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NASM NOTES
CHAPTER 1—The Scientific Rational for Integrated Training
A
...
The Past
i
...

ii
...

iii
...

b
...
Wealth of technology has taken a toll on public health
ii
...
Less active people, aging population
iv
...

v
...
Low Back Pain – Affects nearly 80% of adults
2
...
70% non-contact, most happen
between 15 and 25 years of age
...
Chronic Diseases – Chronic diseases
responsible for 5 of leading 6 causes of
disease—Obesity is one
...
Musculoskeletal Injuries – Work-related
injures, 40% are strains, sprains
...

5
...

activity levels
6
...
Current Training Programs on Sedentary adults

1
...
Increase in deconditioned adults—a state in
which a person may have muscle imbalances,
descreased flexibility, or a lack of core and
joint stability
...
Most training programs do not emphasize
multiplanar movements through the full muscle
action spectrum
vii
...
One that challenges internal balance and stab
...
Ex
...

c
...
Today’s client is not ready to begin physical activity
at the same level of a typical client 20 years ago
...
Each training program must consider each person,
their environment, and the tasks that will be
performed
...
The OPT Model – Process of programming that systematically
progresses any client to any goal
...

a
...
Phase 1: Stabilization Endurance Training
1
...
Diff
...
system vs
...

3
...

4
...
Performing exercises in a
proprioceptively enriched environ
(controlled, unstable), the body is forced
to recruit more muscles to stabilize itself,
burning more calories
...
Corrective flexibility

c
...
Strength Level—3 phases of training
i
...
Goal is to enhance stab
...
Use supersets with similar joint dynamics
to accomplish
2
...
Immediately follow with exercise that
challenges stabilization muscles
...
Training strategy:
a
...
Supersets
c
...
Phase 3: Hypertrophy Training
1
...

2
...
Active flexibility
b
...
or low
repetitions (6-10)
iii
...
Works towards the goal of maximal prime
mover strength by lifting heavy loads
...
Goals:
a
...
Increase frequency of motor unit rec
...
Improve peak force
3
...
Active flexibility
b
...

c
...
Phase 5: Power training
1
...
Goals:
a
...
efficiency
b
...
Increase rate of force production
d
...
Training strategy:
a
...
Supersets: strength/power
c
...


CHAPTER 2—Basic Exercise Science

A
...
Structure allows for and provides the basic of function
b
...
If 1 system is not working properly, it affects the other
systems and ultimately affects movement
...
Nervous System
a
...
Sensory function – ability of nervous system to sense
changes in either the internal or external environment
1
...
A stretch placed on muscle (internal)
2
...
The change from walking on sidewalk to
walking on sand (external)
ii
...
to allow for
proper decision making, which produces the proper
response
iii
...
Ex
...
Ex
...

b
...

C
...
The Neuron- Composed of 3 main parts: cell body, axon,
dendrites
i
...
Axon – Cylindrical projection from the cell body that
transmit nervous impulses to other neurons or effector
sites (muscles, organs, other neurons)
...
Provides communication from brain and spinal
cord to other parts of the body
...
Dendrites – Responsible for gathering info
...


b
...

i
...

ii
...
Motor (efferent) neurons – transmit nerve impulses
from the brain and spinal cord to the effector sites
such as muscles or glands
1
...
– Person touches hot object
...

D
...
Central Nervous System
i
...
Serves mainly to interpret information
b
...
Consists of 12 cranial nerves, 31 pairs of spinal
nerves, and sensory receptors
ii
...
Relay info
...

iv
...
that the brain and spinal cord can
interpret to produce a response (4 types)
1
...
Nociceptors (pain)
3
...
Photoreceptors (vision)
v
...
Include
muscle spindles, Golgi tendon organs, and joint
receptors
...
Muscle spindles – sensitive to change in length
and rate of change length
a
...
Info is
transmitted to brain and spinal cord to
update the nervous system on status of
muscle length and the rate at which it is
lengthening
...

2
...

a
...

b
...

3
...

a
...
Can also act
to initiate a reflexive inhibitory response
in the surrounding muscles if there is too
much stress place on that joint
...
Ex
...
The Skeletal System
a
...
Bones – A resting ground for muscles and protection
of vital organs
ii
...
These are the sites where movement occurs as a
result of muscle contraction
...
Divisions of the Skeletal System

i
...

ii
...

iii
...

iv
...
Leverage – bones act and perform as levers
when acted on by muscles
2
...

c
...
Depressions – flattened or indented portion of bone,
which can be a muscle attachment site
...
Ex
...
Processes – projection protruding from the bone
where muscles, tendons, and ligaments can attach
...
Ex
...
Joints – formed by one bone that articulates with another
bone
i
...
Roll movement – one joint rolls across the
surface of another much like the tire of a
bicycle roll on the street
a
...
Slide movement – one joint’s surface slides
across another much like the tire of a bicycle
skidding across the street
a
...
Spin movement – one joint surface rotates on
another much like twisting the lid of a jar
a
...
Classification of Joints
i
...

--produce synovial fluid; egg-white like substance that
works like engine oil to reduce excessive wear and nourish cartilage
cells that line the joint
...
Types:
1
...

a
...
Condyloid joint – the condyle of one bone fits
into the elliptical cavity of another bone to form
a joint
...
In 1 plane
a
...
Hinge joint – uniaxial joint allowing movement
in only sagittal plane
a
...
Saddle joint – one point fits like saddle onto
another
...
Ex – ONLY carpometacarptal joint of
thumb
5
...
Ex – Radioulnar
6
...
Ex – Shoulder
ii
...

1
...
– Sutures of skull
f
...
Ligament – Primary connective tissue that connects
bone to bone, limits improper joint movement
1
...
Collagen fibers are situated in a more
parallel fashion than forces that are place
on ligament, provide ligament with
ability to withstand tension (tensile
strength)
b
...

--Ligaments are characterized by poor vascularity
(blood supply), meaning that they do not heal or
repair very well and may be slower to adapt
...
The Muscular System
a
...
Muscle and its Connective Tissue – compilation of
many individual muscle fibers that are neatly wrapped together
with connective tissue that form different bundles
...
Muscle itself with outer layer called fascia and
inner layer immediately surrounding muscle called epimysium
...
Next bundle is called fascicle wrapped by
connective tissue called perimsium
3
...
muscle fibers wrapped by connective tissue called
endomysium
...
These connective tissues play vital role in
movement; they allow forces generated by the muscle to be
transmitted from the contractile components of the muscle to
the bones, creating motion
...

5
...
Muscle Fibers and Their Contractile Elements
1
...
Sarcomere – the functional unit of muscle, b/t 2
Z lines, that produces contraction containing
actin (thin string-like filaments) and myosin
(thick filaments)
...
Two protein structures, tropomyosin & troponin
a
...

b
...

iii
...
Neural Activation – contraction of a muscle
generated by neural stimulation
a
...

b
...

2
...
Sarcomere shorts as a result of the Z
lines moving closer together
...
The Z lines converge as the result of
myosin heads attaching to the actin
filament and asynchronously pulling
(power strokes) the actin filament across
the myosin, resulting in shortening of the
muscle fiber
...
Excitation-Contraction Coupling
a
...

iv
...
Type I (slow twitch)

a
...
Increased Oxygen deliver
c
...
Less force produced
e
...
Long-term contractions (stabilization)
--important for stabilization and postural control,
sitting upright for example
2
...
Fewer capillaries, mitochondria, and
myoglobin
b
...
Larger in size
d
...
Quick to fatigue
f
...
Muscles as movers **graph on pg
...
Agonist – prime movers
2
...
Stabilizer – support or stabilize the body while
the prime movers and synergists perform the movement patterns
4
...

EX: CHEST PRESS
--Agonist: Pectoralis major
--Synergist: Anterior deltoid, triceps
--Stabilizer: Rotator cuff
--Antagonist: Posterior deltoid

CHAPTER 3—The Cardiorespiratory System
-- System of the body composed of the cardiovascular and respiratory
systems
A
...
The Heart
i
...
Size of an adult fist, weights roughly 300g (10 ounces)
iii
...

iv
...
Muscle fibers are shorter and more tightly
connected than skeletal muscle, thus enabling
the contraction of one fiver to stimulate the
others to contract synthronously
2
...
Typical heart rate is between 70 and 80 bpm
4
...
Atrioventricular (AV) node – delays impulse b/
moving on to the ventricles
...
Structure of the Heart
1
...
Atrium – Superior (higher) chamber of the heart
that gather blood coming into the heart
a
...

