Health + Fitness Assessment
33%of exam
Prescription + Implementation
40%of exam
Counseling + Behavior
20%of exam
Risk + Professional Duties
7%of exam
Quick Facts
- Exam
- ACSM-EP
- Items
- 140 total
- Scored
- 125 scored
- Unscored
- 15 pretest
- Seat time
- 210 min
- Pass
- 550 scaled
- Scale
- 200-800
- Delivery
- Pearson VUE
- Eligibility
- Bachelor plus CPR/AED
- GETP
- 12th edition
Clearance vs Risk Factors
Clearance
- Disease status
- Symptoms
- Activity history
Risk factors
- Prescription context
- Counseling targets
- Not primary gate
Screen first, count later
Clearance Picker
- Signs or symptoms→Medical clearance(Before exercise)
- Known disease inactive→Clearance first(Then progress)
- Known disease active→Continue moderate(If stable)
- Healthy inactive light→Start gradually(No clearance)
- Healthy inactive vigorous→Clearance advised(Before vigorous)
- Healthy active vigorous→Progress normally(Monitor signs)
Screening
- PAR-Q+
- Readiness questionnaire
- Health history
- Baseline risk
- Informed consent
- Before testing
- Known disease
- Clearance gate
- Signs/symptoms
- Medical referral
- Current activity
- Clearance variable
- Desired intensity
- Clearance variable
- Vigorous start
- Often clearance
Strength vs Endurance
Strength
- 1-RM
- High force
- Longer rest
Endurance
- Repeated reps
- Lower load
- Shorter rest
Max load vs fatigue
Assessment Picker
- Resting status→HR and BP
- Cardiorespiratory fitness→Submax test
- Body composition→Skinfold or BIA
- Max strength→1-RM
- Muscular endurance→Push-up test
- Flexibility→Sit-and-reach
- Balance risk→Neuromotor tests
- Functional capacity→6MWT
Risk Factors
- Male age
- >=45 years
- Female age
- >=55 years
- Family history
- Premature CVD
- Smoking
- Current or recent
- Inactivity
- Below PA guideline
- Obesity
- BMI >=30
- Hypertension
- >=140/90 or meds
- Dyslipidemia
- LDL high
- Prediabetes
- FPG 100-125
- High HDL
- Subtract one
Vitals + Body
- Resting BP
- After 5 min
- Normal BP
- <120/<80
- Stage 1 BP
- 130-139/80-89
- Stage 2 BP
- >=140 or >=90
- BMI
- kg/m2
- Overweight
- 25.0-29.9
- Obesity
- >=30.0
- Waist
- Central adiposity
- Skinfolds
- Subcutaneous fat
- BIA
- Hydration sensitive
Fitness Tests
- Rockport
- One-mile walk
- YMCA cycle
- Submax VO2 estimate
- Bruce
- Treadmill stages
- 1.5-mile run
- Field VO2 estimate
- 6MWT
- Functional capacity
- 1-RM
- Max strength
- Push-up
- Upper endurance
- Sit-and-reach
- Hamstring flexibility
- Goniometry
- Joint ROM
- Vertical jump
- Lower power
FITT-VP Memory
Build dose, then progress.
FrequencyIntensityTimeTypeVolumeProgression
Moderate vs Vigorous
Moderate
- 40-59% HRR
- RPE 12-13
- Talk not sing
Vigorous
- 60-89% HRR
- RPE 14-17
- Few words only
Use multiple markers
Prescription Picker
- Improve aerobic fitness→3-5 days/wk
- Moderate aerobic target→40-59% HRR
- Vigorous aerobic target→60-89% HRR
- Strength beginner→2-3 days/wk
- Flexibility goal→Daily ideal
- Fall prevention→Neuromotor training
- Beta-blocker client→RPE/talk test
- Hot humid setting→Reduce intensity
FITT-VP
- Frequency
- Days per week
- Intensity
- Effort level
- Time
- Session duration
- Type
- Exercise mode
- Volume
- Total work
- Progression
- Gradual overload
- Specificity
- Train goal
- Overload
- Stress above baseline
MET Memory
One MET equals resting oxygen.
