated FM = % body fat x total body weight
Fat-free mass (FFM): all fat free tissues in the body, including water, muscle, bone, minerals,
connective tissues and internal organs. Also called Fat-free Weight. Estimated FFM= total
body weight – FM. Lean body mass: contains small percentage of essential fat stores. Remains relatively
constant in water, organic matter, and minerals throughout the adult’s life span. Essential fat: includes lipids in the nerves, heart, lungs, kidneys, intestines, bonne marrow,
brain, muscles, liver, spleen, mammary glands, lipid-rich tissues in the CNS. Larger % in
women
Non-essential fat: storage fat primarily in fat cells (adipose tissues
83% pure fat, 15% pure
water and 2% protein). Subcutaneous (below skin) and visceral (major organs). The amount
of storage fat depends on gender, age, heredity, metabolism, diet and activity level. Two component model of body composition: fat component and fat-free body component. -
5 assumptions: density of fat is 0.901 g*cm^-3 and density of FFB is 1.100 g*cm^-3
(from the Brozek, Grande, Anderson and Keys (1963) study). Densities of fat and FFB
are the same for everyone. The densities of the various tissues composing the FFB are
constant, and their proportional contribution remains constant. The person being
measured differs from the reference body only in the amount of fat and not FFB (stays
73.8% water, 19.4% protein and 6.8% mineral). FFB density: varies w/ age, growth, sexual maturation, gender… depends mainly on the
relative proportions of water and mineral that compose the FFB component. Reference methods for assessing body composition: densitometric methods
estimate total
body density (Db). Db = body mass/body volume = BM/BV. Hydrostatic weighing and air
displacement plethysmography (ADP) are used to measure body volume. Dual-energy X-Ray
Absorptiometry. 12
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
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-
Hydrostatic weighing: estimate of BV from the volume of water displaced by the body’s
volume. Based on the Archimedes’ principle of water displacement. Weight loss under
water is directly proportional to the volume of water displaced by the BV
. If air remains
in body, underwater weight will decrease. More fat = less dense = % body fat will be
higher, more muscular = denser = % body fat will be lower. Density = float or sink.
Displacement = how much place you take in water. So if fat, more displace. o
Db =BM/BV
o
Db = Wa/ [(Wa-Ww/Dw) – (RV+GV)]
Wa = body weight in air
Ww = net body weight in water
Tare weight = chair of platform and supporting equipment
Dw = density of water at a given temperature
Water °C +++ = density ---, inverse relationship RV = residual volume in lungs after a maximal expiration. 1 to 2.4 L
Male: RV = (0.017 x Age) + (0.027 x Ht in cm) – 3.447
Female: RV = (0.009 x Age) + (0.032 x Ht) - 3.90
Closed circuit approach: oxygen, nitrogen, helium dilution. Dilution gas
w/ air of our lungs to reach equilibrium w/ lungs and system.
Open-circuit approach: nitrogen washout. Using oxygen to wash out
nitrogen.
GV = volume of air in the gastrointestinal tract
o
The effect of measurement error on the determination of BV, Db and % BF from
HW:
Overestimate
BV
Db
% BF
Dry land weight
overestimate
underestimate
overestimate
Under water weight
underestimate
overestimate
underestimate
Water °C
overestimate
underestimate
overestimate
RV
underestimate
overestimate
underestimate
-
Sources of error in hydrostatic weighing:
o
Pretesting guidelines: eating (not 4h before), strenuous exercise (not 4h before),
gas producing foods or beverage (not 12h before)
o
Equipment calibration before testing, equipment used.
o
Measurements of BW, UWW, RV: better to do in underwater measure the RV
while they’re submerged.
o
Client factors: people don’t want to go in water or don’t like it. -
Modification of HW procedures
o
UWW client at functional residual capacity: when they are unable to expel all the
air from the lungs. Db is measured at the FRC (volume of air remaining in the
lungs at the end of a normal expiration). FRC = ERV + RV. ERV (expiratory
reserve volume = maximal volume of air that can be expired from the lungs after
a normal expiration) must still measure RV. Db = Wa / [(Wa-Ww)/Dw)-
(FRC+GV)] o
UWW client at total lung capacity: unable to expel all of the air from the lungs
(will displace more water, fat is lense dense than muscle
less dense when
13
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
fat
). Db is measured at TLC. TLC = VC+RV. TLC is the volume of air in the
lungs after a maximal inspiration and VC is the maximal volume of air that can be
expired from the lungs after a maximal inspiration. Still measure RV. Db = Wa/
[(Wa-Ww)/Dw)- (TLC + GV)
o
UWW client at TLC w/ head above water level: fearful of being submerged,
unable to bend forward to assume the proper body position. Db is measured at
TLC w/ head not submerged (TLCNS). Male: Db at RV = 0.5829 (Db at TLCNS)
+0.4059. Female: Db at RV = 0.4745 (Db at TLCNS) + 0.5173. Low error (SEE). -
Disadvantages of UWW: procedure is time-consuming. Equipment is expensive. Some
clients may not be able to perform the procedure.
Calculate % body fat: -
Fat mass = body mass x relative fat (%)
-
Fat-free mass = body mass – fat mass
-
Target body weight = (fat-free mass) / (100%-goal fat %)
-
Conversion /2.2 pounds for kg
Air displacement plethysmography: to measure body volume and density. Uses air displacement
to estimate body volume.
-
Boyle’s law: at a constant °C, volume and pressure are inversely related. P1/P2 = V2/V1.
P1, V1 when Bod Pod chamber is empty. P2, V2 when client is in the Bod Pod chamber.
Body volume = V1-V2. Body density = body mass/body volume
-
Bod Pod testing: Minimal clothing, swim cap (corrects for the isothermal effects of hair),
estimation of the body surface area (from height and weight. Corrects for the isothermal
effects at the body’s surface), measurement or estimation of thoracic gas volume (volume
of air in the lungs (FRC) at midexhalation (accounts for the isothermal conditions in the
lung)
o
Sources of isothermal air: underestimate of body fat = overestimate the body
density. Excess body, excess facial hair, scalp hair, more clothing, body (skin)
surface area, thoracic gas volume.
-
Advantages and disadvantages of ADP: quick, requires minimal technician skill,
instructions are minimal, bod pod is mobile. Equipment is expensive, requires special
clothing.
Dual-Energy X-ray absorptiometry: yields estimate of bone mineral, fat, lean soft-tissue and
visceral adipose tissue mass at the whole body level and regional level. Clinical setting. PART 2
Bioelectrical impedance analysis method: 3-component. Called impedance plethysmography.
Estimating relative body fat and FFM and total body water. A 50 khz current is generated and
passed through the person. The measurement of electrical impedance is detected as the resistance
to electrical current. 14
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
-
Electrical impedance is greatest in fat tissue and least in fat-free tissue. -
Conductive pathway is greatest in tissues with greater amounts of water. -
Conduction is inversely related to resistance. -
Impedance opposes to flow of current and is a function of reactance and resistance. -
Resistance is a measure of pure opposition of current flow through the body. -
Reactance is the opposition to current flow caused by the capacitance produced by the
cell membrane.
-
Pretesting client guidelines: no eating or drinking within 4h. no moderate and vigorous
exercise within 12h. Void completely within 30min. No alcohol within 48h. no caffeine
and diuretics before exam. Postpone for female if in menstrual cycle. -
Sources of BIA measurement error: instrumentation, client factors, technician skills,
environmental factors, client’s body position, prediction equations for FFM
Condition Resistance
FFM
% BF
eating
decreases
overestimates
underestimates
dehydration
increases
underestimates
overestimates
Aerobic exercise
decreases
overestimates
underestimates
Client’s arm must be abducted 30 to 45° from the trunk. Client’s thighs not touching. Ultrasound method: hand-held wand or probe sends and receives sound signals. Assessment of
adipose tissue thickness deep within the body. Two types: A-mode (line drawing of peaks w/
different amplitudes) and B-mode (a series of dots forming horizontal bands of varying
brightness)
-
Sources of error: technician skill, mode of ultrasound, signal frequency, sound speed
(wrong speed = error of about 6% BF)
Skinfold method assumptions: measure the subcutaneous fat. The distribution of subcutaneous
and internal fat is similar for all individuals within each gender. Estimate total body fat (bc of the
relationship between SC fat and total body fat)
-
Sources of error: technician skill, type of SFK caliper, calibration of caliper, client
factors. Other anthropometric methods: refers to the measurement of the size and proportion of the
human body. Can be used to estimate body composition. Prediction equations estimate total body
density (Db), relative body fat (%BF) and fat free mass (FFM) from combinations of body
weight, height, skeletal diameters and circumferences. -
Circumference (C): measure of the girth of body segment (arm, thigh, waist or hip).
Affected by fat mass, muscle mass and skeletal size. o
Waist circumference: measure of regional (abdominal) adiposity. Predicts
musculoskeletal injury risk and health risk w/ BMI. CSEP-PATH (superior border
of iliac crest), WHO (midway between lowest rib and iliac crest), ASRM
(narrowest part of torso). 15
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o
Waist-to-hip circumference ratio: = waist circumference / hip circumference.
indirect measure of lower and upper body fat distribution. Measure of central
adiposity and visceral fat. WHO or ASRM for waist and hip (WHO = widest
point over greater trochanter, ASRM = maximum extension of buttocks)
measurements.
o
Waist to height ratio: = waist circumference / standing height. Better indicator of
adiposity and health risks than WC alone. WC should be less than half of the
height. o
Sagittal abdominal diameter: measure of the anteroposterior thickness of the
abdomen at the umbilical level. Amount of dysfunctional visceral adipose tissue
in body. Related to risk factors for cardiovascular and metabolic diseases than
WC, WHR and BMI. -
Skeletal diameter (D): measure of bony width or breadth (knee, angle, or wrist).
Important estimator of bone and muscle of FFM. Body mass index: BMI = Weight / height ^2. To classify if obese, overweight and underweight.
Obesity 30-34.9. Normal 18.5-24.9. -
Limitations: overestimates body fat in persons who are very muscular. Can underestimate
body fat in persons who have lost muscle mass. Not a good measure of visceral fat. High
BMI for short people.
For this chapter
, you must cover all of the PowerPoint slides in Parts 1 and 2
.
Do not memorize
:
Table 8.1: Body Fat Percentage Categories for Adults and Children by Decade of
Life
Table 8.2: Population-Specific Two Component Model Formulas for Converting
Body Density to Percent Body Fat
Table 8.3: Skinfold Prediction Equations
Table 8.4: Comparison of High-Quality Metal Calipers and Plastic SKF Calipers
Table 8.5: Bioelectrical Impedance Analysis Prediction Equations
Table 8.6: Circumference Prediction Equations
Table 8.8 Waist-to-Hip Circumference Ratio Norms Men and Women
You should know how to use tables 8.1 to 8.8.
Although you are not expected to memorize the body density equation
s in Table
8.2
on page 232
of the course textbook, you should know what they are used for
and how to use them. If I were to include a question relating to this table, the
equations would be provided.
You can summarize some of the information in Chapter 8 by creating tables
based on the following topics:
16
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
principles or assumptions upon which each body composition method is based,
pretest guidelines for each body composition method,
measurements or estimations made for each body composition method,
sources of measurement error for each body composition method, and
advantages and disadvantages of each body composition method.
The following are some sample questions to assist you.
What is body composition?
What is fat mass (FM)?
What is fat-free mass (FFM)?
What is lean body mass (LBM)?
What is the difference between FFM and LBM?
What are the main categories of body fat?
What is essential fat?
What is nonessential fat?
What are the locations of essential and nonessential fat?
Where is nonessential fat found primarily?
Which factors affect the amount of storage fat in a human being?
What differences do you observe between reference man and reference woman?
Which methods of assessing body composition are classified as two-, three-, or
multiple-component models?
Which components of body composition are determined using these body
composition methods?
Which body composition methods are classified as reference methods and field
methods?
What is the two-component model of body composition?
What are the five assumptions of the two-component model of body composition?
Are the five assumptions of the two-component model of body composition valid?
What are the Siri (1961) and Brozek et al. (1963) equations used to determine?
On which populations would you use the Siri (1961) and Brozek et al. (1963)
equations?
Which factors have been shown to alter the density of the fat-free body (FFB)
component by research studies?
Would you overestimate or underestimate your client’s % BF, if the FFB density was
estimated to be greater than 1.100 g·cm
-3
(overestimated)?
Would you overestimate or underestimate your client’s % BF, if the FFB density was
estimated to be lower than 1.100 g·cm
-3
(underestimated)?
Relative to the assumption of the two-component model of body composition that
FFB density is equal to 1.100 g·cm
-3
, would you overestimate or underestimate %
BF for a black man or woman, a pro football player, a white child, or an elderly white
man or woman?
Which methods for assessing body composition are densitometric methods?
What is measured by the densitometric methods?
What principle is hydrostatic weighing based upon?
Understand the principle of hydrostatic weighing.
It is important to understand the equation used to determine total body density (Db)
with the hydrostatic weighing (HW) technique.
17
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
You are expected to know the expanded density equation used for the HW
method, which is D = [Wa / ((Wa – Ww) / Dw) – (RV + GV).
What is body density?
Is there a direct or an inverse relationship between body density and body volume?
Is there a direct or an inverse relationship between body density and % body fat?
Which part of this equation provides values for the weight of water displaced,
uncorrected body volume, and corrected body volume?
What is tare weight?
What is gross underwater weight?
What is net underwater weight?
Which measurements are needed to calculate Db using the HW method?
What is the relationship between water density and water temperature?
Define residual lung volume (RV), functional residual capacity (FRC), expiratory
reserve volume (ERV), and total lung capacity (TLC)?
What methods are used to measure RV?
Can RV be estimated using prediction equations?
What value is assumed to be the gastrointestinal volume (GV) when the HW method
is used to assess body composition?
What must be done to obtain a client’s corrected body volume?
What are the sources of error for hydrostatic weighing?
What is the largest source of error for hydrostatic weighing?
Under which conditions are the most accurate results obtained when using the HW
method to assess a client’s body composition?
Is it better to use an underwater weighing (autopsy or spring) scale or load cells to
obtain accurate results with the HW method?
What are the special considerations for the HW method?
What alternatives are available to a technician when he/she must assess the body
composition of a client who:
1)
cannot or is unable to expel all of the air from his lungs,
2)
is fearful of being submerged,
3)
dislikes facial contact with the water,
4)
is unable to bend forward to assume the proper body position, or
5)
is unable to remain still while under water?
Are body volume, Db, and % BF overestimated or underestimated when dry land
weight, underwater weight, water temperature, and residual volume are
overestimated?
Are body volume, Db, and % BF overestimated or underestimated when dry land
weight, underwater weight, water temperature, and residual volume are
underestimated?
What are the disadvantages of the HW (UWW) method?
You should be able to calculate % BF using the data.
Read and understand the importance of the Guidelines for Hydrostatic Weighing on
page 235 and the Hydrostatic Weighing data collection form (Figure 8.3) on page
234. These guidelines and Figure 8.3 will allow you to understand the steps and the
length of time needed to assess a client’s body composition using the HW method.
Study the Tips for Minimizing Error in Hydrostatic Weighing on page 236.
What is air displacement plethysmography (ADP)?
18
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What is ADP used to measure?
How does ADP assess body composition?
What does ADP use to estimate body volume?
What is Boyle’s law?
What are V
1
and V
2
?
What is represented by V
1
− V
2
?
Which sources of isothermal air affect the accuracy of the BOD POD test results?
