Level Personal Training Online Theory Flashcards

Question

What muscles are the outer unit core musculature.(7)

Answer 1

he following represent some of the main muscles that generate gross movement across the spine and hips: -Rectus abdominis -Lateral fibres of external oblique -Erector spinae -Iliocostalis (thoracic portion) Also included are the multi-joint muscles, namely the Gluteals, Latissimus Dorsi and Psoas, which pass through the core, linking it to the pelvis, legs, shoulders and arms.

Answer 2

- Support of the abdominopelvic viscera (bladder, intestines, uterus, etc.) through their tonic contraction - Resistance to increases in intra-pelvic / abdominal pressure during activities such as coughing or lifting heavy objects - Urinary and faecal continence. The muscle fibres have a sphincter action on the rectum and urethra. They relax to allow urination and defecation.

Answer 3

ligaments.

Answer 4

the pelvic floor.

Answer 5

If a muscle is overused for repetitive motions or held in a specific position during extended periods of inactivity, then collagen can form between the layers of skeletal muscle, creating adhesions or knots that restrict the ability of muscle sheaths to slide against one another. Collagen is a protein molecule bound in a triple-helix formation to give it rigidity. It is a component of fascia that is produced in response to applied mechanical stress. Sensations of pain cain be brought about by fascial tightness. When dehydration results and / or a lack of movement is experienced in the affected region collagen molecules can bind together for stability, which can create an adhesion between the various layers of muscle.

Answer 6

Self-myofascial release (SMR) - Increased range of motion (acute increases of 3–23% persisting for 20 minutes) - Diminished perceived pain - Accelerated recovery from exercise-induced muscle damage - Improved athletic performance (unlike the stretching literature, which has reported impaired performance following prolonged static stretching, the rolling literature generally reports no significant deficits in subsequent muscle strength.

Answer 7

- Golgi tendon organs (GTOs) sense a change in muscle tension from pressure of the roller (located in the muscle-tendon junction) - GTO activation creates an inhibition effect in the same muscle - A sensory signal to the CNS informs of the need to reduce muscle tension - Muscle spindles sense a change in the length of muscles and signal for muscle contraction - A sensory signal from the CNS informs of the need to allow muscle fibres to lengthen

Answer 8

Guide the client to use a pain scale of 1–10. Some discomfort is acceptable, but pain above seven may create further tension or tissue damage. Foam rolling acts to hydrate tissues, which act like a sponge, where water is ‘squeezed’ out before being ‘sucked’ back in. For this to be effective, slow and gentle movements should be encouraged. Note this is good practise to foam roll along the myofascial lines and then follow up with appropriate exercises for these lines also.

Answer 9

Approach 1. Proprioceptively rich input where dynamic actions use momentum, gravity and ground reaction forces. Groups of muscles must first load and lengthen eccentrically as they enter the desired range of motion before they can unload and shorten concentrically to carry the joint out of that range. E.g. reverse lunge with overhead reach with medicine ball (momentum of the medicine ball being driven up and overhead loads tissues on the front of the shoulder, front of the torso and front of the hip). Approach 2. Move into the new range of motion slowly and create isometric contractions in the new range to improve strength and muscular balance between agonists, antagonists, synergists and fixator muscles. Momentum is eliminated which removes any proprioceptive assistance to get in and put of the range. Rather, spending a prolonged duration in the new range creates a strong neural drive to the muscles that need to learn how to control the joint in that position. E.g. Isometric lunge with cable overhead front raise (facing a cable machine, the lunge is held with pelvis and ribs stacked in neutral whilst a cable is raised slowly overhead and then held for 10-seconds, before being lowered under control).

Answer 10

- Progress slowly with a new exercise programme, especially when including new exercises - Begin with low exercise volumes and programme small weekly increments - Avoid excess use of eccentric muscle actions (although this may be desirable in some circumstances) - Pre-workout: caffeine ingestion prior to workouts (supported by some research) - Post-workout: omega 3 fatty acids (supported by some research) - Post-workout: some studies report that SMR using a foam roller may reduce perceived soreness and increase the pressure pain threshold as a result of DOMS during the 48 hours following damaging exercise - Post-workout: light cardiovascular exercise.

Answer 11

- parallel/fusiform muscles - convergent muscles - pennate muscles - circular muscles.

Answer 12

- Fusiform-tendons, parallel-aponeuroses - Most of the skeletal muscles in the body are parallel muscles. - The biceps brachii muscle of the arm is a fusiform muscle with the central body. When a parallel muscle contracts, it gets shorter and larger in diameter. You can see the bulge of the contracting biceps brachii on the anterior surface of your arm when you flex your elbow. - A skeletal muscle cell can contract until it has shortened by roughly 30 percent. Because the fibres in a parallel muscle are parallel to the long axis of the muscle, when the fibres contract together, the entire muscle shortens by the same amount.

Answer 13

- In a convergent muscle, the muscle fibres are spread over a broad area, but all the fibres converge at one common attachment site. They may pull on a tendon, an aponeurosis (tendinous sheet) or a slender band of collagen fibres known as a ‘raphe’. - The muscle fibres typically spread out, like a fan or a broad triangle, with a tendon at the apex. The prominent chest muscles of the pectoralis group have this shape. - A convergent muscle has versatility because the stimulation of only one portion of the muscle can change the direction of the pull. However, when the entire muscle contracts, the muscle fibres do not pull as hard on the attachment site as a parallel muscle of the same size would. The reason is that the convergent muscle fibres pull in different directions, rather than all pulling in the same direction. - This idea gives rise to the need to use different variations of exercises to fully stimulate all the muscle fibres within a target muscle, for example when training for muscle hypertrophy (e.g. flat, incline, decline bench press).

Answer 14

- If all the muscle fibres are on the same side of the tendon, the pennate muscle is unipennate. The extensor digitorum muscle, a forearm muscle that extends the finger joints, is unipennate. - MORE commonly, a pennate muscle has fibres on both sides of the tendon. Such a muscle is called ‘bipennate’. The rectus femoris muscle, a prominent muscle that extends the knee, is bipennate. - Multipennate muscles have multiple rows of diagonal fibres, with a central tendon which branches into two or more tendons. An example is the Deltoid muscle which has three sections, anterior, posterior and middle.

Answer 15

In a pennate muscle, the fascicles form a common angle with the tendon. Because the muscle cells pull at an angle, contracting pennate muscles do not move their tendons as far as parallel muscles do. But a pennate muscle contains more muscle fibres and, as a result, produces more tension than does a parallel muscle of the same size. (Tension production is proportional to the number of contracting sarcomeres; the more muscle fibres, the more myofibrils and sarcomeres.)

Answer 16

Greater tension generation within the muscle.

Answer 17

Unipennate.

Answer 18

Superior is closer to the head/inferior further from head in anatomical position.

Answer 19

Medial towards midline of boyd/lateral away from midline.

Answer 20

Medio-lateral axis-sagittal plane anterior-posterior axis-frontal plane longitudinal axis-transverse plane

Answer 21

Longitudinal axis.

Answer 22

1) Stand still 2) Hard 3) Hip 4) Before 5) Against 6) Down/Lower/Under 7) Beneath 8) Among/Between 9) Within/Inside 10) Same 11) parallel with midline 12) perpendicular with midline 13) diagonal to midline 14) triangle 15) saw-toothed 16) pear-shaped 17) slender

Answer 23

upon/on/above

Answer 24

Ball and socket shoulder joint. It consists of the head of the humerus, which inserts into the shallow glenoid cavity/fossa of the lateral border of the scapula.

Answer 25

Unlike the hip joint the shoulder joint is not fully encapsulated and therefore the joint is more mobile but less stable 1) Rotator cuff muscles 2) Supraspinatus (abduction action), 3) Infraspinatus (lateral rotation action, 4) Teres Minor (lateral rotation action), 5) Subscapularis (medial rotation action).

Answer 26

- The large ball-and-socket joint of the hip consists of the rounded head or ball of the femur and the cup-like acetabulum of the pelvis. - The rounded head or ball of the femur is at the proximal end and is held by an obvious neck. At the base of the neck, the bone flares out laterally to form a collar, named the ‘greater trochanter’. This body protuberance provides attachment sites for the muscles of the thigh and buttocks. - The rounded end or ball fits snugly into the acetabulum of the pelvic girdle and is held in place by the labrum: a fibrocartilage lip. An internal ligament and strong external ligaments provide further support (7 ligaments in total). - At the distal end of the femur, the bone widens again, forming two rounded condyles (knuckle-like processes) that fit neatly into the complementary condyles of the tibia (the lower leg) to form the knee joint.

Answer 27

- Each clavicle articulates proximally with the top / superior end of the sternum (the sternoclavicular joint). This is the clavicle’s only bony link to the axial skeleton. - The sternoclavicular joint is a synovial double gliding joint that has the characteristics of both a gliding joint and a saddle joint, but it also has a cartilaginous disc that absorbs considerable stress (e.g. when falling on the shoulder). In fact, this joint is so strong that the clavicle itself is much more likely to break with the jarring that occurs. - Each clavicle articulates distally at the top of the shoulder with the acromion process of the scapula (the acromioclavicular joint), forming a gliding synovial joint. It can be felt at the top of the shoulder and is the point of contact of each scapula with the rest of the skeleton. - The scapulae are roughly triangular-shaped, thin, flat bones that partially cover the back of ribs 1–7. The posterior surface of each scapula has a raised ridge along its length, known as the ‘spine of scapula’, which ends in a large bony process called the ‘acromion process’. Each scapula is anchored in place by the many muscles of the back and shoulder, giving incredible mobility overall to the shoulder and the associated upper limbs.

Answer 28

-The atlantoaxial joint (articulation of the atlas with the axis) is of a complicated nature, comprising no fewer than four distinct joints. -The atlas (C1) is the top-most bone, sitting just below the skull. There is a pivot articulation, creating two joints, where the odontoid process (or dens) meets the ring of the axis (C2) (formed by the anterior arch and the transverse ligament of the atlas). The two joints are: -Between the posterior surface of the anterior arch of the atlas and the front of the odontoid process -Between the anterior surface of the ligament and the back of the process.

Answer 29

-The wrist joint is formed: Distally – the proximal row of the carpal bones (except the pisiform) Proximally – the distal end of the radius and the articular disc. -The ulna is not part of the wrist joint – it articulates with the radius, just proximal to the wrist joint, at the distal radioulnar joint. It is prevented from articulating with the carpal bones by a fibrocartilaginous ligament, called the ‘articular disc’, which lies over the superior surface of the ulna.

Answer 30

- Tibiofemoral: the medial and lateral condyles of the femur articulating with the tibia - Patellofemoral: the anterior and distal part of the femur articulating with the patella. - The tibiofemoral joint is the weight-bearing joint of the knee, whilst the patellofemoral joint allows the tendon of the quadriceps femoris (the main extensor of the knee) to be inserted directly over the knee, increasing the efficiency of the muscle. - Both joint surfaces are lined with hyaline cartilage and are enclosed within a single joint cavity. The patella is formed inside the tendon of the quadriceps femoris (sesamoid bone); its presence minimises wear and tear on the tendon.

Answer 31

- The patellar ligament-a continuation of the quadriceps femoris tendon distal to the patella. It attaches to the tibial tuberosity (labelled ‘patella tendon’) - Collateral ligaments: these are two strap-like ligaments (both medial (tibial) and lateral (fibial) to the patella). They act to stabilise the hinge motion of the knee, preventing any medial or lateral movement - Cruciate ligaments: (both anterior and posterior)-these two ligaments connect the femur and the tibia. In doing so, they cross each other, hence the term ‘cruciate’ (Latin for ‘like a cross’).

Answer 32

Tibial (medial) collateral ligament: wide and flat ligament, found on the medial side of the joint. Proximally, it attaches to the medial epicondyle of the femur; distally, it attaches to the medial surface of the tibia Fibular (lateral) collateral ligament: thinner and rounder than the tibial collateral, this attaches proximally to the lateral epicondyle of the femur; distally, it attaches to a depression on the lateral surface of the fibular head.

Answer 33

- Anterior cruciate ligament (ACL): attaches at the anterior intercondylar region of the tibia and ascends posteriorly to attach to the femur, in the intercondylar fossa. It prevents anterior dislocation of the tibia onto the femur - Posterior cruciate ligament: attaches at the posterior intercondylar region of the tibia and ascends anteriorly to attach to the femur in the intercondylar fossa. It prevents posterior dislocation of the tibia onto the femur.

Answer 34

-Soft tissue supporting knee -The medial and lateral menisci are fibrocartilage structures in the knee that serve two functions: To deepen the articular surface of the tibia, thus increasing stability of the joint To act as shock absorbers. -They are C-shaped and are attached at both ends to the intercondylar area of the tibia. -In addition to the intercondylar attachment, the medial meniscus is fixed to the tibial collateral ligament and the joint capsule. Any damage to the tibial collateral ligament results in tearing of the medial meniscus.

Answer 35

A bursa is a synovial-fluid-filled sac, found between moving structures in a joint – with the aim of reducing wear and tear on those structures. There are four bursae found in the knee joint: - Suprapatellar bursa: this is an extension of the synovial cavity of the knee, located between the quadriceps femoris and the femur - Prepatellar bursa: found between the apex of the patella and the skin - Infrapatellar bursae: split into deep and superficial. The deep bursa lies between the tibia and the patella ligament. The superficial lies between the patella ligament and the skin - Semimembranosus bursa: located posteriorly in the knee joint, between the semimembranosus muscle and the medial head of the gastrocnemius.

Answer 36

The elbow is the joint connecting the upper arm to the forearm. It is marked on the upper limb by the medial and lateral epicondyles and the olecranon process. Structurally, the joint is classed as a synovial joint; functionally, it is classed as a hinge joint. It consists of two separate articulations: - Trochlear notch of the ulna and the trochlea of the humerus - Head of the radius and the capitulum of the humerus

Answer 37

-The fingers consist of: Five proximal phalanges Four middle phalanges Five distal phalanges. -The proximal end of the metacarpals and phalanges is called the ‘base’, and the distal end is called the ‘head’. -Each finger has two interphalangeal (IP) joints: a proximal interphalangeal (PIP) and a distal interphalangeal (DIP) joint. The thumb has only two phalanges and therefore only one IP joint.

Answer 38

- The ankle joint is formed by three bones: the tibia and fibula of the lower leg and the talus of the foot. - The tibia and fibula are bound together by strong tibiofibular ligaments, producing a bracket-shaped socket, which is covered in hyaline cartilage. This socket is known as a ‘mortise’.The body of the talus fits snugly into the mortise, formed by the bones of the leg. - The articulating part of the talus is wedge-shaped. It is wider anteriorly and thinner posteriorly. During dorsiflexion, the anterior part of the bone is held in the mortise, and the joint is more stable (vice versa for plantar flexion).

Answer 39

There are two sets of ligaments, which originate from each malleolus. -The medial ligament (or deltoid ligament) is attached to the medial malleolus. It consists of four separate ligaments, which fan out from the malleolus, attaching to the talus, calcaneus and navicular bones. The primary action of the medial ligament is to resist over-eversion of the foot. -The lateral ligament originates from the lateral malleolus. It resists over-inversion of the foot. It comprises three distinct and separate ligaments: Anterior talofibular: spans between the lateral malleolus and the lateral aspect of the talus Posterior talofibular: spans between the lateral malleolus and the posterior aspect of the talus Calcaneofibular: spans between the lateral malleolus and the calcaneus.

Answer 40

Acetabulum

Answer 41

Acromion process

Answer 42

Greater trochanter

Answer 43

Talocrural/hinge

Answer 44

Plantar flexion

Answer 45

PAR-Q The Physical Activity Readiness Questionnaire (PAR-Q) is a one-page form to see if you should check with your doctor before becoming much more physically active PAR-Q+ The Physical Activity Readiness Questionnaire-Plus (PAR-Q+) is a four-page form for pre-screening prior to physical activity participation and includes additional questions on chronic conditions for further probing by the qualified exercise professional

Answer 46

Compulsory for Personal Trainer to use with client: Stage 1: to identify those individuals with a known disease, and/or signs or symptoms of disease, who may be at a higher risk of an adverse event due to physical activity/exercise. An adverse event refers to an unexpected event that occurs as a consequence of a physical activity/exercise session, resulting in ill health, physical harm or death to an individual. Stage 1 may be self-administered and evaluated by the client. The screening tool can be administered to both regular and casual users of exercise services. Once completed, the form should be filed appropriately with the client’s records for future reference. Advisable for Personal Trainer to use with client: Stage 2: this stage is to be completed with the exercise professional to determine an appropriate exercise prescription based on established risk factors. The aim is to identify those individuals with risk factors or other conditions that may result in them being at a higher risk of an adverse event due to exercise. Questions 8-12 and 15-18 can be used by the Personal Trainer with the client. If the client has knowledge of the values associated with questions 13-14, these can be recorded; however advising on these tests and providing guidance based on the results are beyond the scope of the Personal Trainer’s education and expertise.

Answer 47

-Stage 1: YES to any of questions 1-6 If they answer NO to all questions, then they are cleared for low–moderate-intensity physical activity and may continue on with any high-intensity activity they have been performing (>150mins/week) -Stage 2: in the event of an extreme risk factor or multiple risk factors that in the judgement of the exercise professional present a high risk of an adverse event, individuals should be referred to a GP or appropriate allied health professional.

Answer 48

- The GP provides permission/clearance for the patient/client to return to you, the Personal Trainer (some suggestions / contraindications may be advised) - GP recommends guidance from a L3 Exercise Referral-qualified Personal Trainer, within an Exercise Referral scheme. Exercise Referral is a multidisciplinary intervention that aims to provide safe and effective exercise for patients with low-risk medical conditions. The role of the GP or health professional is to make a referral into a system that is quality assured and to be satisfied to the best of their knowledge that no evidence exists at the time of the referral to suggest that a course of exercise will adversely affect the health and safety of the patient - The GP refers the patient / client on to a different medical expert for further guidance / treatment.

Answer 49

Infrequent urination.

Answer 50

Symptoms within the questionnaire are rated based upon the health of a client for the past 30 days (if using as a reassessment) or the past 48 hours if using for the first time. It is recommended for the health symptoms questionnaire to be used every other month (i.e. in eight-week cycles) to allow for interventions (exercise, nutrition and lifestyle) to take effect and to provide positive health benefits.

Answer 51

Anterior: Thyroid-stimulating hormone Adrenocorticotropic hormone Gonadotropic hormone Growth hormone (Stimulates the thyroid, Stimulates the adrenal cortex, Stimulates the gonads, Stimulates growth in children and young adults, Promotes muscle mass growth, Promotes lipolysis (fat breakdown)) Posterior: Antidiuretic hormone (Promotes water reabsorption by kidneys)

Answer 52

- Pedicles: there are two of these – one left and one right. They point posteriorly, meeting the flatter laminae - Laminae: the bones between the transverse and spinal processes - Transverse processes: these extend laterally and posteriorly away from the pedicles. In the thoracic vertebrae, the transverse processes articulate with the ribs - Articular processes: at the junction of the laminae and the pedicles, superior and inferior processes arise. These articulate with the articular processes of the vertebrae above and below - Spinous processes: posterior and inferior projections of bone – sites of attachment for muscles and ligaments.

Answer 53

Glucocorticoids (e.g. cortisol) Mineralocorticoids (e.g. aldosterone) (Promotes gluconeogenesis (a metabolic pathway that results in the generation of glucose from certain non-carbohydrate carbon substrates), Promotes sodium reabsorption by kidneys)

Answer 54

When a hormone is released in response to a change in the blood or other body fluids, such as a change in the level of a mineral or a change in temperature, this is called a ‘humoral stimulus’

Answer 55

-The hypothalamus activates the sympathetic nervous system -There is increased secretion of catecholamines from the adrenal medulla -The adrenal medulla secretes approximately 20% noradrenaline (norepinephrine) and 80% adrenaline (epinephrine). To carry out this response, the adrenal medulla receives input from the sympathetic nervous system through nerve fibres originating in the thoracic spinal cord at T5–T11 -The increased sympathetic activity results in: Increased heart rate and blood pressure Blood vessel constriction in the skin and GI tract Smooth muscle dilation Dilating bronchioles and capillaries Increased metabolism.

