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ACE Answers

ACE Answers is here to help you prepare for your ACE Certification Exam, every step of the way. Our resource center offers a wide range of study materials, tools and live education sessions that provide candidates with additional support as they prepare for their exams. We look forward to welcoming you to the ACE family.

Common Study Questions

Technically, everything in the manual can appear on the exam, however, we recommend spending more time focusing on the main ideas versus memorizing each step of the protocol. Know the objective or purpose of each assessment, for whom it is appropriate and any contraindications, and what the outcome reveals about the client. We also recommend reviewing the following blog posts:

Previously, when conducting preparticipation screens, fitness professional followed a criterion of risk factors to determine a client’s risk for CAD, by totaling the number of risks and classifying the client as being low, moderate or high risk. The objective was to assess if medical clearance was needed prior to the client’s participation in assessments and exercise program. ACSM’s update to the risk classification no longer requires totaling the number of risks for CAD. Per ACSM, research indicated the previous pre-participation risk classification, totaling the number of risks, potentially created a barrier to exercise participation. The current guidelines identify 3 factors for consideration and minimize this barrier in the pre-screen process.  This allows the client to engage in activity much sooner.

 

In November 2015, the American College of Sports Medicine (ACSM) formally updated their preparticipation health-screening process. ACSM made this change after recent studies revealed that previous CVD risk-factor profiles and risk-classification processes resulted in excessive physician referrals, possibly creating a barrier to exercise participation. For example, Whitfield and colleagues (2014) (http://circ.ahajournals.org/content/129/10/1113) concluded that most people (nearly 95 percent) older than 40 years of age would be required to visit a physician before engaging in any form of exercise, based on previous standards. This referral recommendation held true even for an activity as simple as walking.

 

The new screening process adopts several changes intended to reduce barriers to physical activity participation, yet still allows for the identification of individuals who should receive medical clearance prior to initiating an exercise program or increasing the volume, frequency, or intensity of an existing program. Research comparing the new prescreening algorithm to the previous version revealed a 41 percent decrease in the number of individuals who would be referred to a physician before beginning exercise (Whitfield et al., 2017) (https://journals.lww.com/acsm-msse/Abstract/2017/10000/Applying_the_ACSM_Preparticipation_Screening.12.aspx). This suggests that the new prescreening procedures decreased the medical-clearance barrier to physical-activity participation by decreasing the number of individuals who require physician approval prior to engagement. Some key takeaways for using the new ACSM prescreening algorithm include:

  • Identifying signs and symptoms of underlying CV, metabolic, and renal disease
  • Identifying individuals with diagnosed CV and metabolic disease
  • Using signs and symptoms, disease history, current PA levels, and desired exercise intensity to guide recommendations
  • Identifying planned exercise intensity

What’s Different:

  • Risk factor profiles are no longer used to determine the need for referral for physician clearance prior to initiating exercise
  • Risk Classifications are no longer required (e.g., low, moderate, and high risk)
  • General recommendations are made for medical clearance versus specific recommendations for exercise testing and medical exams.
  • Clients with pulmonary disease are no longer referred for medical clearance

 

For more detailed information on the updated pre-participation guidelines, please see the following article.

Preparation
Most of the time, if someone has made the effort to meet with a fitness professional, he or she has at least reached the preparation stage. However, you may encounter someone who is still in the pre-contemplation or contemplation stage. When this happens, that person has usually been prompted to meet with you by his or her doctor or a loved one.

Pre-contemplation
If a person is in pre-contemplation, he or she typically does not want to be there and does not believe that exercise can have an impact on health. In this case, it's important for you to take the appropriate steps to get the potential exerciser thinking about inactivity as a relevant issue and to start thinking about becoming more physically active. Some of the interventions used during this stage include providing information about the risks of inactivity and the benefits of activity, acknowledging that there is a lack of readiness to change and reevaluating current behaviors. The reason why it's important to recognize individuals in this stage of change is because people in pre-contemplation aren't necessarily open to the idea of exercise. Therefore, you could potentially increase resistance to physical activity by pushing the idea that they must exercise. However, if you provide information on how exercise can benefit them and then offer your expertise as a resource, while encouraging questions or allowing them to voice their concerns, you can essentially "plant the seed" so that they may consider exercise (moving them to contemplation).

A practical tool the fitness professional can use to determine if someone is in contemplation or pre-contemplation is to ask the following question: "On a scale of 1 to 10 how ready do you believe you are to make this change or adopt this healthy behavior?" If the potential client provides a response below 4, he or she is most likely in the pre-contemplation stage.

Contemplation
A person in the contemplation stage, however, knows the value of exercise, but for whatever reason is not regularly engaging in it. A contemplator is starting to consider the importance of becoming more physically active and has begun to recognize the implications of being inactive. He or she might have an internal dialogue that sounds like this: "I know I should exercise, but I just don't have the time, energy, etc." At this point, the person is allowing the cons of engaging in exercise to outweigh the pros of becoming more physically active. This is the point where we want to encourage the potential client to introduce some type of activity into their day, even if it means starting small, like walking for 10 minutes twice a day. Successfully achieving small tasks related to exercise may get them to realize that regular physical activity can be a part of their life if they can take the appropriate steps to commit. During this stage it is important to help clients explore options (like preferences for physical activity), and provide cues to action, some basic structure and design (such as how often and how long to be active), and opportunities to ask questions.

Tools a fitness professional may use with someone in this stage include the evaluation of the pros and cons of making the change and removing barriers to becoming more active, such as offering a free gym trial.

Operant conditioning is a learning theory that considers the manner in which personal actions are influenced by their consequences.

As an exercise and health professional, effectively applying this principle may help facilitate changes in clients’ lifestyle behaviors. The key is to identify factors (antecedents) that may trigger a client’s behavior, versus addressing only the behavior.

Take, for example, a client who is prone to overeating (behavior), which contributes to the client having obesity (consequence). Through motivational interviewing, it is discovered that the client’s job is quite stressful, which leads him or her to seek food for emotional comfort. Consequentially, this results in the client consuming an excess of daily calories, which is a factor in the client having obesity. 

So, here you learn the stimulus that triggers overeating is stress on the job. Therefore, to facilitate changes in behavior, an exercise and health professional may address the client’s job stress (antecedent).

Ideally, once the stress (stimuli) is effectively managed, we would hope that the client’s desire to overeat (behavior) would cease, thus resulting in a decrease in daily caloric intake, ultimately leading to weight loss (consequence).

As the client begins to lose weight and recognizes that managing his or her stress decreases the desire to overeat, the stress-management behavior is rewarded, thereby the behavior increases (positive reinforcement). 

Your body utilizes two primary nutrients as fuel sources to produce ATP, the energy used for movement and to sustain life—carbohydrates and fats. Depending on the intensity at which you are working, your body will produce a greater percentage of ATP from one source or the other. Protein is primarily a building block for cells and many other elements in our bodies, and is only used as a fuel source when we are running out of carbohydrates.

“Aerobic” refers to cellular metabolism where ATP is produced “with oxygen” and “anaerobic” refers to cellular metabolism where some or all of the ATP is produced “without oxygen.” Aerobic metabolism occurs at lower intensities where our working muscles, organs and other systems are able to get all of the oxygen they need to meet their energy demands. This can include what we think of in the fitness world as “aerobic exercise” (moderate-to-vigorous intensity exercise), but also includes activities that are less strenuous such as reading, washing dishes, sitting at a computer and even sleeping. During all of these activities, the body is able to produce the ATP it needs by utilizing oxygen in the process. The fuel sources for aerobic cellular metabolism are fats and carbohydrates, with a greater percentage of calories coming from fats at lower intensities. As the intensity of work increases, we use a lower percentage of calories from fats, while the percentage of calories utilized from carbohydrates increases. The higher the intensity, the more we use carbohydrates as a fuel source. Our bodies generally draw upon a combination of carbohydrates and fats to produce ATP, with the exception being very short-duration, high-intensity anaerobic activities, such as a 100-meter sprint where the primary fuel sources are creatine phosphate, stored ATP, and muscle glycogen (i.e., carbohydrates stored in the muscle).

Every time you exercise or do other physical work like stocking shelves, mowing the lawn, etc., your caloric expenditure increases to meet the demands of the working muscles. This energy comes from fats and carbohydrates in proportions that vary based on the level of intensity as described above. While our bodies burn a greater percentage of calories from fat at lower intensities, we can actually burn a great deal of calories from fat at higher intensities simply because we burn more total calories both before and after a workout when we engage in higher intensity activities. The limiting factor is a person’s ability to tolerate vigorous activity for durations that bring about significant energy usage. For beginners, or those who are unaccustomed to vigorous exercise, it is necessary to begin at lower intensities in order to build a foundation of fitness before attempting very high-intensity work.

Although your EES manual is the foundation for what you will need to know for the exam, you don’t need to memorize everything. Remember, knowledge of anatomy and physiology is critical to becoming a fitness professional and studying is a layered process. These topics will build on the other chapters as you move through the program and you will need to refer back to the EES manual. Here are a few helpful blogs to assist you with the information you need for the Essentials of Exercise Science book:

You are not expected to master each chapter before moving on to the next. Rather, just make sure you’ve understood what you’ve read, and then refer back to these topics as they reappear. We typically recommend spending no more than one week getting through each chapter (assuming you’re studying the recommended 10 to 12 hours per week).

In this activity, we’re going to use a wall to represent the planes, and all motions you make must be parallel to that wall to occur in that plane:

Frontal Plane
Back yourself up to a wall so that your entire back side is against the wall. Pretend this wall is in your center, dividing you into anterior and posterior halves. This imaginary wall represents the frontal plane. To practice the motions that occur in this plane, you must keep your entire back side and limbs against the wall behind you. Motions in this plane would include movements like making snow angels (adduction/abduction) and elevating and depressing the shoulders. Notice, if you try to do a biceps curl, you would have to lift your forearm off of the wall, so this indicates that flexion and extension do not occur in the frontal plane.

Sagittal Plane:
Turn to one side and place your side against the wall (your arm might have to be slightly in front of the body to get hip against the wall). Pretend this wall is in your center, dividing you into right and left halves. This wall represents the sagittal plane. For this plane, you must keep your side against the wall. Movements in the sagittal plane would include biceps curls (that is, flexion and extension), dead lifts and squats. Any movement where you can keep the side of your body parallel to the wall takes place in the sagittal plane. Notice, if you try to do the motions described for the frontal plane (abduction and adduction or elevation and depression) or any twisting motion, you would have to lift your side off of the wall or move through the wall.

Transverse Plane
This one is a little harder to imagine, but it can be represented by visualizing your body being divided into top and bottom halves and then placing your torso on top of a table and your lower extremities below the table. Movements that occur in this plane should keep the body or a specific joint parallel to the table. This would include movements like rotation of the trunk, pronation and supination of the forearm, and circumduction of the thumb. Notice, performing any of the activities previously mentioned in the other planes would cause you to intersect with the “table.”

Many texts use varied terminology related to the metabolic markers used to describe the physiological response to cardiorespiratory exercise. In the ACE manuals, VT1 and VT2 will be used, but it is important to recognize the other commonly used terms when reviewing the literature:

  • The first ventilatory threshold (VT1) is also referred to as the lactate threshold and the anaerobic threshold.
  • The second ventilatory threshold (VT2) is also referred to as the respiratory compensation threshold and the onset of blood lactate accumulation (OBLA).

Another potential source of confusion involves the term "anaerobic threshold," which has come to mean different things in various parts of the world based on the way it was used in early research on the topic. This is another reason ACE has chosen to utilize VT1 and VT2 throughout this manual.

Autogenic inhibition involves stimulation of the Golgi tendon organ (GTO) during a muscular contraction. The GTO is a proprioceptor responsible for sensing increases in tension during both concentric and eccentric actions. Performing a muscular action activates the GTO causing that muscle’s fibers (specifically, the agonist’s fibers) to relax. Under GTO activation, the agonist muscle is inhibited causing the fibers to lengthen.

A practical example of autogenic inhibition is observed during static stretching. During a static stretch muscle tension temporarily increases and after holding the stretch for 7 to 10 seconds the GTO is activated. When the GTO is activated, the muscle spindle is inhibited. The muscle spindle protects us from overstretching, so if this function is inhibited we can move into a deeper stretch.

Reciprocal inhibition involves stimulation of the muscle spindle during the stretching of muscle fibers. The muscle spindle wraps around the muscle fibers in a parallel fashion and will stretch as muscle fibers stretch. When a muscle group is stretched, the muscle spindle activates causing the stretched muscle (agonist) to contract and the antagonist muscle group to relax. Reciprocal inhibition is also known as the stretch reflex.

A practical example of reciprocal inhibition occurs during proprioceptive neuromuscular facilitation (PNF). During this stretching technique, a low grade muscular contraction of the antagonist muscle (in this case, the muscle group opposite of the muscle group targeted to receive the stretch) is held for 6 to 15 seconds. This low grade muscle contraction inhibits the muscle spindle activity in the agonist muscle (in this case, the muscle targeted to be stretched) allowing that muscle to be stretched further.

To further explore this concept, read this blog: GTOs and Muscle Spindles Explained

For the body to function, it needs a continuous supply of energy. Adenosine triphosphate (ATP) is the body’s immediately usable form of chemical energy for all cellular functions, including muscular contraction. The amount of ATP available in the muscles is very limited, so it must be continuously resynthesized via one of the three main energy pathways—phosphagen, anaerobic glycolytic, or aerobic systems. 

Phosphagen System (short-acting)

The most immediate source of energy at the onset of activity or upon increased intensity is the phosphagen system, which uses creatine phosphate (CP) to produce ATP. CP is a high-energy compound that is rapidly produced but is quickly depleted during muscular contraction, thus it is available for only a limited amount of time—usually 10-30 seconds—before it is exhausted. How quickly it is used depends on the intensity of the exercise. Activities such as plyometric exercise use the phosphagen system for ATP production.

Anaerobic Glycolysis (intermediate)

Anaerobic (without oxygen) glycolysis is a process that uses glycogen (stored glucose) for ATP production. Glycogen is available in greater quantities and for longer periods than CP—up to 3 minutes for activities such as moderate-intensity resistance training. During endurance activities, fuel needs are met by anaerobic glycolysis prior to approaching steady-state aerobic metabolism.

Aerobic System (long-acting)

The aerobic system takes over during endurance activities after the anaerobic systems become depleted and fats and carbohydrates emerge as the primary sources for ATP production. During aerobic activity, there is an abundance of oxygen readily available to be used in the process of metabolizing carbohydrate and fat. This allows activities to be sustained for 30-60 minutes or more at moderate intensity. Cycling at a moderate intensity for 30 minutes, for example, primarily uses the aerobic system for ATP production.

During physical activity, these systems may be used at any time, working together to contribute to the total energy needs of the body. They do not work independently of each other; however, one system will dominate depending on the intensity of the activity and the demands placed on the body.

Activities performed for extended periods, which typically rely on the aerobic system, can also utilize the anaerobic system.

For example, in distance running, the aerobic system is the most dominant source of ATP production. However, during periods where the runner accelerates, and the intensity increases, one of the anaerobic systems will become more prevalent in ATP production.

Note: Both the phosphagen and anaerobic glycolysis systems are considered anaerobic, as they both produce energy in the absence of oxygen.

The lower leg is comprised of muscles in three regions—lateral, anterior, and posterior—divided by the anterior and posterior intermuscular septa (a band of fascia separating muscle compartments), the interosseous membrane (fibrous tissue that helps maintain space between bones), and the tibia and fibula. Muscles in the same region are grouped together with connective tissue. The muscles of the anterior region of the lower leg are grouped together in the anterior compartment, while the muscles of the lateral region are grouped into the lateral compartment. The posterior region has two distinct groups; the deep muscle group and the superficial muscle group.

Some resources introduce this topic presenting the muscles in their three regions, with the posterior region presented as having two layers. Structurally and functionally, the posterior region is really comprised of two distinct compartments (superficial and deep), giving the lower leg four total compartments. The muscles of the lower leg are grouped by compartment in the table below.

Lateral Anterior Posterior
    Deep
- Peroneus longus - Anterior tibialis - Posterior tibialis
- Peroneus brevis - Extensor digitorum longus - Flexor digitorum longus
  - Extensor hallucis longus - Flexor hallucis longus
    - Popliteus
    Superficial
    - Soleus
    - Gastrocnemius
    - Plantaris


For more information on these muscles please see the blog Muscles That Move the Leg

In late 2018, the U.S. Department of Health and Human Services released its first update to the Physical Activity Guidelines for Americans since the original document was published more than 10 years ago. The new Guidelines highlight the value of even small, incremental bits of physical activity in warding off disease and helping individuals sleep better, feel better and more easily perform their activities of daily life. To learn more about the updates and how they affect the work of health coaches and exercise professionals, read the following:

Please note: When guidelines are updated, ACE takes steps to ensure that candidates have a fair opportunity to pass an exam that is not negatively impacted by the updates. As a professional standard, all health coaches and exercise professionals should do their best to stay up-to-date on industry guidelines and standards of care.

The American College of Sports Medicine (ACSM) updated its preparticipation health screening recommendations with the publication of the 10th edition of ACSM’s Guidelines for Exercise Testing and Prescription. These new recommendations are less restrictive and acknowledge that exercise is safe for most people and has many health and fitness benefits. To learn more, read the following:

Please note: When guidelines are updated, ACE takes steps to ensure that candidates have a fair opportunity to pass an exam that is not negatively impacted by the updates. As a professional standard, all health coaches and exercise professionals should do their best to stay up-to-date on industry guidelines and standards of care.

The new blood pressure guidelines change the definition of hypertension from a blood pressure of ≥140/90 mmHg to ≥130/80 mmHg, which means that approximately 46% of the U.S. population is now considered to have hypertension. The good news is that the majority of individuals affected by the change in guidelines can be treated with lifestyle changes instead of medications. To learn more about the role that health coaches and exercise professionals play in this shift from treatment to prevention, read the following:

Please note: When guidelines are updated, ACE takes steps to ensure that candidates have a fair opportunity to pass an exam that is not negatively impacted by the updates. As a professional standard, all health coaches and exercise professionals should do their best to stay up-to-date on industry guidelines and standards of care.

This important screening document is regularly updated and revised and there are different versions depending on the clientele with whom you are working. The PAR-Q+ and ePARmed-X (for clients who have had a positive response to the PAR-Q+ or have been referred to use this more comprehensive form by a healthcare professional) were created to reduce barriers for all individuals to become more physically active. These forms are updated on a regular basis. The PAR-Q+ Collaboration makes these publicly available on their website. Visit the following website to find the most up-to-date version of each questionnaire before using it with clients:

Please note: When guidelines are updated, ACE takes steps to ensure that candidates have a fair opportunity to pass an exam that is not negatively impacted by the updates. As a professional standard, all health coaches and exercise professionals should do their best to stay up-to-date on industry guidelines and standards of care.

The McGill's Torso Muscular Endurance Test Battery assesses the endurance of three torso muscle groups and is comprised of the following tests:

  1. Trunk Flexor Endurance Test: assesses muscular endurance of the deep core muscles.
  2. Trunk Lateral Endurance Test: also called the side bridge test, assesses muscular endurance of the lateral core muscles.
  3. Trunk Extensor Endurance Test: assesses muscular endurance of the torso extensor muscles.

Poor endurance of the torso muscles or an imbalance between the three muscle groups can contribute to low back pain and core instability

The tests are performed individually and involve a static, timed, isometric contraction of the core muscles stabilizing the spine until the individual exhibits fatigue. Refer to the ACE Personal Trainer Manual 5th ed., pg. 187-192, for test instructions. The results are evaluated collectively in the following ratios to indicate balanced endurance among the muscle groups:

Flexion: Extension
  • For muscular balance between the front and back of the torso, the ratio should be less than 1.0 (ratio means dividing the two numbers).
  • In this case, the ratio refers to the number of seconds held in each position, or flexion time/extension time.

Right-side bridge (RSB): Left-side bridge (LSB)

  • Right-side bridge time/left-side bridge time
  • For muscular balance between the sides of the torso, the score should be no greater than 0.05 from a balanced score of 1.0 (that is, an acceptable range would be a score somewhere between 0.95 to 1.05).

Side bridge (SB) (either side): Extension

  • One-side bridge time/extension time
  • For muscular balance between one side and the back of the torso, the score should be less than 0.75.

Let's work through an example. A client completed the three tests with the following results:

Flexor Test: 120 seconds
RS Bridge: 88 seconds
Extension Test: 150 seconds
LS Bridge: 92 seconds

Scoring and Evaluation

Flexion: Extension

  • 120 seconds:150 seconds = 120/150 = 0.8
  • The score of 0.8 fits within the criteria of <1.0 for muscular balance between the front and back of the torso.

RSB: LSB

  • 88 seconds:92 seconds = 88/92 = 0.96 (0.956 rounded up)
  • This score fits within the 0.05 range from 1.0 (that is, it falls between 0.95 and 1.05), indicating muscular balance between the right and left sides of the torso.

Side bridge (choose one side at a time, but remember to perform the ratio calculation for both sides): Extension

  • RSB = 88 seconds:150 seconds = 88/150 = 0.59 (0.586 rounded up)
  • This score fits within the criteria of <0.75 for muscular balance between the right side and the back of the torso.

Side bridge: Extension

  • LSB = 92 seconds:150 seconds = 92/150 = 0.61 (0.613 rounded down)
  • This score fits within the criteria of <0.75 for muscular balance between the right side and the back of the torso.

The results show that this client has well-balanced torso muscles.

A standing, relaxed postural assessment may be conducted to evaluate body-segment alignment. The information gathered in this type of static postural assessment may be used (in combination with movement screens) to evaluate how posture, both good and bad, impacts a client's ability to move. The important observation to make during a static postural assessment is how (if at all) a person's joints differ from what is considered "ideal" or "neutral." Deviations from a neutral posture could mean that muscles on each side of the joint are chronically tight or weak. When muscles are overused or in a chronically shortened position at rest (e.g., hip flexors when seated) they may become tight. When those opposing muscles are underused or in a chronically lengthened position (e.g., hip extensors when seated), they can become weak. What you'll notice in these compensations is that they're almost always paired muscles groups, meaning that the agonist (the one responsible for the action in the compensation) is tight and the antagonist (the opposing muscle group) is weak. In that case, you want to stretch the agonist muscles and strengthen the antagonist muscles. Start by looking at static postural analysis and then move on to the movement assessments.

The talk test is a method for monitoring and controlling exercise intensity, using respiration effort and the ability to speak.  An individual, being able to speak comfortably with more than a few words indicates that he or she is likely below the first ventilatory threshold, VT1.  When using the talk test, it is not required that heart rate be measured, as the objective is to observe respiratory (breathing) effort and the ability to speak.

The individual is evaluated by having them recite a familiar passage or phrase like the pledge of allegiance, and then asking if they can speak.

In contrast to the simplicity of the Talk Test, the Submaximal Talk Test for VT1 is a formal assessment used to determine heart rate at VT1. This test requires preparation and equipment and continuous monitoring of heart rate to avoid missing VT1. The intensity is gradually increased until the ability to talk continuously is compromised, and like the talk test uses a familiar passage or phrase to evaluate effort and ability to speak.

In summary, the talk test method is used to measure exercise intensity, but does not require the measurement of heart rate. While the submaximal talk test for VT1 is a formal assessment where heart rate is measured at VT1 and requires the use of equipment and preparation, to administer the test.

For the physiological assessments section, there are numerous amounts of information, from administration of assessments, and accompanying charts, tables and equations.  The key to approaching this section, is to be strategic. Since there is no practical component to the exam, you are not expected to memorize exact protocol of each assessment or all the information presented in the tables and charts.  However, understanding what information you are gathering from the assessment in relation to the client is essential.

One helpful way to tackle the content, is to categorize the information. Ask the questions:

What is the purpose/objective of this assessment? 

For whom is the assessment most appropriate?

What are the outcomes that I am seeking to observe?

Are there any contraindications?

What do the results mean?

Gathering this information will allow you to remain organized as you complete this section of the course. While you are not expected to memorize the chart and table information, you also, do not want to disregard them. For example, recognizing that for BMI, a score of ≥ 30 mg/m² places a client in the obesity category, is an important factor to remember. On the other hand, memorizing, all the data on the Rockport Fitness Walking test would not be the most effective use of you

The process of selecting assessments is dependent on several factors and is not always a black-and-white or linear process. Different assessments may be administered throughout the course of the client-health and exercise professional relationship and factors like health history, current fitness level, lifestyle factors, and goals determine which assessments may be most appropriate for the client.

 

Prior to performing any physical assessments—in the initial investigation stage—information about the client is gathered via the pre-participation health screening, using forms like a health-history questionnaire and PAR-Q to identify risk factors. This allows the health and exercise professional to determine if a physician’s clearance is needed or if there are any specific programming recommendations to be considered (e.g., considerations related to injury or chronic conditions like diabetes and hypertension).

 

Example of selecting appropriate assessments for a client with a shoulder condition and weight-loss goal:

 

Client: John

Age: 45

Pre-participation screen: Generally healthy with no chronic conditions. He previously tore his rotator cuff and has had surgery to repair the injury. He completed physical therapy over the past 4 months. He is not experiencing any pain or discomfort.

Physician recommendations: Cleared to exercise. Continue with exercises from physical therapy and improve shoulder mobility.

Goals: He has struggled with weight loss and desires to lose 40 pounds and improve strength in his shoulder.

Assessments: Prior to developing an exercise program, the following assessments were performed. To establish baseline measurements for his weight loss goal, anthropometric assessments are performed [i.e., body mass index (BMI) and girth measurements]. A skinfold assessment may not be appropriate since John is currently 40 lb. overweight. In addition, a postural assessment and shoulder mobility tests (i.e., internal and external shoulder rotation and Apley’s scratch test) are performed to determine John’s current joint function. The results of these assessments may be used to design a safe and effective, individualized exercise program for John.

 

Generally, health and exercise professionals may choose to perform postural and/or movement-based assessments to determine the client’s level of functionality and/or the presence of any muscular imbalances before designing and implementing an exercise program. Additional assessments such as body composition, cardiorespiratory fitness, and sports skill may also be administered, depending on the client’s goals. These assessments allow the health and exercise professional to establish a baseline to compare against for tracking progress in a client’s program.

 

While assessments may be beneficial initially to create a personalized program for a client, it is important that the appropriate assessment be selected at the appropriate time. Not all clients will need or be receptive to assessments, as they may cause some people to become discouraged and demotivated, particularly if they are severely deconditioned or have overweight or obesity. To minimize client distress, be empathetic when selecting assessments and consider the needs and goals of the individual.

 

As a certified fitness professional, it is outside of your scope of practice to design and implement nutrition plans or diets. Your role as a fitness professional is to educate your clients on nutrition and share your knowledge of healthy choices to help them adopt more healthful behaviors. This can include showing them how to utilize tools available at www.choosemyplate.gov or educating them about USDA Dietary Guidelines recommendations. If your client needs specific advice or a diet plan, refer them to a registered dietitian.

Within Scope of Practice for Fitness Professionals

  • Principles of healthy nutrition and food preparation
  • Food to be included in a balanced daily diet
  • Essential nutrients needed by the body
  • Actions of nutrients on the body
  • Effects of deficiencies or excesses of nutrients
  • How nutrient requirements vary through the lifecycle
  • Information about nutrients contained in foods or supplements

Outside Scope of Practice for Fitness Professionals

  • Individualized nutrition recommendations or meal planning other than that which is available through government guidelines and recommendations, or has been developed and endorsed by a registered dietitian or physician
  • Nutritional assessment to determine nutritional needs and nutritional status
  • Specific recommendations or programming for nutrient or nutritional intake, caloric intake or specialty diets
  • Nutritional counseling, education, or advice aimed to prevent, treat, or cure a disease or condition, or other acts that may be perceived as medical nutrition therapy
  • Development, administration, evaluation, and consultation regarding nutritional care standards or the nutrition care process
  • Recommending, prescribing, selling or supplying nutritional supplements to clients
  • Promotion or identification of oneself as a “nutritionist” or “dietitian”

For more information, please read the following:

Since its inception in 2011, the United States Department of Agriculture’s (USDA) SuperTracker website has been a valuable resource for 27 million users, as it offered tools for tracking food and physical activity to be used in pursuit of achieving a healthier lifestyle. Earlier this year, the USDA announced a decision to discontinue the SuperTracker as of June 30, 2018. The decision to discontinue this service was made so that efforts could be shifted toward the creation of modern and more efficient ways to support Americans in adopting a healthy eating style. To find out more about this decision, please visit Super Tracker discontinuation frequently asked questions (FAQs). Considering this change, the American Council on Exercise (ACE) will be removing all references to the SuperTracker from its print and online resources and is recommending the use of the National Institute of Health’s bodyweight planner. Use of the bodyweight planner allows individuals to make personalized physical activity and calorie plans to reach or maintain a goal weight within a specific amount of time and then sustain it afterward.

While the bodyweight planner is a great tool for determining caloric needs based on current or planned activity levels and weight-related goals, it does not include all the features that SuperTracker offered. Currently in the private sector, there can be found many tools with a shared mission of allowing users to track food and physical activity in support of a healthier lifestyle. One such tool that can be used in place of SuperTracker is Myfitnesspal, which allows users to track food and exercise, join an online community, and obtain relevant content through blog articles.  Myfitnesspal has over 5,000,000 food items in its data base, which allows users to quickly find items they consume and add them to their diary. Myfitnesspal users begin by creating a personalized diet and fitness profile, which the app uses to generate fitness and nutrition goals. Once a profile is complete, the user can begin logging exercise activities and food intake into his or her personal exercise and food diary, respectively.

Although there are many tools available for tracking food and physical activity, it is important to find one that best suits you and your clients’ unique needs. If you had made a practice of referring clients to the SuperTracker tool as way to support their health-related goals, it will be important to have alternate recommendations for them once this service ends. Also, it may be helpful to familiarize yourself with some useful facts about the discontinuation of SuperTracker and what the changes may mean for your clients.

Below is a list of some common questions your clients may have. More information can be found at SuperTracker discontinuation frequently asked questions (FAQs).

What does this change mean for current SuperTracker users? 
After June 30, 2018, the SuperTracker website will no longer be available. After this time, you will not be able to access the website for any reason, including retrieving previously entered data. User’s account information will no longer be available in any format after June 30, 2018.

Am I able to export my data?
Several reports can be created that contain meal summaries, food groups, calories, physical activity, and other data. Those reports can be exported in multiple file formats for saving or printing.

What other resources are available to track my food and activity?
In addition to Myfitnesspal, the MyPlate Checklist Calculator can be used to determine an appropriate calorie level based on your age, sex, height, weight, and physical activity level. Used in conjunction with the MyPlate Daily Checklist, users are given a printable list of food-group serving recommendations. This feature shows what and how much to eat from the foods groups within your specific calorie allowance.

What will happen to data previously entered into SuperTracker?
All accounts and user data will be purged in their entirety after June 30, 2018. No previous data will be available and the data will not be preserved nor distributed in any format.

Who can I contact for more information?

Please email the USDA with any other questions you may have related to the discontinuation of the SuperTracker website at SuperTrackerHelp@cnpp.usda.gov. 

During submaximal exercise, ventilation (or breathing rate) parallels oxygen uptake and there is a linear increase between intensity and ventilation. In other words, as the heart beats faster, breathing rate becomes more rapid. This linear increase continues until exercise approaches the lactate threshold. At this point, ventilation begins to increase in a non-linear fashion and ventilation is no longer directly linked with oxygen demand. This first disproportionate increase in oxygen consumption represents VT1 and occurs in response to an initial accumulation of metabolic by-products in the blood. At the intensity of VT1 breathing rate increases in an attempt to blow off extra CO2 produced during the buffering of metabolic by-products. A person exercising at the intensity of VT1 will notice a change in breathing rate and speaking will become more difficult. At this point, the exerciser probably cannot speak comfortably. As long as the exerciser can speak comfortably, he or she is almost always below VT1, where the cardiorespiratory challenge to the body is caused primarily by inhalation (and not the expiration of additional CO2, as seen at intensities above VT1).

As exercise intensity continues to increase there is a second disproportionate increase in ventilation that is associated with increased lactate production which coincides with acidosis. At this point, hyperventilation (or increased breathing rate in an attempt to get rid of additional C02) is no longer adequate to buffer the increase in acidity and metabolic by-products begin to accumulate at a rate faster than they can be buffered. This point is considered the onset of blood lactate accumulation (OBLA). Exercise immediately below VT2 represents the highest sustainable exercise intensity. Exercise above VT2 represents an intensity that cannot be sustained for long periods and speech is not possible other than single words.


 

VT1

VT2


ZONE 1

ZONE 2

ZONE 3

HR below VT1

HR VT1- just below VT2

VT2 and above

METS (3-6)

METS (6-9)

METS > 9

RPE (3-4)

RPE (5-6)

RPE (7-10)

RPE (12-13)

RPE (14-16)

RPE (17-20)

70-80% training time

<10% training time

10-20% training time

Low to moderate

Moderate to vigorous

Vigorous to very vigorous

Moderate to somewhat hard

Hard

Very hard to extreme

Talk comfortably

No sure if talking is comfortable

Definitely cannot talk comfortably

You may reschedule your ACE exam up until 11:59 p.m. PST the night before your scheduled exam date for a rescheduling fee of $149 for U.S./Canada and $299 for international exams. Candidates who “no show” and do not reschedule prior to that deadline will be subject to first-time exam fees for a new testing date.
To reschedule, log in to your My ACE account, select “My Exam Information” and then “Reschedule My Exam.” Proceed through the online registration process, paying the fee upon checkout. You’re only eligible to reschedule once, and you may only reschedule for another computer-based exam. Once your new desired examination date, site and time have been approved, you’ll receive an e-mail notification instructing you to download and print your admission ticket.
Exceptions to the reschedule fee will be considered on a case-by-case basis for documented serious illness, bereavement, natural disasters and other emergencies. In these instances, candidates must contact ACE Exam Registration prior to the day of their exam and provide supporting documentation. Candidates who have requested special accommodations will need to contact the ACE Exam Registration via e-mail at examregistration@ACEfitness.org or phone (888) 825-3636, ext. 783 to reschedule.

Unfortunately, there is no way to extend the exam voucher expiration date, however, the date that your exam voucher expires is not the date by which you need to take your exam. It is simply the date by which you need to select the date you will sit for your exam. The day that you actually take the exam can be as far out as the testing locations in your area schedule exams. If you look at the locations in your area (searched by the zip code you have on file in your account), you’ll notice that exams can be scheduled past your voucher expiration date. If you widen your search radius, more dates and locations may appear. 

Candidates who purchase certification bundles that include an exam voucher are subject to the following policies:

  • ACE's Refund Policy allows for returns within 30 days from the date of purchase. All returns are subject to a 20% restocking fee. Customers who have redeemed their exam voucher are not eligible for a refund.
  • Exam vouchers are non-refundable and non-transferable.
  • Exam vouchers must be redeemed within 6 months from the original date of purchase.
  • CPR/AED certification is required to register for the exam and must remain current through the exam date. The course must include a live skills check; online-only CPR/AED courses are not accepted.
  • Extensions are not given on exam vouchers.
  • Retake vouchers (included in select study bundles) must be redeemed within 60 days of the original failed exam date.

Exceptions to the refund deadline will be considered on a case-by-case basis for documented cases of serious illness, bereavement, natural disasters, and other emergencies. In these instances, candidates must electronically date-stamp or postmark their request no later than 30 days after the examination date and provide any and all supporting documentation. With proper documentation, candidates will be offered the option to apply their examination fee toward a future registration to be scheduled within the next six months, or they can request a full refund of examination fees. No refunds will be given for rescheduled exams.

Unfortunately, there is no way to extend the exam voucher expiration date, however, the date that your exam voucher expires is not the date by which you need to take your exam. It is simply the date by which you need to select the date you will sit for your exam. The day that you actually take the exam can be as far out as the testing locations in your area schedule exams. If you look at the locations in your area (searched by the zip code you have on file in your account), you’ll notice that exams can be scheduled past your voucher expiration date. If you widen your search radius, more dates and locations may appear.

The following information will help you navigate through your eBook by explaining the toolbar functions, the navigation hot keys / shortcut keys and other usability functions.

To zoom the publication in and out, either click in the area of the page you wish to zoom in on, or use the zoom button on the toolbar, which will automatically zoom on the center of the pages you are viewing. Then select your preferred level of zoom using the zoom scale, which will appear on the toolbar once the publication is zoomed in.

To move the page around, click and drag the publication or use the scroll bars found at the right hand side and the bottom of the page.

If you are reading on a PC and you have a wheel on your mouse you can use this to scroll up and down.

Click on the publication or zoom icon again to zoom out (a minus sign will appear in the icon for zooming out).

PAGE BROWSING
To turn the page, click on the bottom right corner of the publication or use the arrow buttons on the tool bar for instant page display. You can also move instantly to the first or last page using the keys with a single vertical line, next to the arrow keys.
The page you are viewing will be displayed in the white window, in the middle of the toolbar. You can also type the page you require into this page display, to move instantly.
You can also use the contents drop down menu on the right hand side of the toolbar to select the page you require.

HOTKEYS
To navigate through the publication using hot keys instead of a mouse, use the following keys:
To select items on the menu bar use the TAB key to move through the selections. A yellow box will highlight your selection. To activate the selection hit the space bar.
 - To turn to the next page, press the full stop key.
 - To turn to back to the previous page, press the comma key.
 - To zoom in, press “Z” once. Press the Z key a second time to zoom out again.
 - You can increase or decrease the zoom level by pressing the + or - keys.
 - Once zoomed in, press A to scroll left.
 - Press D to scroll right.
 - Press W to scroll up.
 - Press S to scroll down.

SEARCH
There is a contextual search facility on the far right of the toolbar. Type your search word or term into the box and click the GO button to start the search. A dropdown menu of results will appear under the search box. Click the page you require from the menu and you will be delivered directly to that page. Your keyword or search term will be highlighted in green.

STICKY NOTES
You can add notes to the page for future reference by clicking on the note icon on the toolbar and selecting the area you wish to annotate. Write your notes in the yellow box. Once you have finished, a yellow note icon will be pasted on the selected area. When you wish to view your notes again, simply scroll over the yellow note icon when required.

BOOKMARKING
You can add bookmarks to your eBook that will allow you to return easily to specific pages. ACE eBooks allow for multiple page bookmarking, using different colored bookmarks for each page.
You can also reference each bookmark with a short description.
The bookmarks will remain on your publication if you view the publication from the same computer. You can also save an offline version of your publication to your desktop, which will also save your bookmarks and referencing.

CONTENTS
You can click on the contents button on the left of the toolbar to view a dropdown menu of the publication's contents. Clicking on the page you require will move you directly to that page. You can also click to view thumbnails of each page in the publication.

All four ACE certification programs have competency-based assessments comprised of multiple choice exams with 125 scored items and 25 experimental items that make up the entire credentialing exam. Candidates are given three hours to complete an ACE multiple choice exam for any of the four ACE certification programs.

ACE examinations are scored according to procedures accepted by the American Psychological Association, the American Educational Research Association and the National Council on Measurement in Education. The candidate’s score is derived from the number of questions answered correctly, and is then converted to a scaled score ranging from 200 to 800 points, with the passing point set at a scaled score of 500 points. Candidates who earn a scaled score of 500 or more points will be awarded the ACE certification for which they tested.

For more information, please review the Certification Exam Candidate Handbook.

The test contains math-based questions to determine if you can use basic mathematics (addition, subtraction, multiplication, and division) to apply what you are learning to real-life scenarios. These questions will require calculations and memorization of some fitness formulas. However, you only need to know a few formulas for the exam, and they can all be found on this Helpful Fitness Formulas sheet. While all of these formulas are useful to know as a fitness professional, they may not all be specific to your test. It is recommended you cross-reference the formulas on the handout with what is covered in your text. The exam program itself will have a calculator function and you will also have access to scratch paper and a pencil.
For further guidance on this subject, please see:

Ask yourself the following questions:

  • Have I thoroughly used all of the materials I have available?
  • Have I reviewed the appropriate exam preparation blogs?
  • Have I practiced the assessments or teaching strategies on a friend or family member?
  • Have I tried to explain the topics out loud to see if I actually understand them?
  • Have I reached out to a study coach with my specific questions?
  • Have I reviewed the Exam Content Outline (Appendix B) in the back of the manual?
  • Have I looked over the test-taking strategies blogs?

We generally advise spending 3 to 4 months studying and preparing yourself to not only pass the exam, but also to prepare yourself to become a health and fitness professional. We suggest spending 12 to 15 hours on every lesson, which generally equates to taking 5 to 7 days to cover the video, reading, study companion and quiz. There are 18 lessons plus the exam review and practice tests, and if you spend 5 to 7 days on each that equates to about 3 to 4 months of preparation time.

Since there are multiple certifications and package options, it’s best to contact a study coach to review your materials over the phone. Generally, we advise reviewing your account, course syllabus and emails for instructions on your specific program.

This blog post may also be useful:

4 Tips for a Successful Study Experience

Can you physically not attend your exam or are you just not feeling ready? While rescheduling is the best option if you cannot physically attend your exam, we always encourage you to sit for your exam when possible because of the $149 reschedule fee, compared to the retake fee of $199.

The best case scenario is that you pass your exam on the first attempt and no further action is needed, however, if you are unsuccessful you will still have gained the experience of taking the exam and have an exam score report to work with. Our study coaches can then review that score report and help highlight where you’re doing well, where you need improvement, and provide other helpful study recommendations. Also, if you reschedule you’re limited to scheduling your exam with the options that are posted whereas if you retake your exam, you will have one year from your unsuccessful exam date to retake at the discounted rate of $199. Ultimately you need to determine what works best for you.

We highly recommend reviewing your Exam Content Outline (Appendix B) in your manual, as this is essentially the "blueprint" for the exam. This will divide the information into multiple domains, and each domain has a set list of tasks that you will be expected to understand. Use the "knowledge of" and "skills in" sections to guide you and make sure you feel very comfortable with those sections. A good way to tell if you're comfortable with a topic is to try to explain it to someone else. If you feel confident that you could explain it to a client or class participant, then you're probably proficient with that topic; if you're not quite sure, then you'll probably want to review that topic. Also, if you are signed up for the Study Coach emails or are using one of the online study programs, you will be provided with helpful information about what to focus on as you move through your lessons.

There are thousands of testing locations around the world. To find a location near you log in to your account and select My Exam Information ? Sign up for an Exam. You will be able to select your country and zip code to determine when and where to take your exam. Or, click here to search for an exam testing site in your area.

  1. Determine if you have a retake voucher.
    1. If you have a retake voucher, it is important to know when it expires to understand how much time you have available to review before your next exam.
    2. If you don’t have a retake voucher, you can purchase an additional exam at the retake price of $199. This price is valid for one year after your initial test date.
  2. Determine a date for your retake exam.
    1. When choosing a date, we recommend giving yourself about one week of review time for every ten points you are away from a passing score. For example, if your score is 480 out of a possible 800 and you are 20 points away from the minimum passing score of 500, allow about two weeks of review before your next exam.
  3. Analyze your performance and consider any topics on the exam for which you felt underprepared.
  4. Review your exam score report and compare your domain performance to the Exam Content Outline found in Appendix B of all ACE manuals. Review each domain and determine what areas need improvement.
    1. Focus on improving the domains in which you scored the lowest, but also continue to briefly review the other domains to ensure that you keep all the content fresh in your mind.
  5. Use all your study materials.
    1. Be sure to use all the resources that are available to you. These could be in the form of books, online content, live and recorded webinars, virtual interactive study groups, peer-to-peer interaction on the ACE study center Facebook page, and the Resource Center Landing Page.
  6. Consider what went well during your initial studies and what you might do differently.
  7. Create a game plan for everything you want to do before you retake the exam. Writing down your plan may help create accountability.
  8. Join the ACE Study Coaches for a live webinar to get your specific questions answered.