What are the sources of error when ADP is used to assess body composition?
What are the advantages and disadvantages of using ADP to assess a client’s body
composition?
What is the Bod Pod?
What type of clothing must a client wear during ADP (Bod Pod) testing to obtain
accurate results?
What factors must be corrected during ADP (BOD POD) testing in order to obtain a
client’s actual body volume?
Read the Testing Procedures for the Bod Pod to obtain a better understanding of the
ADP method on page 240.
What are the special considerations for the ADP method?
What is dual-energy X-ray absorptiometry (DEXA)?
How does DEXA assess body composition?
What is the definition of attenuation?
What are the advantages and disadvantages of DEXA?
What factors affect the accuracy of DEXA results?
Read the Basic Testing Procedures for DEXA on page 244.
What are the special considerations for the DEXA method?
What is the bioelectrical impedance analysis (BIA) method?
What are the assumptions upon which BIA is based?
How does the BIA method assess body composition?
What are the definitions of impedance, resistance, and reactance?
What is the relationship between electrical resistance and electrical conductance?
Which tissue is the most resistant to electrical current?
Which tissue is the least resistant to electrical current?
What is the traditional BIA method?
What is estimated by the traditional (tetrapolar whole-body) BIA method?
What do the Tanita BI and Omron BI analyzers estimate?
What are the advantages of the BIA method?
What are the sources of BIA measurement error?
What is not a major source of BIA measurement error?
What is the major source of BIA measurement error?
Sources of measurement error are covered on pages 263 to 268 of your textbook.
Does an inverse or a direct relationship exist between resistance (R) and skin
temperature?
Dehydration has been shown to increase R, whereas exercise-induced dehydration
decreases R. What is the explanation provided in your textbook regarding the
different effects of dehydration and exercise-induced dehydration on R?
19
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
What effects do eating, dehydration, and aerobic exercise have on resistance
measurements and the estimation of FFM and % BF?
What are the BIA pretesting client guidelines?
What are the standardized procedures for the supine, whole-body BIA method?
What are the anthropometric methods?
What is anthropometry?
Which anthropometric methods measure body size, body proportion, and assess the
sizes and proportions of body segments?
Which basic relationships are assumed when you use the skinfold (SKF) method to
estimate total body density in order to calculate relative body fat?
What is indirectly measured by skinfolds?
What types of prediction equations have been developed to predict body density
from SKF measurements?
How many skinfolds are used in most equations to predict body density?
Do nomograms exist for some SKF prediction equations?
What are the sources of SKF measurement error?
What is the major error of SKF measurement error?
What are the major causes of low intertester (intertechnician) reliability for SKF
measurements?
What are the Standardized Procedures for Skinfold Measurements?
What are the Recommendations for Skinfold Technicians?
What are the definitions of circumference (C), waist circumference (WC), skeletal
diameter (D), body mass index (BMI), waist-to-hip circumference ratio (WHR), waist-
to-height ratio (WHTR), and sagittal abdominal diameter (SAD)?
What are estimated by C, D, BMI, WHR, WHTR, and SAD, respectively?
Which anthropometric measures are used to assess total and regional body
composition?
Which anthropometric indices are used to identify and classify disease risk?
What are the uses of the BMI?
What are the limitations of the BMI?
What are the limitations of WHR?
What influences hip circumference and waist circumference?
What is the cutoff boundary value of WHTR?
Which anthropometric measure has been suggested as a better indicator of
adiposity and health risks of WC alone?
What is the purpose of using the Ashwell Body Shape Chart?
Which anthropometric measure is suggested to be an excellent measure of visceral
fat?
Which anthropometric measure is more strongly related to risk factors for
cardiovascular and metabolic diseases?
What are the sources of anthropometric measurement error?
20
EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Chapter 9
Designing Weight Management & Body Composition
Programs (Pages 281-308)
Once again, use the PowerPoint slides as your guide for this chapter.
You are responsible to study the content in:
Slides 1 to 47 in Part 1
and the corresponding material in the course textbook.
Slides 1 to 46 in Part 2
and the corresponding material in the course textbook.
Please refer to the course textbook if you need clarification related to some of
the content in the PowerPoint slides.
PART 1
Definition of obesity: excessive amount of body fat. BMI > 30 kg/ m^2 and greater or equal to
the 95
th
percentile for age and sex. Overweight 85 to < 95
th
percentile, underweight < 5
th
percentile. -
Types of obesity:
o
Android obesity: upper-body obesity, apple-shaped, more typical of males, some
women
o
Gynoid obesity: lower-body obesity, pear-shaped, more typical of females, some
men
-
Difference in metabolic characteristics
21
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
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-
Causes of overweight and obesity: physiological, developmental, genetic, lifestyle,
psychosocial factors. Risk of obesity: cardiovascular ischemic HD, stroke, dyslipidemia, hypertension, glucose
intolerance, insulin resistance, diabetes mellitus, obstructive pulmonary disease, gallbladder
disease, osteoarthrosis. -
Cancer of colon, prostate, ovary, breast, endometrium, cervix esophagus, gallbladder. Risk of being underweight: osteoporosis, osteopenia, bone fractures, sudden death, cardiac
arrhythmias, renal disorders. Energy need and energy expenditure: kilocalories (kcal)
defined as the amount of heat needed
to raise the °C of 1 kg (2.2 lb) of water 1°C. Direct calorimetry
used to measure the energy
yield and caloric equivalent of various foods. Indirect calorimetry
used to measure energy
expenditure (estimated from O2 utilization) during basal, resting, activity states 1L O2 = 5 kcal
expended. Basal metabolic rate: measure of the minimal amount of energy (kcal) needed to maintain basic
and essential physiological functions such as breathing, blood circulation and temperature
regulation. Varies according to age, gender, body size and body composition. Assessed in a
rested and fasted state (> 12h) and in a controlled environment. Is not always practical to
measure, therefore the resting metabolic rate (RMR) is assessed. Resting metabolic rate: resting energy expenditure (REE). Is the energy required to maintain
essential physical processes in a relaxed, awake, and reclined state. Is slightly higher (10%) than
BMR. Is measured 3-4h after a light meal w/o prior physical activity. The largest component of
metabolism. Can be measured using indirect calorimetry by estimating the body’s energy
expenditure from oxygen utilization. 1L O2 = 5 kcal
-
Factors affecting RMR: heredity and environment, hormones, age, gender, body
composition, body size, weight loss, weight gain, exercise.
Total energy expenditure: BMR, RMR, DT (dietary thermogenesis
energy needed for
digesting, absorbing, transporting and metabolizing foods), PA (physical activity = EAT +
NEAT), EAT (exercise activity thermogenesis), NEAT (non-exercise activity thermogenesis
energy expenditure of occupation, leisure, unconscious or spontaneous motion)
-
TEE = BMR + DT + PA
-
TEE = BMR + DT + EAT + NEAT
-
TEE = RMR + DT + PA
-
TEE = RMR + DT + EAT + NEAT
* to select appropriate formula, gender and age. -
Measurement of TEE: doubly labeled water method (gold standard, w/ deuterium and
oxygen-18), prediction equations, indirect calorimetry (1 MET = 3.5 mL x kg x min^-1 =
1.0 kcal x kg^-1 x hr^-1), digital activity log (type and duration of PA in computer)
22
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Energy balance: dynamic approach (assumes that numerous biological and behavioral factors
regulate and influence both sides of EB equation).
-
Static approach: assumes that a change in 1 side of the energy balance equation doesn’t
change the other side of the equation. Describe a person who is in a positive or a negative
energy balance. Energy in = energy out
o
Energy balance: caloric intake = caloric expenditure
o
Energy imbalance: results in weight gain or weight loss. 3500 kcals = 1lb of fat
(Wishnofsky’s Rule)
o
Positive energy balance: caloric intake > caloric expenditure. Food intake >
(resting metabolism + PA level) o
Negative energy balance: caloric intake < caloric expenditure. Reduce food intake
and/or increase PA level.
