personal wellness profile™ - wellsource · height 1. use a scale with a height measuring system....
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Personal Wellness Profile™Health Testing Guidelines
Fitness testing and scoring prepared by Don Hall, DrPH, CHES for Wellsource Inc. © 2009 Wellsource, Inc. Updated 1-15-2009
GuidelinesThis manual is designed to help when filling out and completing the health tests used in the Personal Well-ness Profile™ Advantage Program. Fitness testing is based on the American College of Sport’s Medicine’s Guidelines for Exercise Testing and Prescription. It is recommented that you refer to the ACSM’s manual for a full and complete understanding of fitness assessment and exercise counseling. Other tests and scor-ing are based on research from NIH, NHLBI, NCEP III, American Cancer Society, and the American Diabetes Association.
Body CompositionHeight and WeightWaist Girth MeasurementBody Mass Index (BMI)Percent Body Fat
StrengthGrip StrengthUpper Body Fitness (Push-Ups)Abdominal Fitness (Curl-Ups)
FlexibilitySit-and-Reach Test
Cardiovascular ScreenBlood Pressure
Blood TestsPSAHbA1cCholesterol – Total, HDL, LDLTriglyceridesGlucose
Cardiovascular FitnessOne-Mile Walk Test
AppendixAerobic Capacity Field Test WorksheetsPAR-Q Screening FormSample Informed ConsentFitness Index FormSample Instructions Individual/Administrator
CONTENTS
Note: All questions on the Health Tests section of the Personal Wellness Profile™ questionnaire are optional. All reports (individual and group) can be generated if clinical testing is not included.
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Height1. Use a scale with a height measuring system. If not available, fasten a measuring tape to a flat wall. Tape paper alongside the measuring tape to allow for marking heights with a pencil.
2. Measure height with shoes off. Have the person stand with feet together, arms at side, and heels and back against the wall.
3. Instruct participants to look straight ahead and stand as tall as possible. Make sure heels stay on the floor.
4. Use a rectangular block of wood or a right triangle that can slide down the wall to determine the top of the head. Mark the person’s height on the paper next to the tape measure, putting their initial after it to keep their height separate from other marks. Record the person’s height to the nearest inch.
Body weight, or excess fat weight, is of major inter-est to most people; especially those in a fitness program. As people become more fit it is encouraging to show how their body composition improves. Taking body compo-sition measurements is essential for demonstrating these changes. Several techniques are available:
• Body mass index (BMI) based on height and weight• Waist measurement• Percent body fat
A person’s height and weight are measured using standard procedures to assure accuracy for pre-post comparisons. There is often quite a difference in reported weight and measured weight. People usually over estimate how tall they are and underestimate their weight. For most ac-curate results, it is best to actually measure height and weight rather than taking reported values.
WeightFor accurate weights, use a balance scale if possible. Home scales may be off several pounds. An accurate weight is essential for monitoring change and giving feedback.
1. Be sure the scales are set on a hard flat surface. If on a carpet, put a board under the scales. Arrange the scales so you can adjust the weights from the backside of the scale rather than reaching around the participant.
2. The participant should be weighed without shoes and preferably in exercise shorts. People dressed in regular clothing when being weighed should be sure that they are dressed similarly the next time they are weighed.
3. Record weight to the nearest pound.
Taking MeasurementsRequired Equipment • Accurate balance scales and height measuring system • Tape measure for measuring waist girth • BMI table or calculator • Skinfold calipers (for % fat) or bioelectric impedance analysis equipment.
Body Composition
Entering Waist Circumference• Write the waist measurement value in inches in the space provided and fill in the corresponding bubbles. • Left justify. • When value is a whole number, bubble a zero to the right of the decimal.
A measurement of the waist provides a quick look at how fat is deposited on the body. A high amount of abdominal fat significantly increases the risk for high blood pressure, diabetes, cardiovascular disease, and certain cancers.
1. The waist is defined as the smallest circumference below the ribs and at or above the navel. If there is a question about location, simply measure the waist in the horizontal plane at the level of the navel.
2. Instruct the participant to stand relaxed. Take the measurement at the end of a normal expiration. Pull the tape snug, but avoid pulling the tape tight so it begins to sink into the skin.
