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ACSM-EP Cheat Sheet

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Health + Fitness Assessment

  • 33% of exam
  • Screening Risk Factors Vitals Fitness Tests Assessment Picker

Prescription + Implementation

  • 40% of exam
  • FITT-VP Intensity Metabolic Equations Special Populations Prescription Picker

Counseling + Behavior

  • 20% of exam
  • Behavior Models Motivational Interviewing Goals Adherence Counseling Picker

Risk + Professional Duties

  • 7% of exam
  • Scope Ethics Documentation Emergency Risk Picker

Quick Facts

  • Exam ACSM-EP
  • Items 140 total
  • Scored 125 scored
  • Unscored 15 pretest
  • Seat time 210 min
  • Pass 550 scaled
  • Scale 200-800
  • Delivery Pearson VUE
  • Eligibility Bachelor plus CPR/AED
  • GETP 12th edition

Clearance vs Risk Factors AS

Clearance

  • Disease status
  • Symptoms
  • Activity history

Risk factors

  • Prescription context
  • Counseling targets
  • Not primary gate
  • Screen first, count later

Clearance Picker AS

  • Signs or symptoms → Medical clearance ( Before exercise )
  • Known disease inactive → Clearance first ( Then progress )
  • Known disease active → Continue moderate ( If stable )
  • Healthy inactive light → Start gradually ( No clearance )
  • Healthy inactive vigorous → Clearance advised ( Before vigorous )
  • Healthy active vigorous → Progress normally ( Monitor signs )

Screening AS

  • PAR-Q+ Readiness questionnaire
  • Health history Baseline risk
  • Informed consent Before testing
  • Known disease Clearance gate
  • Signs/symptoms Medical referral
  • Current activity Clearance variable
  • Desired intensity Clearance variable
  • Vigorous start Often clearance

Strength vs Endurance AS

Strength

  • 1-RM
  • High force
  • Longer rest

Endurance

  • Repeated reps
  • Lower load
  • Shorter rest
  • Max load vs fatigue

Assessment Picker AS

  • Resting status → HR and BP
  • Cardiorespiratory fitness → Submax test
  • Body composition → Skinfold or BIA
  • Max strength → 1-RM
  • Muscular endurance → Push-up test
  • Flexibility → Sit-and-reach
  • Balance risk → Neuromotor tests
  • Functional capacity → 6MWT

Risk Factors AS

  • Male age >=45 years
  • Female age >=55 years
  • Family history Premature CVD
  • Smoking Current or recent
  • Inactivity Below PA guideline
  • Obesity BMI >=30
  • Hypertension >=140/90 or meds
  • Dyslipidemia LDL high
  • Prediabetes FPG 100-125
  • High HDL Subtract one

Vitals + Body AS

  • Resting BP After 5 min
  • Normal BP <120/<80
  • Stage 1 BP 130-139/80-89
  • Stage 2 BP >=140 or >=90
  • BMI kg/m2
  • Overweight 25.0-29.9
  • Obesity >=30.0
  • Waist Central adiposity
  • Skinfolds Subcutaneous fat
  • BIA Hydration sensitive

Fitness Tests AS

  • Rockport One-mile walk
  • YMCA cycle Submax VO2 estimate
  • Bruce Treadmill stages
  • 1.5-mile run Field VO2 estimate
  • 6MWT Functional capacity
  • 1-RM Max strength
  • Push-up Upper endurance
  • Sit-and-reach Hamstring flexibility
  • Goniometry Joint ROM
  • Vertical jump Lower power

FITT-VP Memory PR

  • Build dose, then progress.
  • Frequency Intensity Time Type Volume Progression

Moderate vs Vigorous PR

Moderate

  • 40-59% HRR
  • RPE 12-13
  • Talk not sing

Vigorous

  • 60-89% HRR
  • RPE 14-17
  • Few words only
  • Use multiple markers

Prescription Picker PR

  • Improve aerobic fitness → 3-5 days/wk
  • Moderate aerobic target → 40-59% HRR
  • Vigorous aerobic target → 60-89% HRR
  • Strength beginner → 2-3 days/wk
  • Flexibility goal → Daily ideal
  • Fall prevention → Neuromotor training
  • Beta-blocker client → RPE/talk test
  • Hot humid setting → Reduce intensity

FITT-VP PR

  • Frequency Days per week
  • Intensity Effort level
  • Time Session duration
  • Type Exercise mode
  • Volume Total work
  • Progression Gradual overload
  • Specificity Train goal
  • Overload Stress above baseline

MET Memory PR

  • One MET equals resting oxygen.
  • 1 MET 3.5 mL/kg/min VO2 divide 3.5

Walking vs Running PR

Walking

  • 0.1 horizontal
  • 1.8 grade
  • 50-100 m/min

Running

  • 0.2 horizontal
  • 0.9 grade
  • Higher speed
  • Do not swap coefficients

Equation Picker PR

  • Walking 50-100 m/min → Walking equation
  • Running speed → Running equation
  • Cycle watts given → Leg cycle equation
  • Upper-body ergometer → Arm cycle equation
  • Bench stepping → Step equation
  • Need METs → VO2 / 3.5

Aerobic Intensity PR

  • Moderate HRR 40-59%
  • Vigorous HRR 60-89%
  • Moderate RPE 12-13
  • Vigorous RPE 14-17
  • Moderate METs 3 to <6
  • Vigorous METs >=6
  • Talk test Talk not sing
  • HRR Karvonen method
  • VO2R Reserve method
  • 1 MET 3.5 mL/kg/min