3
...
Main pumps of heart

a
...
The
left ventricle receives the reoxygenated
blood from the left atrium and proceeds
to pump it to the entire body
...
Valves prevent backflow or spillage of
blood back into chambers
vi
...
Stroke volume – The amount of blood that is
pumped out with each contraction of a ventricle
a
...
is 75-80 mL/beat
2
...
Typical adult avg
...
Cardiac Output – The combination of how
many times the heart beats per minute and how
much blood is being pumped out with each
beat
...
Measured as Q (with dot above)
b
...
fluid that circulates, carries nutrients and oxygen, rids
body of waste
ii
...
Constitutes 8% of body weight
iii
...
person holds 5 L (roughly 1
...
3 Mechanisms: Transportation, Regulation, Protection
1
...
Transports oxygen and nutrients to
tissues
b
...
Transports hormones to organs and
tissues
d
...
Regulation
a
...
Protection

a
...
Contains
specialized immune cells to help fight
disease and sickness
c
...
Network of hollow tubes that circulates blood
throughout the body
1
...
Leaving the heart are large and elastic
ii
...
It is in the capillaries that substances such as
oxygen, nutrients, hormones and waste products are exchanged
between tissues
...
Veins – carry blood away from the capillaries
toward the heart
a
...

B
...

a
...
3 pg
...
Breathing is down in 2 phases:
1
...

a
...
2 forms
i
...
Heavy (deep, forced) – requires the
additional use of secondary respiratory muscles (scalenes,
pectoralls minor)
...
Expiration – Can be active or passive
a
...
During heavy or forced breathing, the
expiratory ventilation relies on the activity of expiratory
muscles to compress the thoracic cavity and force air out
c
...

b
...
Conduction passageway – all the structures that air
travels through before entering the respiratory passageway
...
Nasal cavity, oral cavity, pharynx, larynx,
trachea, right/left pulmonary bronchi, bronchioles
...
Respiratory passageway – collects the channeled air
coming from the conducting passageway
1
...
It is here that gases
such as oxygen and carbon dioxide are transported in and out of
the bloodstream through a process known as diffusion
...

C
...

oxygen), while removing waste products that can cause
dysfunction in the body
...
Inhalation through nose and mouth, through the bronchi, to
the lungs and alveolar sacs
b
...

c
...
Then pumped to the left ventricle of the heart and pumped to
the body’s tissues

i
...
Capacity to efficiently use oxygen is dependent
on the respiratory system’s ability to collect
oxygen and the cardiovascular system’s ability
to absorb and transport it to the tissues of the
body
...
The usage of oxygen by the body is
oxygen uptake (or consumption) -VO2
max, the highest rate of oxygen transport
and utilization achieved at maximal
physical exertion
...
At rest, VO2 is estimated to be 3
...
Max values can range from 40-80
mL
ii
...
Aerobic – Requires oxygen, more than 30
seconds
2
...

3
...
Energy is gathered from an energyyielding source (the breakdown of food)
by some storage unit and then
transferred to a site that can use this
energy (muscle contraction)
...
ATP – a cellular structure that supplies energy
for many biochemical cellular processes by
undergoing enzymatic hydrolysis
...
Composed of adenine, 5-carbon sugar
called ribose, and 3 phosphates—large
amounts of energy are stored in the
chemical bonds of those phosphates,
needed for muscle contraction
...
Supply of ATP in each cell is limited,
so cells, so cells need means of
producing more
...
3 main bioenergetic pathways that
produce ATP called bioenergetic
continuum
5
...
ATP-CP
i
...
limited b/c it relies on ATP
storage and CP storage within
cell
iii
...
Up to approx
...
Glycolysis
i
...
Breakdown of carbs to rapidly
produce ATP, lactic acid can
develop if pyruvate is not used by
muscle fast enough
iii
...
30-50 seconds of activity
c
...
Aerobic system, 1 glucose
molecule produces 38 ATP
ii
...
Lower Intensity, longer duration
activities such as walking on the
treadmill for 20-30 minutes
iv
...
Dysfunctional Breathing
1
...
Result can create excessive muscular tension,
resulting in headaches, lightheadedness,
dizziness
3
...
Inadequate oxygen and retention of metabolic
waste within muscles can create stiff muscles
and joints
...
Biomechanics – study that uses principles of physics to
quantitatively study how forces interact within a living body
a
...
Superior – Positioned above a point of reference
ii
...
Proximal – Positioned nearest the center of the body,
or point of reference
iv
...
Anterior (or ventral) – On the front of the body
vi
...
Medial – positioned near the middle of the body
viii
...
Contralateral – Positioned on the opposite side of the
body
x
...
Planes of Motion, Axes, and Joint Motions
i
...

1
...

a
...
Extension – The straightening of a joint, causing
the angle to the joint to increase
b
...
EX
...
Frontal Plane – Bisects the body to create front and
back halves, occurs around anterior-posterior axis
1
...

2
...

3
...
Eversion/Inversion – same principles but
relates to tarsals and calcaneus

5
...
– Side lateral raises, side lunges, side
shuffling
...
Transverse Plane – Bisects the body to create upper
and lower halves, occurs around longitudinal or vertical axis
...
Internal Rotation – rotation of a joint toward
the middle of the body
2
...
Pronation, Supination of radioulnar
4
...
– Trunk rotation, turning lunges, throwing
a ball, golfing, swinging a bat
c
...
Eccentric – exerting less force than is being placed on
it, resulting in the lengthening of a muscle
1
...
Decelerates or reduces force, a ‘negative’
ii
...
No visible movement with or against resistance
2
...
Concentric – exerting more force than is being placed
on it, shortening the muscle
e
...
Force – an influence applied by one object to another,
which results in an acceleration or deceleration of the
second object
...
Magnitude (how much)
2
...
Length-Tension Relationship - the length at which a
muscle can produce the greatest force
1
...
Lengthening beyond this point reduces overlap,
causing reduced force production
...

3
...

iii
...

1
...

2
...

iv
...
Each muscle has different attachment sites,
pulls at a different angle, and creates a different
force on that joint, the motion that results from
these forces is dependent on the structure of the
joint and the collective pull of each muscle
involved
...
All muscles working together for the
production of proper movement (all muscle
actions and all functions)
3
...
- Internal & External obliques for trunk
rotation, Deltoid & Rotator cuff for shoulder
abduction
...
Muscular Leverage and Arthrokinematics
1
...

2
...

3
...

4
...
The closer the weight is to a joint, the
less torque it creates, the farther the more
torque it creates
b
...
Motor Behavior
i
...
Motor Control – The study of posture and movements
and the involved structures and mechanisms that the
central nervous system uses to assimilate and integrate
sensory information with previous experiences
...
Synergies – Groups of muscles that are recruited by
the central nervous system to provide movement
1
...
Proprioception – The cumulative sensory input to the
central nervous system from all mechanoreceptors
that sense position and limb movements
...
Vital information that CNS uses to gather info
...

2
...
This provides a rationale for core and balance
training to enhance one’s proprioceptive
capabilities, increasing postural control and
decreasing tissue overload
...
Sensorimotor Integration – The ability of the nervous
system to gather and interpret sensory information and
to select and execute proper motor response, through
cooperation of nervous and muscular system
...
Only as effective as quality of incoming
sensory information

2
...
train with improper form, improper
sensory info
...

3
...
– Individual consistently performs a chest
press while rounding and elevating their
shoulders, can lead to altered length-tension
relationships of muscles (decreased force
production), altered force-couple relationships
(improper recruitment pattern of muscles), and
altered arthrokinematics (improper joint
motion)
...

vi
...

1
...

a
...

i
...

b
...

i
...

Improves neuromuscular
efficiency

ii
...
about the quality of
the movement during the exercise
...
Client must not completely depend
on external feedback, rather it should
augment their internal sensory input
...
Systematic problem-solving method that provides the health
and fitness professional with a basis for making educated
decisions about exercise and acute variable selection
i
...
Objective Information – Physiological assessments,
body composition testing, cardiorespiratory assessments,
static/dynamic postural assessments, and performance
assessments
...
Subjective Information
i
...
Par-Q (Physical Activity Readiness
Questionnaire) directed toward detecting any possible
cardiorespiratory dysfunction
...
Extended periods of sitting – hips are flexed, can
lead to tight hip flexors and postural imbalances
...
Repetitive Movements – Can create pattern
overload to muscles and joints, leading to tissue trauma and
eventually kinetic chain dysfunction
4
...