Answer 56

``` • Sleeping and feeding patterns • Alertness • Core body temperature • Brain wave activity • Hormone production • Regulation of glucose and insulin levels • Urine production • Cell regeneration -many more! ```

Answer 57

- The most important hormones affected by the circadian clock, at least insofar as they affect sleep, are melatonin (which is produced in the pineal gland in the brain and which chemically causes drowsiness and lowers body temperature) and cortisol (produced in the adrenal gland and used to form glucose or blood sugar and to enable anti-stress and anti-inflammatory functions in the body). - Growth hormone, essential to the repair and restoration processes of the body, is also secreted during sleep, particularly during deep non-REM sleep, as are other hormones like testosterone. - Thyrotropin (or thyroid-stimulating hormone), on the other hand, is actively inhibited or suppressed during sleep, and this makes sense, as it stimulates metabolism and signals for cells to make more ATP.

Answer 58

3-4 hours. | *foods containing tryptophan eg bananas, milk may aid sleep.

Answer 59

-The heart requires a blood supply. There are two major coronary arteries that provide this supply: Left coronary artery Right coronary artery. -The left coronary artery divides into two branches, known as the ‘left anterior descending artery’ (LAD) and the ‘left circumflex artery’. The left circumflex artery goes around the left side of the heart and distributes oxygenated blood to the walls of the left atrium The LAD artery goes down the front of the heart and supplies oxygenated blood to the walls of the left ventricle. -The main portion of the right coronary artery provides oxygenated blood to the right side of the heart (connecting the pulmonary circulation). The rest of the right coronary artery and its main branch, known as the ‘posterior descending artery’, together with the branches of the circumflex artery, run across the lower surface of the heart, supplying the bottom portion of the left ventricle and the back of the septum. -As the myocardium has virtually no anaerobic capacity, it is crucially dependant on blood flow through the coronary arteries. Due to the pressure the heart is under during systole (ejection), the majority of blood flow through the coronary arteries occurs during diastole. -As a client’s cardiorespiratory fitness increases through regular physical activity, the resting heart rate, as well as the heart rate at a given exercise workload, decreases. This in turn means that the time the heart spends in diastole (refilling) increases. This therefore allows more blood flow through the coronary arteries, thus improving blood flow.

Answer 60

Total peripheral resistance (TPR) x cardiac output (Q). **note: The average blood pressure across one cardiac cycle is known as the ‘mean arterial pressure’.

Answer 61

- The aorta and the carotid sinus contain important baroreceptors that constantly monitor blood pressure fluctuations through the stretch exerted on the artery walls. - These baroreceptors transmit their data to the central nervous system: more specifically, to the cardioregulatory centre of the medulla oblongata in the brain (via glossopharyngeal nerve)-reduce BP via vagus nerve

Answer 62

- Kidney cells release renin into the blood stream - It is activated to angiotensin I-as angiotensin I passes through the lung capillaries, an enzyme in the lungs converts angiotensin I to angiotensin II-angiotensin II stimulates the release of aldosterone when it reaches the adrenal glands (adrenal cortex), angiotensin II is also a vasoconstrictor and therefore raises blood pressure in the body’s arterioles - The target organ for aldosterone is the kidney-aldosterone promotes increased reabsorption of sodium (salt) from the kidney tubules - As sodium moves into the bloodstream, water follows. The reabsorbed water increases blood volume and therefore blood pressure. Remember BP effected by water as plasma 55% water which is 94% water.

Answer 63

- post exercise hypotension experienced in both normotensive and hypertensive individuals - however post exercise ambulatory (throughout the day) is proven but varies considerably in hypertensive individuals-same session is multiple short bouts rather than1 continuous might lengthen this effect-intensity duration not yet confirmed but regular health guidleines should be sufficient

Answer 64

- Large-scale studies suggest that aerobic training effects in blood pressure are associated with reductions of 3.3 and 3.5 mmHg in waking systolic and diastolic blood pressures, respectively. Although these reductions appear modest, it has been shown that blood pressure decreases of as little as 2 mmHg are associated with a 6% decrease in stroke mortality and a 4% decrease in coronary artery disease - The mechanism for long-term blood pressure reductions with aerobic training is likely due to a reduction in peripheral vascular resistance - In summary, aerobic training can reduce ambulatory blood pressure in hypertensive subjects; however, the specific training parameters that are necessary to maximise this effect are not yet known. Moreover, individual responses to aerobic training are quite variable – this suggests that hypertensive clients should be assessed at regular intervals to assess the effectiveness of an exercise programme.

Answer 65

- Systolic blood pressure does increase slightly - Diastolic blood pressure shows dramatic increases with this form of exercise - Muscular contractions provide too much peripheral vascular resistance for an optimal blood pressure response.

Answer 66

-Specifically, the valsalva manoeuvre is increased pressure developed against a closed glottis – usually done by taking in a large ‘belly-breath’ and closing the mouth whilst attempting to exhale through it. It serves to generate pressure against the inner unit core musculature which are then required to contract in response to this pressure (and thus develop stability in this region). This stability is helpful for moving through the ‘sticking point’ of an exercise (e.g. a back squat). At this time, blood pressure ‘spikes’ and would be contraindicated for hypertensive clients: -The primary change is caused by an increase in pressure within the chest (intrathoracic pressure) and the abdomen. During normal breathing, intrathoracic pressure is lower than atmospheric pressure, and this negative intrathoracic pressure aids the flow of blood to the heart from the peripheral veins. -general recommendation for breathings is inhale during eccentric and exhale during concentric.

Answer 67

- All studies that have investigated clinical (single-measurement) blood pressure after resistance exercise have verified a significant post-exercise hypotensive effect; however, data regarding ambulatory (throughout the day) blood pressure is both scarce and controversial - The effectiveness of resistance training in bringing about a post-exercise hypotensive effect suggests a reduction in cardiac output due to a decrease in stroke volume, probably due to a pre-load reduction (reduced left ventricular filling due to reduced venous return) - In general, low-intensity resistance exercise seems to have stronger hypotensive effects, and subjects with higher blood pressure seem to experience greater blood pressure reductions after resistance exercise, similar to what is observed for aerobic exercise

Answer 68

-It is important to emphasise that frequent participation in resistance training does not trigger hypertension In the general population, resistance training reduces systolic and diastolic clinical blood pressure by 3.2 and 3.5 mmHg, respectively -The failure to observe the hypotensive effects from resistance training in hypertensive clients may be linked to the absence of sympathetic nervous activity reduction after this kind of training -In summary, there is no strong evidence that resistance training is effective in reducing ambulatory blood pressure in hypertensive subjects; however, the lack of data addressing this issue makes any conclusion premature -Light-/moderate-intensity resistance training performed in a circuit format is likely to be the most effective for a hypertensive client.

Answer 69

- Do not take your RHR within one to two hours after exercise or a stressful event. Your heart rate can stay elevated after strenuous activities - Wait at least an hour after consuming caffeine, which can cause heart palpitations and make your heart rate rise - The American Heart Association recommends checking your RHR first thing in the morning (before you get out of bed).

Answer 70

- The principle of indirect measurement is to apply pressure by use of an inflatable cuff to the surface of the limb over the artery in order for the blood supply to be temporarily ceased. As the pressure of the cuff is slowly released (3–5 mmHg/second), the pressure at which blood flow is re-established is recorded: - The value at which the first Korotkoff sound is heard is the systolic pressure (heard when using manual sphygmomanometers) - As the pressure is released further, the sounds become -muffled to the point of silence. This value is that of the diastolic reading. * *note: Multiple measurements (e.g. x3), separated by approx. five minutes and averaged, will help to ensure accuracy and reliability.

Answer 71

-90 over 60 (90/60) or less: You may have low blood pressure -More than 90 over 60 (90/60) and less than 120 over 80 (120/80): Your blood pressure reading is ideal and healthy -More than 120 over 80 and less than 140 over 90 (120/80-140/90): You have a normal blood pressure reading but it is a little higher than it should be -140 over 90 (140/90) or higher (over a number of weeks): You may have high blood pressure (hypertension)-lowered to 130/80 in some American bodies**

Answer 72

The size of the cuff is important, as a cuff that is too wide will give a low blood pressure reading, whereas a narrow cuff gives higher blood pressure readings due to the surface area it covers. Automatic cuffs are becoming more and more popular within the industry due to the ease of administration. The Personal Trainer should keep in mind that automated blood pressure monitors may be susceptible to variation in accuracy, particularly for those readings that are at extreme ends of the norms.

Answer 73

- Inflate cuff to approx. 160–180 mmHg or 20 mmHg above the predicted systolic pressure - Deflate the cuff 3–5 mmHg every second. It is at this point that delay should be avoided - Place the cuff 2-3cm above cuff on brachial artery, make sure tubes arent in the way of the stethoscope listening for sounds (auscultation).

Answer 74

- They are commonly prescribed for high blood pressure, migraine headaches and heart dysrhythmias, i.e. rapid or irregular heart rate. - They lower the heart rate and blood pressure both at rest and during exercise. This makes readings of heart rate during exercise for predicting exercise intensity unreliable. Other methods of monitoring intensity would therefore be necessary. - Names: Ends in ‘olol’ (e.g. acebutolol, propranolol and penbutolol)

Answer 75

- They relax the blood vessels to relieve pressure in the vascular system. They can cause rapid heart rate or low blood pressure during exercise. - Cooling down after exercise is very important for a participant on vasodilators, as hypotension may occur at this time.

Answer 76

- They are similar to vasodilators in that they relax peripheral blood vessels. - Unlike beta blockers, they do not have an effect on the heart rate. The heart rate of participants using alpha blockers can therefore be used as a good indicator of exercise intensity.

Answer 77

- They are medications which increase the excretion of water and some minerals known as electrolytes from the body. They are usually prescribed for high blood pressure, or when a person is accumulating too much fluid, as with congestive heart failure. - They have no primary effect on the cardiovascular system, but they can cause water and electrolyte imbalances, which may lead to dangerous cardiac dysrhythmias. It is also important to monitor for dehydration and heat exhaustion in clients taking diuretics, especially when exercising in hot or humid environments. - Diuretics are also used by athletes who need to lose weight for sport. This practice can be quite dangerous. - Generic names: Thiazide, Amiloride

Answer 78

- They are usually given to sufferers of asthma. These medications relax or open the air passages in the lungs, allowing better air exchange. - In addition to opening the airways, these medications increase the heart rate and may cause the client to have a shaky feeling.

Answer 79

- They act directly on the smooth muscles of blood vessels to stimulate vasoconstriction. In the upper airways, this constriction reduces the volume of the swollen tissues and results in more air space. - Because vasoconstriction in the peripheral blood vessels may raise blood pressure, participants on decongestants should be cautious when exercising, especially when performing heavy resistance training exercises.

Answer 80

- They are used to stop mucus production and alleviate allergic reactions. These medications do not have a direct effect on the heart rate or blood pressure. - They do, however, produce a drying effect in the upper airways and may cause drowsiness. Most cold medications are a combination of decongestants and antihistamines and so have the combined effects of both drugs.

Answer 81

- Ends with ‘nitrate’ (e.g. isosorbide dinitrate) - Heart rate: Increases at rest, Increases or does not alter during exercise - Blood pressure: Decreases at rest, Decreases or stays the same during exercise

Answer 82

- Ends in ‘ine’ Nicardipine Amlodipine - Increases or stays the same during exercise - Lower blood pressure

Answer 83

- Ends in ‘pril’: Captopril, Enalapril, Lisinopril - Heart rate: Does not change - Blood pressure: Decreases during rest and exercise

Answer 84

- Arteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from your heart to the rest of your body (arteries) become thick and stiff — sometimes restricting blood flow to your organs and tissues. - Healthy arteries are flexible and elastic, but, over time, the walls in your arteries can harden – a condition commonly called ‘hardening of the arteries’. - Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably. Atherosclerosis refers to the build-up of fats, cholesterol and other substances in and on your artery walls (plaques), which can restrict blood flow. - These plaques can burst, triggering a blood clot. Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in your body.

Answer 85

- The normal artery has three layers: intima, media and adventitia. The inner layer (intima) has a line of endothelia cells, and these are in contact with the blood as it flows past. Within the intima, there are also smooth muscle cells (SMCs). - Atherosclerosis begins with some form of damage and injury to the inner lining of the artery, which creates inflammation. This draws inflammatory cells into the area from the immune system. These blood leukocytes find their way into the injured and inflamed inner artery layer. They then turn into another type of immune cell called a ‘macrophage’. Macrophages are effective at ‘scavenging’ other substances from the blood, moving past the injured area, for example LDL cholesterol. This causes the macrophages to grow into foam cells. At the core of these foam cells are the fat molecules that the LDL carrier offloads. - To assist with repair and recovery, SMCs move from the middle media layer of the artery to the inner intima layer. The intima also continues to make its own SMCs, as well as other proteins, for example collagen. Even new blood vessels try to grow into the area. As the macrophages and SMCs get trapped in the expanding layer of the artery, they can die and the formation of the plaque begins to advance. When a cell dies, it is called ‘apoptosis’. - The presence of lots of dying cells creates a lipid / fatty core, which grows further and then becomes unstable. Eventually, thrombosis may occur: the ultimate complication of atherosclerosis. This is when the cap of the plaque ruptures. The space of the artery is narrowed because molecules like platelets, which help blood to coagulate and clot, come into contact with contents of the plaque, which are spilling out. - The body is programmed to react to a soft tissue injury like this by forming a clot over the damaged area, like a scab that forms on a cut on your arm – however, within an important blood vessel, this can cause a blockage

Answer 86

- Results either from atherosclerotic or inflammatory processes causing blood vessel space (lumen) narrowing (stenosis) or from thrombus formation (usually associated with underlying atherosclerotic disease). When these conditions arise, there is an increase in blood vessel resistance, which can lead to a reduction in blood flow to the peripheries. - Although atherosclerosis is generally a diffuse process affecting all of the arteries to some degree, some arterial segments in the limbs often undergo greater stenosis than others. Therefore, it is common to find stenotic lesions associated with specific arteries, such as the external iliac or the femoral artery of the legs. - PAOD can lead to limb ischemia (poor blood supply). In mild to moderate PAOD, the increased resistance to flow will lead to decreased flow capacity during limb exercise (i.e. decreased active transport of blood to that exercising region). This can result in ischemic pain during exercise, which is termed ‘intermittent claudication’. The pain is caused by a lack of oxygen delivery to tissue (hypoxia) when oxygen demand is elevated. - As a result, metabolites formed under anaerobic conditions in the muscle can stimulate pain receptors. Also associated with the relative ischemia during exercise are muscle weakness and fatigue.

Answer 87

- Age - Sex (men more likely-same once women reach menopause) - Ethnicity (South Asian most likely to, African caribbean more likely to have high BP-both groups more likely to have type II diabetes - Family history-If a first-degree blood relative has had coronary heart disease or a stroke before the age of 55 years (for a male relative) or 65 years (for a female relative), the risk increases.

Answer 88

- High blood pressure: regular aerobic activity can lower systolic and diastolic blood pressure by 5-10 mmHg, which translates into a 10–20% reduction in heart attack risk - Cigarette smoking: smokers who become physically active are more likely to stop smoking or at least reduce the amount they smoke - Diabetes: regular aerobic activity has a profound effect on improving resting blood sugar levels and reducing the complications associated with diabetes - High cholesterol: individuals who perform regular aerobic activity lower their 'bad' cholesterol (i.e. LDL cholesterol) levels whilst simultaneously significantly increasing their good 'cholesterol' (i.e. HDL cholesterol) levels - Obesity: although regular aerobic physical is only associated with moderate weight loss (e.g. a reduction of approximately 5% in body weight), this amount of weight loss is associated with positive changes in blood pressure, cholesterol and blood sugar.

Answer 89

- Gather equipment: stopwatch, pen, RPE scale (rating of perceived exertion), claudication scale (see below), and relevant paperwork - Explain to the client that they must walk 6-minutes over a set distance. An athletics track works well so that laps can be counted and a chair can readily be available should he / she need to sit. A treadmill can also be used where the client uses a self-selected pace (they can modify at any time) - The client must walk at a moderate pace that is comfortable to them. Inform the client that they can stop at any time but encourage them to give their best efforts - Pre-test: measure blood pressure, heart rate and any symptoms - Inform client of every 1-2 min of time lapse (to keep them focused and motivated) - Post-test: measure blood pressure, heart rate and any symptoms. Also assess RPE score, claudication score, and distance / laps completed. If the client could not complete 6-minutes, note the time and distance / laps completed (e.g. 5:33,7 ½ laps)

Answer 90

1) Definite discomfort or pain but only of initial or modest level 2) Moderate discomfort or pain from which attention can be diverted 3) Intense pain from which attention can diverted 4) Excruciating / unbearable pain

Answer 91

Aerobic- Modes: Walking (treadmill, track or road) and stair climbing (stair-stepper or stairs) are the most functional and beneficial. Other aerobic activity can supplement the aerobic training component (e.g. cycling) Intensity: Walking intensity should elicit a leg pain rating 3 on the 4-point claudication scale. The client should experience initial claudication within 3-5 min of walking and continue until the pain reaches an intense level (i.e 3 on the 4-point scale). The exercise professional should have a copy of and be familiar with explaining and interpreting the 4- points claudication scale to their clients Duration: Walking duration should be progressed from 20 min initially to >50 min/session. Walking should be performed in multiple bouts until the desired time is accumulated. Full recovery from claudication should be allowed between exercise bouts Frequency: 3-5 d/wk is recommended Progression: Progress by approximately 5 min/session as tolerated, until duration goal is achieved. As clients improve, walking ability exercise workload(s) should be increased to ensure that there is always a stimulus of claudication pain in each workout. Warm-up / Cool-down: A warm-up and cool-down of slower walking for several minutes should precede and follow each exercise session Resistance training- Modes: A variety of modalities are acceptable including bands, tubing, machines, free weights and medicine balls Exercises: Perform 8-10 exercises for major muscle groups (e.g hips, thighs, lower legs, chest, back, shoulders, arms and abdominals) Sets: Perform 1 set initially. If well-tolerated and time permits, multiple sets may produce additional strength gains after approximately 3 months Repetitions: Use a resistance that allows the completion of 12-15 repetitions on all exercises Intensity: Use loads / resistances equivalent to 30-40% and 50-60% of estimated 1RM for upper and lower extremities, respectively. An RPE of 11-14 out of 20 can also be used to monitor intensity Exercise order: Exercise large muscle groups before smaller groups Frequency : Perform 2-3 RT sessions per week on non-consecutive days Progression: Increase resistance by approximately 5% when ≥15 repetitions are performed properly and comfortably Breathing: Exhale during exertion (lifting) and avoid the valsalva manoeuvre. Resistance training should be a compliment to, not a substitute for, walking Flexibility training- Mode: Perform static stretches for all major muscle groups Intensity: Stretch to point of tension but not pain Duration : Hold stretches between 15-30 seconds each. Perform each stretch 2-3 times Frequency: Perform stretches 5-7 times/wk

Answer 92

Poor blood supply.

Answer 93

-COPD describes a progressive and irreversible decline in lung function that results in reduced airflow in the lungs. It includes three main diseases: • Chronic bronchitis: bronchitis is where inflammation narrows the bronchi (the tubes carrying air to and from the lungs) and causes chronic bronchial secretions • Emphysema: a permanent and destructive enlargement of the air spaces within the lungs without any accompanying fibrosis of the lung tissue • Asthma: may also be included within the term ‘COPD’ if there is some degree of chronic airway obstruction (reversible narrowing or constriction of the bronchial tubes). -COPD is a long-latency disease, meaning that cases tend to develop a number of years after first exposure to the particular causative agents, and in many cases symptoms manifest during mid-life or later. The most important causative factor is smoking, but others include occupational exposures to fumes, chemicals and dusts, as well as genetic susceptibility and environmental pollution.

