ACSM-RCEP cheat sheet

Cardiac output = heart rate × stroke volume; Fick principle: VO2 = Q × (a-vO2 difference).

Rate-pressure product (RPP) = systolic BP × heart rate; an ischemic threshold is commonly cited near 20,000-25,000 mmHg·min⁻¹.

Max heart rate estimate: 220 − age (standard) or Tanaka: 208 − (0.7 × age).

MET = 3.5 mL O2·kg⁻¹·min⁻¹; convert VO2 (mL·kg⁻¹·min⁻¹) to METs by dividing by 3.5.

Normal resting left ventricular ejection fraction is approximately 55-70%; <40% indicates reduced systolic function.

Chronotropic incompetence: failure to reach ≥80% of age-predicted HR reserve or a blunted HR response during graded exercise.

Angina equivalent symptoms include dyspnea, nausea, diaphoresis, and jaw/arm discomfort, especially in women and people with diabetes.

Peripheral arterial disease: ankle-brachial index ≤0.90 supports diagnosis; claudication occurs at a reproducible walking workload.

Beta-blocker therapy blunts heart-rate response, so use RPE (6-20 Borg) and symptom thresholds rather than HR targets.

FITT-VP framework: Frequency, Intensity, Time, Type, Volume, and Progression structure every exercise prescription.

ACSM aerobic volume target for health: 150-300 min/wk of moderate or 75-150 min/wk of vigorous activity, plus 2+ days/wk resistance training.

Relative contraindication to exercise testing: resting SBP >200 mmHg or DBP >110 mmHg.

Stop a graded exercise test for: ST depression ≥2 mm, drop in SBP >10 mmHg with rising workload, serious arrhythmia, or patient request.

Intensity anchors: moderate = 40-59% HRR or 64-76% HRmax; vigorous = 60-89% HRR or 77-95% HRmax.

Karvonen method: target HR = [(HRmax − HRrest) × %intensity] + HRrest.

Type 2 diabetes: avoid exercise if blood glucose >250 mg/dL with ketones, or >300 mg/dL without ketones.

Heart failure: interval or continuous aerobic training at 40-70% HRR improves functional capacity; resistance training at 40-70% 1RM is safe.

Resistance training progression: begin at 40-50% 1RM for sedentary or cardiac clients, progressing to 60-70% 1RM.

Transtheoretical Model stages: Precontemplation, Contemplation, Preparation, Action, Maintenance (relapse can recur).

Self-Determination Theory: autonomy, competence, and relatedness support intrinsic motivation and sustained adherence.

Social Cognitive Theory: self-efficacy, outcome expectations, and observational learning predict exercise behavior.

SMART goals: Specific, Measurable, Achievable, Relevant, Time-bound; short-term goals (1-2 weeks) support early success.

Motivational interviewing uses open questions, affirmations, reflective listening, and summarizing (OARS) to build change talk.

Relapse prevention: identify high-risk situations, build coping plans, and reframe lapses as temporary rather than failure.

Health literacy: use plain language, teach-back, and written materials at or below a 6th-8th grade reading level.

Stages of change matched interventions outperform one-size-fits-all counseling for long-term adherence.

ACSM preparticipation screening classifies clients as apparently healthy, medically controlled, or medically unstable using symptoms and known disease.

Informed consent must be obtained before exercise testing and documented in the client record.

Emergency plan: written protocol, accessible AED, emergency numbers, and annual staff drill; response time target under 3-5 minutes.

Scope of practice: exercise professionals do not diagnose, prescribe medication, or interpret diagnostic tests beyond their training.

Documentation should include session date, activities, intensity, duration, client response, and any adverse events.

HIPAA: protected health information may be shared only for treatment, payment, or operations, or with written authorization.

Negligence requires duty, breach, causation, and damages; standard of care follows accepted professional guidelines.

Facility safety: inspect equipment, maintain emergency supplies, and verify current CPR/AED certification for all staff.