ACE CPT cheat sheet

Pre-participation screening begins with a health history and the PAR-Q+; any positive cardiovascular, metabolic, or renal response requires physician clearance before moderate-to-vigorous exercise.

Resting heart rate is counted for 60 seconds (or 30 seconds x 2); the normal adult range is 60-100 bpm.

Age-predicted max HR: 220 minus age (simple) or 208 minus (0.7 x age) (Tanaka, more accurate in older adults).

Heart rate reserve (Karvonen): HRR = HRmax - HRrest; target HR = (HRR x intensity%) + HRrest.

Blood pressure categories: normal <120/<80 mmHg; elevated 120-129 and <80; stage 1 hypertension 130-139 or 80-89; stage 2 140 or higher or 90 or higher.

BMI = weight (kg) / height (m) squared; underweight <18.5, normal 18.5-24.9, overweight 25-29.9, obese 30 or higher.

Waist circumference risk thresholds: greater than 40 in (102 cm) in men and greater than 35 in (88 cm) in women.

Static posture is assessed from lateral, anterior, and posterior views at five checkpoints: foot/ankle, knee, lumbo-pelvic-hip complex, shoulder, and head.

Cardiorespiratory assessments include the YMCA cycle test, 3-minute step test, 1.5-mile run, 12-minute run, Rockport walk, and submaximal talk test.

FITT-VP: Frequency, Intensity, Time, Type, Volume, and Progression must be specified for cardiorespiratory, resistance, flexibility, and neuromotor training.

Aerobic guidelines: at least 150 min/week of moderate intensity, 75 min/week of vigorous intensity, or an equivalent combination.

Resistance training guidelines: 2-3 days/week per muscle group, 1-3 sets of 8-12 repetitions for general fitness, progressing to 2-4 sets at 50-70% 1RM.

Flexibility prescription: static holds of 15-60 seconds, 2-4 repetitions per stretch, performed 2-3 days per week (daily is most effective).

Session structure: 5-10 minutes of low-intensity warm-up, the conditioning phase, then a 5-10 minute cool-down with optional static stretching.

ACE IFT model phases: 1 Function (posture, balance, movement), 2 Health (aerobic base, load training), 3 Fitness (aerobic efficiency, muscular development), 4 Performance (anaerobic capacity, maximal strength, power).

Intensity anchors: %HRR or %HRmax, RPE 0-10, talk test, and METs; roughly 40-59% HRR is moderate and 60-89% HRR is vigorous for most adults.

Program all primary movement patterns weekly: squat, hinge, push, pull, lunge, rotation, and gait/carry.

Exercise order: large muscle groups before small, multi-joint before single-joint, and higher-intensity lifts before lower-intensity work.

2-for-2 rule: when a client performs two or more repetitions beyond the goal in two consecutive sessions, increase load approximately 2-10% (about 5% upper body, 10% lower body).

Progress novices by increasing duration or frequency before intensity; aerobic volume increases are generally capped near 5-10% per week.

Change only one FITT variable at a time; simultaneous increases in frequency, intensity, and duration raise injury and overtraining risk.

Regression levers: decrease load, decrease range of motion, decrease speed, add stability (bilateral instead of unilateral), and simplify the movement.

Detraining: measurable declines in aerobic capacity appear within about 2 weeks of stopping training, with muscular endurance declining faster than maximal strength.

Plateau rule: if performance is unchanged over 4-6 weeks despite good adherence, adjust one variable such as volume, intensity, exercise selection, or recovery.

Pain rule: sharp pain, joint pain, or pain that worsens during a set is a signal to stop, modify the exercise, or refer the client.

Progression continuum: stable to unstable surfaces, static to dynamic, simple to complex, and bodyweight to external load.

Scope of practice: trainers may screen, assess, design, and instruct exercise and provide general health education; they may not diagnose, prescribe, treat, or deliver individualized medical nutrition therapy.

Referral rules: chest pain or cardiac symptoms to EMS/physician; disordered eating to a registered dietitian or psychologist; suspected injury diagnosis to a physician or physical therapist.

Informed consent and a liability waiver must be explained and signed before the first session; minors require a parent or guardian signature.

Confidentiality: client health records, assessment data, and personal information are shared only with written authorization or as required by law.

ACE recertification requires 2.0 continuing education credits (20 contact hours) every 2 years plus current CPR/AED certification.

CPR/AED certification must remain current and is renewed every 2 years; skills should be practiced between renewal cycles.

Professional liability insurance should be maintained and verified against each setting worked (studio, in-home, outdoor, online).

Dual relationships and sexual or romantic relationships with clients are prohibited under the ACE Code of Ethics.

Emergency action plan elements: assigned roles, EMS activation, AED location, first aid kit, exits, emergency contacts, documentation, and rehearsed drills.

Survival from sudden cardiac arrest falls roughly 7-10% for each minute that defibrillation is delayed; early AED use is the priority response.

Stop exercise and activate EMS for chest pain, syncope, severe dyspnea, or signs of stroke (face droop, arm weakness, speech difficulty, time to call).

Heat illness continuum: heat cramps, then heat exhaustion (heavy sweating, weakness, dizziness), then heat stroke (core temp above 104 F, confusion) which is a medical emergency.

Heat management: 1-2 weeks of acclimatization, hydration before/during/after, cooler training times, and awareness that high humidity impairs evaporative cooling.

The Valsalva maneuver raises blood pressure and intrathoracic pressure; teach clients to exhale during the exertion phase, especially with hypertension.

Spotting is required for free-weight work over the head or face (bench press, shoulder press, squats) and whenever the load cannot be safely racked alone.

Facility safety: inspect cables, belts, and equipment before use, keep clear floor space, use appropriate flooring, and maintain gloves and disposal supplies for blood or body fluids.