Exercise Testing and Prescription
Core concepts
Know how to screen, assess, and prescribe exercise safely. Understand pre-participation screening, risk stratification, and when medical clearance is warranted. Master the components of fitness testing: cardiorespiratory (submaximal and maximal protocols), muscular strength and endurance, flexibility, and body composition. Apply the FITT-VP principle (frequency, intensity, time, type, volume, progression) and use intensity anchors such as percentage of heart rate reserve (Karvonen method), percentage of VO2 reserve, RPE, and the talk test. Know how to estimate maximal heart rate and calculate target heart rate zones.
Traps in questions
Common traps include using the wrong maximal heart rate formula, forgetting to add resting heart rate in the Karvonen method, and confusing relative versus absolute contraindications to exercise. Another trap is prescribing intensity without considering the client's current fitness or medications that blunt heart rate (for example, beta-blockers). Questions may also test progression: the principle of gradual overload, not sudden jumps. Be careful not to confuse muscular strength (low reps, high load) with muscular endurance (high reps, lower load).
Worked example
A 40-year-old client has a resting heart rate of 70 bpm and wants to train at 60% of heart rate reserve. Estimated maximal heart rate = 220 − 40 = 180 bpm. Heart rate reserve = 180 − 70 = 110. Target = (110 × 0.60) + 70 = 66 + 70 = 136 bpm.
Rule of thumb
Always state the formula, substitute values in order, and include resting heart rate when using heart rate reserve; check medications before trusting heart rate targets.