Answer 94

* Systemic inflammation * Changes to the lungs * Respiratory muscle remodelling * Peripheral muscle wasting * Reduced activity level.

Answer 95

- Interval training may be a better option for individuals with COPD. Interval training will train the cardiac and pulmonary systems, but its intermittent nature may be less challenging in terms of ventillatory limitations - A 1:1 work:rest ratio is likely to be appropriate for interval work (i.e. aerobic intervals) - Walking and cycling are probably the least stressful types of aerobic exercise on the individual’s respiratory system - Resistance training is effective for people with COPD to help to preserve lean tissue - Resistance training should also be progressive in nature, beginning with a moderate volume (1–2 sets per exercise for 8–15 repetitions per set) at a moderate intensity (e.g. 50–60% of 1RM) - Over time, this can progress to three sets per exercise, with fewer repetitions and a higher training intensity - Focus on multi-joint exercises and adopt a whole-body approach to training, with 2–3 sessions per week - COPD clients may require more rest between each set than individuals without.

Answer 96

1 in 20, fourth.

Answer 97

30-60 secs.

Answer 98

-Maximal anaerobic rate: ATP–PC rate / very short-term power Relevance: ability to produce high amounts of work in a short period of time (e.g. 20-metre sprint in a field sport) -Maximal anaerobic capacity: ATP–PC + lactic acid capacity / short-term power Relevance: size of the anaerobic ‘engine’ and the ability to display repeat or prolonged power output (e.g. a round of boxing or martial arts) -Maximal aerobic rate: VO2max / medium-term power Relevance: knowledge of the maximal power the aerobic engine possesses and the effectiveness of the cardiorespiratory and muscular systems to work together -Highest sustainable work rate: the ‘switch’ between energy systems where aerobic energy production becomes less of a contributor overall and reflects the highest sustainable level of power output before metabolism becomes significantly fatiguing Relevance: maximal sustainable speed or ‘race pace’.

Answer 99

Relative peak power is determined simply by dividing the peak power by body mass and is expressed as W/kg.

Answer 100

Anaerobic tests are divided into tests measuring anaerobic power and anaerobic capacity. These could be measured with the following units: - Measures of power output, such as watts (instantaneous or averaged) (e.g. 2.25-metre horizontal jump) - Height or distance covered over durations related to the ATP–PC or lactate systems (e.g. 400 metres) - Relative peak power is determined simply by dividing the peak power by body mass and is expressed as W/kg.

Answer 101

- Aerobic tests often seek to determine the VO2 max of an individual. Heart rate max (HRM) will also occur at the same intensity of activity because the heart and circulatory system is working maximally to help deliver oxygen to the working tissues. VO2 max and HRM could be a direct measure, through a maximal test that takes a client to maximal aerobic power, or through a predictive sub-maximal test that uses an equation to estimate the VO2 max from working at a lower intensity. - VO2 max is achieved when exercise intensity is increased but no further increase in oxygen intake is observed. The same goes for heart rate. It is very unlikely that a Personal Trainer can take direct measures of oxygen intake in a regular health and fitness setting, therefore heart rate makes for an easy-to-measure surrogate. - Whilst VO2max is a metric often discussed, assessed and used from which to prescribe cardiorespiratory exercise, it has been suggested that a client will only be able to exercise at an intensity equivalent to VO2max for 3–10 min.

Answer 102

the metabolic cost of performing an activity. One MET is the energy equivalent expended by an individual whilst seated at rest. Whilst exercising, the MET equivalent is the energy expended compared to rest, so MET values indicate the intensity. An activity with a MET value of 5 means you are expending 5 times the energy (number of calories) than you would at rest.

Answer 103

To reduce the error variation from +/- 12 bpm to 7 bpm, the ACSM recommends the following MHR formula: 208 – (0.7 x age) = MHR

Answer 104

-Represents a level of intensity at which blood lactate accumulation can be cleared but is close to being at an intensity where it will be produced faster than it can be cleared. The client can cover oxygen needs and carbon dioxide removal through increased tidal volume but will need to start breathing faster if intensity rises beyond this point to eliminate the excess carbon dioxide being produced by the cells of the working muscles - RPE associated with exercise at this intensity: 13 - RER (substrate): 0.85–0.87. (fat and carb fuel-RER 0.7 fat main fuel) - Approximately the highest intensity that can be sustained for one or two hours of exercise and correlates well with the talk test (below VT1, talking is comfortable).

Answer 105

- Represents a level of intensity where there is a disproportionate increase in ventilation resulting from the need to breath more quickly. Breathing frequency may already be somewhat elevated prior to this threshold, however because lactic acid is increasing at a rate significantly faster than it can be cleared an increase in acidity (reduced pH) begins to create a need for hyperventilation. - RPE associated with exercise at this intensity: 15 - RER (substrate): 1.0 (carb main fuel) - Approximately the highest intensity that can be sustained for 30–60 min of exercise in well-trained individuals.

Answer 106

Option 1: a graded test with stages of increasing intensity until a maximum power output (speed) is achieved but cannot be sustained at any higher level of intensity Option 2: a time trial where a pre-defined distance has to be covered in the quickest time.

Answer 107

- This test requires the participant to run as long as possible on a treadmill using incline increments at timed intervals - The participant warms up for ten minutes - The assistant sets up the treadmill with a speed of 8.05 km/hr (5 mph) and an incline of 0% - The assistant gives the command “GO” and starts the stopwatch; the participant commences the test - The assistant, after three minutes into the test, adjusts the treadmill incline to 2.5% and then every two minutes thereafter increases the incline by 2.5% - The assistant stops the stopwatch and records the time when the participant is unable to continue - From the total running time (expressed as minutes and fractions of minutes), an estimate of the athlete’s -VO2max can be calculated as follows: - VO2max = (time × 1.444) + 14.99

Answer 108

One critique of the Astrand protocol is that it requires individuals with higher cardiorespiratory fitness to perform at very high treadmill grades (>20%), which can cause local fatigue of calf muscles and potentially an early test termination. This would limit the individual from maximally stressing their cardiorespiratory system as their muscular system would first ‘give up’.

Answer 109

A specific workload is predetermined, and the participant is asked to work at the maximal work rate for a designated time-10 secs for CP and 30-60 sec for lactic-2 sprints separated by 1-2min rest-3 min warm up required too-reading distance achieved.

Answer 110

-Equipment needed: scale, step (30 cm females, 40 cm males), a metronome, a stopwatch and a heart rate monitor -The test lasts for 6-minutes where the client is required to step up and down at a set frequency -Once bodyweight has been taken and the step is set up then the test can begin -A specific warm up is not needed as the test is submaximal, however in some instances it might be appropriate for the Personal Trainer to take their client through some simple lower body movement or stretch drills (e.g. dynamic calf, dynamic hip flexor, dynamic glute) -The step frequency to be used is 22.5 steps per minute – this remains constant throughout -A metronome can be set at either 45 bpm or 90 bpm: 45 bpm = step up on 1 count (both feet within each beat) and down on 1 count (both feet within each beat) i.e. “up, down” 90 bpm = step up on 1 count (one foot each beat) and down on 1 count (one foot each beat) i.e. “up, up, down, down” Note: these achieve the same objective. Personal preference can dictate which option to use. The client may find it easier to synchronise their steps with particular audible feedback -;Heart rate is recorded and noted at the end of each minute until the test is completed -Once completed, the client can be asked to sit for 3 minutes and recovery heart rate can be observed. Whilst this is not compulsory it would allow the Personal Trainer to observe how quickly the heart rate returns to rest (where a reading is noted at minute 1, 2 and 3 post-test) -The Åstrand-Ryhming Nomogram is then used to calculate predicted VO2max.

Answer 111

5-10 degree flexion.

Answer 112

Metabolic syndrome is the name for a group of risk factors that raise disease risk. - A Large Waistline (>30 women, >40 men) - A High Triglyceride Level(>150mg/dL) - A Low HDL Cholesterol Level-which removes cholesterol from your arteries (<50mg/dL women, <40mg/dL men) - High BP-A blood pressure of 130/85 mmHg or higher (either measurement being high is still a risk) - High Fasting Blood Sugar-normal is 100mg/dL, 100-125 considered prediabetes and >126 diabetes

Answer 113

It is important to keep in mind that the data gathered is not only specific to the client but is also specific to the modality of exercise. For example, if a threshold assessment was made using a treadmill then this data should be used for programming treadmill running. A different profile is likely to be observed for cycling or rowing as the different muscles being used affect the efficiency of movement. If the movements in swimming for example, are less well practiced then the energy cost is likely to be greater and this would produce an increased heart rate response vs. a modality that is more regularly used.

Answer 114

Zone 1: intensity from rest to VT1 (aerobic) Zone 2: intensity from VT1 to VT2 (approx.75/25 aerobic–anaerobic) Zone 3: intensity from VT2 to HRmax (approx.50/50 aerobic–anaerobic) Zone 4: intensity from HRmax to maximum power output (anaerobic)

Answer 115

-low ATP replenishment rate -fats are the primary substrate -little lactate production -small increase in inspiration (not expiration or frequency) talking should be easy -suitable for very deconditioned / sedentary clients -high benefit-to-risk ratio for beginning exercisers -increasing exercise duration and frequency can facilitate health improvements and caloric expenditure should not exceed a 10% volume increase from one week to the next -once clients are performing 30 min of continuous exercise just below the talk-test threshold (RPE 13). They are ready to begin including training in zone 2.

Answer 116

-shift of substrate from fat towards carbohydrate accumulation of blood lactate begins but is matched by clearance rate via buffering systems leading to increased C02 production -ventilation increases via greater frequency -still possible to speak but much less comfortable -sustained exercise is possible but uncomfortable (RPE 15) (thus effective for weight management) -moderate caloric expenditure -effective for recreation endurance athletes participating in events e.g. 10k or half marathon -helps improve exercise economy -can be used for Zone 2 intervals (alternate Zone 2 work with Zone 1 active rest e.g. 1:2 or 120-sec, 240-sec and progress to 2:1 or 240-sec, 120-sec) progressively transition and build more time in Zone 2

Answer 117

- intensities just below VT2 represent the highest intensity an individual can sustain for approximately 20 to 30 minutes - buffering systems to clear lactate can no longer keep up with rate of production, blood pH begins to drop (increased acidity) - only single word talking possible - represents 'anaerobic threshold training', also improves V02 max - suitable for highly trained fitness enthusiasts / clients performing multiple hours cardiorespiratory training per week - appropriate for performance goals within endurance-based events - helping clients improve anaerobic endurance so they can perform more physical work at or near VT2 for an extended period - can be used for Zone 3 intervals (alternate Zone 3 work with Zone 1 active rest e.g. 1:3 or 60-sec, 180-sec and progress to 3:1 or 180-sec, 60-sec)

Answer 118

- anaerobic power development (lactate and alactate) - very high rates of ATP replenishment - max or close to max intensity (power output) - improved phosphate stores - improved lactate buffering capability - enhanced speed development and speed-endurance - effective for team sports participants - can incorporate movement specific drills (change of direction agility training) - can be used for Zone 4 intervals (alternate Zone 4 work with Zone 1 active rest e.g. 1:10 or 10-sec, 100-sec)

Answer 119

- modality - training frequency - intensity - duration - progression (no more than 10% of one variable each week) * *note for tests a good retest is 12 weeks later.

Answer 120

-Enhanced cardiovascular and thermoregulatory (heat regulation) function -Improved mitochondrial energy production and oxidative capacity of skeletal muscle -Increased utilisation of fat as a fuel (to spare glycogen) -Likely to improve the VT2 / lactate threshold intensity by enhancing the body’s ability to clear lactate -Long-term use of LSD / LISS can cause an eventual shift of type IIb fibres to type I fibres. However, it lacks the specific neuromuscular activation patterns that match endurance competition (i.e. not running at race pace does not activate / stress the tissues as it would in a real race).

Answer 121

- This type of training is also often called ‘threshold training’, as the intensity corresponds to VT2 - Is a form of continuous training with durations of approximately 30–60 min - The specific intensity selected (VT2) improves energy production from both aerobic and anaerobic metabolism - The primary objective is to develop a sense of race pace and enhance the body systems’ ability to sustain exercise at that pace - Same pattern of muscle fibre recruitment as is required in competition - Improves running economy and increases the lactate / V2 threshold.

Answer 122

- ‘Fartlek’ originates from the Swedish term for ‘speed play’ - Is a combination of several types of cardiorespiratory training using intensities from multiple zones - Can be unplanned / random or planned / structured - Challenges all energy systems of the body and may help to reduce the boredom and monotony associated with daily training - Likely to enhance VO2max, increase the lactate threshold, and improve running economy and substrate utilisation.

Answer 123

-Involves exercise at intensities close to VO2max -Work intervals should last 4–10 min -The rest intervals should be equal to or less than the work interval -Interval training permits the client to train at intensities close to VO2max for a greater amount of time than would be possible in a single exercise session with a continuous format -This type of training should not be performed until a firm base of aerobic endurance training has been attained Requires energy production from both aerobic and lactic acid energy systems -Long interval training is very stressful and should be used sparingly -Increases VO2max and enhances anaerobic metabolism.

Answer 124

- High-intensity interval training, or HIIT, is a form of training that uses repeated high-intensity exercise bouts interspersed with brief recovery periods - Work bouts are performed above VO2max - Beneficial for improving running speed and economy, which are important towards the later stages of an aerobic endurance race when the final ‘kick’ or ‘push’ is needed to pass a competitor or to set a record or personal best time - Work intervals should last 2–4 min - The rest intervals should be equal to the work interval; if the rest periods are too long, many of the benefits experienced from challenging the lactic acid energy system will likely diminish.

Answer 125

- Work bouts performed at an intensity between VO2max and max power - Lower end of Zone 4 - Increased intramuscular levels of anaerobic substrates: ATP, CP and glycogen - Increased quantity and activity of key enzymes that control the anaerobic phase of glycolysis - Increased capacity to generate high levels of blood lactate (and pain tolerance).

Answer 126

- Work bouts performed at an intensity very close to max power-ipper end of Zone 4 - Exercises such as sprints and plyometric drills primarily stress the phosphagen system; they are usually less than ten seconds in duration and minimise fatigue by allowing almost complete recovery between sets (e.g. 5–7 minutes rest) - Drills that incorporate other fitness components can be used (e.g. agility, plyometric and sport-specific movement patterns) - Increases intramuscular levels of anaerobic substrates: ATP and CP - Many physiological adaptations are comparable to those from resistance training (strength and power) - Enzyme adaptations represent a major metabolic adaptation to very high-intensity sprint training, with the enzymes of all three energy systems showing signs of adaptation to training and some evidence of a return to baseline levels with detraining - Myokinase and creatine kinase have shown small increases as a result of short-sprint training in some studies, and elite sprinters appear to be better able to rapidly break down phosphocreatine (PCr) than sub-elite sprinters do - Mitochondrial enzyme activity also increases after sprint training, particularly when long sprints or short recovery between short sprints is used as the training stimulus - After the use of anaerobic training methods, the recruitment of fast-twitch motor units has been shown to be elevated as a means to support heightened levels of force expression - Enhanced neural transmission capabilities (communication between the nervous and muscular systems) - Morphological adaptations to sprint training include increased muscle fibre cross-sectional area - The aerobic system ultimately has limited involvement in high-intensity anaerobic activities, but it does play an important role in the recovery of energy stores during periods of low-intensity exercise or rest.

Answer 127

Heart rate.

Answer 128

- The aim of negative splits is to complete the second portion of each work interval at a faster pace than the first portion. The interval is often split halfway through, although the split can come at any point in the interval. - During a negative split the intensity increases at a time when fatigue may be accumulating. This becomes both physiologically and psychologically challenging. Learning to ‘hold’ a given intensity helps the client become familiar with how it feels to work at that intensity whilst establishing the ability to ‘switch gears’. This interval arrangement may be beneficial for clients that compete in middle- and long-distance events where a fast finish may be needed to overtake fellow competitors.

Answer 129

- A ladder interval training system consists of intervals that become progressively quicker without recovery. This approach is similar to the pyramid approach used in resistance training. - Such a training system pushes a client through the metabolic thresholds of VT1 and VT2, all the way up to VO2max. It provides a tough challenge and should be used in a progressive manner i.e. incrementally add stages across sessions to allow for the accumulation of and adaptation to greater volume. The number of ladders should also be progressively increased.

Answer 130

Turnarounds are effective at developing speed-endurance. First, a relevant set distance to cover is selected, for example 400m around a running track. The goal of the session will dictate the target time (and therefore intensity) for completion of the distance. Next, a fixed total interval duration is established, for example 5-minues; this incorporates the time to complete the interval as well as the recovery duration. As each interval passes it is likely that the time to complete the distance will increase as fatigue will accumulate, however, the total interval duration remains fixed and the client / athlete must begin the next interval once the 5-minutes has elapsed, which is likely to incrementally reduce the rest time portion.

Answer 131

- In 1997 Japanese researchers demonstrated that a workout of just four minutes using intervals of short duration and maximal intensity (170% of VO2max) can be effective for increasing aerobic and anaerobic fitness simultaneously (Tabata et al., 1997). Tabata training can be defined as: “training at the intensity that exhausts subjects during the 7th or 8th set of a 20-s exercise bouts with a 10-s rest between the exercise bouts”. - The Tabata method has the advantage of time efficiency and is ideal for well-motivated clients who only have limited time to train. The maximum intensity bursts of work that last 20-seconds coupled with rest periods of just 10-seconds elicits a very high concentration of blood lactate and therefore high levels of pain and discomfort. - Authentic Tabata training is performed using cardiorespiratory modalities. It is hard to reach and sustain the necessary intensity when using modalities such as traditional bodyweight exercises and resistance exercise.

Answer 132

- Functionality: enhanced ability to perform activities of daily living - Movement efficiency: decreased energy cost - Movement ease: pain free and unrestricted - Movement control: stabilisation and prevention of unwanted motion - Movement autonomy: minimal need to ‘think’.

Answer 133

Muscle fibres are strongest in their mid-ranges of motion, and there is a steep drop-off at the end of each side of the muscle tension spectrum, indicating that when a muscle is fully shortened or fully lengthened, it is weakest.

Answer 134

- Reciprocal inhibition is a neuromuscular reflex. To help to rearrange the posture to maintain COM over the BOS, an increase in the neural drive of a muscle, or a group of muscles, reduces the neural activity to the opposite group – this reduces their muscle tone or tonicity. - This neurological arrangement does not imply that an ‘on-or-off’ switch exists – merely that the signal strength is increased or decreased. With reciprocal inhibition, there is a decrease in signal strength to the muscles held long, whilst the muscle, or the group of muscles, held in the shortened position may experience hypertonic conditions, where an increase in signal strength helps to hold the joint in position.

Answer 135

- Considering that the average head weighs approx. 7% of the total body mass, a forwards shift in head position would generate a need for hypertonicity of the neck extensors to increase support and stabilise this position. - As a consequence of heightened muscle activity, reduced blood flow might be experienced as contracting muscles ‘squash’ the blood vessels that pass through them. In turn, a lack of oxygen may force nearby tissues to generate ATP via increased contributions of the anaerobic system. A raised level of lactic acid may create feelings of pain and discomfort to accompany the already raised tension in the region. - Finally, it has been suggested that for every inch that the COM of the head moves forwards, the lower cervical spine is subjected to compressive forces equivalent to an additional single head weight! Over time, this may cause degeneration in the joints of the neck, spine and shoulder.

Answer 136

Normal values of anterior pelvic tilt seem to range between six and 13 degrees and are greater in females than in males.

Answer 137

Abductors.

Answer 138

Lateral rotation where the patellae angle out.

Answer 139

Anterior longitudinal ligament stretched.

Answer 140

Furthermore, significant limitations or right and left side imbalances exist in some clients at very basic levels of movement, and it has been suggested that clients with >15% contralateral strength differences have an increased injury risk.

Answer 141