Genetic factors: approximately 25% of the variability among individuals in absolute and relative
body fat is attributed to genetic factors. 30% of the variability is associated w/ cultural
(environmental factors). Much of the interindividual variability in body weight is attributable to
the interactions between genes and environment or genes and behavior. Development factors: -
Traditional theory: the number of fat cells doesn’t change from birth. Weight gain (hypertrophy of adipocytes), weight loss (atrophy of adipocytes)
-
New theory: Tchoukalova and colleagues (2010) include a body fat gain about 4 kg in normal weight adults. Adipocytes experienced hypertrophy in upper body and hyperplasia in lower body.
PART 2
2 methods for assessing energy expenditure:
-
Factorial method: total daily caloric needs depend on RMR (50% to 70%), occupational
activity level and PA level. TEE (kcal) = RMR + occupational activity + PA
o
Estimation of RMR or REE: indirect calorimetry or prediction equations (+ by
physicians, kinesiologists)
o
Estimation of additional energy requirements: work, household chores, personal
daily activities and exercise. Physical activity log
used to estimate the
additional caloric expenditure due to PA and exercise. -
Total energy expenditure method: the physical activity coefficient depends on the client’s
PA level (PAL). PAL = TEE/BMR. Tools used to estimate PAL
physical activity
diaries, heart rate monitors, self-reported physical activity questionnaires. Weight management principles for weight loss: a well-balanced diet for good nutrition
(carbohydrate, protein, fat vitamins, minerals and water), weight loss should be gradual (no more
than 2 lb/week), caloric intake (>1200 kcal/day), caloric deficit (not exceed 1000 kcal/day), a
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
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caloric deficit of 3500 kcal (is needed to lose 1 lb of body weight), weight loss should be due to
loss of fat rather than lean body tissue, on the same diet a taller heavier person will lose more
weight at a faster rate than a short lighter person due to a higher RMR, weight loss rate decreases
over time. Men lose weight faster. -
Hypertrophy: increase in fat size
-
Hyperplasia: increase in fat number
Reasons that exercise is an essential part of a weight loss program: maximize energy
expenditure, creates larger negative energy balance, maintain, or slows down loss of FFM,
maintains weight loss after dieting, has a positive effect on RMR. Essential nutrients: the body needs them but cannot produce them at all, cannot produce in
adequate quantities or cannot manufacture at least fast enough to meet its physiological needs. -
6 major classes of essential nutrients: carbohydrates (macronutrients, energy, organic),
proteins (macronutrients, energy, organic), fats (macronutrients, energy, organic),
vitamins (micronutrients, no energy, organic), minerals (micronutrients, no energy,
inorganic), water (macronutrients, no energy, inorganic). Functions of carbohydrates: supply energy to the body’s cell, body’s preferred form of energy,
during high- intensity exercise muscles obtain most of their energy from them, have a protein
sparing effect, serve as primer for fat metabolism. -
Glucose will go down with fasting and starvation. Fatty acids will go up with fasting and
starvation. Ketones will go up (very fast) with fasting and starvation. Functions of proteins: build body tissues (muscle, bone, blood, enzyme, antibodies, cell
membranes, some hormones), repair tissues, regulate water and acid-base balance, help in
growth, supply energy, contains nitrogen. Functions of fats: supply energy. Most concentrated source of energy, major body fuel during
rest and light activity. Help absorb fat-soluble vitamins (A, D (increase absorption of Ca2+ in
small intestine, E, K), necessary for growth and healthy skin, add flavor to foods to satisfy the
appetite.
Functions of vitamins: facilitate chemical reactions such as a release of energy stored in CHOs,
proteins and fats. Critical in the production of red blood cells. The maintenance of nervous,
skeletal and immune systems. Act as antioxidants (vitamin E, C (absorption of non-heme iron
good for vegetarians, acts as antioxidant to destroy free radicals) and beta-carotene (vitamin A
derivative).
Function of minerals: adequate amount of potassium, calcium, sodium… (not too high, not too
low), help regulate body processes, aid in growth and maintenance of body tissue, regulation of
nerve and muscle function, regulation of heart rhythm, maintenance of acid-base balance, used in
formation of hormones, RBC, bone and connective tissue, aid in the transport of O2 in blood,
help release energy, used to form enzymes, maintain normal volume, help as an antioxidants. Supplementation: -
Vitamin B12: does not increase muscle growth and strength.
-
Boron: doesn’t increase FFM or serum testosterone
24
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-
Chromium: doesn’t increase FFM or decrease BF
-
Magnesium: doesn’t improve muscle strength
-
Carnitine: doesn’t facilitate loss of BF. Functions of water: provides a medium for chemical reactions, transport chemicals, regulates
body °C, removes waste products.
What are the health consequences of being underweight, overweight, or obese?
What are the risks of obesity?
What are the risks of being underweight?
What are the definitions of obesity, overweight, and obesity?
What are the different subtypes of obesity?
What are the characteristics of these obesity subtypes?
How can you differentiate between one obesity subtype and another subtype?
For instance, what is the difference between MONW and MUHO?
What are the types of obesity and how are they distinguished from another?
What are the causes of obesity?
Study the causes of obesity in depth?
What is the difference between direct and indirect calorimetry?
What is energy or caloric need dependent upon?
What is the energy yield of carbohydrate, protein, and fat?
What is the basal metabolic rate (BMR)?
What is the resting metabolic rate (RMR)?
What is represented by BMR or RMR?
What is the main difference between BMR and RMR?
What factor contributes the greatest to total energy expenditure (TEE) in relative
terms?
How can TEE be measured or estimated?
Which factors affect RMR?
How do these factors affect RMR?
What is energy balance?
What are the differences between the static and dynamic energy balance
approaches?
What are the assumptions of the static and dynamic energy balance approaches?
What is the importance of energy balance relative to the design of weight
management and body composition programs?
What is Wishnofsky’s Rule?
According to the Dynamic Energy Balance approach, does an energy deficit of 3500
kcal per week correspond to a 1-lb loss of body weight or fat?
How can an individual achieve a negative energy balance (energy deficit)?
What is the difference between hypertrophy and hyperplasia of fat cells?
What are the key components of a weight management program?
What are the preliminary steps in the design of a weight management program?
You must study these steps in detail.
How can body weight goals be set?
Calculate present FFM, present % FFM, present FM, present % BF, and FFM goal?
Calculate a healthy or target body weight?
25
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
You must know the target body weight equation.
How can a client’s caloric intake be assessed?
How can a client’s caloric expenditure be assessed?
What is the difference between the factorial and TEE methods?
Which factors determine a client’s total daily caloric needs?
How can you estimate a client’s additional caloric requirements using the factorial
method?
How are a client’s RMR, occupational activity level, and physical activity level
determined using the factorial method?
How can you obtain a quicker but less accurate estimate of RMR when using the
factorial method to assess a client’s energy needs?
Which equations were widely used in the past to estimate RMR?
Which equations are recommended to estimate the RMR of healthy individuals by
the American Dietetic Association?
Which equations that are used to estimate RMR take into account the gender,
height, weight, and age of a client?
You need to know how to use the equations to estimate RMR, which means you
should not memorize them.
Is TEE estimated or measured using the TEE method?
What is the physical activity coefficient (PAC)?
How is the PAC determined or obtained?
How is a client’s physical activity level (PAL) determined?
What tools are used to estimate PAL?
What is the gold standard for determining PAL and measuring TEE?
Study the weight management principles for weight loss.
Do not study the weight management principles for weight gain
It is important to understand the importance of each weight management principle
for weight loss as discussed in class?
What physical activity and exercise recommendations are made by various
organizations to achieve goals such as health benefits, healthy weight loss,
prevention of weight gain, and prevention of weight regain? (See Table 9.5
, which
can also be found in the slides.)
