ACSM-EP Exam Questions

Correct answer: Rockport

Cardiorespiratory Fitness (CRF) can be assessed through a variety of step tests, field tests, and submaximal VO2 prediction tests. The advantage of having a wide variety of available tests is that it allows you as the trainer to select an appropriate assessment that provides the desired physiological information while adhering to the needs of the client.

The following are all examples of step tests:

• Queens College
• Harvard
• Astrand-Rhyming

Rockport is a type of walk test.

Correct answer: Slowing down heart rate

Proprioception is the sense of knowing where one's body is in space and, as it relates to fitness, it allows the client to do many things even with their eyes closed, including the following salient features:

• Postural control
• Precise calibration of limb position in space
• Maintenance of steady muscle force production / movement amplitudes
• Discrimination of object weight
• Production of coordinated gait patterns
• Controlling the timing of muscular contraction for dynamic stabilization and multisegmental movement
• Feedback and feed-forward motor control

Correct answer: 60% to 80% 1-RM

The use of Repetition Maximum (RM) loads is a relatively common method to prescribe resistance training intensity. RM loads of 60% to 80% for 8 to 12 repetitions are best for enhancing general muscular fitness.

As an example, if the one-repetition maximum (the maximum amount of weight someone can lift once with perfect form) on the leg press is 100 pounds, a training intensity of 60% to 80% would be between 60 and 80 pounds.

Correct answer: 5 beats per minute

CardioRespiratory Fitness (CRF) can be assessed through a variety of step tests, field tests, and submaximal VO2 prediction tests. The advantage of having a wide variety of available tests is that it allows you as the trainer to select an appropriate assessment that provides the desired physiological information while adhering to the needs of the client.

The Ebbeling Single-Stage Submaximal Treadmill Walking Test is an assessment to help the exercise physiologist determine VO2 max.

The exercise physiologist should extend the testing time by one minute if the client's heart rate differs by more than five beats per minute.

Here is the protocol:

1. Warm up for 4 minutes at a 0% grade and a walking speed between 2.0 and 4.5 mph that elicits a heart rate between 50% to 70% of age-predicted heart rate max, adjusting speed after first minute as needed.
2. Following the warm-up, elevate the treadmill to a 5% grade and continue walking for an additional 4 minutes at a speed of 2.0, 3.0, 4.0, or 4.5 mph. Record the steady-state HR (SS HR) from the average of the final 30 seconds of the last two minutes at the 5% grade. If HR differs for more than 5 beats per minute, extend the test by an additional minute and record the SS HR from the new final 2 minutes.
3. Enter the SS HR into this equation: VO2 max (mL x kg-1 x min-1) = 15.1 + (21.8 x speed in mph) - (0.327 x SS HR in bmp) - (0.263 x speed in mph x age in years) + (0.00504 x SS HR in bpm x age in years) + (5.98 x gender: female = 0, male = 1).

Correct answer: Stabilizing muscles

Some experts have classified muscles as two distinct yet interdependent systems; a muscle is either a stabilizer or a mobilizer. Stabilizing muscles are more centrally located and largely function to create stiffness across joints. 

Mobilizers, on the other hand, are considered global muscles, as they comprise long lever arms and allow for greater force production, torque, and gross multiplanar movements.

Correct answer: 6 minutes

CardioRespiratory Fitness (CRF) can be assessed through a variety of step tests, field tests, and submaximal VO2 prediction tests. The advantage of having a wide variety of available tests is that it allows you as the trainer to select an appropriate assessment that provides the desired physiological information while adhering to the needs of the client.

The Astrand-Rhyming Cycle Ergometer test is one of the most recommended methods for fitness trainers to measure an adult client's cardiorespiratory fitness level, and the working portion only lasts six minutes.

After you set the seat on the cycle ergometer to ACSM guidelines, you will select the appropriate work rate based on the sex and self-reported fitness level of the client:

• Females, unconditioned: 300 or 450 kg-m x min-1 (50 or 75 w)
• Females, conditioned: 450 or 600 kg-m x min-1 (75 or 100 w)
• Males, unconditioned: 300 or 600 kg-m x min-1 (50 or 100 w)
• Males, conditioned: 600 or 900 kg-m x min-1 (100 or 150 w)

While you should have access to these formulas during the assessment through the ACSM textbook, it's still useful to memorize them as you progress in your field. Here is the rest of the process for the Astrand-Rhyming Cycle Ergometer test.