HRR vs HRmax PR

HRR

  • Uses resting HR
  • Karvonen
  • More individualized

HRmax

  • Age predicted
  • Simpler
  • Less precise
  • HRR adjusts baseline

Metabolic Equations PR

  • Walking horizontal 0.1 x speed
  • Walking grade 1.8 x speed x grade
  • Running horizontal 0.2 x speed
  • Running grade 0.9 x speed x grade
  • Leg cycling 10.8W/kg + 7
  • Arm cycling 3WR/kg + 3.5
  • Stepping vertical 1.33 factor
  • Grade Decimal value
  • Speed Meters per minute
  • Convert METs VO2 divide 3.5

Training Modes PR

  • Aerobic Large rhythmic muscles
  • Resistance Major muscle groups
  • Flexibility ROM improvement
  • Neuromotor Balance agility
  • Warm-up Gradual transition
  • Cool-down Venous return
  • Intervals Work recovery cycles
  • Circuit Station sequence

Special Populations PR

  • Hypertension Avoid Valsalva
  • Beta-blocker Use RPE
  • Diabetes Monitor glucose
  • Neuropathy Inspect feet
  • COPD Dyspnea scale
  • Pregnancy Avoid supine
  • Older adult Balance priority
  • Obesity Joint-friendly modes
  • Asthma Warm-up longer
  • Osteoporosis Avoid spinal flexion

OARS Memory CO

  • Ask, affirm, reflect, summarize.
  • Open questions Affirmations Reflections Summaries

Action vs Maintenance CO

Action

  • Under 6 months
  • Active change
  • Relapse risk

Maintenance

  • Six months plus
  • Sustained behavior
  • Prevent relapse
  • Time in behavior

Counseling Picker CO

  • No intent → Raise awareness
  • Ambivalent client → Reflective listening
  • Ready within month → Action plan
  • Needs confidence → Mastery steps
  • Vague goal → SMARTS goal
  • Low adherence → Barrier problem-solving

Behavior Models CO

  • TTM Stages of change
  • Precontemplation No intent
  • Contemplation Intent within 6 months
  • Preparation Intent within 30 days
  • Action <6 months active
  • Maintenance >=6 months active
  • SCT Self-efficacy central
  • SDT Autonomy competence relatedness
  • Health belief Threat plus benefit
  • Planned behavior Intent predicts action

SDT ARC CO

  • Autonomy fuels lasting adherence.
  • Autonomy Relatedness Competence

Coaching Tools CO

  • OARS Core MI skills
  • Open questions Explore barriers
  • Affirmations Reinforce strengths
  • Reflections Show understanding
  • Summaries Collect change talk
  • SMARTS Goal structure
  • Self-monitoring Track behavior
  • Social support Improve adherence
  • Cues Trigger behavior
  • Rewards Reinforce adherence

Emergency Memory RI

  • Stop, assess, activate, document.
  • Stop exercise Assess client Activate EAP Document event

Scope vs Diagnosis RI

EP scope

  • Assess fitness
  • Prescribe exercise
  • Educate behavior

Diagnosis

  • Medical provider
  • Disease labeling
  • Treatment decisions
  • Refer beyond scope

Risk Picker RI

  • Chest pain occurs → Stop exercise
  • Frayed cable found → Tag out
  • Client data shared → Authorization first
  • Medical diagnosis asked → Refer provider
  • Adverse event → Incident report
  • Emergency response → Activate EAP

Exam Logistics RI

  • Seat time 210 minutes
  • Scored items 125 questions
  • Pretest items 15 unscored
  • Passing score 550 scaled
  • Score scale 200 to 800
  • Calculator Provided onscreen
  • Equations Exhibit tab
  • Audit Eligibility check

Professional Risk RI

  • Scope Stay credentialed
  • Diagnosis Medical provider role
  • Standard care Reasonable professional
  • Negligence Duty breach harm
  • Confidentiality Protect client data
  • Documentation If not charted
  • Incident report Document adverse event
  • EAP Emergency action plan
  • AED Accessible and maintained
  • Equipment Inspect and tag

Common Traps

Screening Trap

  • Clearance algorithm ≠ Risk-factor counting

Equation Trap

  • Walking 0.1/1.8 ≠ Running 0.2/0.9

Beta-Blocker Trap

  • RPE/talk test ≠ Age HRmax target

BIA Trap

  • Hydration controlled ≠ Recent exercise ignored

Goal Trap

  • SMARTS behavior ≠ Vague outcome wish

Scope Trap

  • Exercise prescription ≠ Medical diagnosis

Safety Trap

  • Tag damaged equipment ≠ Warn and leave open

Last Minute

  • 1. Domains: 33/40/20/7
  • 2. 140 items; 125 scored
  • 3. Pass: 550 scaled
  • 4. GETP 12 applies
  • 5. Equations in Exhibit tab
  • 6. Consent before fitness testing
  • 7. Screen symptoms before testing
  • 8. Moderate: 40-59% HRR
  • 9. Vigorous: 60-89% HRR
  • 10. 1 MET = 3.5 VO2
  • 11. Walking: 0.1 and 1.8
  • 12. Running: 0.2 and 0.9
  • 13. Beta-blockers: use RPE
  • 14. OARS drives MI
  • 15. Refer beyond scope

ACSM-EP

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