Disclaimer : Care has been taken to ensure accuracy of the information presented in this webinar and in the responses to subsequent questions. The presenter and host are not responsible for any consequences from the application or misapplication of the information provided. Application of this information in a particular situation remains the professional responsibility of the reader.
PROCESS AND PROCEDURES QUESTIONS
Why is failure to complete at least 30 min, 3x week moderate exercise for the last three months how you determine whether the client is active or not? We typically consider a person inactive if they are not meeting the PA guidelines of 150 min/wk (per the ACSM recommendations).
This is the same criteria that is used to determine physical inactivity as part of the risk factor analysis that is now listed in chapter 3. The references are listed below:
Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402-7.
U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans [Internet]. Rockville (MD): Office of Disease Prevention & Health Promotion, U.S. Department of Health and Human Services; 2008 76 p. Available from: http://www.health.gov/paguidelines
Is (defining physical activity as moderate exercise) 3 days a week arbitrary? What about definition of planned structured exercise is it the same as recreational exercise?
The three days per week has been used in previous editions and current edition of ACSM Guidelines to define physical inactivity. Please see the list of risk factors in Chapter 3. Regarding the definition of planned structured exercise, it could be recreational activities if the estimated intensity is moderate.
With these new recommendations, has the PAR-Q questionnaire changed?
PAR-Q was updated and the recommendation for self-guided methods of screening is the PAR-Q+.
Is medical clearance recommended in the last 12 months for someone that does not exercise but has a known disease or symptoms? GETP 10 does not specify clearance within the past 12 months for any category except the person that exercises and has a known disease.
ACSM recommends a conservative approach. When medical clearance is recommended at least every 12 months, the health care provider should approve of participation in new forms of exercise.
… As a personal trainer, one would first have their client complete the PAR-Q+ which would be Fig 2.1 in GETP10. Then you would have the client complete the new HSQ which would be fig. 2. 3. Next you would go over the signs and symptoms which would be table 2.1 Last of all, you would use the new algorithm which is fig. 2.2. Is this correct?
In general, CPTs should have their client complete the PAR-Q+.
DETERMINING EXERCISE INTENSITY
… a lot of times people do not really know what intensity they are working at so makes it hard to evaluate, any suggestions?
When individuals are joining a fitness facility to exercise without supervision, how can we do more then give a recommendation for intensity level?
Please look at the new ACSM Guidelines, chapter 6. There are several recommendations on how to gauge intensity. One may use the talk test, HR, VO2 or METs to gauge intensity.
To clarify: if someone is participating in exercise now (moderate) and they have disease (asymptomatic), they do need medical clearance before progressing to vigorous?
Should COPD clients start exercise at low intensity?
Light to moderate intensity is recommended as a starting point for all participants. However, one must use sound clinical judgment and assess clients on a case by case basis.
FIGURES AND CITATIONS
Which publication (is Meir referring to)?
… where do I find those figures (discussed on the webinar)?
The 2015 guidelines we have available in PDF....is that the most up-to-date?
The webinar refers to figure and 2.1 and 2.2 in the Guidelines of Exercise Testing and Prescription, Edition 10 (GETP 10). The screening algorithm has been uploaded to the webinar and are available to download here.
What is the citation of the publication he referred to from 2015?
D. Riebe, B. A. Franklin, P. D. Thompson, C. E. Garber, G. P. Whitfield, M. Magal and L. S. Pescatello. Updating ACSM's Recommendations for Exercise Preparticipation Health Screening. Medicine and Science in Sports and Exercise. 47 (8): 2473-2479, 2015.
What is the citation for indicating > 90% of 40 year-olds would be recommended for a medical check-up under the old risk stratification guidelines?
The reference is provided below:
Whitfield GP, Pettee Gabriel KK, Rahbar MH, Kohl HW 3rd. Application of the American Heart Association/American College of Sports Medicine Adult Preparticipation Screening Checklist to a nationally representative sample of US adults aged >=40 years from the National Health and Nutrition Examination Survey 2001 to 2004. Circulation. 2014 Mar 11;129(10):1113-20.
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Meir Magal, PhD, FACSM
Associate Professor of Exercise Science, North Carolina Wesleyan College
Chair, ACSM Committee on Certification and Registry Boards (CCRB)