Waist Circumference
Waist GirthTest Procedure
Equipment:measuring tape
known % fat
waist circumference
(inches)
9 3 2. 0
Body Composition
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Waist Girth U.S. Standards
Adult FemaleAdult Male
Maximum MaximumMinimumMinimumRisk Category
Desirable
Overweight
High Risk
Lean
28 36.9 25 32.9
37 39.9 33 34.9
40 >40 35 >35
<27.9 27.9 <24.9 24.9
Norms indicating obesity and high risk are:Men more than 40 in. and Women more than 35 in.
BMI is a measure of weight for height which correlates closely with longevity and risk for excess weight related problems: heart disease, certain cancers, diabetes, arthritis, high blood pressure, and high blood lipids. BMI is defined as: (Weight kg) / (Height m)2
Body Mass Index
Note: BMI is automatically calculated in the program using height and weight values. BMI is not entered on the questionnaire.
Body Mass Index ChartInstructions: Find your height in the left column. Run your finger along the row to find your weight or closest weight. Then run your finger up the column to the top of the page to find your BMI.
The recommended upper limit of healthy weight is a BMI under 25. Look at the chart above for your height and a BMI of 25. You should weigh no more than this amount for good health.
• Women have best life expectancy at a BMI of about 22-23.• Men have best longevity at a BMI of about 24-25. • Weight lifters have a higher muscle mass and thus have a higher BMI without negative health consequences. They should use a percent fat test to determine ideal weight.
Source: NIH, NHLBI, Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults
Body Mass Index Chart
Overweight (lb)Healthy Weight Range (lb)Ht (in) Obese (lb)
BMI
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
91 96 100 105 110 115 119 124 129 134 138 143 148 153 158 162 167
94 99 104 109 114 119 124 128 133 138 143 148 153 158 163 168 173
97 102 107 112 118 123 128 133 138 143 148 153 158 163 168 174 179
100 106 111 116 122 127 132 137 143 148 153 158 164 169 174 180 185
104 109 115 120 126 131 136 142 147 153 158 164 169 175 180 186 191
107 113 118 124 130 135 141 146 152 158 163 169 175 180 186 191 197
110 116 122 128 134 140 145 151 157 163 169 174 180 186 192 197 204
114 120 126 132 138 144 150 156 162 168 174 180 186 192 198 204 210
118 124 130 136 142 148 155 161 167 173 179 186 192 198 204 210 216
121 127 134 140 146 153 159 166 172 178 185 191 198 204 211 217 223
125 131 138 144 151 158 164 171 177 184 190 197 203 210 216 223 230
128 135 142 149 155 162 169 176 182 189 196 203 209 216 223 230 236
132 139 146 153 160 167 174 181 188 195 202 209 216 222 229 236 243
136 143 150 157 165 172 179 186 193 200 208 215 222 229 236 243 250
140 147 154 162 169 177 184 191 199 206 213 221 228 235 242 250 258
144 151 159 166 174 182 189 197 204 212 219 227 235 242 250 257 265
148 155 163 171 179 186 194 202 210 218 225 233 241 249 256 264 272
152 160 168 176 184 192 200 208 216 224 232 240 248 256 264 272 279
156 164 172 180 189 197 205 213 221 230 238 246 254 263 271 279 287
19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
UnderweightHealthy weightOverweightObeseObese, high risk
Less than 18.518.5 to 24.925.0 to 29.930.0 or more35.0 or higher
Body Mass Index (BMI) Standards
Body fat percentage is an estimate of the fraction of the total body mass that is adipose tissue (or referred to as Fat Mass), as opposed to lean body mass (muscle, bone, organ tissue, blood, and everything else) or referred to as Fat Free Mass. This index is often used as a means to monitor progress during a diet or as a measure of physical fitness for certain sports, such as body building. It is more accurate as a measure of excess body weight than body mass index (BMI) since it differentiates between the weight of muscle mass and that of the fat mass while BMI lumps all masses into one figure. However, its popularity is less than BMI because equipment required to perform the body fat percentage is not readily available and skills are required to perform the measurement. Even when measured by a skillful person, there are factors that contribute to a significant margin of error.