``` The Functional Movement Screen (FMS) is a pre-participation test made from seven individual tests, comprising standardised, compound movements that are rated 0–3 by an examiner. In its original format, 7 assessments are used: Deep squat Hurdle step In-line lunge Shoulder mobility Active straight leg raise Trunk stability push-up Rotary stability. ```

Answer 142

- A score of zero is given if pain occurs (alongside potential referral to an allied health practitioner) - A score of one is given if the client cannot perform the movement - A score of two is given if the client is able to complete the movement but compensates in some way - A score of three is given if the client performs the movement correctly - The individual scores for the movements are combined into a final score out of 21 points, which is thought to predict injury risk - Gray Cook has suggested that scores ≤14 points predict individuals who are at a greater risk of injury than those with scores that are >14 points-In most populations, norms for the FMS sum score range between 13 and 15 points, and many trials have reported norms of around 14 points.

Answer 143

An abbreviated version of the screen can be used to improve time efficiency and assess global movement competency (without compromising understanding of the client’s capabilities). The trunk stability push-up and rotary stability tests are dropped.

Answer 144

The squat is a movement needed in most athletic events. It is required for most power movements involving the lower extremities. The deep squat is a test that challenges total body mechanics when performed properly. The deep squat is used to assess bilateral, symmetrical, functional mobility of the hips, knees, and ankles. The dowel held overhead assesses bilateral, symmetrical mobility of the shoulders, as well as the thoracic spine.

Answer 145

The hurdle step is designed to challenge the body’s proper stride mechanics during a stepping motion. The movement requires coordination and stability between the hips and torso, as well as single leg stance stability. The hurdle step assesses bilateral functional mobility and stability of the hips, knees and ankles.

Answer 146

This test attempts to place the body in a position that will focus on the stresses simulated during rotational, decelerating and lateral type movements. The in-line lunge is a test that places the lower extremity in a scissored position, challenging the body’s trunk and extremities to resist rotation and maintain proper alignment. This test assesses hip and ankle mobility and stability, quadriceps flexibility and knee stability.

Answer 147

The shoulder mobility screen assesses bilateral shoulder range of motion, combining internal rotation with adduction and extension, and external rotation with abduction and flexion. It also requires normal scapular mobility and thoracic spine extension.Clearing exam: -There is a clearing exam at the end of the shoulder mobility test. This movement is not scored; it is simply performed to observe a pain response. If pain is produced, a positive is recorded and a score of zero is given to the entire shoulder mobility test. This clearing exam is necessary because shoulder impingement can sometimes go undetected by shoulder mobility testing alone. -clearing exam involves placing hand on opposite shoulder and lifting elbow up

Answer 148

The active straight leg raise tests the ability to disassociate the lower extremity while maintaining stability in the torso. The active straight leg raise test assesses active hamstring and gastroc-soleus flexibility while maintaining a stable pelvis and active extension of the opposite leg.

Answer 149

hold-relax supine hamstring PNF stretch With the client resting supine on the ground or on a table the trainer / therapist moves the client’s extended leg upwards so the hip is in flexion. The movement is halted when the point of mild discomfort is felt (i.e. 7/10) This passive stretch is held for ten seconds On instruction, the client isometrically contracts the hamstring by pushing their flexed leg back / down against a block (usually the hand / shoulder of trainer / therapist) using 20% of maximum effort. Just enough force is applied by the trainer / therapist so that the leg remains static despite the efforts of the client. This is the ‘hold’ phase and lasts for six seconds The client is then instructed to ‘relax’ whilst the trainer / therapist moves the hip into more flexion for a second passive stretch. This is held for: a) ten seconds if repeating the sequence or b) 30 seconds if ending the sequence. For each sequence the client’s extended leg should move farther than before (greater hip flexion) due to AI being created in the hamstring The number of times the sequence is performed will be dependant on the needs of the client and the time available to perform the stretch. contract-relax The same protocol above is used except: On instruction, the client concentrically contracts the hamstring by pushing their flexed leg back / down against a block (usually the hand / shoulder of trainer / therapist) using 20% of maximum effort. Just enough force is applied by the trainer / therapist so that there is resistance whilst allowing the client to push their leg to the floor across three seconds (i.e. through the full range of motion back to a neutral hip). This is the ‘contract’ phase.

Answer 150

Dynamic stretching Active isolated stretching Sustained isometric contractions

Answer 151

- strength - aesthetics - health, successful aging and quality of life - performance

Answer 152

- Myofibrillar hypertrophy is accomplished via the growth and multiplication of the myofibrils inside each muscle fibre (NOT the muscle fibres). The myofibrils are made up of contractile proteins that make the muscle fibre contract-Myofibrillar hypertrophy implies that the sarcoplasm expands at roughly the same rate as the myofibrils grow and expand. - Sarcoplasmic hypertrophy is accomplished by the expansion of the sarcoplasm (the cytoplasm of the muscle) inside the muscle fibre.- Sarcoplasmic hypertrophy implies that the sarcoplasm expands at a significantly faster rate than the myofibrils grow and divide. It is difficult to suggest to what extent sarcoplasmic hypertrophy alone contributes to a meaningful gain in muscle fibre cross-sectional area. It is likely that the following factors would also increase the volume of the sarcoplasm: - Supplements like creatine - Carbohydrate loading (1 g of glycogen is stored with 3 g of water) - Blood flow restriction / occluded training - Muscle damage/inflammation. - Hyperplasia-refers to an increase in the number of muscle fibres via longitudinal fibre splitting in response to high-intensity resistance training. Hyperplasia has been shown to occur in animals, but the findings are controversial in humans

Answer 153

- In multi-joint exercises like a squat, whilst the highest threshold motor units are recruited when going to failure during relatively low-load training, they never reach anything approaching the maximal tension they are capable of generating (this would only be achieved with a 1RM!) This suggests a reason as to why both high and low load training will be effective for muscle hypertrophy. High loads are important for providing mechanical tension to specific motor units capable of generating high forces. There is also evidence to show that during multi-joint exercises certain muscles used in that exercise (e.g. vastus lateralis and pectoralis major) may get close to full recruitment early on in the set, further from failure (e.g. little difference in recruitment when loads increase from 60-100% 1RM). - In single-joint exercises like a bicep curl, research suggests there is an increased likelihood that going very close to failure is indeed required to achieve full motor unit recruitment and thus maximise hypertrophic gains.

Answer 154

12-18 | 6-12/workout

Answer 155

Undoubtedly, both compound (multi-joint) and isolation exercises are needed to bring about optimal gains in muscle hypertrophy. By definition, compound lifts can efficiently work several muscles at once because multiple joints are moving, and this ‘shares’ the work across those joints. However, they only stimulate maximal muscle growth in the muscles that are the ‘weak links’. For example, in the DB shoulder press, both deltoids and triceps are stimulated, but the deltoids will limit performance, and so the deltoids receive the greater stress and get the larger growth signal. To ensure maximal growth in the triceps, additional isolation exercises would be beneficial.

Answer 156

Hyperplasia.

Answer 157

Central: inside the central nervous system (neural adaptation) • Peripheral: changes to hard and soft tissues (structural or morphological changes).

Answer 158

-Pennation angle is the angle between the longitudinal axis of the entire muscle and its fibres. The longitudinal axis is the force generating axis of the muscle and pennate fibres lie at an oblique angle. As tension increases in the muscle fibres, the pennation angle also increases. Different muscles have different pennation angles of their muscle fibres: -Larger pennation angles allow for more muscle fibres to align between the two ends of the muscle and this results in more force but (as a trade-off) reduced range of motion -Smaller pennation angles allow for that muscle to move over a greater range of motion which makes it effective for generating speed, but (as a trade-off) are not so effective for force production.

Answer 159

- Although it is a counter-intuitive idea, research has shown that when undertaking a combination of high-intensity resistance and aerobic endurance training, nearly all of the type IIb fibres transition into more aerobic / oxidative type IIa fibres: - Interestingly, detraining has the opposite effect, resulting in an increase in type IIb fibres and a reduction in type IIa fibres - Transformation from type I to type II or vice versa appears less probable.

Answer 160

- Mechanical loading stimulates osteoblast activity to increase, whereby more collagen proteins are produced and deposited into spaces between existing bone cells. Once this new protein matrix becomes mineralised, greater stability of the bone tissue is found. - Most bone remodelling occurs on the outer surface of the bone, close to the periosteum, thus resulting in appositional bone repair and reinforcement. This is effective because when increasing the diameter of bone, the force can be shared across a larger surface area, thereby decreasing the amount of mechanical stress on any one region.