5
...
Lifestyle
1
...

2
...
Medical History
1
...
Past Surgeries – surgery will cause pain and
inflammation that can alter neural control to the
affected muscles and joints if not rehabilitated
properly
3
...
of physical activity, daily
...
Medications**Table 5
...
Objective Information
a
...

i
...
Heart rate – Can be taken on inside of the wrist
(radial) or windpipe (carotid), get resting heart
rate three mornings in a row from client
a
...
resting rate for Males is 70 bpm
b
...
resting rate for Fem
...
To Calculate Heart Training Zone
a
...
Zone 1 – Max
...
65 and Max
...
75
c
...
heart rate x
...
85
d
...
86 and Max
heart rate x
...
Blood Pressure
a
...
Diastolic pressure – signifies the
minimum pressure within the arteries
through a full cardiac cycle
c
...

Normal is 120-130 mm Hg over 80-85
mm Hg
...
To take blood pressure inflate cuff to 20
to 30 mm Hg above point when pulse can
no longer be felt at wrist
...
Systolic
is first observation of pulse
...

ii
...
Body fat measurements
a
...
Durnin formula – measures biceps,
triceps, subscapular (left of lat on

back), and lilac crest (just inside
love handle)
ii
...
Scale weight – fat mass = lean
body mass
b
...
Underwater weighing can measure fat to
lean tissue
...
Circumferences Measurements:
i
...
Waist-to-Hip Ratio
i
...
Ratio above
...
95 for men at risk for diseases
f
...
Weight divided by height
ii
...
Moderate – 30-35
iv
...
Cardiorespiratory Assessments
a
...
Step one – Determine Max heart rate zones
ii
...

Rest for 1 minute, then measure for 30 seconds to get
recovery pulse
...
Duration of exercise (sec) x 100/ Recovery
pulse X 5
...
Step three –
1
...
39-48 – Fair
3
...
60-70 – Good
5
...
Step four –
1
...
Fair – Zone one
3
...
Good – Zone two
5
...
Rockport Walk Test
i
...
Step Two – Record client’s weight, have them walk 1
mile as fast possible, record time it took and heart rate
and use formula for Vo2 score
iii
...
Step Four – Find starting program category
F
...
Posture – the alignment and function of all components of
the kinetic chain at any given moment, under control of
central nervous system
...
Main purpose of proper posture is to maintain enough
structural efficiency to overcome constant forces
placed on the body
1
...
Any deviation from proper postural alignment can
cause a change in the body’s center of gravity,
affecting functional efficiency of the kinetic chain
1
...
Postural equilibrium is maintaining a state of balance
in the alignment of the kinetic chain
b
...
Allows optimum neuromuscular efficiency
ii
...


iii
...

iv
...
This affects other joints and muscles in the
kinetic chain, which can cause tissue stress throughout
the body, called postural distortion patterns
...
Dynamic Postural Assessments- observation process
should search for any imbalances in anatomy, physiology, or
biomechanics that may decrease a client’s results and
possibly lead to injury
...
Overhead Squat Assessment – designed to assess
dynamic flexibility on both sides of the body as well
as integrated total body strength
...
Position
a
...
Foot
and ankle complex should be in a neutal
position
b
...
Movement
a
...
Have the client repeat the movement five
repetitions in each position (anterior and
lateral)
3
...
View feet, ankles, and knees from front
b
...
Single-Leg Squat Assessment – The observation is
designed to assess ankle proprioception, core strength,
and hip joint stability
1
...
Client should stand with hands on the
hips and eyes focused on an object
straight ahead
b
...
Movement
a
...
Have client squat to a comfortable level
and return to the start position
c
...
Views
a
...

iii
...
Position
a
...
Movement
a
...
Perform up to 20 reps in controlled
fashion
c
...
Pulling Assessment
1
...
Instruct client to stand with abdomen
drawn inward, feet shoulder-width apart,
and toes pointing forward
2
...
Instruct client to pull handles toward
their body and return slowly
b
...
Use checklist to record movement faults
v
...
Performance assessments:

a
...
Shark skill: Assesses overall athletic
ability
c
...
Lower extremity strength: Same but for
lower
2
...
Overhead squat: Assesses dynamic
flexibility and integrated total body
strength
b
...
Pushing and pulling: Assesses upper
extremity neuromuscular efficiency
d
...
Davies Test – observation to assess upper extremity
agility and stabilization, not suitable for individ
...

1
...
Place 2 pieces of tape on floor, 36 inches
apart
b
...
Movement
a
...
Perform alternating touching on each
side for 15 seconds
c
...
Reassess in the future to measure
improvement of number of touches
e
...
Shark Skill Test – observation designed to assess
lower extremity agility and neuromuscular control
...

1
...
Position client in the center box of a grid,
with hands on hips and standing on one
leg
...
Movement
a
...
Perform 1 practice run through the boxes
with each foot
c
...
Record times
e
...
10 seconds for each of these faults:
i
...
Hands come off hips
iii
...
Foot does not return to center
square
iii
...
Advanced assessment for
strength-specfic goals
1
...
Position client on bench, feet pointed
ahead, low back in neutral position
2
...
Instruct client to warm up with light
resistance that can be easily performed
for 8-10 reps
b
...
Add 10-20 pounds (5-10%) and perform
3-5 reps
d
...
Repeat steps 4 & 5 until individ
...
Use 1-rep max est chart in appendix
...
Lower Extremity Strength Assessment, Squat –
observation is designed to estimate the one-rep squat
maximum, for training intensity purposes, advanced
assessment for strength

1
...
Feet should be shoulder-width apart,
pointed straight ahead, and with knees in
line with the toes, low back in neutral
position
2
...
Instruct client to warm up with light
resistance easily performed 8-10 reps
b
...
Add 30-40 pounds (10-20%) and perform
3-5 reps
d
...
Repeat steps 4-5 until individ
...
Use 1-rep max chart in appendix
...
Flexibility – the normal extensibility (capability to be
stretched) of all soft tissues that allow the full range of motion
of a joint
...
Dynamic range of motion – combo of flex
...
For soft tissue to achieve efficient extensibility
there must be this optimum control
...
Neuromuscular efficiency – ability of the nervous
system to properly recruit the correct muscles to produce force,
reduce force, and dynamically stabilize the body’s structure in
all planes of motion
...
Dynamic functional flexibility – Multiplanar soft tissue
extensibility with optimal neuromuscular efficiency through the
full range of motion
i
...

B
...
Postural distortion patterns – predictable patterns of
muscle imbalances
i
...
Relative Flexibility – tendency of body to seek the
path of least resistance during functional movement patterns
i
...
EX
...
EX
...
with tight latissimus dorsi have
decreased sagittal-plane shoulder flexion, so they must
compensate for lack of range of motion
...
Muscle Imbalance – Alternation of muscle length
surrounding a joint, in which some are overactive (forcing
compensation to occur) and others may be underactive
(allowing for the compensation to occur

a
...
Altered Reciprocal Inhibition – the concept of
muscle inhibition caused by a tight agonist, which decreases
neural drive of its functional antagonist
1
...
- Tight psoas (hip flexor) would
decrease the neural drive of the gluteus maximus (hip extensor)
ii
...

1
...
- Tight psoas leads to reciprocal
inhibition of the gluteus maximus
...

iii
...
Causes poor
movement efficiency
...
EX
...
Alters lengthtension relationships of muscles at knees and hips, putting the
gluteus maximus (agonist) in a shortened pos
...
This causes the biceps femoris to
become synergistically dominate, altering joint motion, leading
to increasing stress on knee and back, over time stress can lead
to pain, which can further alter muscle recruitment and joint
mechanics
...
Neuromuscular Efficiency
a
...

i
...
When a muscle on one side of a joint is
lengthened (owing to a shortened muscle on the other side), the spindles of
the lengthened muscles are stretched
...
This info
...
Golgi Tendon Organs

1
...
Prolonged Golgi tendon organ stimulation
provides an inhibitory action to muscle spindles, this neuromuscular
phenomenon is called autogenic inhibition, and occurs when the neural
impulses sensing tension are greater than the impulses causing muscle
contraction
...
Static stretching for example
...
This tension stimulates the Golgi
tendon organ, which overrides muscle spindle activity in the muscle being
stretched, causing relaxation in the overactive muscle and allowing for
optimal lengthening of the tissue
...
Scientific Rational for Flexibility Training
a
...

b
...
This is treated by the body as an injury, and as a result
body will initiate repair process
...
Tissue trauma > Inflammation > Muscle spasm
>Adhesions > Altered neuromuscular control > Muscular imbalance
ii
...
Left unchecked, these adhesions can begin to form permanent
structural changes in the soft tissue that is evident by Davis’s law
iii
...
Soft tissue rebuilds itself in a random
fashion with an inelastic collagen matrix that usually does not run in
the same direction as the muscle fibers
2
...
This creates alterations in normal tissue
extensibility and causes relative flexibility

F
...

a
...

i
...
By applying
gentle force to an adhesion or ‘knot,’ the elastic muscle fibers are
altered from a bundled position into a straighter alignment with the
direction of the muscle or fascia
...
With foam roll
ii
...
Low force with longer duration
...

