chapter 6 fitness assessment. purpose to provide the fitness professional with valuable techniques...

Chapter 6

Fitness Assessment

Purpose

• To provide the fitness professional with valuable techniques to build a complete fitness assessment for a client.

• To provide the fitness professional with information about how the human body should move and how kinetic chain imbalances alter movement.

Objectives

• After this presentation, the participant will be able to:– Explain the components of and rationale for an integrated

fitness assessment.– Understand how to administer a health history questionnaire

and, from the results, be able to stratify a client’s overall risk for fitness assessment.

– Understand the importance of posture: how it relates to movement observation and how to assess it.

– Understand how to perform a comprehensive health-related fitness assessment, how to obtain subjective and objective information about clients, and how to use the information collected to help design an exercise program.

Introduction

• 2008 physical activity guidelines show how inactive Americans are.

• As little as 2.5 hours a week can prevent illness

• Only 31% of Americans engage in the recommended amounts of physical activity.

• To properly train people, an accurate assessment of readiness is important.

Definition

• Fitness Assessment– A systematic problem-solving method that provides the

fitness professional with a basis for making educated decisions about exercise and acute variable selection

– Not designed to diagnose any condition, but rather to observe each client’s individual structural and functional status, creating a starting point from which to work

– Not intended to replace a medical examination

Guidelines

• Fitness professionals should not:– Diagnose medical conditions: Obtain exercise or health guidelines

from a physician, physical therapist, registered dietitian, and so forth.

– Prescribe treatment: Refer clients to a qualified medical practitioner for medical exercise prescription.

– Prescribe diets or recommend specific supplements unless qualified: Refer clients to a qualified dietitian or nutritionist for specific diet plans.

– Provide treatment of any kind for injury or disease (aside from basic first aid): Refer clients to a qualified medical practitioner for treatment of injury or disease.

– Provide rehabilitation services for clients: Design exercise programs for clients after they are released from rehabilitation.

– Provide counseling services for clients: Act as a coach for clients.

Fitness Assessment Components

• Use a variety of observation methods to obtain a balanced overview of a client– Subjective Information

• General and medical history

– Objective Information• Physiologic assessment

• Body composition

• Cardiorespiratory assessments

• Static and dynamic postural assessments

• Performance assessments

Subjective Information

• Gathered from a prospective client to give the fitness professional feedback regarding personal history such as occupation, lifestyle, and medical background– One of the easiest forms of gathering this information is

through a questionnaire. • Physical Activity Readiness Questionnaire (PAR-Q) is directed

toward detecting any possible cardiorespiratory dysfunction, such as coronary heart disease (CHD).

General History

• Ask some very basic questions concerning a client’s history and personal background to obtain a wealth of information. – Occupation

• Does your occupation require extended periods of sitting?

• Does your occupation require extended periods of repetitive movements?

• Does your occupation require you to wear shoes with a heel (dress shoes)?

• Is your occupation mentally stressful (causes anxiety)?

– Lifestyle • Recreation

• Hobbies

Medical History

• Find out a client’s medical history to obtain information about life-threatening or chronic diseases as well as structural and functional health.– Past injuries– Past surgeries– Chronic conditions– Medications

Objective Information

• Gathered to provide the fitness professional with forms of measurable information

• Can be used to compare beginning numbers to those measured weeks, months, or years later, denoting improvements in the client as well as the effectiveness of the training program – Physiologic assessments– Body composition assessments– Cardiorespiratory assessments– Posture and movement assessments– Performance assessments

Physiologic Assessments

• Provide valuable information regarding the status of the client’s health – Heart rate– Blood pressure


• Measuring Heart Rate– Radial pulse

• Lightly place two fingers along the arm in line with and just above the thumb.

• Once pulse is identified, count the pulses for 30 seconds and multiply by two.

• Record the 60-second pulse rate and average for 3 days.


• Measuring Heart Rate– Carotid pulse

• Lightly place two fingers on the neck, just to the side of the larynx.

• Once pulse is identified, count the pulses for 30 seconds and multiply by 2.

• Record the 60-second pulse rate and average for 3 days.

– Average resting heart rates• Males: 70 beats/min

• Females: 75 beats/min


• Training Heart Rate– Calculate the client’s training heart rate zone for

cardiorespiratory exercise.– Find estimated maximal heart rate (220 – age).– Multiply the estimated maximum heart rate by the

appropriate intensity (65–90%).• Zone One: Maximum Heart Rate x 0.65

Maximum Heart Rate x 0.79

• Zone Two: Maximum Heart Rate x 0.80


• Zone Three: Maximum Heart Rate x 0.86


Heart Rate Reserve Method

• Heart rate and oxygen uptake are linearly related during dynamic exercise, selecting a predetermined training or target heart rate (THR) based on a given percentage of oxygen consumption is the most common and universally accepted method.