Answer 161

-cigarette smoking, malnutrition, diabetes, rheumatoid arthritis and osteoporosis

Answer 162

- The junctions between the tendon (and ligament) and the bone surface - Within the body of the tendon or ligament - In the network of fasciae within skeletal muscle.

Answer 163

- An increase in collagen fibril diameter - A greater number of covalent cross-links within the hypertrophied fibre - An increase in the number of collagen fibrils - An increase in the packing density of collagen fibrils.

Answer 164

Inside the muscle.

Answer 165

-Whilst muscle hypertrophy results appear to be derived from optimising volume (with training frequency being less important), strength training gains are more likely to be influenced by frequency. According to independent analysis of the strength training research, Greg Nuckols (2018) reports: • Even when volume is matched, it seems that higher training frequencies lead to larger strength gains. Especially for upper body pressing exercises, spreading a given number of sets over more training days (up to at least 4) seems to increase strength gains • Higher frequencies seem to lead to 20-23% faster strength gains, in both trained and untrained lifters, and there seems to be a fairly linear increase in the benefits of increased frequency, with 1<2<3<4+ • Upper body muscles recover faster between training sessions vs. lower body muscles and therefore higher training frequencies in upper body muscles may be needed to optimise strength gains. -Greater training frequency may indeed allow for greater training volume across the week but even when volume is equated training more often may simply allow for more practice of exercises and therefore movement skill improves. Training 4x per week with squats vs. 2x per week may also improve the quality of all reps in those sessions (and therefore the ‘effort’) because a client is not required to ‘cram in’ all their sets within fewer weekly sessions.

Answer 166

-Whilst muscle hypertrophy training is more likely to be programmed according to selected muscle groups, strength training is typically performed via: • Movement patterns: e.g. squat (back squat), single leg (lunge), bend (deadlift), (pull) bent-over row and (push) military press and bench press • Specific lifts: some clients may wish to compete in events such as powerlifting or weightlifting, where a requirement exists to lift the most weight possible. Therefore, the majority of strength training is focused around performing these specific lifts along with accessory exercises that help to focus on ‘weak links’ (to further improve those lifts): • Powerlifting: deadlift, bench press and back squat • Weightlifting: snatch, clean and jerk.

Answer 167

- The nervous system is ‘potentiated’ using incrementally heavier loads. Provided that adequate inter-set and inter-wave rest is used (e.g. 2-5 minutes) the first wave enhances the second wave until strength capacity is reached. - First, select a load corresponding to a 6RM (85% 1RM) for wave 1. - When a set cannot be completed i.e. completion of all 3 reps with sound technique, this component of the workout is done. - Add extra load to wave 1 only at week 3 and only if at least 1 of the previous 3 sessions were successful i.e. all 3 waves completed. - Week 3: add approx. 2.5 kg to wave 1 start weight (and adjust all others up from here).

Answer 168

- Previous high intensity contractions (a potentiating stimulus) acutely increases the strength / power production in a subsequent exercise that is biomechanically similar. - The 2 exercises together are sometimes referred to as a ‘strength-power potentiating complex’ or ‘complex-pair’. - Vertical jump and sprint performance have been improved when applied between 4 and 18.5 minutes after the completion of potentiating near-maximal back squat or power cleans. - Similar performance improvements have been noted for bench-throws after near-maximal bench press.

Answer 169

Involves using short intra-set rest periods of anywhere from 10–30 seconds. The brief rest allows for some replenishment of ATP and may help preserve neural drive. Thus, the second half of the set may result in more powerful repetitions or more total repetitions with a heavy load, and thus may enhance the overall volume of the session along with the density of work in the session (more volume-load in a shorter period of time).

Answer 170

-The time of day: The environmental temperature -Client factors: Well rested / prior physical activity Fed vs. fasted Stimulants ingested (e.g. caffeine) -Instructor influence: The warm-up protocol The instructions provided The level of motivation provided. -In addition, 1RM tests should be conducted before any other fatiguing tests so that a true representation of force generating capabilities can be assessed. Fatigue-inducing assessments include: • Muscular endurance (e.g. press-ups, calf-raises) • Anaerobic power and capacity (e.g. sprint testing) • Aerobic power and capacity (e.g. VT1 / VT2 / MHR testing). Client ability: • Competent technique in the lift to be tested • Confidence in working at maximal exertion • In good health, with no previous injuries and no obvious postural distortions or asymmetries.

Answer 171

Whichever protocol is followed, the same protocol should be used each time a client is tested to ensure the reliability of the test data gathered: - The client should perform a warm-up with a self-selected load that will allow them to complete a minimum of 6–10 repetitions (approx. 50% predicted 1RM) - The client should then have 1–5 min of rest (as needed) - The client then selects a weight based on previous effort / experience that will allow them to perform three repetitions (approx. 80% of predicted 1RM) - The client should then have 1–5 min of rest (as needed) - The client now increases the load and begins attempting their 1RM. A series of single attempts should be completed until 1RM is achieved - Rest periods should remain at 1–5 minutes between each single attempt, and load increments are typically 5–10% for upper-body exercises and 10-20% for lower-body exercises. 1RMs should be achieved within 3–5 attempts (otherwise fatigue will build) - If multiple 1RM tests are being administered (e.g. back squat, bench press and deadlift), then it is recommended that all test exercises should be separated by a minimum of 5-minutes rest.

Answer 172

Power is defined as the product of force and velocity. or The rate at which work is done, where work done is the product of force and distance.

Answer 173

* Extrafusal muscle fibres are the standard muscle fibres that are innervated by motor neurons and generate tension by contracting, thereby allowing for skeletal movement. They make up a large mass of skeletal (striated) muscle and are attached to bone by fibrous tissue extensions (tendons) * Intrafusal muscle fibres are skeletal muscle fibres that serve as specialised sensory organs (proprioceptors) that detect the amount and rate of change in the length of a muscle. They constitute the muscle spindle and are innervated by two axons: one sensory and one motor. Intrafusal muscle fibres are ‘walled off’ from the rest of the muscle by a collagen sheath.

Answer 174

-When a muscle lengthens, the muscle spindle is stretched and its nerve activity increases (dashed lines). This increases motor neuron activity, causing the muscle fibres to contract and thus resist the stretching. A secondary set of neurons also causes the opposing muscle to relax. The reflex functions to maintain the muscle at a constant length. The stretch reflex is known as a ‘monosynaptic reflex’: • Resistance training has been shown to increase reflex potentiation by between 19% and 55% • A stiffer myofascia has a stronger reflex response and captures more energy when stretched / loaded (think about doubling up and stretching two elastic bands together: more stiffness = more energy return • Kubo (2002) showed a 15–20% increase in Achilles tendon stiffness following eight weeks of resistance training • Relatively heavy loads (80% of 1RM) increase tendon stiffness but light loads (20% of 1RM) do not.

Answer 175

- Plyometric exercise refers to those activities that enable a muscle to reach maximal force in the shortest possible time. Therefore, such exercises typically involve forms of jumps, hops and bounds - Eccentric-The momentum generated in a downward direction (assisted by gravity) help to ‘load’ the body on impact with the ground. The stretch reflex is initiated, and energy is captured in the elastic components of the myofascia. - Amortisation-There is a brief isometric transition phase during ground contact where the monosynaptic stretch reflex is put into action (the sensory neurons surrounding the stretched intrafusal muscle fibres feed back to the CNS, where a motor response is initiated). - Concentric-If the ground contact time during the amortisation phase is short enough, then the captured energy can be optimally released back into the concentric phase of the movement. This is potentiated by the shortening stimulus from the stretch reflex of the motor neuron. * *note power training should always be performed first as aerobic exercise would negatively impact performance.

Answer 176

Experience hypertrophy.

Answer 177

Speed-strength.

Answer 178

Strength-speed.

Answer 179

When referring back to the F–V curve, it has often been suggested that because peak power is produced at intermediate velocities with the lifting of light–moderate loads, this should dictate the load selected when training for power. “Non-weightlifting multipoint power exercise (jump squat, bench press throw, overhead press throw) and single-joint muscle action data reveal that peak power is generally reached with the lifting of very light loads— from body weight (0%) to 30% of the 1RM.”

Answer 180

- Points of contact - Speed - Height of drill - Body weight (or weighted vests)

Answer 181

- The NSCA recommends using loads equivalent to 75–90% 1RM for a range of 1–5 reps. It is important to note that these loads do not match the traditional repetition–load tables, however: - For example, performing 3–5 reps is typically associated with loads of 93% to 87% 1RM, not 75% to 85% of the 1RM. The reason for the lower intensity assignment for these power exercises is because when a maximum repetition–load is used, exercise form during these highly technical exercises is very likely to be compromised. - The Personal Trainer should fully appreciate that any power-focused movement not performed to near perfection is likely to result in suboptimal power output at best, a missed lift in the intermediate or an injury in the worst instance. Power exercises are usually limited to five repetitions per set but with loads up to and equal to 10RM (i.e. approximately 75% of the 1RM). - One final view with respect to the intensity prescribed to power-training workouts relates to the effort or intent to perform that exercise with maximal velocity, regardless of the actual external velocity achieved.

Answer 182

-When considering the volume of power training to be undertaken, the Personal Trainer should refer to the guidelines for strength training. Training for muscular strength and power places a high physiological stress on an athlete’s / client’s body; thus, some modifications may be required to ensure that movement quality is always maintained and that power output is not compromised through the completion of too many reps, sets or workouts per week. -As Sheppard (2016) explains, volume assignments for power training may be lower than those for strength training in order to maximise the quality of exercise. This reduction in volume results from fewer goal repetitions and lighter loads, rather than the recommended number of sets: -The common guideline is 3–5 sets (after warm-up) for externally loaded power exercises The plyometric volume is typically expressed as the number of repetitions and sets performed during a given training session. Lower-body plyometric volume is -normally determined by: -The number of foot contacts (each time a foot, or the feet together, contacts the surface) per workout. -Distance covered (if travelling with consecutive jumps, hops, bounds, etc.; e.g. 30 metres).

Answer 183

-As per the recommendations of the NSCA and as described by Sheppard (2016), common guidelines for rest period length for externally loaded exercises are at least two minutes or a range of 2–5 min or 3–5 min. These recovery intervals appear to apply equally to resistance-training programmes designed to improve maximal strength and those that focus on muscular power. -Because plyometric drills involve maximal efforts to improve anaerobic power, complete and adequate recovery (the time between repetitions, sets and workouts) is required: 5–10 seconds between single maximal jumps 1:5–1:10 work–rest ratio or approx. 2–3 min between sets.

Answer 184

- Power training can be performed multiple times per week, especially for clients and athletes of an advanced training status; however, considering the high levels of stress imposed on the body, it is likely that sustained power training for multiple workouts each week across multiple weeks would result in a state of overtraining. - If power development is an important focus within a training cycle, accommodation of high training frequencies can be planned using an ‘undulation’ of training intensity, as it would be difficult to continuously perform the same high-load, low-volume plan, especially with only one or two days of rest between sessions. * *undulating is performing some sessions at submaximal effort to allow for appropriate recovery.

Answer 185

- Complex training alternates biomechanically similar high load weight training exercises with plyometric exercises, set for set, in the same workout. An example of complex training would include performing a set of squats followed by a set of jump squats - The main benefit for complex training is that the explosive capability of a muscle is enhanced after it has undergone maximal (or near maximal) contraction – the physiological explanation for this is called ‘post-activation potentiation’ (PAP). - The theory behind PAP is that the acute change in contractile proteins and motor neuron activity can help to induce greater explosive power performance for a 2–20 min period following heavy loading. - Complex training represents a great way to be time efficient and to combine strength and power training. This has the additional benefit of allowing strength gains to be maintained whilst moving on to a training cycle that aims to improve power. - They can do a softer version but still, if a Personal Trainer elects to design a programme in this way they should still ensure that the clients has adequate motor control, is competent with the techniques of the planned exercises and has had some experience with strength training (for example, two training mesocycles of 6-weeks).

Answer 186

These benefits might come from both central and peripheral influences: - Central: improved excitability of the motor neuron, which more easily allows action potentials to flow along it and thus enables the more rapid activation of the muscle fibres - Peripheral: myosin may have a more rapid rate of binding to actin because of the high amounts of calcium released from the sarcoplasmic reticulum, which hangs around long enough for a power-focused exercise to follow.

Answer 187

Test they have the strength and motor control, ensure no injuries by recording in slow 3 tuck jumps: The knees should track in line with the feet (with the avoidance of a knee valgus i.e. rotation in towards the midline) The feet should remain flat and face forwards (with the exception of a slight heel lift) The hips should remain parallel to the ground. Deviation from this ‘blueprint’ would signify that excessive stresses are likely to be placed upon structures such as the medial knees, which may indicate a greater likelihood of injury in future training and athletic participation.

Answer 188

- Vertical or horizontal (counter-movement) jump test - Hexagon agility test - Barbell push press / push jerk

Answer 189

Use a squat rack with sufficient surrounding space and height Administer as per the guidelines for 1RM strength testing Encourage an upright torso angle Encourage the client / athlete to rapidly flex at the knees and ankles before rapidly extending both joints Encourage work to come from the lower body (vs. too much reliance on pushing) Encourage strong lock-out action when overhead position is reached Note the weight lifted for future comparisons.

Answer 190

Essentially stand in middle of hexagon (2ft length) and jump out at all sides and back to middle facing forward at all times (3 revolutions clock-wise and anti-clockwise) - Use a flat studio floor, prepare and mark out hexagon grid as shown - Encourage relatively stiff legs - Encourage landing on two feet for all contacts - Allow two warm-up jump sequences (one in each direction) - Allow two maximal attempts (one in each direction) and record the best - Allow a standardised rest time of approx. two minutes between attempts - Note the time taken for future comparisons.

