Exercise Physiology and Health Assessment
What this domain tests
Preparticipation screening, cardiovascular risk classification, physiological responses to acute and chronic exercise, and the interpretation of basic fitness and health measurements: resting and exercise heart rate, blood pressure, METs, VO2max, body composition, and submaximal test predictions.
Core rules and concepts
- Screen with a structured instrument (PAR-Q+ or an ACSM-style preparticipation algorithm) combined with medical history; refer for medical clearance when the tool or symptoms indicate it.
- Blood pressure categories: normal <120/<80; elevated 120–129/<80; stage 1 130–139 or 80–89; stage 2 ≥140 or ≥90; crisis >180 and/or >120 requires prompt medical referral, not an exercise test.
- HRmax = 220 − age is a population average with a standard deviation near 10–12 bpm; use a measured or symptom-limited value when precision matters.
- Karvonen (percent heart rate reserve) is more individualized than percent HRmax: THR = [(HRmax − HRrest) × intensity] + HRrest.
- VO2max is the strongest index of cardiorespiratory fitness; 1 MET ≈ 3.5 mL·kg⁻¹·min⁻¹. Moderate intensity is 3.0–5.9 METs; vigorous is ≥6.0 METs.
- Submaximal tests (YMCA cycle, 6-minute walk) extrapolate from steady-state heart rate; stop for chest pain, dizziness, unusual dyspnea, or abnormal blood pressure.
Worked example
A 40-year-old client has a resting heart rate of 70. Estimated HRmax = 220 − 40 = 180. At 60% HRR: (180 − 70) × 0.60 + 70 = 66 + 70 = 136 bpm. At 80%: (110 × 0.8) + 70 = 158 bpm. Prescribe 136–158 bpm, then cross-check against RPE 12–16 and the talk test, because the age formula can be off by more than 10 bpm.
Traps that cost marks
Forgetting to subtract resting heart rate before adding it back; clearing a client with 168/104 for vigorous training; misplacing MET thresholds (moderate begins at 3.0, not 5.0); treating a screening questionnaire as a diagnosis; ignoring beta-blockers, which blunt heart rate so RPE must guide intensity.