1
...
Acute Variables – 1-3 sets, 20-30 seconds
per stretch
3
...
Active Flexibility – designed to improve the
extensibility of soft tissue and increase neuromuscular efficiency by
using reciprocal inhibition
...
Self-myofascial release (above)
ii
...
Preactivity warm-up as long as no postural distortion
patterns are present
...
Mechanism of Action – Reciprocal
inhibition
2
...
Examples – Active supine biceps femoris
stretch, active kneeling quadriceps stretch,
active standing adductor stretch, active
pectoral wall stretch
...
Functional Flexibility – integrated, multiplanar soft
tissue extensibility with optimum neuromuscular control through full
range of motion, movement without compensations, appropriate for
Phase 5 of OPT model
i
...
Dynamic stretching – the active extension of a
muscle, using force production and momentum to move the joint
through the full available range of motion
...
Mechanism of action – Reciprocal
inhibition
2
...
Examples – Prisoner squats, multiplanar
lunges, single-leg squat touchdowns, tube
walking, medicine ball chop/lift

CHAPTER 7—Cardiorespiratory Training Concepts
A
...
Warm Up
i
...
EX
...
Specific Warm-Up – Low-intensity exercise consisting
of movements that mimic those that will be included in more
intense exercise that is to follow
1
...
– body-weight squats, push-ups
**every warm-up should include both
...
Benefits/Effects
1
...
System’s capacity to
perform work, increases blood flow to active
muscle tissue, and increases oxygen exchange
capacity
2
...
Increased psychological preparation for bouts
of exercise – increases the mental readiness of
an individual
iv
...
Speculation between whether warm-up is
helpful in prevention of musculoskeletal injury,
some studies show it does, other don’t
...
May be beneficial for enhancing performance
of kinetic chain
3
...
Acidosis is accumulation of
excessive hydrogen that causes acidity of the
blood and muscle that is related to lactic acid
...
Warm-up for Stabilization Level Client (Phase 1)
1
...
Static stretching (5-10 mins)
3
...
Clients should do this before workout
vi
...
Self-myofascial release (5-10 mins)
2
...
Cardiorespiratory exercise (5-10 mins)
vii
...
Self-myofascial release (5-10 mins)
2
...
Cool Down – 40-50% of max heart rate for 5-10 mins,
corrective stretching to bring muscles back to original
resting length
i
...
Improved flexibility
2
...
Minimizes muscle soreness
4
...
Avoids dizziness or possible fainting
6
...

ii
...
Benefits accrue as result of
many physiological adaptations to cardio training
...
Vo2>Increase
2
...
Cardiac output> Increase
4
...
Resting heart rate>Decrease
6
...
General Guidelines for Cardiorespiratory Training
a
...
I
...
T
...
(Frequency, Intensity, Time, Type, Enjoyment)
i
...

ii
...
Time – The length of time engaged in the activity
...
Type – the mode of physical activity that individual is
engaged in
...
Enjoyment – The amount of pleasure derived from
performing the physical activity
...
General Health Activity Recommendations
i
...
Intensity – Moderate (enough to increase heart and
respiration rates)
iii
...
Type – General activities (walking, stairs, gardening)
v
...
Improved Fitness Recommendations
i
...
Intensity – 40-85% VO2 max, or 60-90% HR max
iii
...
Type – Any activity
v
...
The Myth of the Fat-Burning Zone
a
...

i
...

For them to be used more efficiently, the body was be
able to receive enough Oxygen, burning fat and glucose
as ‘fuel’, producing waste products of carbon dioxide and
water
...
RER – Respiratory exchange ratio
...
Normally,
CO2 and oxygen exchanged in the lungs equals that used
and released in body tissues, so we can use these to
estimate caloric expenditure
...
Percentages of Calories derived from Fats and Carbs
1
...
71 – body at rest, 100% from Fat
2
...
85 – 50
...
3% from
Fat
3
...
95 – 84% from Carbs, 16% from Fat
4
...
00 – 100% from carbs, 0% from Fat
iv
...
Excess Postexercise Oxygen Consumption (EPOC)
1
...
The body is designed to expend as little
energy as possible
...
The body will continue to burn more calories
after exercise than before exercise was initiated
...

D
...
Translating RER Into Heart Rate Zones
i
...
80-
...

1
...

2
...
Zone 2 (
...
0 RER) – 80-85% HR max
...
Near anaerobic threshold (the point at which
body can’t produce enough energy for muscles
with normal oxygen intake), so higher levels of
lactic acid
2
...

3
...
Zone 3 (1
...

1
...
Just using Zones 1 & 2 will cause clients to
plateau
...

3
...

b
...
Stage 1 (Stabilization Level)
1
...

2
...
Zone 1 (30-60 mins)
ii
...
Will use heart rate Zones 1 & 2 (interval
training)
2
...
Zone 2 (1 minute)
4
...
Zone 2 (1 minute)
6
...
Zone 2 (1 minute)
8
...
Cool-down
10
...

iii
...
Zone 1 (5-10 mins)
2
...
Zone 3 (1 min)
4
...
Zone 1 (10 mins) recovery, cool down
...
Rotate all three zones to increase EPOC
c
...
Just as beneficial as traditional forms of cardio exercise
for improving fitness levels
ii
...
Produced near-identical caloric expenditure for the
same given time span, when compared with walking at a fast
pace
...
Postural Considerations in Cardiorespiratory Training
a
...
During use of stationary bicycles, treadmills, etc,
watch for rounding of shoulders and protruding head
ii
...

iii
...
Clients who possess an anteriorly rotated pelvis (low back
arches)
i
...
If
they are used, emphasize hip flexor stretches before
and after use
...
Treadmill speed should be kept to a controllable pace,
to avoid overstriding
...

Hip flexor stretches should be emphasized before and
after use
c
...
Use of all cardio equipment that involves lower
extremities will require proper flexibility of the ankle
joint
...

ii
...
If these
modalities are used, emphasize the foam roll protocol
and keep the pace at a controllable speed
...
Core Musculature
a
...
Stabilization System – responsible for stability of
complex
...

ii
...

iii
...
Must work from inside (stabilization
system) to the outside (movement system) to provide
foundation for movement
...
Importance of Properly Training the Stabilization System
a
...
This leads to
compensation, synergistic dominance, and inefficient
movements
...
EX
...
Scientific Rationale for Core Stabilization Training
a
...

b
...
Thus crucial to incorporate systematic progressive approach
when training the core, ensuring the muscles that stabilize the spine
(stabilization system) are strengthened before the musculature that moves
the spine (movement system)
D
...
Drawing-in maneuver – The action of pulling the belly button
in toward the spine
...
Also, maintaining the cervical spine in a neutral
position during core training improves posture, muscle balance, and
stabilization
ii
...
If sternocleidomastoid muscle is hyperactive and
extends the upper cervical spine, the pelvis rotates anteriorly to realign the
eyes, leading to muscle imbalances and decreased pelvic stabilization
...
Requirements for Core Training
a
...

b
...
Need sustained contractions (6 to 20 seconds) to
improve this, enhances static and dynamic stabilization of lumbo-pelvic-hip
complex
...
Intermuscular coordination – The ability of the
neuromuscular system to allow all muscles to work together with proper
activation and timing between them
...
Core-movement system is primarily geared toward
movement of the lumbo-pelvic-hip complex
F
...
Stabilization (Phase 1) – designed to improve the functional
capacity of the stabilization system
i
...
- Marching, Floor bridge, Floor prone cobra, Prone
iso-ab
b
...
EX
...
Power (Phase 5) – designed to improve the rate of force
production of the core musculature
...
EX
...