Wikipedia - The Free Encyclopedia
Percent Body Fat
Note: Personal Wellness Profile™ - Advantage uses the Institute of Medicine’s Standards for scoring percent body fat. If ACSM Standards are preferred they can be selected as an alternative in the program.
To change to ACSM percent fat scoring within the Advantage program:• Click on Utilities tab – Program Settings – Scoring• Under the scoring tab check box “Use ACSM Standard for Percent Fat, otherwise use basic standard”
Percent Fat Norms Table
Adult FemaleAdult Male
Maximum MaximumMinimumMinimumRisk Category
Healthy Range
Overweight
Obese
Lean
10 20.9 20 30.9
21 24.9 31 36.9
25 >25 37 >37
.1 9.9 .1 19.9
Percent Body FatEntering Percent Fat• Round percent fat value to the nearest whole number. • Write the value in the space provided and fill in the corresponding number bubble in the same column. • Right justify. • A leading zero is NOT required when values are less than ten.
known % fat
waist circumference
(inches)
9 3 2. 0
Body Composition
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Percent Body Fat - Men
30 - 39 40 - 49 50 - 59 60+20 - 29
13.9 or less 17.9 or less 18.4 or less16.3 or less9.4 or lessIdeal
Doing Well
Needs Improving
Caution
9.5 - 14.1 16.4 - 19.6 18 - 21.3 18.5 - 22
14.2 - 25.8 19.7 - 28.8 21.4 - 30.2 22.1 - 31.1
25.9+
14 - 17.5
17.6 - 27.2
27.3+ 28.9+ 30.3+ 31.2+
Rating/Age
Percent Body Fat - Women
30 - 39 40 - 49 50 - 59 60+20 - 29
18.0 or less 25 or less 25.1 or less21.3 or less17.1 or lessIdeal
Doing Well
Needs Improving
Caution
17.2 - 20.6 21.4 - 24.9 25.1 - 28.5 25.2 - 29.3
20.7 - 32.0 25.0 - 34.9 28.6 - 37.8 29.4 - 39.2
32.1+
18.1 - 21.6
21.7 - 32.7
32.8+ 35+ 37.9+ 39.3+
Rating/Age
ASCM Percent Body Fat Norms
Percent Body FatWorksheetPercent body fat is a good way to track changes in body composition due to physical activity and/or dieting. Percent fat can be easily measured using a bioelectric impedance assessment (BIA). Another method requiring more training and practice for accuracy is taking skinfold measurements. Results are usually accurate to within plus or minus 2-3% body fat if you carefully follow the testing guidelines below.
1. The following instructions are for using a BIA instrument. See instructions in the Fitness Test Manual for using skinfold measurements.
2. For most accurate results using BIA testing:• Take the test at least 1-2 hours after eating• Don’t test soon after: exercise, getting out of a hot tub or shower, drinking alcohol, or drinking a large amount of water.• If hands are cold, warm them first before testing (warm room or warm water).• If hands are very dry, slightly moisten hands with a damp towel.• When doing repeat testing, take measurements at a similar time of the day.• Follow good technique as described in the manual that came with the equipment (arms fully extended and level in front of you, grip easily with fingers around grips, thumbs on top of instrument, stand quietly until measurement is completed.
3. Record test results
Test Procedure
Equipment: BIA testing instrument
Source: American College of Sports Medicine, Guidelines for Exercise Testing and Prescription, 2000. © 2007 Wellsource Inc.
Percent Body Fat Test Results
TestDate
YourRating
PercentFat
BMIWeight
(lbs)
General StrengthGrip strength correlates fairly closely with overall upper body strength and is easily administered. Grip is measured using a hand grip dynamom-eter. The subject does a maximal grip using one hand and then the other. The best scores from each hand are combined for the overall grip score.
1. Test subject should be screened for arm or shoulder pain. Persons suffering arm/shoulder pain or who have high, uncontrolled blood pressure should not do this test.
2. Be sure participants are well instructed in the proper technique. Describe, and if needed, demonstrate the correct technique as follows:
• Adjust the hand grip dynamometer so the second joint of the fingers fit snugly on the handle when gripping.
• The participant should hold the dynamometer with arm extended down about thigh level.
• Instruct subject to make a maximal squeeze. Don’t let the dynamometer touch any part of the body or any other object. Also avoid sudden thrusts or jars which can make the reading inaccurate.