1. After a proper warm-up, instruct your client to pedal at 50 rpm for six minutes at the work rate selected above.
2. Assess heart rate two times during minutes 5-6, and average the values.
3. Estimate VO2 max from a nomogram.
4. Because HRmax decreases with age, the value from the monogram must be adjusted for age by multiplying VO2 max value by the following correction factors:

        Age / Correction Factor

         15 / 1.10

         25 / 1.00

         35 / 0.87

         40 / 0.83

         45 / 0.78

         50 / 0.75

         55 / 0.71

         60 / 0.68

         65 / 0.65

Correct answer: Third degree

Ligaments are collagenous fibrous structures that connect bone to bone and provide passive soft-tissue restraint of bone-to-bone contact. When a client has a third degree ligament sprain, surgical repair may be required.

In the meantime, you can advise your client to follow the PRICE acronym and immobilize the area.

Correct answer: To inform the client about their current exercise capacity

Informed consent is collected before any personal information is obtained, fitness tests are conducted, and exercise participation begins. There are three main purposes of informed consent:

1. To inform the client of any personal and confidential information that will be collected
2. To inform the client how personal information will be used
3. To detail the risks involved with physical activity

Fitness testing is not performed until after the informed consent forms have been signed.

Correct answer: Lower trapezius

Joint stabilization occurs through coordinated muscle coactivation, creating a suitable amount of stiffness to maintain joint alignment. The following mobilizers and stabilizers, respectively, have an important codependent relationship that ensures proper stabilization of joints through movement and exercise:

• Levator scapulae—Lower trapezius
• Rectus abdominis—Gluteus medius and maximus
• Upper trapezius—Deep cervical flexors
• Pectoralis major and minor—Serratus anterior
• Deltoids—Rotator cuff
• Erector spinae—Middle and lower trapezius
• Quadriceps—Multifidus

Correct answer: Density of neurons within the brain

Social Cognitive Theory (SCT), or social learning theory, is one of the most popular theoretical frameworks for understanding physical activity adoption. Social cognitive theory emphasizes reciprocal determinism, which is the interaction between individuals and their environments.

SCT identifies three primary factors that influence behavior:

• Environment: An example of the environment would be the client's neighborhood and proximity to the gym.
• Individual personality characteristics and experience: An example of this would be how long the client has been exercising.
• Behavioral factors: An example of this would be how the client behaves in relation to rewards and punishments.

Using SCT for physical activity adoption can be individual-based self-regulation like self-monitoring, goal setting, and feedback, or it can be more complex involving all three factors.

Correct answer: Seeking and using social support to start or continue exercising

Processes of change can be broken down into experiential processes and behavioral processes. Both are recommended to help increase self-efficacy and facilitate the required transition from precontemplation to action to maintenance.

The focus of the process of change known as helping relationships is seeking and using social support to start or continue exercising. For example, you can have the client join an adult sports league or ask a friend to walk around the neighborhood.

Other types of behavioral processes include the following:

• Self-liberation
• Counterconditioning
• Reinforcement management

Correct answer: One-repetition maximum

The standard muscular strength assessment would be the one-repetition maximum (1-RM), which is when the client attempts to lift the heaviest weight they can only once with perfect technique and form.

With that said, due to the higher risk for injury, it is possible to use other assessments such as the 5-RM or 10-RM assessment. The latter would be especially useful if the client is training within an 8 to 12 repetition range.

Correct answer: Alarm

The physiological stress response has a pattern across all species known as the general adapatation syndrome. There are three stages:

• Alarm: This is when the stressor is first recognized by the system and a fight-or-flight response is initiated.
• Resistance: This is when a cascade of cardiovascular, metabolic, hormonal, and immune changes is generated as a compensatory stress reaction.
• Exhaustion: This is when the organism has depleted all biochemical substrates and additional resources and is no longer able to mount a defense against the stressor.

It is during the alarm stage that a stressor is recognized and several bodily systems are activated to cope with the stressor and restore homeostasis as effectively and efficiently as possible.