What are the reasons that exercise is an essential part of weight loss programs?
What is the importance of Figure 9.1
You need to know how to use:
Table 9.2 (Prediction Equations for Estimating TEE of Children and Adults)
Methods of Estimating Resting Metabolic Rate on page 291 of the course
textbook.
Table 9.3: Additional Energy Requirements for Selected Activity levels.
These tables would have to be given to you on an exam, which means you do not
memorize these tables.
How do you use Table 9.7?
It is important to read and understand the material on Designing Programs for
Weight-Loss
. 26
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
You are not responsible to study
the Guidelines for Exercise Prescription for
Weight Gain (p. 304), Fat Loss (p. 307), and Fat-Free Mass Gain (p. 307).
It is important that you understand the importance of aerobic and resistance exercise
training in any weight management program, especially in a weight loss program.
Study and understand the Steps for Designing a Weight Loss Program on
pages 296 & 297. However, as indicated in class, the caloric deficit given in the
case study is incorrect. This can be verified by comparing the caloric intake and
caloric expenditure. 27
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Chapter 10
Assessing Flexibility
(Pages 309 to 329)
You are responsible to study most of the material in this chapter.
Use the PowerPoint slides as your guide for this chapter (slides 1 to 50 and
the corresponding content in the course textbook).
Please refer to the course textbook if you need clarification related to some of
the content in the PowerPoint slides.
Flexibility: ability of a joint or a series of joint to moth thought a full ROM w/o injury.
Factors affecting it are body type, age, gender, PAL, warm-up, amount of stretching and
flexibility training. -
Body type: body builders (large, hypertrophied muscle, score poorly on the ROM test),
obese individuals (excessive amounts of subcutaneous fat, score poorly on the ROM test).
-
Static flexibility: total ROM at the joint. Limited by the extensibility of the
musculotendinous unit. Assessed in field and clinical settings. Test ROM indirectly and
directly. -
Dynamic flexibility: rate of torque or resistance developed during stretching throughout
the ROM. Assessed in research setting. Measure the increase in resistance during muscle
elongation. Expensive. Flexibility and joint stability: highly dependent on joint, structure, strength and number of
muscles spanning the joint, strength and number of ligaments spanning the joint. -
Morphological factors: joint geometry, joint capsule, ligaments, tendons, muscles. Soft tissues structures that limit flexibility: joint capsule (47%
collagen), muscle and its
fascia (41%
elastin), tendon and ligaments (10%), skin (2%). -
Muscle tendon unit: the tension within this unit
affects both static and dynamic
flexibility. Attributed to the viscoelastic properties of connectives tissues, degree of
muscular contraction from the stretch reflex. o
Elastic deformation: proportional to the load and tension applied during
stretching.
o
Viscous deformation: proportional to the speed at which the tension is applied
during stretching. o
During fixed length static stretching: the tension decreases over time, which is
called viscoelastic stress relaxation.
o
Single static stretch sustained for 90s: produces a 30% increase in viscoelastic
stress relaxation. Decreases muscle stiffness for 1h. 28
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
General guidelines for flexibility testing: general warm-up. Static stretching before test.
Performance of test. Administer 3 trials of each test item. Select best score. Obtain a flexibility
rating from norms. Identify weaknesses that need improvement. Methods of measuring static flexibility: direct
goniometer (protactor-like device at joint
angles in °), universal goniometer, digital goniometer (digital ROM), flexometer, inclinometer,
electrogoniometer (1 or 2 flexible potentiometers or strain gauges between 2 end-blocks).
Indirect
sit and reach, modified Schober, skin distraction tests.
-
Advantages of electrogoniometers vs goniometers and digital goniometers: flexible,
easier to use bc the technician’s hands are free. Measurements can be made in 2 planes
simultaneously when using a 2-channel electrogoniometer. -
Leighton flexometer: goniometer. Device composed of a weighted 360° dial and
weighted pointer that measures the ROM for a given joint in relation to the downward
pull of gravity on the dial and pointer. -
Inclinometer: gravity-dependent goniometer. Measure the angle between long axis of the
moving segment and line of gravity. Easier to use than the flexometer and universal
goniometer.
Validity and reliability of direct measures of ROM: the devices are highly dependent on the joint
being measured and technician skill. Radiography is the best reference for the validity of
goniometric measurements. -
The intratester and intertester reliabilities of goniometric measurements are affected by
difficulty in identifying the axis of rotation and palpation bony landmarks. Intertester
reliability is variable and joint specific.
-
Measurement of upper extremities joints: more reliable than ROM of lower extremities
Sit and reach test: lack of flexibility associated w/ low back pain and musculoskeletal injuries but
not a valid measure of low back and hamstring flexibility. Indirect, linear measurement of ROM. -
Warm up (modified hurdler). Zero is at 26 cm. W/o shoes. Hands together. 6 inches apart
for the feet. Hold for 2 sec. Nearest .5 cm 29
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Lumbar stability tests: instability
increase the risk of developing low back pain. Sorensen test
(trunk extensors), v-sit test (trunk flexors), side bridge test (lateral flexors) isometric endurance.
What is the relative importance of flexibility to other health-related components of
physical fitness?
What is the association between a lack of flexibility, and musculoskeletal injuries and
low back pain?
What are some of the conclusions of current research regarding flexibility?
What are flexibility and joint stability highly dependent on?
What is a general definition of flexibility?
Define static and dynamic flexibility?
What is the main difference between these two types of flexibility based on their
definitions?
Which morphological factors affect joint ROM?
What is the relative contribution of various soft tissue structures to the total
resistance encountered at a joint during movement?
What factors affect flexibility?
How is flexibility affected by each of these factors?
How can a technician assess a client’s flexibility?
30
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
What are the general guidelines for flexibility testing?
What methods are available to measure static flexibility either directly or indirectly?
What is the double inclinometer technique used to measure?
What is the CSEP-PATH (2021) Sit-and-Reach test protocol?
Why is the Sit-and-Reach test included in most health-related fitness test batteries?
Is the Sit-and-Reach test a valid measure of low-back and hamstring flexibility?
What are the other Sit-and-Reach tests available for flexibility testing?
What are the intended populations of these other Sit-and-Reach tests?
For example, why would you use the Back-Saver Sit-and-Reach test?
Which flexibility tests measure lumbar ROM?
Which tests assess the flexibility of senior individuals?
What is assessed by these senior flexibility tests?
Do NOT study Tables 10.2, 10.3, 10.4, 10.5, 10.6, 10.7, and 10.8
Chapter 11
Designing Programs for Flexibility & Low Back Care
(Pages 331 to 340)
You are responsible to study the content from pages 331 to 341
.
Use the PowerPoint slides as your guide for this chapter (slides 1 to 44 and
the corresponding content in the course textbook.
Please refer to the course textbook if you need clarification related to some of
the content in the PowerPoint slides.
Elasticity: property that enables a tissue to return to its original shape or size when force is
removed. Plasticity: property of a material to permanently deform when it’s loaded beyond elastic
range. Stress: the force per unit area of a material (= force/cross sectional area)
Strain: change in length or amount of deformation caused by the applied force. Extension /
original length. Stiffness: ratio of stress to strain, or force to deformation. Ratio of change in force to change
in length. Viscosity: property of materials to resist loads that produce shear and flow. Resistance of
flow. Apparent force that prevents fluids from flowing easily. Viscoelasticity: anelasticity. Materials that exhibit both viscous and elastic characteristics
when undergoing deformation. Combination of viscous and elastic properties exhibited by
biological tissues. 31
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
-
Viscoelastic stress relaxation: Time dependent mechanical property of soft tissue. When
it’s stretched to a new constant length, it will decline in tension in the muscle-tendon unit
over time when the joint is held at constant angle. The gradual decrease in stress in a
material stretched and held at constant length. -
Viscoelastic creep: time dependent mechanical property of soft tissue. Slow, progressive
deformation of a material under constant stress. Small increase in joint angle due to the
elongation of the muscle-tendon unit during constant-torque static stretching. The
lengthening that occurs when a constant force pr load is applied to a muscle. Stress relaxation is the reduction in stress in a material subjected to constant strain,
whereas creep is the increase in strain in a material under constant stress.