CHAPTER 9—Balancing-Training Concepts
A
...
Adequate force reduction and stabilization are required for
optimum force production, the ability to reduce force at the
right joint, at the right time, and in the right plane of motion
requires optimum levels of functional balance and
neuromuscular efficiency
...
Balance threshold – the distance outside of the base of
support that one can go without losing control of his or her
center of gravity
...
Training functional movements in a proprioceptively
enriched environment (unstable, yet controllable) with
appropriate progressions/technique/progressions facilitates max
sensory input to CNS, resulting in selection of the proper
movement pattern
...
Progressions
1
...
2 legs stable>1 leg stable>2 legs unstable>1
leg unstable
B
...
Dynamic joint stabilization – The ability of the kinetic chain
to stabilize a joint during movement
...
EX
...

b
...
EX
...

c
...
Balance and Joint Dysfunctions
a
...
with altered neuromuscular control like have specific
kinetic chain imbalances, that affect the quality of movement, create faulty
movement patterns, and lead to lowered neuromuscular efficiency
...

D
...
Stabilization Level (Phase 1) – Designed to improve
reflexive joint stabilization contractions to increase joint stability, which
means when the body is placed in unstable environments, it must react by
contracting the right muscles at the right time to maintain balance
i
...
- Single-leg balance, Single-leg balance reach,
Single-leg hip internal and external rotation, Single-leg lift and chop
b
...

Movements require dynamic control in mid-range of motion, with isometric
stabilization at the end-range of motion
...
EX
...
Power Level (Phase 5) – designed to develop high levels of
eccentric strength, dynamic neuromuscular efficiency, and reactive joint
stabilization
i
...
- Multiplanar hop with stabilization, Box hop-up
with stabilization, Box hop-down with stabilization
...
Reactive Training – Exercises that use quick, powerful
movements involving an eccentric contraction immediately followed
by an explosive concentric contraction
...
Accomplished through the use of plyometric exercises and
defines the stretch-shortening cycle of the integrated
performance paradigm (to move with precision, forces must be
reduced (eccentrically), stabilized (isometrically), and then
produced (concentrically)
...
Exercises enhance reactivity of the neuromuscular system
and increase the rate of force production (power), motor-unit
recruitment, firing frequency (rate coding), and
synchronization
...
Rate of force production – Ability of muscles to exert
maximal force output in a minimal amount of time through
muscle spectrum (eccentric deceleration, isometric stabilization,
concentric acceleration)
i
...
Body will only move within a range of speed that the
Nervous System has been programmed to allow, reactive training improves
this
...
Only incorporate once proper flexibility, core
strength, and balance capabilities have been achieved
...
Levels of Reactive training
a
...
EX
...
, Box jump-up w/ stab
...
, Multiplanar jump w/stab
...
Strength Level (Phase 2-4) – exercises require greater
specificity, speed, and neural demand, involve more dynamic
eccentric and concentric movement through entire range of motion,
designed to improve dynamic joint stabilization, eccentric strength,
rate of force production, performed in a more repetitive fashion (short
amount of time on ground)
i
...
- Squat jump, Tuck jump, Butt kick, Power step-up
c
...

i
...
– Ice Skater, Single-Leg power stepup,
Proprioceptive plyometrics: cones & hurdles

CHAPTER 11—Speed, Agility, and Quickness Training
A
...
Speed – The ability to move the body in one intended
direction as fast as possible
i
...
Stride Length – the distance covered in one stride
1
...
velocity has a
high correlation to leg length **(2
...
5
times leg length)
iii
...
Frontside mechanics – the emphasis on triple
flexion of the front leg
a
...
Knee flexion
c
...
Keeping the lumbar spine neutral
2
...
Ankle plantarflexion
b
...
Hip extension
d
...
Agility Training
a
...

i
...
Can help to prevent injury by enhancing body’s ability
to effectively control eccentric forces in all planes of motion as well
as by improving the structural integrity of the connective tissue
C
...
Quickness – The ability to react and change body position
with the maximum rate of force production, in all planes of motion,
from all body position, during functional activities
...
Involves the ability to react to visual, auditory, and
kinesthetic feedback during functional activities with minimal
hesitation
...
Adaptation
a
...
Alarm Reaction Stage – the alarm reaction is the initial
reaction to a stressor
1
...

2
...
Initially inefficient, the body was increase
ability to meet these new demands
ii
...
Increased functional capacity to adapt to stressor
such as increasing motor unit recruitment, more efficiently recruiting
muscle fibers
...
Exhaustion – Prolonged stress or stress that is
intolerable and will produce exhaustion of distress to the system
1
...
Periodization – Division of a training program
into smaller, progressive stages will help avoid
this
b
...

i
...

ii
...
EX
...
Metabolic specificity – Refers to the energy demand
placed on the body

1
...

B
...
Strength – The ability of the neuromuscular system to
produce internal tension to overcome an external force
i
...
Stabilization Level Resistance Training (Phase 1)
i
...
Type I motor unit types (smaller) are recruited before
Type II (larger) b/c they are recruited by size, new clients have not
established an ability to recruit a high percentage of motor units
iii
...
The ability to overcome gravity, ground
reaction forces, and momentum on a continual
basis is vital in the prevention of injury and
allows proper kinetic chain alignment and
performance
iv
...
Training with controlled, unstable exercises
increases the body’s ability to stabilize or balance itself
...
Arguably the most important adaptation b/c it
increases the ability of the kinetic chain to stabilize the lumbo-pelvichip complex and joints during movement, allowing the arms and legs
to work more efficiently
c
...
Type II muscle fibers are predominantly recruited to
increase body’s capacity to produce internal tension
...
Heavy weights, and higher volumes of training are
used to increase the recruitment, synchronization, and firing rate of motor
units, while placing necessary mechanical stress on the muscles to increase
their size and strength
...
Strength Endurance (Phase 2)
i
...
Higher levels of force with lower reps (6 to 12) more
sets, with minimal rest, often with supersets
e
...
Hypertrophy – Enlargement of skeletal muscle fibers in
response to overcoming force from high volumes of tension
...
Increase in the cross-sectional area of individual
muscle fibers and is believed to result from an increase in the myofibril
proteins (myofilaments)
iii
...

iv
...
Maximal Strength (Phase 4)
i
...

ii
...
Max
...
training
...

g
...
Power – Ability of the neuromuscular system to
produce the greatest force in the shortest time
...
Focus is on rate of force production, an increase in
either force or velocity will produce an increase in power
...
Power training allows for increased rate of force
production by increasing the number of motor units activated, the
synchronization between them, and the speed at which they are activated
...
Resistance-Training Systems
a
...
Multiple-Set System – Many sets, reps, etc
...
Pyramid System – progressive or regressive step approach
that either increases weight with each set or decreases weight with each set
1
...
performs 10 to 12
reps with a light load and increases the resistance for each following set,
until individual can perform 1 to 2 reps, usually in 4-6 sets

2
...
Superset System – uses a couple of exercises performed in
rapid succession of one another, features use of independent subsystems
with similar systems
1
...
Tri-sets – 3 exercises in rapid succession for the same
muscle group or body part
e
...

f
...
Split-Routine System – Breaking body into parts trained on
separate days
h
...
Doing 1 set of chest, then back, then shoulders, then
biceps, then legs,
i
...
Doing all sets of chest, then all sets of back, then all
sets of shoulders, then all sets of biceps, then all sets of legs
...
Program Design
a
...

B
...
Acute variables – Important components that specify how
each exercise is to be performed
i
...
Power adaptations require 1 to 10 reps at 3045% of the 1RM, or approximately 10% of body
weight
**2
...

**3
...
Endurance is best achieved by performing 1225 reps at 50-70% of the 1RM
ii
...
For power adaptations, 3-6 sets b/t 1-10 reps
at intensity of 30-45% of 1RM or approx
...

**2
...
Hypertrophy adaptations require 3-4 sets of 812 reps at 70-85% of 1RM
**4
...
Training Intensity – An individual’s level of effort,
compared with their maximal effort, which is usually expressed as a
percentage
**1
...
10% of
body weight when using medicine balls
...
Max Strength adaptations require training
with 85-100% of 1RM
**3
...
Endurance is best developed with a training
intensity of 40-70% of 1RM
iv
...

