CSCS Special Populations & Injury Prevention 4 — Questions and Answers
Question 1: An athlete with sickle cell trait is at greatest risk for exertional sickling during:
- Low-intensity steady-state aerobic exercise
- High-intensity exercise at altitude combined with heat and dehydration (Correct answer)
- Moderate resistance training in a climate-controlled gym
- Flexibility training in humid conditions
Correct answer: High-intensity exercise at altitude combined with heat and dehydration
The combination of hypoxia (altitude), heat, dehydration, and intense exertion creates optimal conditions for red blood cell sickling in sickle cell trait carriers.
Question 2: For a client with multiple sclerosis (MS), exercise programming should be carefully managed to avoid:
- Lactate accumulation from high-intensity intervals
- Overheating, which can temporarily worsen neurological symptoms (Uhthoff's phenomenon) (Correct answer)
- Excessive muscle hypertrophy causing spasticity
- Cardiovascular overload from resistance training
Correct answer: Overheating, which can temporarily worsen neurological symptoms (Uhthoff's phenomenon)
Elevated core body temperature in MS patients can temporarily block nerve conduction in demyelinated fibers, causing symptom flares (Uhthoff's phenomenon).
Question 3: Which resistance training set-rep scheme is most appropriate for an older adult focused on fall prevention?
- 3×3 at 95% 1RM for maximal strength
- 2-3×15 at 40-60% 1RM focusing on rate of force development (Correct answer)
- 5×5 at 85% 1RM for hypertrophy
- 4×12 at 70% 1RM for muscular endurance
Correct answer: 2-3×15 at 40-60% 1RM focusing on rate of force development
Moderate loads performed explosively develop the rate of force development needed for rapid protective responses to balance perturbations.
Question 4: When a young athlete (age 15) has not yet reached skeletal maturity, heavy axial loading is most concerning for potential injury to:
- Articular cartilage surfaces
- Epiphyseal growth plates (Correct answer)
- Muscle-tendon junctions
- Bursa surrounding major joints
Correct answer: Epiphyseal growth plates
The cartilaginous epiphyseal growth plates are weaker than surrounding bone and soft tissue in skeletally immature athletes and are vulnerable to compressive overload.
Question 5: An athlete with asthma experiences exercise-induced bronchoconstriction (EIB). Which warm-up strategy is most effective at reducing EIB during subsequent exercise?
- Skipping warm-up to minimize total exercise duration
- A high-intensity warm-up utilizing the refractory period (Correct answer)
- Very long low-intensity warm-up lasting 45 minutes
- Breath-holding intervals during warm-up
Correct answer: A high-intensity warm-up utilizing the refractory period
A high-intensity warm-up can induce a refractory period of 1-3 hours during which subsequent exercise is less likely to trigger bronchoconstriction.
Question 6: Anterior cruciate ligament (ACL) injury rates are significantly higher in female athletes compared to males. The most evidence-supported anatomical risk factor is:
- Greater tibial torsion angle
- Wider Q-angle combined with increased knee valgus collapse tendency (Correct answer)
- Reduced hamstring-to-quadriceps ratio
- Greater ankle pronation
Correct answer: Wider Q-angle combined with increased knee valgus collapse tendency
A wider pelvis increases the Q-angle and predisposes females to dynamic knee valgus, which places substantially greater stress on the ACL.
Question 7: For a client post-myocardial infarction cleared for exercise, the CSCS should initially structure training to:
- Prioritize heavy resistance training to rebuild cardiac muscle
- Begin with low-intensity aerobic exercise with close RPE monitoring, avoiding the Valsalva maneuver (Correct answer)
- Focus on flexibility and static stretching only for the first 6 months
- Use high-intensity interval training to maximize cardiac adaptation
Correct answer: Begin with low-intensity aerobic exercise with close RPE monitoring, avoiding the Valsalva maneuver
Post-MI clients require conservative aerobic progressions with RPE monitoring and avoidance of Valsalva to prevent dangerous blood pressure spikes.
CSCS Special Populations & Injury Prevention 4
An athlete with sickle cell trait is at greatest risk for exertional sickling during: