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ACSM Algorithm · 3-Step Checklist · PAR-Q+ · Signs & Symptoms · Medications
Chapter 5 Theory Quiz
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—MCQ (20)
—Fill-In (5)
—T/F (5)
Part A — Multiple Choice
20 Questions · 1 pt each
Part B — Fill in the Blank
5 Questions · 1 pt each
Part C — True / False
5 Questions · 1 pt each
Chapter 5 Case Studies
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Case Studies (Multiple Choice)
7 Cases · 35 Questions · 1 pt each
ACSM Preparticipation Algorithm
| Exercise Status | No Disease / No Symptoms | Known Disease, Asymptomatic | Any Signs or Symptoms |
|---|---|---|---|
| NOT exercising regularly | Medical clearance NOT necessary. Begin light–moderate; progress gradually. | Medical clearance RECOMMENDED before vigorous. Light–moderate permitted. | Medical clearance RECOMMENDED regardless. STOP if symptoms appear. |
| IS exercising regularly | Continue moderate–vigorous. Progress as tolerated. | Continue moderate without clearance. Clearance recommended before vigorous. | DISCONTINUE exercise. Seek clearance. May return after clearance. |
3-Step Checklist
Step 1 — Symptoms (STOP if yes)Chest discomfort with exertion, unreasonable breathlessness, dizziness/fainting/blackouts, ankle swelling, rapid/irregular HR, burning/cramping in legs when walking
Step 2 — Activity Level≥30 min moderate intensity, ≥3 days/week, ≥3 months = "regularly exercising"
Step 3 — Medical ConditionsHeart attack, heart surgery/cath/angioplasty, pacemaker/ICD/rhythm disturbance, heart valve disease, heart failure, heart transplant, congenital heart disease, diabetes, renal disease
Step 3 LogicNo Step 3 conditions → no clearance needed. Step 2 Yes + Step 3 → light–moderate OK, clearance before vigorous. Step 2 No + Step 3 → clearance recommended
PAR-Q+ Pathways
No to all 7 (Page 1)Cleared — no need to complete Pages 2–3
Yes to any (Page 1) + No to all follow-ups (Pages 2–3)Cleared with caution — start slow, build gradually
Yes to any follow-up (Pages 2–3)Complete ePARmed-X+ at eparmedx.com before becoming more active
ValidityValid for 12 months; invalid if health status changes. Pregnant → ePARmed-X+. Temporarily ill → delay activity
9 Signs & Symptoms (Red Flags)
Chest PainPain in chest, neck, jaw, arms — possible myocardial ischemia
DyspneaShortness of breath at rest or mild exertion
Dizziness/SyncopeFaintness — reduced brain perfusion
Orthopnea/PNDDyspnea lying down or 2–5 hrs after lying down
Ankle EdemaSwelling — possible cardiac/circulatory dysfunction
PalpitationsForceful, rapid, or irregular heartbeat awareness
ClaudicationBurning/cramping in lower legs during exercise
Heart MurmurKnown murmur → follow-up before vigorous exercise
Unusual FatigueDisproportionate fatigue or SOB with usual daily activities
Medications & Exercise HR Effects
| Drug | Resting HR | Exercise HR | VO₂max | Trainer Notes |
|---|---|---|---|---|
| Beta Blockers | ↓ | ↓ | ↓ dose-related | Use RPE or talk test — NOT target HR |
| Ca Channel Blockers | ↓ or → | ↓ or → | → | Effect varies by specific agent |
| ACE Inhibitors | → | → | → | No HR effect; BP lower at rest + exercise |
| ARBs | → | → | → | Well tolerated; no lipid/rebound issues |
| Diuretics | → | → | → | Dehydration + electrolyte imbalance → arrhythmia risk |
| Stimulants / Decongestants | ↑ | ↑ | ↓ endurance | ADHD meds, some decongestants |
| Bronchodilators | → | → | ↑ (COPD/asthma) | Minimal effect in healthy; improves exercise capacity in airway obstruction |
| Caffeine | ↑ | ↑ | ↑ endurance | Ergogenic at moderate doses |
| Antihistamines | ↑ or ↓ | ↑ or ↓ | ↑ perf/endurance | Drowsiness + drying effect in airways |
| Alcohol | variable | variable | ↓ | No exercise while under influence |
| NSAIDs | → | → | ↓ possible | May mask pain — caution with intensity |
Key Documents
Agreement to ParticipateAcknowledges understanding + voluntary participation — fundamental liability doc
Informed Consent / Assumption of RiskExplains exercise risks; client acknowledges and consents — must be reviewed by local legal professional
Lifestyle & Health-History QuestionnaireComprehensive beyond screening: medications, injuries, family history, nutrition, sleep, stress, substance habits, weight history, goals
Medical Release FormSent to physician → provides trainer with medical info + physical-activity limitations/guidelines. Any deviation must be physician-approved