Stretch reflex: muscle spindles, inverse stress reflex: inverse myotatic reflex (golgi tendon
organs)
Neurophysiology of flexibility:
-
Autogenic inhibition: reduction in the excitability of the targeted muscle bc of inhibitory
signals sent from the GTO during isometric contraction. Relaxation occurs in the same
muscle experiencing increase in tension. Accomplished by actively contracting a muscle
immediately before a passive stretch of the same muscle. -
Reciprocal inhibition: as the opposing muscle group is voluntarily contracted, the target
muscle group is reflexively inhibited. Relaxation occurs in the muscle opposing the
muscle experiencing the increase tension. Accomplished by simultaneously contracting
the muscle opposing the muscle being passively stretched. Training principles: overload (stretch beyond normal resting state), specificity (exercises that
stretch the appropriate muscle groups), progression (periodic increase), interindividual variability
(depends for everyone)
Guidelines for designing flexibility programs: 32
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Total stretch duration: = stretch duration x reps per stretch. ROM gains are achieved w/
multiple shorter duration stretches or fewer longer duration stretches. -
Clients w/ a low stretch tolerance: prescribe shorter stretch duration and more reps.
Clients w/ high stretch tolerance: prescribe longer stretch duration an fewer reps. Stretching techniques: active (by himself), passive (assistant moves body), active-assisted
stretching (client to active and assistant beyond active).
Comparison of stretching methods: -
Behm et al. 2016: concluded that it’s not possible to rank one stretching method over
another for increasing ROM. Constant angle static stretching: the joint angle doesn’t change, stays static, exhibits the
viscoelastic stress relaxion response. Changes only the viscosity of the MTU. Constant torque static stretching: the joint angle increases bc of the constant pressure applied to
the MTU that causes it to elongate. Joint angle not static, exhibits viscoelastic creep. Changes
both the viscosity and elasticity of the MTU. -
Herda et al 2011: constant torque static stretching more appropriate than constant-angle
static stretching if the primary goal is to decrease MTU stiffness and if the objective is to
reduce the risk of muscle strain when treating injuries such as Achilles tendonitis and
plantar fasciitis. Ballistic stretching: uses jerky bouncing movements to lengthen the target muscles. Evokes the
stretch reflex through activation of the muscle spindles. Exhibits a greater resistance to
elongation than slow static stretching bc of the viscous properties of muscle tissue. Places greater
strain on the muscle. Dynamic stretching: slow movements that are repeated several times, increasing ROM. Athletes!
33
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Proprioceptive neuromuscular facilitation: involves maximal or submaximal contractions
(isometric or dynamic) of target and opposing muscle groups followed by passive stretching of
the target muscles. Disadvantages
requires assistant and needs proper training. Modified CR PNF stretching technique: Kay, Dobs, Blazevich (2016). The isometric muscle
contraction is not performed when the muscle is stretched. Results in a stretch return contract
sequence. As effective as CR PNF technique. Reduces risk of muscle damage, produce less pain.
General recommendations for PNF: moving joint to the end of ROM. Immoveable resistance for
5-10 sec. Relax target muscle group as stretch actively or passively to a new point of limitation.
For CRAC technique, contract the opposing muscle group submaximally for 5-6 s to facilitate
further stretching of TMG. Warm-up: dynamic stretching, cool down: static stretching.
-
Shorter duration static stretching < 45 sec can be included in preparticipation warm-up
routines w/o negatively affecting strength, power or speed performance. CSEP says that
prolonged static stretching > 60 sec is not recommended if the activity will take place
within 5 min of stretch. Stretching before exercise is equivocal (will maybe prevent
injuries but not sure).
Do not study
the content pertaining to DESIGNING LOW BACK CARE EXERCISE
PROGRAMS
on pages 340 to 346.
Define flexibility training?
What are the definitions of common terms used in the flexibility research?
What is stretch tolerance?
Which factors should be addressed in order to individualize a client’s flexibility
program?
What are the 6 steps for designing a flexibility program?
Which training principles are applied to the development of flexibility programs?
What are the classifications of the stretching techniques
?
What are the 4 stretching methods
(modes) used to increase ROM?
Compare these 4 stretching methods in detail.
For example, which of these stretching methods produces the highest or lowest
resistance to stretch?
Which of these 4 stretching methods activates the stretch reflex the most or the
least?
34
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
What are some of the advantages and disadvantages of these 4 stretching
methods?
What is constant-angle static stretching?
What is constant-torque static stretching?
According to Herda et al. (2011)
, which type of static stretching (constant-angle or
constant-torque decreases muscle-tendon unit stiffness?
What are the viscoelastic stress relaxation response and viscoelastic creep?
What are commonly used PNF stretching techniques?
What are the general recommendations for performing PNF stretches?
What are the physiological mechanisms underlying the increased ROM produced by
the PNF stretching method?
Which sensory receptors mediate the stretch reflex and inverse stretch reflex?
Where are the muscle spindles and Golgi tendon organs located?
What is sensed by the muscle spindles and the Golgi tendon organs?
What is autogenic inhibition?
What is reciprocal inhibition?
What is the viscoelastic hypothesis?
What is the gate control theory of pain modulation?
What are the guidelines for designing flexibility programs using static or PNF
stretching?
What are the ACSM’s 2022 guidelines for designing flexibility programs using
the static, and PNF stretching methods?
What are the general (textbook) guidelines for designing flexibility programs
using the static, and PNF stretching methods?
What are the general recommendations for performing PNF stretches?
Which exercises are contraindicated
for a flexibility program?
Which exercises are recommended for a flexibility program?
Should flexibility exercises be performed before or after a bout of exercise?
Does stretching affect maximal muscle performance?
Does stretching prior to physical activity prevent injury?
Which factors decrease ROM with age?
What are the client guidelines for stretching programs?
What is the CSEP-PATH’s (2021) FITT for flexibility?
Examine the Sample Flexibility Program on pages 342 and 343 of the current course
textbook.
35
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
CSEP-PATH Manual
Section 3: Behaviour Change
(Pages 3 to 21; Slides 1 to 56)
You are responsible to study the content from pages 3 to 21
in Section 3
of the
CSEP-PATH (2021) manual.
Use the PowerPoint slides as your guide for this chapter (slides 1 to 56 and
the corresponding content in the CSEP-PATH manual).
Please refer to the CSEP-PATH (2021) manual if you need clarification related
to some of the content in the PowerPoint slides.
Exercise program adherence: almost 50% drop out within 1 year.
Health behavior change: replacement of health-compromising behaviors, such as physical
inactivity and sedentary, by health-enhancing behaviors like regular PA and reduced sedentary
time. Theories (SCT, SDT, TMBC, HAPA) reflect 2 distinct approaches: cognitive-based approach
(behaviors are controlled by rational cognitive activity), stage-based approach (individuals go
through stages to adopt new behaviors). -
Broad ideas of these theories: behavior change is a process not an event. Effective change
must come from within the individual, intervention strategies must be carefully tailored
to everyone’s unique set of circumstances and planning is a critical factor in change
management. -
Social cognitive theory: propose that people learn through their experiences. Includes the
notion of reciprocal determinism (dynamic interaction between and individual, their
environment and their behavior). Consider behavior change and maintenance to be a
function of an individual’s expectations and the outcomes (benefits), self-efficacy (most
powerful factor), self-regulation, barriers and facilitators. o
4 sources of self-efficacy: mastery experiences (success boost self-efficacy while
failures erode it), vicarious experiences (watch a peer success the task), social
persuasion (communication and feedback), emotional state (positive mood). -
Self-determination theory: focus on the degree to which a person’s behavior is self-
motivated and self-determined. People have 3 basic psychological needs (independently
solve problems, master task, interact socially). o
SDT stages of change: amotivation (no intention or desire to do it), external
regulation (motivated by external forces), introjected regulation (takes on the
behavior w/o accepting it yet), identified regulation (consciously values a goal as
personally important), integrated regulation (the goals are fully assimilated with
self), intrinsic motivation (sheer enjoyment of it). 36
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
-
Transtheoretical model of behavior change: known as stages of change model, stages of
readiness theory or readiness for change theory. 1
st
developed for smokers. Most popular.
