Exercise Testing and Prescription
The Exercise Testing and Prescription domain tests whether you can select safe, valid assessments and translate results into an individualized FITT-VP plan. Questions commonly combine screening, intensity calculation, protocol choice, and termination criteria.
Core rules and concepts
- Screen before testing. PAR-Q+ is a self-report tool; a positive answer triggers follow-up. Preparticipation screening considers current exercise participation, signs/symptoms, and known cardiovascular, metabolic, or renal disease to decide whether medical clearance is needed.
- FITT-VP: Frequency, Intensity, Time, Type, Volume, and Progression. Aerobic guidance commonly uses 3–5 days/week, 40–59% VO2R or HRR for moderate intensity, 60–89% for vigorous, and 30–60 minutes/day of moderate activity or 20–30 minutes/day of vigorous activity.
- Use heart-rate reserve (Karvonen) when possible: target HR = resting HR + intensity × (HRmax − resting HR). HRmax can be estimated as 208 − 0.7 × age (Tanaka), not only 220 − age.
- RPE and the talk test are useful adjuncts, especially when HR is unreliable (beta-blockers, pacemakers).
- Match the protocol to the question: Bruce treadmill for maximal tolerance in adults; Balke or modified protocols for lower-functioning clients; YMCA cycle for submaximal prediction; 6-minute walk test for functional capacity, not VO2max.
- Stop testing for chest pain, ST-segment changes, a drop in systolic BP with increasing workload, severe dyspnea, dizziness, pallor, or the participant’s request.
Worked example
A 50-year-old client has a resting HR of 64 bpm. Estimated HRmax = 208 − (0.7 × 50) = 173 bpm. For 60% HRR: 64 + 0.60 × (173 − 64) = 64 + 65.4 ≈ 129 bpm. For 80% HRR: 64 + 0.80 × 109 = 151 bpm. The target range is about 129–151 bpm. If you instead took 60% of HRmax (0.60 × 173 = 104 bpm), you would prescribe intensity that is too low because you ignored resting HR.
Traps
- Confusing %HRmax with %HRR; they give different targets.
- Using an estimated HRmax as if it were measured.
- Applying a maximal protocol to a deconditioned or symptomatic client.
- Forgetting that beta-blockers blunt HR, so RPE or workload must guide intensity.
- Treating the 6-minute walk test as a VO2max test.
- Progressing intensity before duration and frequency are established.