**1
...
Strength – (2/0/2) Moderate
**3
...
Rest Interval – The time taken to recuperate between
sets
...

**1
...

**2
...
Stability/Endurance 30 to 90 seconds
4
...

i
...
Approx
...
40 secs
...
75% recovery
iii
...
, Approx
...
3 mins
...
Training Volume – Amount of physical training
performed within a specific period
...
Power – 6 sets of 30 reps
2
...
Stabilization – 36 sets of 75 reps
vii
...
Training Duration – The timeframe of a workout
(including warm-up and cool-down) or the length of time
spent in one phase of training
...
Timeframe from start to finish (programs that
exceed 60-90 minutes associated with declining
energy levels)
2
...

ix
...
Power level – Total body; multijoint
(explosive)
**2
...
Stabilization level – total body; multijoint or
single joint; controlled unstable
...
Periodization and the OPT Model (Planned fitness Training)
a
...

i
...
The OPT Model**
a
...
Correcting muscle imbalances
ii
...
Preventing tissue overload by preparing
muscles/tendons/ligaments/joints for the upcoming imposed demands of
training
iv
...
Established proper movement patterns or exercise
technique
vi
...
Stabilization Endurance Training (Phase 1) focusing on
i
...
Increasing muscular endurance
iii
...
Improving intermuscular & intramuscular
coordination
v
...
Strength focuses on:
i
...
to stabilize the pelvis and
spine under heavier loads, through more-complete ranges of motion
ii
...
Increase the volume of training w/ more reps, sets,
intensity

iv
...
Increase motor unit recruitment, frequency of motor
unit recruitment, and motor unit synchronization (maximal strength)
d
...
Hybrid form of training that promotes increased
stabilization endurance, hypertrophy, and strength, using superset
techniques in which a more-stable exercise is immediately followed
by stabilization exercise using same biomechanical motions
e
...
Specific for the adaptation of maximal muscle growth,
focusing on high levels of volume with minimal rest periods to force
cellular changes resulting in increase muscle size
f
...
Focused on increasing the load placed upon the tissues
of the body, improving:
1
...
Rate of Force production
3
...
Can help increase the benefits of forms of power
training used in Phase 5
...
Power
i
...
Therefore increase in force or velocity will increase
power, accomplished by either increasing the load (or force) or
increasing speed with which you move the load (velocity)
iii
...

h
...
Accomplished by combining strength exercise with a
power exercise for each body part (barbell bench press with medicine
ball chest pass)
ii
...
Speed exercises (30-45% intensity) & 10% intensity
medicine ball training affect velocity side of power equation
...
Applying the OPT Model
a
...
Annual plan consists of cycling between Phases 1 & 2,
4 weeks spent at each, 3 workouts per week
b
...
Annual plan consists of cycling 4 weeks a piece as
follows: Phase 1, 2, and 3, Phase 2, 3, 4, Phase 1, 2, 3, and Phase 4, 3,
2,
ii
...
Applying the Model to Improve General Performance
i
...
Annual plan:
1
...
4 Weeks @ Phase 2
3
...
4 Weeks @ Phase 2,5
5
...
Monthly plan
1
...
For March, M (Phase 2), W (Phase 1), F (Phase
5)

CHAPTER 14—Specific Populations
A
...
Youth Training (between 11-21 years old)
i
...
of 20 minutes, 3 or more days of the week
ii
...

b
...
The term ‘maximum oxygen uptake’ should not be
used in children b/c they do not exhibit a plateau in oxygen uptake at
maximum exercise, peak oxygen consumption is similar for young and
mature males, and slightly higher for young females, similarity in peak
oxygen uptake between children and adults means children perform
endurance-related tasks fairly well (Phase 1)
ii
...

iii
...

c
...
Resistance training in the youth population is
associated with decrease in the number of common injuries
ii
...

d
...
Decrease in following functions: Max attainable heart
rate, cardiac output, muscle mass, balance, coordination (neuromuscular
efficiency), connective tissue elasticity, bone mineral density
ii
...
Obesity – The condition of subcutaneous fat exceeding the amount
of lean body mass
...
33% of adult population & 15% of children ages 6 and older
b
...

i
...
5-24
...
9 overweight, >30 obese
ii
...
Causes of obesity – Fundamental problem is energy balance
...
15% decrease if fat-free mass between ages
of 30 and 80
...
Obesity and Training – use exercises in standing or seated
position
i
...

ii
...

iii
...

C
...
The body’s ability to produce insulin (a hormone secreted by the
pancreas to help deliver glucose to cells) or to utilize glucose (blood sugar)
is altered
...
Nearly 6% of US population with diabetes, expected to
double in next 15 to 20 years
b
...
To control
this high level of blood sugar, insulin may be injected to compensate for
what their pancreas cannot produce
...
If they do not control their glucose levels before,
during, and after exercise, blood sugar levels can drop rapidly and cause a
condition called hypoglycemia (low blood sugar) leading to weakness,
dizziness, and fainting
...
Type 2 (adult-onset diabetes) – associated with obesity,
particularly abdominal obesity
...
Can lead to
hyperglycemia
...
Chronic hyperglycemia is associated with a number of
diseases associated with damage to the kidneys, heart, nerves, eyes, and
circulatory system
...
Exercise and Diabetes
i
...


ii
...

iii
...
Hypertension – raised systemic arterial blood pressure, which, if
sustained at a high enough level, is like to induce cardiovascular or endorgan damage
...
Systolic greater than or equal to 140 mm Hg and Diastolic
reading greater than or equal to 90 mm Hg
...
Should engage in low-intensity aerobic exercise, but may
wan tot avoid heavy resistance training
...

c
...
Supine or prone
positions (especially when the head is lower in elevation than the heart) may
be avoided
...
Full flexibility continuum can be used, avoid self-myofascial
release
...
Medication (Beta Blockers) are used, but cardio, diet changes
can have effect
...

E
...
40% of deaths annually, 18 million individuals have coronary
artery disease or chronic heart failure, with another 50 million diagnosed
with high blood pressure
...
Plaque accumulation in the coronary arteries, and the
eventual obstruction of the artery, resulting in a myocardial infarction (or
heart attack)
c
...
Heart disease may be slowed (ore even reversed) when a
multifactor intervention program of intensive education, exercise,
counseling, and lipid lowering medications are used
...
Perform exercises in a seated or standing position
...
Flexibility limited to static/active in seated position
...
Programs should be performed in
circuit style or using Peripheral Heart Action (PHA) training system
...
Weekly caloric expenditure goal of 1500-2000 kcal,
resistance training should not be attempted until client has been exercising
without problems for 3 months
...
Osteoporosis
a
...
Osteoporosis – Condition in which there is a decrease in
bone mass and density as well an increase in the space between bones,
resulting in porosity and fragility
...
Erodes core, affects more than 25 million people each
year, and 1
...
Peak bone Mass – the highest amount of bone mass a
person is able to achieve in a lifetime
...
New bone formation (remodeling) occurs as the
result of stress placed on the musculoskeletal system
...

iii
...

iv
...
20% increase
is necessary to offset fractures
...
Flexibility limited to static and active in seated
position
...
Cardio on phase I, progress to II
with physician’s advice
...
Reactive Training not recommended
...
6 months of consistent exercise at
high intensities, progressed appropriately will be required to have an effect
on bone mass
...
Use circuit style or PHA train system, focusing on
hips, thighs, back, and arms and progressing to exercises in standing position
G
...
Most common chronic condition, effects 50% of persons
older than 65 and more than 15% of American population
...
Osteoarthritis – Arthritis in which cartilage becomes soft,
frayed, or thins out, as a result of trauma or other conditions
i
...

c
...
Body’s immune system
mistakenly attacks its own tissue, causing inflammatory
response in multiple joints, leading to pain and stiffness
...
Pain persisting for more than 1 hour after exercise should be
modified or eliminated from the routine
...
Higher intensity or higher repetitions should be avoided to
decrease joint aggravation, so circuit program or multiple
session is suitable
...
Oral corticosteroids may lead to osteoporosis
...

g
...

h
...
Improving muscle strength and enhancing flexibility
through exercise can assist in decreasing symptoms
associated with arthritis
...
Static/active of stretching, use of self-myofascial release can
be used if tolerated, cardio training can being in stage I and
progress to stages II and III
...
Phase 1 of OPT model
with modified reps (10 to 12) to avoid heavy, repetitive joint
loading that increases stress to the affected joints
...
Cancer – any of various types of malignant neoplasms, most of
which invade surrounding tissues, may metastasize to several
sites, and are likely to recur after attempted removal and to cause
death of the patient unless adequately treated
a
...