Correct answer: Worker compensation insurance

An important element of risk management involves acquiring the proper types of insurance to protect your business, its customers, and its employees. As an exercise physiologist who is working as an independent contractor, it would be most appropriate to buy the following types of insurance:

• General liability insurance: Protects your business if someone pursues a legal claim as a result of experiencing bodily injury or property damage that happened while interacting with your business.
• Professional liability insurance: Protects not only your business but your employees in the event someone pursues a legal claim for the professional misconduct of an employee.
• Property insurance: This insurance protects the physical assets of your business by covering the cost to fix or replace physical assets damaged or destroyed by an incident.

Workers compensation insurance would be least appropriate unless you have active employees working under you, since this insurance protects your employees and business from claims resulting from employment-related accidents, injuries, and even death.

Correct answer: 110 BPM 

Tachycardia means high heart rate. At rest, this means greater than 100 BPM (or greater than 80 BPM, based on some sources). 

A normal resting heart rate is generally considered to be between 60 and 100 BPM. Lower than 60 BPM is considered bradycardia.  

Correct answer: Lifting heavy weights 

As an exercise physiologist, you will work with a variety of individuals, all of whom are going to have a wide array of potential intrinsic and extrinsic risk factors that may predispose them to injury. Common intrinsic risk factors include the following:

• History of previous injury
• Inadequate fitness and/or conditioning
• Body composition issues such as morbid obesity
• Bony alignment abnormalities such as genu varus
• Strength and/or flexibility imbalances
• Joint or ligamentous laxity
• Predisposing musculoskeletal disease such as EDS

Excessive load on the body by lifting heavy weights is an example of an extrinsic risk factor.

Correct answer: Facilities will have one AED for the gym floor

The American College of Sports Medicine has identified 35 fundamental standards relating to risk management and emergency procedures. As an exercise physiologist, you will be training clients in a variety of locations, and therefore, it's important to take basic precautions that these fundamental standards lay out.

As it pertains to automated external defibrillators, the following are required:

• Provide public access to an automated external defibrillator.
• AED practice sessions must occur at least twice per year.
• At least one staff member who is trained in CPR and AED must be on the gym floor at all times.

Facilities will have enough AEDs placed throughout the building based on a 3-minute response time from the moment of collapse.

Correct answer: Screening 

All clients should be screened to ensure that they are healthy enough to start an exercise program. This process is known as a preparticipation activity screening. 

A preparticipation physical activity screening is recommended for new clients for the following reasons:

• To identify those with medical contraindications for performing physical activity
• To identify those who should receive a medical/physical evaluation exam and clearance prior to performing a physical activity program
• To identify those who should participate in a medically supervised physical activity program
• To identify those with other health/medical concerns such as orthopedic injuries

Motivational interviewing is used to help clients set and determine their goals. Pre-testing is used to determine a client's starting point. Collaboratively evaluating is not a recognized term in this field.

Correct answer: Multifidus

Joint stabilization occurs through coordinated muscle coactivation, creating a suitable amount of stiffness to maintain joint alignment. The following mobilizers and stabilizers, respectively, have an important codependent relationship that ensures proper stabilization of joints through movement and exercise:

• Quadriceps—Multifidus
• Upper trapezius—Deep cervical flexors
• Levator scapulae—Lower trapezius
• Pectoralis major and minor—Serratus anterior
• Deltoids—Rotator cuff
• Erector spinea—Middle and lower trapezius
• Rectus abdominis—Gluteus medius and maximus

Correct answer: Daily / Intensity as tolerated below pain threshold / 2-3 reps, Hold for 10-30 seconds / Limit back exercises

For clients with low back pain, exercise is highly encouraged as it can help to correct muscle overcompensation and alleviate the pain itself, but only when the training program is within the client's ability and does not push past the pain threshold. The following best captures the acute variables for a flexibility training program for a client with low back pain:

• Frequency: Daily
• Intensity: As tolerated below pain threshold
• Time: 2-3 reps, Hold for 10-30 seconds
• Type: Limit back exercises

A special note of consideration is that clients should avoid exercise just upon waking because of disc hydration levels and subsequent loading.