ACSM-EP Exercise Prescription — Questions and Answers
Question 1: A 70-kg adult walks on a treadmill at 3.0 mph and 5% grade. Using the ACSM walking equation, what is the estimated VO2?
- 11.5 mL/kg/min
- 24.1 mL/kg/min
- 18.8 mL/kg/min (Correct answer)
- 15.3 mL/kg/min
Correct answer: 18.8 mL/kg/min
3.0 mph = 80.4 m/min, so VO2 = 0.1(80.4) + 1.8(80.4)(0.05) + 3.5 = 18.8 mL/kg/min.
Convert speed: 3.0 mph x 26.8 = 80.4 m/min. Horizontal component = 0.1 x 80.4 = 8.04; vertical component = 1.8 x 80.4 x 0.05 = 7.24; resting component = 3.5. Sum = 8.04 + 7.24 + 3.5 = 18.8 mL/kg/min, or about 5.4 METs (18.8/3.5). The 11.5 value ignores the grade term, and values near 24 come from entering the grade as a whole number or double counting. The walking equation is valid for speeds of about 1.9 to 3.7 mph.
Question 2: A client has a measured HRmax of 180 bpm and a resting HR of 60 bpm. Using the heart rate reserve (Karvonen) method, what is the target heart rate at 60% intensity?
- 132 bpm (Correct answer)
- 108 bpm
- 120 bpm
- 144 bpm
Correct answer: 132 bpm
Target HR = 0.60 x (180 - 60) + 60 = 132 bpm.
HRR = HRmax - HRrest = 180 - 60 = 120 bpm. Target HR = (0.60 x 120) + 60 = 72 + 60 = 132 bpm. The 108 bpm answer comes from taking 60% of HRmax and ignoring resting HR, which is the %HRmax method and not the HRR method. Forgetting to add resting HR back gives 72 bpm. ACSM defines moderate intensity as 40 to under 60% HRR and vigorous intensity as 60 to under 90% HRR.
Question 3: A 70-kg client cycles on a leg ergometer at 100 W. Using the ACSM leg cycling equation, what is the estimated VO2? (1 W = 6 kg-m/min)
- 29.2 mL/kg/min
- 18.9 mL/kg/min
- 15.4 mL/kg/min
- 22.4 mL/kg/min (Correct answer)
Correct answer: 22.4 mL/kg/min
WR = 100 x 6 = 600 kg-m/min; VO2 = 1.8(600)/70 + 7 = 22.4 mL/kg/min.
Convert power: 100 W x 6 = 600 kg-m/min. Leg cycling VO2 = 1.8 x WR / BM + 7 = 1.8 x 600 / 70 + 7 = 15.43 + 7 = 22.4 mL/kg/min (about 6.4 METs). The constant of 7 combines 3.5 mL/kg/min resting and 3.5 mL/kg/min for unloaded cycling. Using 3.5 gives 18.9, using only the work term gives 15.4, and 29.2 results from applying the arm ergometry equation (3 x WR/BM + 3.5).
Question 4: Which resistance training prescription is consistent with ACSM recommendations for a novice adult aiming to improve muscular fitness?
- Five sets of 1 to 3 repetitions at 95% 1RM, performed daily
- One set of 20 to 25 repetitions at 30% 1RM to failure, performed daily
- Two to four sets of 15 to 20 repetitions at 40% 1RM, 5 days per week on the same muscles
- One to three sets of 8 to 12 repetitions at 60 to 70% 1RM, 2 to 3 nonconsecutive days per week (Correct answer)
Correct answer: One to three sets of 8 to 12 repetitions at 60 to 70% 1RM, 2 to 3 nonconsecutive days per week
For novices ACSM recommends 1 to 3 sets of 8 to 12 repetitions at 60 to 70% 1RM, training each major muscle group 2 to 3 nonconsecutive days per week.
ACSM advises each major muscle group be trained 2 to 3 days per week with at least 48 hours between sessions for the same group. Novices start at about 60 to 70% of 1RM for 8 to 12 repetitions, and 1 to 3 sets produce meaningful gains. Near-maximal loads of 95% 1RM are inappropriate for beginners because of injury risk and technique demands. Training the same muscles daily does not allow recovery, and very light loads to failure are not the primary recommendation for strength gains in novices (light loads of 40 to 50% 1RM are used for older or very deconditioned individuals).
Question 5: A 80-kg client exercises at 6 METs for 40 minutes. Approximately how many kilocalories are expended?
- 252 kcal
- 420 kcal
- 168 kcal
- 336 kcal (Correct answer)
Correct answer: 336 kcal
kcal/min = 6 x 3.5 x 80 / 200 = 8.4; 8.4 x 40 = 336 kcal.
Use kcal/min = METs x 3.5 x body mass (kg) / 200 = 6 x 3.5 x 80 / 200 = 1680 / 200 = 8.4 kcal/min. Over 40 minutes, 8.4 x 40 = 336 kcal. The 252 kcal figure corresponds to only 30 minutes. 420 kcal would require 10.5 kcal/min, and 168 kcal would require only 20 minutes. This calculation is useful for prescribing exercise toward energy expenditure goals such as 1,000 kcal/week.
Question 6: To achieve clinically significant weight loss and prevent weight regain, ACSM recommends progressively increasing moderate-intensity physical activity to at least how many minutes per week?
- 60 minutes
- 90 minutes
- 150 minutes
- 250 minutes (Correct answer)
Correct answer: 250 minutes
ACSM recommends more than 250 min/week of moderate-intensity activity (roughly 2,000 kcal/week) for clinically significant weight loss and weight-loss maintenance.
For general health, 150 min/week of moderate activity is the minimum. For weight management, 150 to 250 min/week prevents weight gain and produces modest loss, while more than 250 min/week is associated with clinically significant loss and better maintenance after loss. This is typically combined with a caloric deficit, and exercisers should progress gradually, often starting from lower durations. Values of 60 and 90 minutes fall below even the general health minimum.