American men have a 44% probability and women have a
38% probability of developing cancer during their lifetime
...
Exercise can improve exercise tolerance, reduce the cellular
risks associated with cancer, and improve the quality of life
...
Moderate level exercise has positive effect on immune
system, moderate to high levels seem to be associated with
decreased incidence and mortality rates for certain forms of
cancer
...
Flexibility active/static, self-myofascial stretching is okay,
cardio is important and can progress to stages II and III with
physician consent
...

Reactive training not recommended until client progressed
to three phase 1 workouts a week
...


I
...
May continue with moderate levels of exercise until the third
trimester, when a logical reduction in activity is
recommended
...
Gradual growth of fetus can alter posture, making flexibility
and core-stabilization training important
...

c
...
Flexibility in seated/standing position esp
...
Static/active stretching, selfmyofascial release ok, but not on varicose veins that are
sore, or areas where there is swelling
...
No reactive
training
...

J
...
Restrictive lung disease – The condition of a fibrous lung
tissue, which results in a decreased ability to expand the
lungs
...
Obstructive lung disease – The condition of altered airflow
through the lungs, generally caused by airway obstruction as
a result of mucus production
...
Problems during exercise include decreased ventilation and
decreased gas exchange ability, fatigue at low levels and
shortness of breath
...
)
d
...
Upper extremity
exercises place an increased stress on the secondary
respiratory muscles that are involved in stabilized upper
extremities
...
Use of PHA is advised
...

K
...
Intermittent claudication – the manifestation of the
symptoms caused by peripheral arterial disease

b
...


d
...

f
...
Characterized by limping, lameness, or pain in the
lower leg during mild exercise resulting from a
decrease in blood supply (oxygen) to the lower
extremties
Peripheral arterial disease – A condition characterized by
narrowing of the major arteries that are responsible for
supplying blood to the lower extremities
...

Exercise in intermittent format, rest as necessary between
exercise bouts
...

# of repetitions for assessment may have to be decreased to
5 to 10
...
Phase 1 and 2 of the OPT model should be used
...
Exercise bouts may initially start with 5 to 10 minutes of
activity and progress slowly to 20 to 30 minutes
...
Nutrition and Body Composition
a
...

B
...
Also involved in
synthesis of hormones, enzymes, and other regulatory peptides, and can be
used for energy if calories or carbohydrate are insufficient in the diet
...
20 amino acids to build proteins, 2 classes of amino acids,
essential and nonessential
b
...
8 essential amino acids
...
Nonessential amino acids – body is able to manufacture them
from dietary nitrogen and fragments of carbohydrates and fat
...
Semiessential amino acids – because of their rate of synthesis
within the body, arginine and histidine are semiessential, they can’t be
manufactured by the body at a rate that will support growth (especially in
children)
e
...
Proteins must be broken down into constituent amino
acids before the body can use them
...
As ingested proteins enter the stomach, they encounter
hydrochloric acid, which uncoils (denatures) the protein so the
digestive enzymes can begin dismantling the peptide bonds
iii
...
The resulting dipeptides, tripeptides, and singular
amino acids are then absorbed through the intestinal wall into the
enterocytes and released into the blood supply to the liver
...
Amino acids for immediate Energy
i
...

ii
...


iii
...

h
...
If protein intake exceed need for synthesis, carbon
fragments may be stored as fat
i
...
If food supplies all of the essential amino acids in
appropriate ratios, it is called a complete protein, if
food source is low or lacking in one ore more essential
amino acids, it is called an incomplete protein
...
The essential amino acid that is missing or present in
the smallest amount is called the limiting factor of the
protein
...
Because the process of protein synthesis works on
an all-or-none principle, all amino acids must be
present at the site of protein manufacture, or synthesis
will be reduced to the point where the cell runs out of
the limiting amino acid
...
(PER) – Protein efficiency ratio, (NPU) – net protein
utilization, (BV) – biological value
v
...
Consuming only high BV proteins will cause
amino acid requirements would be met with less protein
2
...

j
...
Exercise – Both anaerobic & aerobic exercise effect
protein requirements in different ways
...

ii
...
Negative Energy Balance – during this, amino acids
are used to assist in energy production (called gluconeogenesis)
...
Protein and the Bodybuilder – protein intake could be
dramatically increased (during cut/contest phase) to theoretically lessen the
obligatory loss of lean tissue during these drastic measures
...

k
...
Protein-intake recommendations
i
...
0g/kg per day or 15 to 30% of total caloric
intake
ii
...
0 g/kg per day), Endurance athlete (1
...
Adaptation period – Bodybuilder (1
...
0 g/kg per
day), Active recreational athlete (1
...
8 g/kg per day), Endurance athlete
(1
...
0 g/kg per day)
iv
...
More than 30% of total caloric intake,
associated with higher intake or saturated fat
and low fiber intake, both of which are risk
factors for heart disease and some types of
cancer, also kidneys have to work harder to
eliminate the increased urea produced
...
Calcium is excreted with high-protein diet, and
need for fluids is increased, protein requires 7
times the water for metabolism than carbs
and fats
...
Low-carb consumption typically accompanies
high-protein diets (esp
...

v
...
Enhanced recovery after exercise – research has
shown that the use of protein and carbs supplements
before and after weight training can enhance anabolic
hormones
...
Weight production programs – replace wholefood proteins, eliminating unwanted calories to maintain
equal or positive nitrogen balance during body-fat
reduction for competitive cosmetic athletes
...
Convenience
4
...

m
...
1 gram yields 4 calories
ii
...

iii
...
These must be met for body to synthesize endogenous
protein: availability of all essential & nonessential amino acids in proper
groups, adequate supply of exogenous protein (supplying amine groups,
which synthesize the nonessential amino acids), adequate energy-yielding
carbs and fats (sparing the protein),
v
...
0 g/kg depending on goal, activity, protein source, and total
caloric intake, falls in range of 15-30% of total caloric intake
vi
...
5 times the
RDA) diets can lead to:
1
...
Fluid imbalance
3
...
Slower metabolism
5
...
Energy Loss
C
...


a
...

1
...
- Glucose (blood sugar), fructose (fruit sugar), and
galactose
...
Disaccharides – two sugar units
1
...
- Sucrose (common sugar), lactose (milk sugar)
and maltose
c
...

d
...
Principal carbs present in food occur in the form of
simple sugars, starches, and cellulose
1
...
Double sugars, (table sugar) require some
digestive action
3
...

4
...

ii
...

1
...

2
...

3
...
Fructose must be converted to glucose in
the liver before it can be used for energy
...
Small portion of glucose is converted to
glycogen after meal within liver and muscles, excess is converted to fat and
stored throughout the body as a reserve source of energy
...
Fiber and its role in health
1
...
Increases satiety value of foods, delays emptying of
stomach
3
...
Retains health and tone of digestive tract muscles,
preventing diverticulosis, which causes the weakening
of intestinal walls, then causing them to swell and
distend
5
...
Lowers risk of colon cancer
7
...
Regulates body’s absorption of glucose
9
...

iv
...
When performing high-intensity, short-duration
activity (anaerobic), muscular demand for energy is
dependent on muscle glycogen
...
During endurance exercise (aerobic) performed at a
moderate intensity (60% of maximal oxygen
consumption), muscle glycogen provides approx
...
During high-intensity aerobic exercise (>79% of VO2
max), it yields nearly all of energy needs
4
...

5
...

v
...
Endurance Exercise
i
...


ii
...

iii
...

2
...
Consume a high-carb meal 2 to 4 hours before
exercising for more than an hour, esp
...
Some research intake of 1 to 4
...
Carbohydrate Loading
i
...
Week-long program, 4 days of glycogen
depletion (through low-carb diet and exhaustive exercise),
followed by 3 days of rest and high-carb diet, but this method
can have drawbacks (hypoglycemia, increased susceptibility to
injury)
4
...
For exercise more than 1 hour, can help supply
glucose to working muscles as well as maintain blood glucose
levels
...
Endurance athletes should have between 30-60 g
of carbohydrates every hour to accomplish this, sports
beverages can help as well
3
...

5
...
Consuming 1
...

2
...
Additional meals of 1
...
For Altering Body Composition
1
...