Answer 191

Use a wall with a high ceiling and stand parallel to it • Place some chalk powder on the fingertips; stand tall and reach the arm up at full length; make a chalk mark (point 1) • Encourage a fast counter-movement to be used • Jump up as high as possible and touch the wall at the peak height of the jump (chalk mark, point 2) • Measure the distance between the chalk marks (point 1 and 2) • Allow 1–2 warm-up jumps • Allow three maximal attempts and record the best • Allow a standardised rest time of approx. 1–2 min between jumps • Use the formula shown to provide an estimate of power output for future comparisons.

Answer 192

* Use a flat studio floor, track or sandpit * Line up a tape measure parallel to the direction of jumping * Encourage a fast counter-movement to be used * Encourage the client / athlete to lean / angle forwards before the jump * Ensure their toes are behind the start line * Measure the landing point from the back of their heels * Allow 1–2 warm-up jumps * Allow three maximal attempts and record the best * Allow a standardised rest time of approx. 1–2 min between jumps * Use the formula shown to provide an estimate of power output for future comparisons.

Answer 193

Power output (W)=60.7*jump(cm)+45.3*body mass(kg)-2055

Answer 194

Sagittal plane.

Answer 195

In its most general form, periodisation divides a long-term training period called a ‘macrocycle’ (which typically spans six months to one year but may be up to four years, such as with Olympic athletes) into smaller phases called ‘mesocycles’ (usually lasting several weeks to months), which are also subdivided into weekly microcycles. Microcycles are made from the smallest training units, often referred to as ‘single sessions or workouts’:

Answer 196

GAP is the response to stress, it has 3 stages: - The alarm phase (phase 1) represents the impact and initial depletion response to the session. This may be in the form of fatigue, stiffness or DOMS, for example. - The resistance / restitution phase (Phase 2) is then initiated, in which the body is returned to either its pre-exercise level of homeostasis or its newly adapted higher state (i.e. super-compensation occurs). - Finally, and assuming that the accumulation of stress is too great (e.g. the absence of adequate rest and ‘unloading’ of stress), the exhaustion phase (phase 3) occurs, and this may be considered synonymous with overtraining.

Answer 197

Overload implies that there must be a training stimulus provided that exceeds the current capabilities of the kinetic chain to elicit the optimal physical, physiological and performance adaptations Progression refers to the intentional manner in which a programme is designed to progress according to the physiological capabilities of the kinetic chain and the goals of the client.

Answer 198

Mesocycle blocks are usually arranged in a 3:1 loading paradigm, whereby the volume–load gradually increases for the first three microcycles (weeks) before an unloading phase in the fourth (creating the typical undulating appearance of periodised programmes).-however can be discretional - A workout performed at 50% of the volume of the previous session (whilst maintaining intensity) - Active recovery (e.g. extra mobility / technique / cross- training; like doing something completely different, such as a Pilates class or playing a sport recreationally).

Answer 199

Whilst many progressive schemes exist to support client programming, three overarching approaches are: - linear - undulating - conjugate.

Answer 200

- Progressing a training stress or fitness characteristic in a linear fashion. This is roughly equivalent to ‘progressive overload’ for single or multiple variables (reps / sets / load) - You’re effectively exposing your body to the same stimulus each workout. Even with the application of some sort of progressive overload, the volume is similar, the weights are similar, the reps are similar, and the goal is incremental progress - Pros: one fitness component is challenged exclusively and consistently, which will bring about fast results. Works well with beginners because they have more sensitivity to a consistent or similar training stress (the repeated bout effect – the more you’re exposed to a stimulus, the weaker your reaction to it will be – is yet to become effective at slowing progress) - Cons: other fitness components are not developed, and previously trained fitness components may detrain; this would not work well with team sport athletes, for example. Furthermore, the risk of overtraining is greater through ‘pattern overload’ (the same movements) and the need to inch ever closer to maximum effort. - From a macrocycle perspective, linear periodisation is like moving up the levels of the TRAINFITNESS Training Progression Pyramid (e.g. Work Capacity > Hypertrophy > Strength). Each phase would see an increase in training intensity and a concomitant decrease in volume. - From a mesocycle / microcyle perspective, progression between sessions would take the form of a change in one acute variable such as a rep, set or load increase.

Answer 201

- Daily (or weekly) changes to the training volume and / or intensity to expose the body to different stressors across a week - Pros: tissues don’t adapt with as much specificity as they otherwise could, decreasing the impact of the repeated bout effect and allowing responsiveness to training to remain higher. This approach exposes the body to novel stimuli more frequently (i.e. different rep and set ranges), leaving more ‘room to progress’ over time. - From a macrocycle perspective, the focus of training is likely to stay within the level of the TRAINFITNESS Training Progression Pyramid corresponding to the primary goal (e.g. strength vs. cycling through all levels). - From a mesocycle perspective, the ranges of sets and reps used should still reside mostly within the guidelines for the primary goal (e.g. strength: one to eight reps).

Answer 202

-There are two ways to view a conjugate set up: 1. Training multiple fitness components or skills simultaneously with a relatively even focus on each, for example: Monday (strength), Tuesday (speed), Thursday (gymnastics skills), Friday (hypertrophy), Saturday (cardio) OR 2. Maintaining a focus on a particular fitness quality or goal but alternate training across the sub-components of the fitness quality. For example, if lower body strength training was to be undertaken three times per week, one session may tackle maximum strength, one may tackle reactive strength (through plyometric type training) and the third might tackle explosive strength (using Olympic lifting, for example). Each week, one fitness quality might be the target of very high intensity training whilst the other two would be trained at medium intensities (rotating across intensities over a block of three weeks). -Pros: multiple fitness components are challenged across a week, which builds well-rounded fitness. Overtraining is further minimised via the inclusion of a greater variety of exercises -Cons: any single fitness component may not be trained to its fullest extent, and progress may be slower. If a specific lift or exercise must be improved, exposure / practice is more limited (if viewing a conjugate plan as described in option 1.)

Answer 203

“Aerobic exercise if often performed in combination with resistance training for accelerating fat loss, enhancing sports performance, or both. The strategy, called concurrent training, has been shown to have a positive effect on weight management. However, evidence suggests the addition of aerobic exercise to a regimented resistance training program may compromise muscle growth…” In addition, it has also been reported that: -Maximal strength is negatively affected by >3 aerobic sessions per week but not < 2; therefore, low volumes and frequencies of cardiorespiratory training might be used to support health and leanness without compromising strength gains -Within the same session, the greatest interference effect has been shown for when aerobic training is performed before resistance training; therefore, cardiorespiratory or conditioning work should be performed after higher-intensity resistance training if an undulating single-session plan has been developed for the client -It should be noted the same does not apply for roles reversed with strength and plyometrics (power) positively improving 10km race performance.

Answer 204

- When first meeting them/training them - Typically, testing might be performed at the end of each mesocycle or every other mesocycle, or around key dates in the training calendar (e.g. at the start and end of pre-season training for athletes or when a short-term goal has been achieved with a client).

Answer 205

- Time efficient – classes can last 20–60 min - Affordable – often included within facility membership fees or ‘pay-as-you-go’ fees, which are much cheaper than one-to-one personal training fees - Social facilitation / group camaraderie – an opportunity to meet regularly with like-minded people - Competitive – some workouts can be designed to include elements of competition to enhance the motivation to turn up and work hard - Scalable – when space and equipment needs are carefully considered, many workouts can accommodate both small and large numbers of participants - Differentiation – exercises can be provided to offer regressions and progressions to cater for a range of participant abilities - Progression / progressive overload – intelligently programmed workouts can include components of periodisation within them so that session–session or week–week progression is included - Variety – endless workout arrangements and structures can be designed and modified using existing and new templates and session plans.

Answer 206

Highly personalised-one–one personal training clients Personal Trainers have traditionally written their own programmes for clients. This style of programming allows for specific tailoring to clients’ wants, needs and abilities but is more time-consuming for the trainer. Unfortunately, in many cases, trainers either use the same programme for all of their clients or use the same programme for the same client week in, week out; month in, month out; and year on year Predesign-exercise to music; circuit and small-group fitness training Predesigned programmes are very popular and offer a ‘one-size-fits-all’ solution. These types of workouts are preformatted, rigid in their implementation and offer a ‘plug-and-play’ approach for instructors / coaches. Once the routines have been learned, they are easier to deliver to participants and do not require or promote modification / adaptation Pro-design-exercise to music; circuit and small-group fitness training Pro-design offers the best of both worlds: a structured workout that provides an intelligently programmed training session that can be modified to suit the needs of participants. Coaches are required to learn the workout routine and are encouraged/obliged to review the abilities of the participants before them and then act accordingly, in order to: Offer regression or progression options that depart from the base exercise in the original programming template Offer differentiated support, encouragement and motivation based upon the needs of individual participants Restructure, where necessary, the format of the predesigned workout. For example, the trainer can include extended warm-up cycles, offer practice sets of newly learned / complex movements, increase recovery between exercises and / or cycles, remove a particularly challenging exercise within the round (and replace in future weeks), and partner participants of matching abilities to enable them to successfully complete partner drills.

Answer 207

- anaerobic, ATP in muscles - anaerobic, ATP in muscles and CP - anaerobic, ATP + CP + glycogen in muscles - anaerobic lactic, muscle glycogen - aerobic + anaerobic, muscle glycogen + lactic acid - aerobic, muscle glycogen + fatty acids.

Answer 208

- 1:10 - 1:4-1:6 - 1:2-1:4 - 1:1-1:2 - 0.5:1-1:1.

Answer 209

- Time-based protocols: time-based protocols are where exercises are performed for a set amount of time. Time-based protocols include: - Constant time – the time each exercise is performed for is constant (i.e. the same for each cycle / round) - Pyramid – the time may gradually increase then decrease each cycle / round, or vice versa - Ladder – the time may gradually increase or it may gradually decrease each cycle / round - Repetition-based protocols: repetition-based protocols involve performing each exercise for a set number of repetitions. Repetition-based protocols include: - Constant repetition – each exercise is performed for the same number of repetitions each cycle / round - Pyramid – the number of repetitions is gradually increased and then decreased each cycle / round, or vice versa - Ladder – the number of repetitions is either gradually increased or gradually decreased each cycle / round.

Answer 210

Practice reps for challenging exercises.

Answer 211

An adequate diet includes sufficient energy for the person’s needs. The energy in the diet can be in any form (e.g. carbohydrate, protein, fat, etc.) A balanced diet not only includes sufficient energy for the person's needs but all of the person’s dietary requirements in the correct proportions.

Answer 212

The Glycaemic Index (GI) is a dietary index that’s used to rank carbohydrate-based foods. The GI predicts the rate at which the ingested food will increase blood sugar levels The glycaemic load (GL) is equal to the GI of a food times the number of grams of carbohydrates in the serving of food that’s being eaten. The GL is believed to correlate more directly to changes in blood sugar levels than the GI does

Answer 213

The resting metabolic rate (RMR) is the body’s metabolic rate (rate of energy use) early in the morning after an overnight fast and a full eight hours of sleep. This is different from the basal metabolic rate (but the two are commonly used interchangeably).

Answer 214

Organic nutrients are typically found in living beings: humans, animals and plants. They include carbohydrates, proteins, lipids and vitamins. Organic nutrients possess carbon–hydrogen (C–H) bonds Inorganic nutrients are typically found in non-living things but, in smaller amounts, also in living beings. They include minerals. Water can be considered an inorganic nutrient. Inorganic nutrients do not possess carbon–hydrogen (C–H) bonds

Answer 215

Subcutaneously (below the skin) Viscerally (around the organs) Intramuscularly (within the muscle fibres).

Answer 216

Diabetes symptoms (e.g. polyuria, polydipsia and unexplained weight loss for Type 1) plus: - A random venous plasma glucose concentration ≥ 11.1 mmol/l or - A fasting plasma glucose concentration ≥ 7.0 mmol/l (whole blood ≥ 6.1 mmol/l) or two hour plasma glucose concentration ≥ 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).

Answer 217

- Referred to glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells that carries oxygen throughout the body, joins with glucose in the blood, becoming glycated. - By measuring HbA1c, clinicians are able to get an overall picture of what average blood sugar levels have been over a period of weeks / months (this is because red blood cells in the human body survive for eight to 12 weeks before renewal). An HbA1c of 6.5% is recommended as the cut point for diagnosing diabetes.

Answer 218

Foods containing carbohydrate that are digested, absorbed and metabolised quickly are considered high-GI foods (GI >70 on the glucose scale). Foods that are digested, absorbed and metabolised slowly are considered low-GI foods (GI < 55 on the glucose scale).

Answer 219

The authors of the consensus report note that questions remain as to the applicability of the GI for general use, however, there are suggestions that research points to the benefits of using the GI with clients / patients: * That have insulin resistance, increased BMI, and raised waist circumference (as a marker of central adiposity), especially in the presence of diabetes * That are diabetic and present with indicators of metabolic syndrome, such as raised systolic blood pressure.

Answer 220

- Replace refined starches (e.g. flour and potatoes) with intact whole grains, where possible - Whole grains, or foods made from them, contain all the essential parts of the grain seed; in other words, they contain 100% of the original kernel, which includes the bran, germ, and endosperm - Because these layers are intact, the grain contains a richer nutritional profile of antioxidants, B vitamins, protein, minerals, fibre, and healthful fats than grains that have been stripped of the bran and germ layers through processing - Milled whole grains go through a process in which the bran, endosperm, and germ layers are milled into a fine flour to make whole grain pasta, breakfast cereals, and breads. Refined grains have the bran and germ layers removed during processing. Only the endosperm remains, which mostly is comprised of refined starch. -Refined grains have a high glycaemic load and therefore are rapidly absorbed into the bloodstream.

Answer 221

- Hulled (or dehulled) barley is considered an intact grain because only the outermost hull of the grain is removed, while pearl barley isn’t considered an intact grain because its hull and bran have been removed. - Barley contains 13 g of fibre per cup along with selenium, phosphorus, copper, and manganese. The dietary fibre in barley is high in beta-glucan, which helps lower cholesterol by binding to bile acids and removing them from the body. Clients can use barley in soup or dishes that normally call for rice (e.g. stir-fries).

Answer 222

-These are a good source of dietary fibre, manganese, selenium, magnesium, zinc, and phosphorus. After they’re harvested and cleaned, oats go through a roasting process. They’re hulled, although not stripped of their bran and germ layers, ensuring they retain their fibre and other nutrients. Oats are processed in the following ways that don’t alter their nutritional value: -Oat groats are unflattened kernels that are best used as a breakfast cereal or for stuffing Steel-cut oats have a dense and chewy texture. To produce the grain, processors place them on a machine of steel blades that thinly slice them Old-fashioned oats are steamed and then rolled flat Quick-cooking oats are processed like old-fashioned oats except they’re finely cut before being rolled. These oats found in instant flavoured oatmeal contain higher sodium levels to help speed the cooking process, thus clients aiming to reduce their sodium intake should be aware of this.

Answer 223

-The process of producing brown rice removes only the hull of the rice kernel and is the least damaging to its nutritional value. When brown rice is further processed to make white rice, the majority of the B vitamins, phosphorus, and iron and all the dietary fibre and essential fatty acids are removed, requiring producers to add back the B vitamins and iron. Brown rice is a good source of manganese, selenium, magnesium, and fibre.

Answer 224

-Considered a pseudocereal, quinoa technically is a seed. Quinoa contains significant amounts of the amino acids lysine and isoleucine, which makes it a valuable protein source. About 25% of quinoa’s fatty acids come in the form of oleic acid, a health-promoting monounsaturated fat, and about 8% comes in the form of alpha-linolenic acid (ALA), the omega-3 fatty acid most commonly found in plants. -Quinoa contains significant amounts of certain tocopherols that typically aren’t found in grains. It’s also a good source of folate, copper, and phosphorus. Quinoa can be used in any recipe in which you’d use rice.

Answer 225

-While many people think buckwheat is a cereal grain, it’s actually a fruit seed making it suitable for people sensitive to wheat or other gluten-containing grains. Buckwheat contains various flavonoids, such as rutin, that help lower blood lipids. It’s a good source of magnesium, with 20% of the Daily Value found in 1 cup. It also contains all eight essential amino acids.

Answer 226

* Glucose and insulin levels initially rise much higher than after a low-GI / low-GL meal, leading to stimulation of cellular nutrient uptake, inhibition of hepatic (liver) glucose production and suppression of lipolysis (fat breakdown). * Subsequent declines in blood glucose concentration induced by the relative hyperinsulinaemia of a high-GI diet have been proposed to stimulate appetite and overeating. * High-GI diets have therefore been hypothesised to promote weight gain (with total daily energy intake still the primary cause).

Answer 227

-High in fibre: dietary fibre (both soluble and insoluble) adds bulk and delays gastric emptying. This helps promote feelings of fullness • Food recommendation: oats, chia seeds, lentils, dals -Protein rich: of the three macronutrients, protein offers the greatest satiation response. It may trigger release of hormones that are associated with satiety, such as Ghrelin and Glucagon like Peptide (GLP-1) • Food recommendation: eggs, fish, beef, Greek yoghurt -High in volume: highly satiating foods contain more water and air. Simply, these foods take up more space and may distend the stomach to trigger feelings of fullness • Food recommendation: sweet potatoes, soups, popcorn -Nutrient dense: foods that are most filling typically contain more micronutrients and are lower in calories for the same amount of weight. • Food recommendation: apples, oranges, carrots, broccoli, cabbage.

Answer 228

-“Regularly drinking more than 14 units a week risks damaging your health” Fourteen units is equivalent to six pints of average-strength beer or ten small glasses of low-strength wine. Furthermore, to minimise adverse health risks from alcohol intake, the following is recommended: -Spread your drinking over three or more days if you regularly drink as much as 14 units a week If you want to cut down, try to have several drink-free days each week. The Mayo Clinic states that moderate alcohol consumption may provide some health benefits, such as: -Reduced risk of developing and dying from heart disease Possibly reducing risk of ischemic stroke (when the arteries to the brain become narrowed or blocked, causing severely reduced blood flow) Possibly reduced risk of diabetes. These health risks are potentially reduced as a result of improved insulin sensitivity, lowered triglyceride concentrations and improved glycaemic control. -Moderate alcohol use for healthy adults means up to one drink a day for women of all ages and men older than 65, and up to two drinks a day for men aged 65 and younger. -7cals for g of alcohol but NOT satiating -In addition, the Personal Trainer should appreciate that studies confirm that alcohol ingestion reduces fat oxidation and favours a ‘positive fat balance’ across a day. Therefore, if a client wishes to consume alcohol, it might be prudent for the trainer to advise a reduction in dietary fat intake on the days of any drinking – this would serve to help to maintain a calorie balance across the day and mitigate the better fat-storing conditions that alcohol promotes.

Answer 229

LDL: responsible for transporting fats away from the intestines and liver to the peripheral tissues Loosely known as ‘bad cholesterol’ HDL: responsible for transporting fats away from the peripheral tissues and back to the liver Loosely known as ‘good cholesterol' High levels of LDLs are hypothesised to increase the risk of cardiovascular disease by contributing to plaque build-up in the blood vessel walls, therefore increasing atherosclerosis formation.

Answer 230

- The long-term use of pharmaceuticals (most notably non-steroidal anti-inflammatory drugs (NSAIDs), birth control and corticosteroids) - Excessive sugar / refined carbohydrate consumption - Excessive alcohol consumption (although red wine in moderation seems to improve gut health) - Pathogenic bacteria (e.g. infections from H. pylori and E. coli), which can compromise gut health for up to three years - Parasites, yeast and stress (acute and chronic) - Environmental contaminants.

Answer 231

- Foods containing excess fructose: honey, apples, mango, pear, watermelon and high-fructose corn syrup - Foods containing lactose: milk, ice cream, custard, dairy desserts, condensed and evaporated milk, milk powder, yoghurt, and soft unripened cheeses (e.g. ricotta, cottage, cream and mascarpone cheese) - Other foods known to cause digestive distress in some circumstances: artichokes (globe), artichokes (Jerusalem), garlic (in large amounts), leek, onion (brown, white, -Spanish and onion powder), spring onion (white part), shallots, wheat (in large amounts), rye (in large amounts), barley (in large amounts), legume beans (e.g. baked beans, kidney beans and borlotti beans), lentils and chickpeas - Some artificial sweeteners, such as sorbitol, mannitol, and xylitol.

Answer 232

- In addition, eating a complex meal that’s high in fibre, protein or fat before a high-intensity workout is not a good idea, as these nutrients are slowest to digest and transit through the system. - Ideally, eat about three hours before exercise. Eat smaller meals if dining less than two hours before your workout - Eat food that can be digested easily, like those high in carbohydrates and low in fats. Bananas, toast and oats are excellent low/moderate-fibre carbohydrate sources. - Avoid proteins and high-fibre foods, which are digested slower

Answer 233

-A small alternating electrical current is passed through the body, and the impedance (resistance) to this is measured. Muscle tissue contains a high water content which allows the electrical current to pass through quickly, however the electrical current experiences resistance when passing through fat tissue. The resistance allows total body water (TBW) to be measured, which is then converted to FFM using the assumption that 73% of FFM is water. Single frequency BIA scales are typically used allowing only TBW to be measured, however if multiple frequency scales are used, this can be further differentiated into extracellular (outside cells) water and intracellular (inside cells) water. BIA has poor accuracy in estimating body fatness or body water content, with large errors in estimates of up to ~5%. Estimates are largely influenced by hydration status, because the scales measure the resistance to the electrical current (better hydrated = less resistant). If measures are taken repeatedly over time, then changes in estimates may be due to a change in hydration status as opposed to a change in body composition.

Answer 234

ISAK stands for the International Society for the Advancement of Kinanthropometry who train practitioners to perform skinfold measurements in a standardised way. The skinfold technique measures a double fold of skin, which reflects the subcutaneous fat thickness at various sites across the body. Skinfold thickness is measured in milimetres (mm), and various population-specific equations have been created to attempt to convert these measures into body fat percentage. However, it is important to note that this is only an estimate of body fat percentage, based off another estimation measure and these calculations do not take into account differences between populations and / or individuals. Skinfolds are best used as a monitoring tool over time, with the same person taking the measurements each time. The thickness of a skinfold also depends on hydration status. So although this method is relatively easy there are also quite a few limitations. When generalised equations are used, the error can be up to ~5%. Skin fold measures are often used in their raw value (millimetres skinfold), as opposed to converting to body fat % using an equation. By doing this, we accept that translating the number to body fat is too inaccurate, but we can still track changes in skinfold thickness over time within one person. Skinfold measures can be looked at individually at each site, or values can be summed together (e.g. sum of skinfold thickness at 7-sites), which allows changes in total and individual sites to be tracked over time. In terms of reliability, if the same measurer is used each time and a standard protocol is adhered by, the results can be reliable. Adequate training, and experience is essential to get reliable results.

Answer 235

-Air displacement plethysmography measures body composition through a person sitting within an enclosed chamber (i.e. Bodpod) whereby body volume is indirectly assessed through measuring the volume of air the body displaces within the chamber. In other words, the amount of air that you displace when stepping in the chamber is equivalent to your body volume. Volume, in addition to body weight, can then be used to calculate body density, which then allows FM and FFM to be estimated.

Answer 236

-This technique involves being fully submerged in a tank of water and expelling all air in the lungs whilst underwater weight is measured. Both bone and muscle have a greater density than water, whereas fat mass has a lower density than water. Therefore, someone with a larger amount of FFM will weigh more in water. Body density is calculated using underwater weight, body weight outside of the water, density of the water and residual volume of the lungs. The residual volume in the lungs is measured by inhaling helium and measuring the dilution. Estimations of FM and FFM can then be made. This technique is perhaps the most direct and accurate technique to measure body fat, but there are few places that have this facility and it is not a very practical method.

Answer 237

Two low energy x-rays are passed through the body which are absorbed differently by bone and tissues. A scan takes ~10-20 minutes, exposing subjects to very minimal doses of radiation (equivalent to <2 days of natural background radiation or roughly a 2 hour plane flight). DXA can measure regional body composition, sub-dividing the body into different components (i.e. arms, legs and trunk), as well as bone density. DXA relies on certain assumptions, and when these are violated, errors in measurements can occur. It is therefore extremely important that the ‘Best Practice DXA Protocol’ is followed. The estimated error for prediction of body fat % is between 2-3%.

Answer 238

-Men: < 15%, Women: <24% <0.5–1.5 lb per week, 0.2–0.7 kg per week or; 0.25-0.75% of bodyweight per week -Men: 16–25%, Women: 25–34% 1–2 lb per week 0.5–0.9 kg per week or 0.75–1.5% of bodyweight per week -Men: 26+%, Women: 35+% 1.5–3.5 lb per week 0.7–1.6 kg per week or 1.0–1.5% of bodyweight per week

Answer 239

-When it comes to maximising performance and producing high-quality training sessions, research shows that neither the glycaemic load nor the glycaemic index of carbohydrate-rich meals affects the metabolic or performance outcomes of training once the carbohydrate and energy content of the diet have been taken into account. For the Personal Trainer, this could be interpreted as: -The most important factor is that the target total carbohydrate intake has been achieved The source of the carbohydrate is less important To optimise health and to ingest the maximum micronutrient content, unrefined wholefoods should form the basis of carbohydrate intake (e.g. potatoes, grains and fruit) For convenience, some processed / refined carbohydrate sources can be used to ensure optimal total amounts are achieved (e.g. cereal bars, fruit juice).

Answer 240

A significant consequence of dehydration is hypovolaemia (decreased plasma / blood volume), resulting in: -Cardiovascular strain Increased glycogen use Altered metabolic and central nervous system function A greater rise in body temperature Increased risk of life-threatening exertional heat illness (i.e. heatstroke).

Answer 241

Aerobic performance: Fluid deficits of > 2% bodyweight can compromise cognitive function, particularly in hot weather Anaerobic performance: When 3– 5% of bodyweight is lost due to dehydration, decrements in high-intensity activities and sport-specific technical skills are seen.

Answer 242

Finally, clients / athletes should aim to avoid the excessive overconsumption of fluids, which might dilute sodium in the blood – this is known as ‘hyponatraemia’ or ‘water intoxication’. This can often happen when the individual is overcautious and / or believes that they should be drinking large amounts of water. The risk may be greater for women, as they have a smaller body size and lower sweat rates than men. The most serious consequence of hyponatraemia if left untreated is death!

Answer 243

Most women do not need any extra calories during the first six months of pregnancy. It is only in the last 12 weeks that they need to eat a little more, and then only an extra 200 calories a day, which is roughly the same as two slices of bread. To account for the greater energy demand of producing milk for the baby, the mother’s energy intake will need to be increased by up to 500 calories per day during breastfeeding.

Answer 244

- Lower-2500 men to 2300, 2000 to 1900 women - Reductions in the thermal effect of physical activity also reduce the overall total daily energy requirement of an older adult - Whilst the Personal Trainer should not directly prescribe nutritional supplements, they might inform their older client that the British Nutrition Foundation currently recommends that all adults over the age of 65 take a supplement containing 10 mg of vitamin D. - Fibre and micronutrient intake is of concern because if an older person eats less overall, then there is a greater chance for a micronutrient deficiency to occur; vitamin B12 deficiency is an example of a common deficiency.

Answer 245

7th or 8th month.

Answer 246

Adequate hydration.

Level Personal Training Online Theory Flashcards

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