• The heart rate reserve (HRR) method is defined as:

THR = [(HRmax – HRrest) × desired intensity] + HRrest


• Blood Pressure– Systolic and diastolic readings

• Systolic (top number)

– The pressure produced by the heart as it pumps blood to the body

– Normal systolic pressure is <120 mm Hg.

• Diastolic (bottom number)

– The minimum pressure within the arteries through a full cardiac cycle

– Normal diastolic pressure is <80 mm Hg.


• Blood Pressure Testing – Instruct the client to assume a comfortable, seated position

and place the appropriate-size cuff just above the elbow.– Rest the arm on a supported chair or support the client’s arm

using yours and place the stethoscope over the brachial artery using a minimal amount of pressure.

– Rapidly inflate the cuff to 20 to 30 mm Hg above the point when the pulse can no longer be felt at the wrist.

– Release the pressure at a rate of about 2 mm Hg per second, listening for sounds.

– To determine the systolic pressure, listen for the first observation of sound.

– Diastolic pressure is determined when the sounds fade away.

Body Composition

• There are a variety of methods used to estimate body composition, they vary in cost, accuracy, and skill needed to perform them.– Skinfold: measures skin fold thickness– Bioelectrical impedance: measures resistance to electrical

current– Hydrostatic weighing: Measure body density by measuring

buoyancy (ability to float)

Body Composition

• Some benefits of body composition testing include:– Identifying a client’s health risk for excessively high or low

levels of body fat– Promoting a client’s understanding of body fat– Monitoring changes in body composition– Helping estimate healthy body weight for clients and athletes– Assisting in exercise program design

Skinfold Measurement

• Effective for trainers without a lab at their disposal– Indirect measure of adipose tissue through thickness of skin– Take a minimum of two measurements at each site– Be accurate when locating landmarks– Do not measure after exercise– Not effective on extremely obese clients

Body Composition

• Body Fat– Skin-fold caliper method

• Durnin–Womersley formula’s four sites of measurement

– Biceps

– Triceps

– Subscapular

– Iliac crest

Body Composition

• Body Fat– Biceps

• Vertical fold on the front of the arm over the bicep muscle

• Halfway between the shoulder and the elbow

Body Composition

• Body Fat– Triceps

• Vertical fold on the back of the upper arm, with the arm relaxed and held freely at the side

• Halfway between the shoulder and the elbow

Body Composition

• Body Fat– Subscapular

• At a 45-degree angle, 1 to 2 cm below the inferior angle of the scapula

Body Composition

• Body Fat– Iliac crest

• At a 45-degree angle, just above the iliac crest and medial to the axillary line

Body Composition

• Calculating Body Fat Percentages– After the four sites have been measured, add the totals of

the four sites. – Use the table in the textbook for corresponding body fat

percentage.

Body Composition

• Circumference Measurements– Another source of feedback used with clients who have the

goal of altering body composition – Most important factor is consistency

• Take measurements on the same side of the body each time you test and retest

Body Composition

• Circumference Measurements– Neck

• Across the Adam’s apple

Body Composition

• Circumference Measurements– Chest

• Across the nipple line

• Or upper chest for women

Body Composition

• Circumference Measurements– Waist

• At the narrowest point of the waist, below the rib cage and just above the top of the hip bones

– If there is no apparent narrowing of the waist, measure at the belly button.

Body Composition

• Circumference Measurements– Hips

• With feet together, at the widest portion of the buttocks

Body Composition

• Circumference Measurements– Thigh

• 10 inches above the top of the patella, just below the buttocks

Body Composition

• Circumference Measurements– Calf

• At the maximal circumference between the ankle and the knee

Body Composition

• Waist-to-Hip Ratio – There is a correlation between chronic diseases and fat

stored in the midsection.• Measure the smallest part of the waist without instructing the

client to draw abdomen in.

• Measure the largest part of the hips.

• Compute the waist-to-hip ratio by dividing the waist measurement by the hip measurement.

– A ratio higher than 0.80 for females and 0.95 for males may put people at risk for a number of diseases.

Body Composition

• Body Mass Index (BMI) – To assess weight relative to height, divide body weight (in

kilograms) by height (in meters squared) or kg/m2

– Obesity-related health problems increase when a person’s BMI exceeds 25.

Cardiorespiratory

• Provide valuable information regarding cardiorespiratory efficiency and overall condition

• Provide a starting point for cardiorespiratory training zone specific to their physical condition and goal

• Two common forms – Step Test – Rockport Walk Test

Cardiorespiratory Assessments

• Step Test– Determine the client’s maximum heart rate by subtracting the

client’s age from the number 220 (220 – age).– Take the maximum heart rate and multiply it by the following

figures to determine the heart rate ranges for each zone.

• Zone One: Maximum Heart Rate x 0.65







• Step Test– Perform a 3-minute step test by having a client do 24 steps

per minute on an 12-inch step, for 3 minutes (96 steps total). • Then, measure client’s pulse for 60 seconds and record the

number as the recovery pulse.

• Locate score in the chart provided in your text.


• Step Test– Determine the appropriate starting program:

• Poor: Zone One

• Fair: Zone One

• Average: Zone Two

• Good: Zone Two

• Very good: Zone Three


• Rockport Walk Test – Determine the client’s maximum heart rate by subtracting the

client’s age from the number 220 (220 – age).– Then, take the maximum heart rate and multiply it by the

following figures to determine the heart rate ranges for each zone.

• Zone One: Maximum Heart Rate x 0.65







• Rockport Walk Test– Record the client’s weight and perform assessment.

• Have the client walk 1 mile, as fast as he or she can on a treadmill.

• Record the time it takes the client to complete the walk.

• Immediately record the client’s heart rate (beats per minute) at the 1-mile mark.

• Use the formula listed in the textbook to calculate ⩒O2 score.


• Rockport Walk Test– Determine the appropriate starting program:

• Poor: Zone One

• Fair: Zone One

• Average: Zone Two

• Good: Zone Two

• Very good: Zone Three

Posture and Movement

• Every movement needs a base from which to generate (and accept) force. – Better known as posture

• Posture is the alignment and function of all components of the HMS at any given moment.

• Allows for proper neuromuscular function and optimal movement

Posture

• Proper posture ensures that the muscles of the body are optimally aligned at the proper length–tension relationships necessary for efficient functioning of force–couples and joint motion (neuromuscular efficiency).

• Neuromuscular efficiency is the ability of the nervous system to properly recruit all muscles in all planes of motion.

Posture

• Without proper postural alignment, we set the body up for a series a traumas known as postural distortion patterns. – Predictable patterns of muscle

imbalance

Muscle Imbalance

• Condition in which the lengths of muscles are altered at a joint.

• Poor posture, repetitive movement, and a lack of daily movement are considered contributing factors.

Postural Distortions

• Predictable Patterns of Muscle Imbalance– Pronation Distortion Syndrome– Lower Crossed Syndrome– Upper Crossed Syndrome

Pronation Distortion Syndrome

• Characterized by– Feet

• Flattened or externally rotated

– Knees• Adducted and internally rotated

– Tight• Gastrocnemius, soleus,

peroneals, adductors, iliotibial band (IT band), hip flexors, and biceps femoris (short head)

– Weak• Anterior and posterior tibialis,

vastus medialis (VMO), gluteus maximus and medius, and hip external rotators

Lower Crossed Syndrome

• Characterized by– Anterior pelvic tilt– Tight

• Gastroncnemius, soleus, hip flexors, adductors, latissimus dorsi, and erector spinae

– Weak• Gluteus maximus and medius,

anterior tibialis, posterior tibialis, transversus abdominis, and internal obliques

Upper Crossed Syndrome

• Characterized by– Shoulders

• Protracted (rounded)

– Head• Forward

– Tight• Latissimus dorsi, pectoralis major

and minor, upper trapezius, scalenes, teres major, subscapularis, levator scapulae, and sternocleidomastoid

– Weak• Serratus anterior, rhomboids,

rhomboids, mid/lower trapezius and deep cervical flexors, infraspinatus

Movement Observations

• Dynamic postural observations (looking at movement) are often the quickest way to gain an overall impression of a client’s functional status.

• Should relate to basic functions such as squatting, pushing, pulling, and balancing

• Can also be incorporated as a first workout for your client


• Overhead Squat Assessment– Designed to assess dynamic

flexibility on both sides of the body as well as integrated total body strength.

• Position– Client stands with feet shoulder-

width apart and pointed straight ahead. The foot and ankle complex should be in a neutral position.

– Have client raise his or her arms overhead, with elbow fully extended. The upper arm should bisect the ears.


• Overhead Squat Assessment– Movement

• Instruct client to assume a comfortable, controllable squat position.

• Have the client repeat the movement.


• Overhead Squat Assessment – Views

• Anterior– Foot

Turns out– Knee

Moves inward or outward vs.


• Overhead Squat Assessment – Views

• Lateral– Lumbo-pelvic-hip complex

Excessive forward lean Low back arches

– Shoulder complex Arms fall forward

vs.


• Single-Leg Squat Assessment – Designed to assess ankle

proprioception, core strength, and hip joint stability

• Position– Client should stand, place

hands on the waist, and focus on an object straight ahead.

– The feet should be pointed straight ahead, and the foot, ankle, knee, and lumbo-pelvic-hip complex should be in a neutral position.


• Single-Leg Squat Assessment– Movement

• Instruct client to raise one leg and accept weight with opposite side (stance leg). The foot of the lifted leg should be positioned next to the stance leg.

• Once the single-leg stance is achieved, progress to a single-leg squat movement

• Have the client repeat the movement.

• Perform up to five repetitions before switching sides.


• Single-Leg Squat Assessment– Views

• Anterior– Knee

Moves inward


• Pushing Assessment– Position

• Instruct client to draw abdomen in, feet shoulder width, and toes pointing forward.

– Movement• Instruct client to press

handles forward and return slowly.

• Perform up to 20 repetitions


• Pushing Assessment– Lumbo-pelvic-hip complex

• Lumbar spine arches

– Shoulder complex• Shoulders elevate

– Head• Head protrudes forward

while pushing


• Pulling Assessment– Position

• Instruct client to draw abdomen in, feet shoulder width, and toes pointing forward.

– Movement• Instruct client to pull handles

toward body and return slowly.

• Perform up to 20 repetitions


• Pulling Assessment– Lumbo-pelvic-hip complex

• Lumbar spine arches

– Shoulder complex• Shoulder elevates

– Head• Head protrudes forward

while pulling

Performance

• Performance assessments can be used for clients trying to improve athletic performance.

• Basic performance assessments include:– Davies Test– Shark Skill Test – Bench Press Strength Assessment– Leg Press Strength Assessment

Performance Assessments

• Davies Test– Designed to assess upper extremity agility and stabilization – May not be suitable for individuals who lack shoulder stability


• Davies Test– Position

• Begin by placing two pieces of tape on the floor, 36 inches apart.

• Position client in a push-up position, with one hand on each piece of tape.

– Movement• Instruct client to quickly move his or her right hand to touch the

left hand.

• Perform alternating touching on each side, for 15 seconds.

• Repeat for three trials.


• Shark Skill Test – Designed to assess lower extremity agility and neuromuscular

control – Should be viewed as a progression from the single-leg squat – May not be suitable for all individuals


• Shark Skill Test– Position

• Position client in the center box of a box grid, with hands on hips and standing on one leg.

– Movement• Instruct client to hop to each box in a designated pattern, always

returning to the center box. Be consistent with the pattern that you expect of the client.

• Perform one practice run through the boxes with each foot.• Perform twice with each foot (four times total). Keep track of time. • Penalize 0.10 seconds for each of the following faults:

– Nonhopping leg touches ground– Hands come off hips– Foot goes into wrong square– Foot does not return to center square


• Bench Press Strength Assessment– Designed to estimate the one-rep maximum, for training intensity

purposes – Advanced assessment (for strength-specific goals)– May not be suitable for many clients


• Bench Press Strength Assessment– Position

• Position client on a bench, lying on his or her back. Feet should be pointed straight ahead. The low back should be in a neutral position.

– Movement• Instruct client to warm with a light weight for 8–10 repetitions

then rest 1 minute.

• Add 30 to 40 pounds (10–20% of initial load) and perform 3 to 5 repetitions then rest 2 minutes.

• Repeat this step until a true one-rep maximum has been achieved.


• Squat Assessment – Designed to estimate the one-rep leg press maximum, for

training intensity purposes – Advanced assessment (for strength-specific goals)– May not be suitable for many clients


• Squat Strength Assessment– Position

• Position standing with bar on his or her back. Feet should be pointed straight ahead and knees in line with the toes. The low back should be in a neutral position.

– Movement• Instruct client to perform 3–5 repetitions with perfect form.

• Chart amount of weight used for accomplished repetitions.

• Refer to the appendix of the textbook for comparison charts to estimate the one-rep maximum.

Summary

• The fitness assessment enables the fitness professional to decide the appropriate selection of flexibility, cardiorespiratory, core, balance, power, and strength training exercises.

chapter 6 fitness assessment. purpose to provide the fitness professional with valuable techniques...

Documents

clients history

complete fitness assessment

integrated fitness assessment

fitness assessmentpurposeto

fitness professional

qualified medical practitioner

medical exercise prescription

clients overall risk