2
...
Weight
lost on low-carb diet can be attributed to two factors: lower
caloric intake, and loss of fat-free mass (FFM)
3
...
For every gram of glucose taken
out of glycogen, it brings with it 2
...
This adds to
weight loss in first week, but long-term success is not easily
maintained
...
Carbohydrates and Weight Gain: The Facts
1
...
Only during the last two decades has there been a
significant increase in obesity because of 2 factors: increased
energy intake, and reduction in energy expenditure
...
Review of properties of carbohydrates
1
...
Satiety by keeping glycogen stores full and adding
bulk to diet
3
...
Proper blood sugar levels with intake of low-glycemic
carbohydrates
5
...
Body needs carbohydrates because
1
...
Constantly need to be replaced, causing craving that
must be satisfied
...
Parts of the CNS rely exclusively on carbs
4
...
Recommended carbohydrate intake
1
...
Carb intake should be between 50-70% of total caloric
intake according to preference, performance, and
satiety
3
...
Fruits, whole grain, and vegetables, are all excellent
sources of fiber
...
Lipids
a
...
95% are fats and oils
...
Structurally,
triglycerides are three fatty acids attached to a glycerol backbone
...

i
...

1
...
Polyunsaturated (such as omega-3 found in
cold-water fish) – if there is more than one point of unsaturation
i
...

3
...

ii
...
Trans-fatty acids – the result of hydrogenation (the
process of adding hydrogen to unsaturated fatty acids to make them harder at
room temperature and increase food shelf-life)
1
...

b
...
Most concentrated form of energy, 1 gram yields 9
calories when oxidized
2
...
Involved in cellular membrane structure and function
4
...
Regulation and excretion of nutrients in the cells
6
...
Insulating the body from environmental temperature
changes and preserving body heat
8
...
Initiating the release of the hormone cholecystokinin
(CCK), which contributes to satiety
...
Digestion, absorption, and utilization
1
...
In intestine, fat interacts with bile to become
emulsified so that pancreatic enzymes can break the triglycerides
down into 2 fatty acids and a monoglyceride
3
...

4
...

5
...
Throughout the day, triglycerides are constantly cycles
in and out of tissues including muscles, organs, and adipose
d
...
Between 10-30% of calories from fat
...
Fat has lower thermic effect (TEF) than other
macronutrients
...

As fat % increases, amount of heat given off (TEF) decreases
...

3
...
Only 3% of calories in fat are required to store it as
fat
...
Dietary fats stimulate release of CCK, hormone that
signals satiety
...
Diets containing more than 30% of calories from fat
lose the volume of food provided by higher-carb diets
...
Fat Supplementation during Exercise
1
...

f
...
Metabolic syndrome is a cluster of symptoms
characterized by obesity and insulin resistance
...
Obesity itself is a risk factor for development of IR, not
other way around
...
If one constantly overeats, excess calories are stored in
fat, fat cells then increase in size
...

3
...

g
...
1 gram of fat yields 9 calories
2
...

3
...
Energy
ii
...
Precursors to hormones
iv
...
Regulation of uptake and excretion of nutrients
in cells
4
...
Fat intake can range from 10-30%, according to
performance, satiety, and palatability
ii
...

iii
...
More than 30% leads to overeating (lack of
food volume) and often slows metabolism
E
...

Those participating in fat-loss program should drink an additional 8 ounces
of water for every 25 pounds they carry above ideal body weight
...
Importance of Water
1
...
Endocrine gland function improves
3
...
Liver functions improve, increasing % of fat used for
energy
5
...
Nutrients distributed throughout the body
7
...
Blood volume is maintained
b
...
Fluid loss of even 2% of body weight will adversely
affect circulatory functions and decrease performance levels
...
Consume 16 oz of fluid 2 hours before exercise,
additional 8-16 oz may be needed in warmer weather
3
...
Fluids should be cold b/c of more rapid gastric
emptying
5
...
If exercise is less than 60 minutes, water is experts
choice for fluid replacement
7
...
Ingest 20 oz of fluid for every pound of body weight
lost after an exercise bout
F
...
For Fat Loss:
1
...
Whole Grains and fresh vegetables over refined grains
and simple sugars
3
...

4
...
Lots of water (8-12 cups per day)
6
...
For Lean Body Mass Gain:
1
...
Spread protein throughout the day to take advantage of
previous tip

3
...

4
...


CHAPTER 16—Supplementation – Sales of $3
...
7 billion in
2002
...
Dietary supplement – A substance that completes or makes an
addition to daily dietary intake
...
A dietary supplement is:
i
...
A dietary substance for use by man to supplement the
diet by increasing the total daily intake
iii
...
Intended for ingestion in pill, capsule, tablet, or liquid
form
vi
...
Labeled as a ‘dietary supplement’
b
...
Specific health problems, enhancing physical/mental
performances, altering body composition, stimulating metabolism,
controlling appetite, or dealing with age-related changes in body
structure and function
ii
...
Supplementation Guidelines (Dietary Reference Intakes
(DRI’s))
a
...
Recommended Dietary Allowance (RDA) – The average
daily nutrient intake level that is sufficient to meet the nutrient
requirement of nearly all (97-98%) healthy individuals who are in a
particular life stage and gender group
...
Adequate Intake (AI) – A recommended average daily
nutrient intake level, based on observed (or experimentally
determined) approximations or estimates of nutrient intake that are
assumed to be adequate for a group(s) of healthy people
...


d
...
As intake increases above the UL, the potential risk of adverse
health effects increases
...
Dietary Reference Intake Values and Guidelines
a
...
Excess intake of Vitamin A can cause birth defects
ii
...
Excess intake of vitamin B6 can cause permanent
damage to sensory nerves
b
...
Excess (and inadequate) calcium intake can increase
the risk of developing kidney stones
ii
...

c
...

d
...
EX
...
Also, use of various drugs can contraindicate the use of
specific nutrient supplements
f
...
available to establish UL
value
...
Safe Upper Levels (SULs) provides safe upper levels for 8
nutrients and guidance levels for 22 vitamins and minerals, for which
data were inadequate to set an SUL
D
...
Units of Measure used on Dietary Supplement Labels
i
...
Most are still fairly accurate, however
recommendations today for A, D, E, and iron are different
E
...
Most commonly used supplement is a multi-Vit/Min)

b
...
Most nutrients in a multi-vitamin should be around 100% of
DV except for the following:
1
...
B-Carotene is contraindicated in smokers
3
...

d
...
Vitamin A, D, Iron, and Zinc

CHAPTER 17—Behavior Modification
A
...
Step One - Vision –
i
...
Root cause analysis – A method of asking questions on
a step-by-step basis to discover the initial cause of a fault
1
...
Uncovers motivations behind superficial
answers
iii
...
Step Two – Strategy –
i
...
S – Specific goals result in better performance
2
...
A – Approach to goal setting should be on
desired ends to move toward
4
...
P – Proximal, short-term goals raise sense of
confidence and determination
6
...
Step Three – Belief –
i
...
Should have visualizations of success, as well as
proper form
iii
...

d
...
For example, people who successfully maintain New
Year’s resolutions after 2 years, report 14 slips, but use setbacks as
motivation
...
Reward success, facilitate networks of excellence, and
have a strategy for setbacks, such as calling a friend in the event of a
slip-up or to carry a ‘reminder card
...
Step Five – Learning i
...

ii
...

iii
...


CHAPTER 18—Professional Development
A
...
Uncompromising customer service – being adamant about
providing an experience and level of assistance that is rarely, if
ever experienced anywhere else
B
...
Avoid the following when approaching a club member doing
an exercise
1
...
Rather, ask them if they want to know how to
maximize the exercise
...
The READ system
a
...

1
...

2
...
Empathy – Action of awareness, understanding, and
sensitivity of the thoughts, emotions, and experience of another
without personally having gone through the same
...
All decisions and actions are the result of motivation
...
4 initial questions: What are you trying to achieve?
How long has this been your goal? What is the most important to you
about achieving that? What has prevented you from achieving it in the
past?
3
...

4
...

c
...

1
...
’ In other words, open-ended questions
2
...
Paraphrasing – shows a client that health professional
is listening and understand what the client is saying
...
Developing Solutions – the program that best meets needs
4
...
Benefits – features of personal training
and products are the number of sessions, what materials come
with product, assessments that will be taken, etc
...
Every time a
feature is explained to a client, be sure to correlate it back to
answering his or or her mental question, ‘What’s in it for me’
D
...
Most sales are lost b/c they are not asked for
...
There was not enough value built into the sale
2
...

3
...
The potential client legitimately does not have the
ability to pay
...
No today is not a No indefinitely

---