1 MET3.5 mL/kg/minVO2 divide 3.5
Walking vs Running
Walking
- 0.1 horizontal
- 1.8 grade
- 50-100 m/min
Running
- 0.2 horizontal
- 0.9 grade
- Higher speed
Do not swap coefficients
Equation Picker
- Walking 50-100 m/min→Walking equation
- Running speed→Running equation
- Cycle watts given→Leg cycle equation
- Upper-body ergometer→Arm cycle equation
- Bench stepping→Step equation
- Need METs→VO2 / 3.5
Aerobic Intensity
- Moderate HRR
- 40-59%
- Vigorous HRR
- 60-89%
- Moderate RPE
- 12-13
- Vigorous RPE
- 14-17
- Moderate METs
- 3 to <6
- Vigorous METs
- >=6
- Talk test
- Talk not sing
- HRR
- Karvonen method
- VO2R
- Reserve method
- 1 MET
- 3.5 mL/kg/min
HRR vs HRmax
HRR
- Uses resting HR
- Karvonen
- More individualized
HRmax
- Age predicted
- Simpler
- Less precise
HRR adjusts baseline
Metabolic Equations
- Walking horizontal
- 0.1 x speed
- Walking grade
- 1.8 x speed x grade
- Running horizontal
- 0.2 x speed
- Running grade
- 0.9 x speed x grade
- Leg cycling
- 10.8W/kg + 7
- Arm cycling
- 3WR/kg + 3.5
- Stepping vertical
- 1.33 factor
- Grade
- Decimal value
- Speed
- Meters per minute
- Convert METs
- VO2 divide 3.5
Training Modes
- Aerobic
- Large rhythmic muscles
- Resistance
- Major muscle groups
- Flexibility
- ROM improvement
- Neuromotor
- Balance agility
- Warm-up
- Gradual transition
- Cool-down
- Venous return
- Intervals
- Work recovery cycles
- Circuit
- Station sequence
Special Populations
- Hypertension
- Avoid Valsalva
- Beta-blocker
- Use RPE
- Diabetes
- Monitor glucose
- Neuropathy
- Inspect feet
- COPD
- Dyspnea scale
- Pregnancy
- Avoid supine
- Older adult
- Balance priority
- Obesity
- Joint-friendly modes
- Asthma
- Warm-up longer
- Osteoporosis
- Avoid spinal flexion
OARS Memory
Ask, affirm, reflect, summarize.
Open questionsAffirmationsReflectionsSummaries
Action vs Maintenance
Action
- Under 6 months
- Active change
- Relapse risk
Maintenance
- Six months plus
- Sustained behavior
- Prevent relapse
Time in behavior
Counseling Picker
- No intent→Raise awareness
- Ambivalent client→Reflective listening
- Ready within month→Action plan
- Needs confidence→Mastery steps
- Vague goal→SMARTS goal
- Low adherence→Barrier problem-solving
Behavior Models
- TTM
- Stages of change
- Precontemplation
- No intent
- Contemplation
- Intent within 6 months
- Preparation
- Intent within 30 days
- Action
- <6 months active
- Maintenance
- >=6 months active
- SCT
- Self-efficacy central
- SDT
- Autonomy competence relatedness
- Health belief
- Threat plus benefit
- Planned behavior
- Intent predicts action
SDT ARC
Autonomy fuels lasting adherence.
AutonomyRelatednessCompetence
Coaching Tools
- OARS
- Core MI skills
- Open questions
- Explore barriers
- Affirmations
- Reinforce strengths
- Reflections
- Show understanding
- Summaries
- Collect change talk
- SMARTS
- Goal structure
- Self-monitoring
- Track behavior
- Social support
- Improve adherence
- Cues
- Trigger behavior
- Rewards
- Reinforce adherence
Emergency Memory
Stop, assess, activate, document.
Stop exerciseAssess clientActivate EAPDocument event
Scope vs Diagnosis
EP scope
- Assess fitness
- Prescribe exercise
- Educate behavior
Diagnosis
- Medical provider
- Disease labeling
- Treatment decisions
Refer beyond scope
Risk Picker
- Chest pain occurs→Stop exercise
- Frayed cable found→Tag out
- Client data shared→Authorization first
- Medical diagnosis asked→Refer provider
- Adverse event→Incident report
- Emergency response→Activate EAP
Exam Logistics
- Seat time
- 210 minutes
- Scored items
- 125 questions
- Pretest items
- 15 unscored
- Passing score
- 550 scaled
- Score scale
- 200 to 800
- Calculator
- Provided onscreen
- Equations
- Exhibit tab
- Audit
- Eligibility check
Professional Risk
- Scope
- Stay credentialed
- Diagnosis
- Medical provider role
- Standard care
- Reasonable professional
- Negligence
- Duty breach harm
- Confidentiality
- Protect client data
- Documentation
- If not charted
- Incident report
- Document adverse event
- EAP
- Emergency action plan
- AED
- Accessible and maintained
- Equipment
- Inspect and tag
Common Traps
Screening Trap
Clearance algorithm ≠ Risk-factor counting
Equation Trap
Walking 0.1/1.8 ≠ Running 0.2/0.9
Beta-Blocker Trap
RPE/talk test ≠ Age HRmax target
BIA Trap
Hydration controlled ≠ Recent exercise ignored
Goal Trap
SMARTS behavior ≠ Vague outcome wish
Scope Trap
Exercise prescription ≠ Medical diagnosis
Safety Trap
Tag damaged equipment ≠ Warn and leave open
Last Minute
- 1.Domains: 33/40/20/7
- 2.140 items; 125 scored
- 3.Pass: 550 scaled
- 4.GETP 12 applies
- 5.Equations in Exhibit tab
- 6.Consent before fitness testing
- 7.Screen symptoms before testing
- 8.Moderate: 40-59% HRR
- 9.Vigorous: 60-89% HRR
- 10.1 MET = 3.5 VO2
- 11.Walking: 0.1 and 1.8
- 12.Running: 0.2 and 0.9
- 13.Beta-blockers: use RPE
- 14.OARS drives MI
- 15.Refer beyond scope
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