While the practice tests can be completed as many times as you would like, we do not recommend taking them repeatedly, as this may lead to memorization of correct answers, rather than a deeper understanding of the content.  Instead, try the tips and strategies shared below to get the most out of your certification exam practice tests.

  1. Review your answers.
    1. Look at the questions that were incorrect and go back to review the material. The goal is to understand the “why” behind the question and the correct answer. Try to explain why the correct answers are correct and why the other options are incorrect. A helpful way to use this strategy is to imagine you are teaching someone else why an answer is correct.
    2. Look at the questions that were correct but were only guessed correctly. Review the corresponding content.
    3. This is a great time for self-reflection. These practice tests are meant to serve as a diagnostic tool to identify what your strengths are and what areas need the most improvement. Be honest with yourself when reviewing the questions— determine whether you guessed the correct answer or if you really know why the correct answer is correct.
    4. Review your overall practice test score report and compare your results to each domain of the Exam Content Outline (found in Appendix B of all ACE manuals).
  2. After reviewing the practice test and studying your answers, clear out your answers from the practice test and go through it again. Look for changes in your score related to increased knowledge and understanding as opposed to memorization.  If questions are missed on the second attempt, it is important to again ask yourself why you might have marked them incorrectly.  Now move on to your next practice test and follow the same steps as above.

1. Open the quiz or test that you want to clear the answers to.

2. Click on “Quiz Settings” in the upper left corner

3. Check the “Yes…Delete all my previous answers” box at the bottom

4. Click on the “Proceed with Delete” button

5. Take the quiz as many times as desired and repeat steps above

ACE produces textbooks for each ACE Certification program, first and foremost as resources to help candidates prepare for professions in health and fitness. Because industry guidelines frequently change, it’s critical that candidates view these study materials as helpful resources rather than the sole authority for a particular profession or examination. It is important to understand that ACE Certification exams are written to assess if candidates can consistently apply their knowledge to make safe and effective decisions in scenarios commonly faced by exercise professionals and health coaches. When guidelines are updated, ACE takes steps to ensure that candidates have a fair opportunity to pass an exam that is not negatively impacted by the updates. As a professional standard, all health coaches and exercise professionals should do their best to stay up-to-date on industry guidelines and standards of care.

Get help from experienced professionals

We have a wide variety of ways you can directly interact with ACE Study Coaches and other aspiring ACE Professionals. Connect with us on our ACE Answers Facebook page to get study tips and more! Tune into our live webinars, where we address frequently asked questions and topics to help you prepare for your ACE Certification Exam. Or join our live virtual study sessions which are another great way to get your questions answered by ACE Study Coaches in a virtual small group setting.

Take a look at our upcoming sessions and sign up!

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Our ACE Study Coaches are here to help! Get to know the friendly Study Coaches behind ACE Answers who will help guide you through your certification study experience. Our Study Coaches are ACE Certified Exercise Professionals and Health Coaches with degrees in exercise science and related health fields.

Alana

Favorite Workout: Hiking and Swimming

Alana Myers, M.S., is an ACE Certified Personal Trainer and Health Coach. She holds a bachelor's degree in exercise & sport science and a master's degree in kinesiology from Point Loma Nazarene University. Before joining ACE, Alana was a head swim coach and a personal trainer. She is passionate about learning new things and sharing her extensive knowledge in aquatics, cycling, triathlons, health and fitness, and nutrition. In her spare time, you can find Alana traveling, thriving outdoors, consuming artisanal coffee and obsessing over adorable dogs.

Chris

Favorite Workout: Hiking

Chris Gagliardi holds a bachelor's degree in kinesiology from San Diego State University, a master’s degree in kinesiology from A.T. Still University, and a certificate in orthotics from Northwestern University Fienberg School of Medicine. He is an ACE Certified Personal Trainer, Health Coach, Group Fitness Instructor, and Medical Exercise Specialist, NSCA Certified Strength and Conditioning Specialist, NBHWC certified NBC-HWC, and NASM Certified Personal Trainer who loves to share his enthusiasm for fitness with others and is committed to lifelong learning.

Dennis

Favorite Workout: Mountain Biking
Dennis Sanchez holds a bachelor's degree in exercise science with an emphasis in human performance and sport from Metropolitan State University of Denver. Before joining ACE, Dennis spent more than six years working as a health coach for a national insurance company. Prior to working as a health coach, he spent five years working as an ACSM Certified Personal Trainer and a boot camp instructor. Dennis loves helping others find their way to well-being.

Nicole

Favorite Workout: Long-distance Running
Nicole Thompson, M.A., is an ACE Certified Personal Trainer, Medical Exercise Specialist, Group Fitness Instructor, and Health Coach, as well as an ACE Senior Fitness Specialist and Fitness Nutrition Specialist. She holds a master's degree in sport and performance psychology and studied fitness instruction/exercise science at the University of California, San Diego. Before joining ACE, she worked in the fitness industry for many years as a personal trainer, health coach and sport psychologist. When she is not studying for her next ACE Certification Exam, she is usually training for her next half marathon or traveling.

Sabrena

Favorite Workout: Elliptical and Movement-based Resistance Training
Sabrena Jo, M.S., has worked in the fitness industry since 1987. As a certified group fitness instructor, personal trainer and health coach, she has taught group exercise and owned her own personal training and health coaching businesses. Sabrena is a former full-time faculty member in the Kinesiology and Physical Education Department at California State University, Long Beach. She has a bachelor's degree in exercise science and a master's degree in physical education/biomechanics from the University of Kansas. Sabrena is the Director of Science and Research Content for ACE and enjoys finding ways to help people start and stick with physical activity.

Todd

Favorite Workout: Mountain Biking and Trail Running
Todd Galati, M.A., is the Senior Director of Science and Research for the American Council on Exercise. He holds a bachelor's degree in athletic training, a master's degree in kinesiology and four ACE certifications (Medical Exercise Specialist, Personal Trainer, Health Coach and Group Fitness Instructor). Prior to joining ACE, Todd directed health research programs at the University of California, San Diego School of Medicine focused on reducing youth risk for cardiovascular and metabolic diseases; taught biomechanics, applied kinesiology and anatomy at California State University, San Marcos and San Diego State University; served as a research physiologist with the U.S. Navy; and worked as a personal trainer and endurance athlete coach.

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