Based on that people change habitual behaviors slowly.
o
5 stages of change at different rates: precontemplation (no intention of changing,
cons > pros), contemplation (intention to take action within 6 months, cons >
pros), preparation (planning to take action within 1 month, pros > cons), action
(successful change for less than 6 months), maintenance (6 months or more). -
Health action process approach: provide a framework of motivational and volitional
constructs that help explain and predict individual changes. Motivation phase
(deliberation that leads to the formation of intention), volition phase (during which
intentions foster planning). o
Action planning (when, where and how. More important for the initiation).
Coping planning (anticipation of barriers and the design of alternative actions.
More important for the maintenance). Motivational interviewing: working w/ clients to assist them in accessing their motivation and
confidence to change behavior. Do not tell what to do and how to do it. Act as a guide. -
4 elements that reflect the spirit and are essential to its practice: partnership (work in
collaboration w/ the client), acceptance, compassion, evocation (ideas come from the
client).
-
Skills to motivate client: open-ended questioning (to help them find the power to change
from within), active listening (include affirmations, paraphrasing, summarizing,
reflection on meaning and feelings), eliciting change talk (discussion of their desire,
ability and need to change), developing discrepancy (the greater the gap between where
the client currently is and where they want to be), managing sustain talk (allow the client
to express the reasons for not undertaking change). -
Reflection tactics used in motivational interviewing: content reflections (to elicit basic
facts, paraphrasing), feeling/meaning reflections (take the form of “you are feeling
embarrassed about your weight”), amplified negative reflection (way of exaggerating the
benefits associated w/ undesirable behavior), double sided reflection (client’s reason is
heard both for and against change), action reflection (possible solutions to the client’s
barriers or a potential course of action). Moving from WHY to HOW: exploring (client’s story), guiding (conversation toward the
possibility of change), choosing (how to put the desired change into action). Brief action planning: help qualified exercise professionals (QEPs). 3 questions and 5 skills. -
Key feature: delivery, time, use (is flexible and be used many times), how was BAP
developed (literature), evidence supporting BAP (studies), how do you do BAP (Gutnick
et al. 2014 paper). -
3 questions plan: 1. To elicit ideas for change from the client. 2. To evaluate the client’s
confidence. 3. To arrange a follow-up w/ the client or client’s accountability. 37
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
-
5 skills: offer a behavioral menu (when they don’t have any ideas), SMART planning
(specific, measurable, achievable, relevant and time-bound), elicit a commitment
statement (tell back the specifics of the plan), problem solving for low confidence (score
below then 7), follow-up (to build trust between client and QEP).
What is meant by health behaviour change?
What are the 4 most prominent theories/models
of behaviour change
used in the
context of physical activity?
Which 2 distinct approaches are reflected in the theories/models of behaviour
change described in Section 3
of the CSEP-PATH (2021)?
What is one of the most popular & contentious stage-based models of behaviour
change in relation to physical activity?
Which theory or model of behaviour change
proposes that people learn through their experiences?
includes the notion of reciprocal determinism?
considers behaviour change & maintenance to be a function of self-efficacy &
perceived benefits?
involves 4 sources of self-efficacy.
focuses on the degree to which an individual’s behaviour is self-motivated & self-
determined?
contends that individuals have basic psychological needs to independently solve
problems, master tasks, & interact socially?
indicates that individuals may experience motivation along a spectrum starting
from amotivation and ending with intrinsic motivation?
suggests that the initiation, adoption, & maintenance of health behaviours in a
structured process that includes a motivation phase & a volition phase?
includes the notions of self-efficacy & outcome expectations as predictors of
behaviour change?
classifies individuals as pre-intenders, intenders, & those who are already in the
action phase?
postulates that intention & volitional factors are more proximal predictors of
behaviour change?
involves action and coping planning?
involves pre-actional, coping, & maintenance self-efficacy?
What is self-efficacy?
What are the 4 sources of self-efficacy?
How can self-efficacy be improved?
What is the most robust source of self-efficacy?
What are the stages of change of the self-determination theory?
38
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
How can a qualified exercise professional bolster (improve) a client’s autonomy,
competence, & relatedness for regular physical activity?
What are the basic concepts of the transtheoretical model of behaviour change
(TMBC)?
What are the stages of the TMBC?
What stage of the TMBC corresponds to an individual that
has no intention to change his or her behaviour?
Intends to take action within 6 months?
plans to take action within 1 month?
has successfully changed his or her behaviour for less than 6 months?
has successfully changed his or her behaviour for 6 or more months?
What is the busiest stage of change in the TMBC?
In which stage of the TMBC is the main goal to prevent relapse?
In which stage or stages of the TMBC should a qualified exercise professional (QEP)
prescribe an exercise program?
The Transtheoretical Model of Behaviour Change (TMBC)
is one of the 4 most
prominent theories/models used to change a person’s behavior from physical
inactivity to physical activity. An individual can pass through 5 stages of the model. It
is possible to identify the stage of your client. For example, if a client is planning to
take action within a month
, he or she will be identified as being in the preparation
stage of the model. A client that has bought a pair of jogging shoes is an example of
a person in the preparation stage
. A person who has exercised for the past 7
months is in the maintenance stage of the TMBC.
What is needed to translate an individual’s intentions into action for the Health Action
Process Approach?
For the Health Action Process Approach, which type of planning is considered more
important for the
initiation of health behaviours?
maintenance of health behaviours?
What are the commonalities between the behavioural theories & models of behavior
change?
Which practices allow qualified exercise professionals to apply the 4 theories/models
of behavior change described in this section of the CSEP-PATH manual?
What is motivational interviewing?
What is the premise upon which motivational interviewing is based?
What are the 4 elements that reflect the “spirit of motivational interviewing (MI)?”
What are basics of motivational interviewing?
Which skills are required by qualified exercise professionals (QEPs) who use
motivational interviewing?
What are tips for motivational interviewers?
Which reflection tactics are used in motivational interviewing?
What is the importance of asking open-ended questions during motivational
interviewing?
Why is active listening important for motivational interviewing?
What are the tools for active listening?
What is the purpose of eliciting ‘Change Talk?’
What is developing discrepancy?
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
What is managing ‘Sustain Talk?’
What is core to motivational interviewing?
What is a recent adaptation to the motivational interviewing model?
What are the 3 phases of motivational interviewing?
What is brief action planning (BAP)?
What is BAP used for?
What is the overall goal of BAP?
What are key features of BAP that are relevant to qualified exercise professionals?
What are the 3 questions and 5 skills of BAP?
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
CSEP-PATH Manual
Section 4: Physical Activity Training for Health
(Pages 41-55 and 65-87; Slides 1 to 49)
You are responsible to study the content from pages 41
to
55 and
65
to
87
in
Section 4
of the
CSEP-PATH (2021) manual.
Use the PowerPoint slides as your guide for this chapter (slides 1 to 49 and
the corresponding content in the CSEP-PATH manual).
Please refer to the CSEP-PATH (2021) manual if you need clarification related
to some of the content in the PowerPoint slides.
6 key step of the CSEP PATH sequence: 1. Ask
get to know client. 2. Assess
physical activity, fitness, lifestyle, change questionnaire (SOC-Q
to identify a
client’s stage of motivational readiness and transtheoretical model of behavior change, Tool 10 at
26). Client Information sheet, stage to change questionnaire, physical activity and
sedentary behavior questionnaire, anthropometry, aerobic tests, musculoskeletal tests, 1-
RM, Y-balance…
3. Advise
evaluation report and discussion CSEP-PATH evaluation summary report for
adults and youth
(Tool 27 and 28). 4. Agree
devise an action plan (SMART. Tool 29, 30, 31, 38-39-40-41). Goal Setting
Worksheet, CSEP PATH physical activity and exercise prescription card, can canadian
movement guidelines, inventory lifestyle needs and physical activity preferences. 5. Assist
increase motivation and overcome barriers (change precontemplation stage to
contemplation stage). Go through preparation and action stages. Tool 32 to 35). Barriers, to
physical activity, decision balance worksheet, first step planning worksheet, alternatives for
action worksheet. -
Content reflection (to confirm understanding and demonstrate that you’re listening),
reflection on feeling/meaning (to demonstrate empathy), amplified negative reflection
(stuck on yes, but), double-sided reflection (heard your client’s reasons for and against
change), action reflections (made a commitment and moves into action planning).
6. Arrange
provide continuing support (meeting wrap up, establish a follow-up, schedule a
resistance training demonstration, relapse planning, maintain regular contact. Tool 36 and 37).
Weekly Physical Activity planner and Log, Relapse planning worksheet.
-
Weekly physical activity planner and log: to help clients plan and keep track of their
physical activity and to facilitate review w/ trainer. Promotes adherence.
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Relapse planning worksheet: to facilitate a discussion of things that might derail the efforts of
clients and what strategies might help them remain on track. Promotes self-efficacy. Between precontemplation and comtemplation stages: the tool The Barriers to Physical
Activity tool
is used in the transtheorical model behavior change. -
Most common barrier : fear of injury or getting re-injured.
Does the CSEP-PATH
use a client-centered
or practitioner-centered approach?
What are the key steps
of the CSEP-PATH sequence
?
What are the purposes & detailed objectives
for steps 3, 4, 5, and 6 of the CSEP-
PATH?
Which tools & protocols
are used for steps 3, 4, 5, and 6 of the CSEP-PATH?
What are the best practices
for steps 3, 4, 5, and 6 of the CSEP-PATH?
What are the purposes
of the tools
used for steps 3, 4, 5, and 6 of the CSEP-
PATH?
What is the SOC-Q
?
What is the purpose of the SOC-Q
?
The SOC-Q
is based on which theory or model of behaviour change?
What are the best practices for Step 3
(Advise: Evaluation Report and Discussion)
of the CSEP-PATH?
Which tools and protocols are used for Step 3 (Advise)
of the CSEP-PATH?
What is the purpose of the Evaluation Summary Report?
What are the best practices for Step 4
(Agree: Devise an Action Plan) of the CSEP-
PATH?
Which tools and protocols are used for Step 4 (Agree)
of the CSEP-PATH?
What are the purposes of the Inventory of Lifestyle Needs and Physical Activity
Preferences, Goal Setting Worksheet, and CSEP-PATH Physical Activity and
Exercise Prescription Card?
In which stage of change of the Transtheoretical Model of Behaviour Change
(TMBC) should you use the Goal Setting Worksheet?
What is SMART goal setting?
What does each letter in the acronym SMART represent?
Which tools
and protocols
are used for Step 5 (Assist)
of the CSEP-PATH?
What are the best practices
for Step 5
(
Assist: Increase Motivation and
Overcome Barriers
) of the CSEP-PATH?
What may be needed by clients with low motivation and/or high ambivalence?
What should QEPs do to help clients with low motivation and/or high ambivalence?
How does one support self-efficacy?
What is used to elicit ‘Change Talk?’
What provides signals of progress towards making commitment?
What is ‘Sustain Talk?’
What is another term that can be used interchangeably with ‘Sustain Talk?’
What types of reflection tactics are used with clients showing resistance so that the
qualified exercise professional can keep things moving forward?
What distinguishes one reflection tactic from another reflection tactic? For instance,
content reflections involve paraphrasing the client’s words.
What are commonly cited barriers to physical activity? Which ones are the most
common?
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
What are the purposes
of the Inventory of Lifestyle Needs & Activity Preferences,
Goal Setting Worksheet, CSEP-PATH Physical Activity and Exercise Prescription
Card, Barriers to Physical Activity, Decision Balance Worksheet, First Step Planning
Worksheet, Alternatives for Action Worksheet, Weekly Physical Activity Planner &
Log, and Relapse Planning Worksheet?
In which stage(s) of change of the Transtheoretical Model of Behaviour Change
(TMBC)
should you use the:
Goal Setting Worksheet,
Barriers to Physical Activity,
Decision Balance Worksheet,
First Step Planning Worksheet, and
Alternatives for Action Worksheet?
To answer
the
last 2 questions
, you
should create tables like the ones below and
cut & paste your answers from the PowerPoint slides to the table.
Table 1.
Summary of the purposes of tools used in Steps 3 to 6 of the CSEP-PATH.
Tool
Purpose of Tool
CSEP-PATH STEP
Evaluation Summary Report Adult
Provides clients with a summary of the
results of their physical activity, fitness,
and lifestyle assessment in terms of the
HBRs.
Step 3 - Advise
Evaluation Summary Report Youth
Provides clients with a summary of the
results of their physical activity, fitness,
and lifestyle assessment in terms of the
HBRs.
Step 3 - Advise
Inventory of Lifestyle Needs &
Activity Preferences
Step 4 - Agree
Goal Setting Worksheet
CSEP-PATH Physical Activity and Exercise Prescription Card
Barriers to Physical Activity
Decision Balance Worksheet
First Step Planning Worksheet
Alternatives for Action Worksheet
Weekly Physical Activity Planner &
Log
Relapse Planning Worksheet
Table 2.
Summary of tools used in the stages of change of the TMBC.
Tool
CSEP-PATH STEP
TMBC Stage of Change
Goal Setting Worksheet
Step 4 - Agree
Preparation
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EXCI 252 INTRODUCTION TO PHYSICAL ACTIVITY, HEALTH, & FITNESS FALL 2023
STUDY CONTENT GUIDE FOR THE FINAL EXAM
Barriers to Physical Activity
Step 5 - Assist
Precontemplation and Contemplation
Decision Balance Worksheet
First Step Planning Worksheet
Alternatives for Action Worksheet
What are the best practices
for Step 6
(Arrange: Providing Continuing Support) of
the CSEP-PATH?
Which tools
and protocols
are used for Step 6 (Arrange)
of the CSEP-PATH?
What are the purposes
of the tools used in Step 6
? Refer to Table 1
after you have
created it.
Why is it important for clients to keep track of their physical activity?
What facilitates adherence & helpful adjustment to the action plan and physical
activity prescription?
Equations You MUST Know for the EXCI 252 Final Exam
Total Body Weight (TBW)
= Fat Mass (FM) + Fat-Free Mass (FFM)
Estimated FM
= % Body Fat x Total Body Weight
Estimated FFM
= Total Body Weight – FM
Body Density (Db)
= Body Mass / Body Volume = BM / BV
Db
= W
a
/ [((W
a
– W
w
) / D
w
) – (
RV
+ GV)]
Db
= W
a
/ [((W
a
– W
w
) / D
w
) – (
FRC
+ GV)]
Db
= W
a
/ [((Wa – Ww) / Dw) – (
TLC
+ GV)]
Target Body Weight (TBWt):
TBWt = (Fat-Free Mass) / (100% – Goal Fat %) or
= (Fat-Free Mass) / (Goal Fat-Free Mass%)
Weight Loss = Total Body Weight – Target Body Weight Good luck!
Sincerely,
Robert Panenic
Robert Panenic
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