ACSM EP-C cheat sheet

Cardiac output (Q) = heart rate × stroke volume; resting Q is about 5 L/min and maximal Q reaches roughly 20–25 L/min in trained adults.

Fick equation: VO2 = Q × (a–vO2 difference), so oxygen uptake equals central oxygen delivery multiplied by peripheral oxygen extraction.

Energy system dominance: ATP-phosphocreatine for efforts up to ~10 s, anaerobic glycolysis for ~10 s to 2 min, oxidative phosphorylation beyond ~2 min.

Net ATP yield: about 2 ATP per glucose from anaerobic glycolysis and about 32 ATP per glucose from complete oxidation.

Fiber recruitment follows the size principle (Type I → Type IIa → Type IIx); Type I is most fatigue resistant and Type IIx is most glycolytic and fastest.

RER = VCO2 / VO2; ~0.70 indicates fat oxidation, ~1.00 carbohydrate, and values above ~1.15 usually reflect hyperventilation rather than substrate use.

Bohr effect: increased CO2, H+, temperature, and 2,3-DPG shift the oxyhemoglobin curve right, reducing hemoglobin's affinity for oxygen and improving tissue unloading.

Estimated HRmax = 208 − (0.7 × age) (Tanaka); the traditional 220 − age carries a standard deviation of about ±10–12 beats/min.

Blood pressure = cardiac output × total peripheral resistance; stroke volume is determined by preload, afterload, and contractility.

ACSM positive risk factors: age (men ≥45, women ≥55); family history of premature CVD (male first-degree relative <55 y, female <65 y); current smoker or quit within 6 months; sedentary lifestyle; obesity (BMI ≥30 kg/m² or waist >102 cm men / >88 cm women); hypertension ≥130/80 mmHg or on medication; dyslipidemia (LDL ≥130 mg/dL, HDL <40 mg/dL, or on medication); prediabetes (HbA1c 5.7–6.4%, FPG 100–125 mg/dL, or 2-h OGTT 140–199 mg/dL).

Negative risk factor: HDL cholesterol ≥60 mg/dL subtracts one from the total risk factor count.

Risk categories: low = ≤1 risk factor with no disease or symptoms; moderate = ≥2 risk factors without disease; high = known cardiovascular, metabolic, or renal disease or symptoms.

ACC/AHA blood pressure categories: normal <120/<80; elevated 120–129/<80; stage 1 = 130–139 or 80–89; stage 2 = ≥140 or ≥90 mmHg.

BMI = weight (kg) / height (m)²; normal 18.5–24.9, overweight 25.0–29.9, obesity ≥30.0 kg/m².

Karvonen target HR = [(HRmax − HRrest) × % intensity] + HRrest; the percent-of-HRmax method uses HRmax × % intensity.

Epley 1RM = load × (1 + reps/30); Brzycki 1RM = load × 36 / (37 − reps); both are reasonably valid when repetitions are ≤10.

Field tests: 1.5-mile run and 12-minute run estimate VO2max; the Rockport 1-mile walk uses post-exercise heart rate and is suited to low-fit or older clients.

Absolute contraindications to exercise testing include acute myocardial infarction within 2 days, unstable angina, uncontrolled arrhythmia, and severe symptomatic aortic stenosis.

FITT-VP organizes every prescription: Frequency, Intensity, Time, Type, Volume, and Progression.

Aerobic: ≥150 min/week of moderate activity (40–59% HRR, 64–76% HRmax, RPE 12–16) or ≥75 min/week of vigorous activity (60–89% HRR), spread over 3–5 days.

Resistance: 2–3 days/week per major muscle group, 2–4 sets of 8–12 reps at 60–70% 1RM for novices; 40–50% 1RM with 10–15 reps for older or deconditioned adults.

Flexibility: 2–3 days/week, static holds of 15–60 seconds for 2–4 repetitions, accumulating about 60 seconds per muscle group, to the point of tightness.

Neuromotor exercise (balance, agility, coordination, gait): 2–3 days/week, 20–30 minutes, particularly for older adults at fall risk.

Session structure: 5–10 minute warm-up and 5–10 minute cool-down; the initial conditioning phase lasts 2–4 weeks at 40–50% HRR before progressive overload.

1 MET = 3.5 mL·kg⁻¹·min⁻¹; kilocalories per minute = (METs × 3.5 × body weight in kg) / 200.

Resistance progression rule: increase load 2–10% when the client completes 2 or more repetitions above the target in the final set on two consecutive sessions.

Hypertension prescription: aerobic ≥150 min/week plus dynamic resistance 2–3 days/week; avoid the Valsalva maneuver and heavy isometric lifting.

Acceptable macronutrient distribution ranges: carbohydrate 45–65%, fat 20–35%, and protein 10–35% of total daily energy intake.

Athlete protein intake is approximately 1.2–2.0 g/kg/day, with endurance athletes near the higher end and resistance trainers around 1.6 g/kg/day.

Hydration: about 5–7 mL/kg body weight 4 hours before exercise, then 400–800 mL/hour during exercise depending on sweat rate and conditions.

Weight loss: a 500–1,000 kcal/day deficit produces roughly 0.5–1 kg (1–2 lb) per week; about 3,500 kcal approximates 1 lb of adipose tissue.

A 5–10% reduction from initial body weight is the threshold for clinically meaningful improvement in blood pressure, lipids, and glycemic control.

Dietary reference targets: sodium <2,300 mg/day, added sugars <10% of total energy, and fiber 25–38 g/day for adults.

Transtheoretical model stages: precontemplation → contemplation → preparation → action → maintenance, with relapse returning a client to an earlier stage.

SMART goals are Specific, Measurable, Achievable, Relevant, and Time-bound; self-monitoring and stimulus control are core behavioral strategies.

Self-efficacy, decisional balance (pros versus cons), and the processes of change are the mechanisms that move a client between stages.