• When squeezing, instruct subject to breath out or exhale during contraction, to prevent high intrathoracic pressure.
• Measure both hands alternately giving two tries per hand. Combine the best score of each hand to give a total grip strength reading. Record test results accurately in the units specified on the data sheet, generally kilograms.
Grip Strength (kg, both hands combined)
124 65 71113
123 736611330 - 39
40 - 49
50 - 59
60+
110 65 72
102 59 65
93
119
110
102 54 60
20 - 29
Ages Good Excellent Good Excellent
Men Women
Grip StrengthTest Procedure
Equipment: handgrip dynamometer
Grip Strength Norms (kg, scores from both hands combined)
Grip Strength WorksheetGrip strength, measured with a handgrip dynamometer, correlates with overall upper body strength and is an easy, safe test to perform. A good grip is linked to higher lean body mass, lower risk of disability in old age, and increased longevity. Compare your test results with the norms shown below.
1. Don’t do this test if you have arm or shoulder pain, or high, uncontrolled blood pressure.
2. Use the proper technique as described below for accurate and consistent results. If needed, ask for a demonstration.
3. Adjust the handgrip dynamometer so the second joint of the fingers fit snugly on the handle when gripping. Hold the dynamometer with arm extended down about thigh level.
4. Make a maximal squeeze. Don’t let the dynamometer touch any part of the body or any other object. Also avoid sudden thrusts or jars, which can make the reading inaccurate.
5. When squeezing, breathe out or exhale during contraction to prevent high intrathoracic pressure. Don’t hold your breath and strain.
6. Measure both hands. Take two tries per hand. Combine the best score of each hand to give a total grip strength reading. Record test results in kilograms.
Source: Canadian Society for Exercise Physiology, The Canadian Physical Activity, Fitness, and Lifestyle Appraisal, 2nd Edition, reprinted 2001 © 2004 Wellsource Inc. Do not make unauthorized copies.
Grip StrengthTest Procedure
Equipment: handgrip dynamometer
Grip Strength Norms1 (kg, scores from both hands added together)
Grip Test Results
TestDate
YourRating
LeftHand
RightHand
Total(kg)
Upper Body FitnessThis is an easily administered test for upper body strength/endurance. The subject attempts as many consecutive pushups as they can without stopping to rest. Men do pushups from the toe, women from the knee.
1. Test subject should be screened for shoulder or lower back impairment or pain. Persons suffering back pain or high, uncontrolled blood pressure, should not do this test.
2. Be sure participants are well instructed in the proper technique. Describe and, if needed, demonstrate the correct technique. They may want to practice once or twice before beginning the test. Instruct the subject to:
• Lie on stomach on a mat, legs together
• Hands should be pointing forward, positioned under shoulders
• Do pushup, keeping back straight, pivoting from toes for men, from knees for women.
• Return to starting position, but only let chin touch the mat (chest and legs should not touch the mat)
• Do as many pushups using this technique as possible, without undue strain, and without stopping to rest.
• There is no time limit. Stop the test when the person is either unable to maintain the proper technique over two consecutive push-ups, or shows signs of excessive straining.
3. Caution participants not to overstrain or hold their breath, but rather to breathe rhythmically, exhaling on the upward phase, and inhaling on the downward phase.
Push Ups (# continuous)
36 20 3028
30 27192130 - 39
40 - 49
50 - 59
60+
16 14 24
12 10 21
10
25
21
18 11 17
20 - 29
Ages Good Excellent Good Excellent
Men WomenPush-up Norms1 (number of push-ups completed)
Push-upsTest Procedure
Equipment: exercise matstop watch
Abdominal FitnessThe partial curl-up is a safe assessment of abdominal fitness.
1. Test subject should be screened for lower back impairment or pain. Persons suffering back pain or high, uncontrolled blood pressure should not do this test.
2. Instruct test subject to lie on their back on a mat with knees bent at 90 degrees. The arms are at the side with fingertips just touching a piece of masking tape or other physical marker. A second piece of masking tape (or other marker such as Velcro tape or a wood block) is placed 8 cm beyond the first marker for persons 45 or older, or 12 cm for those less than 45 years old.
3. The individual flattens their lower back and curls up lifting the head and shoulder blades off the mat (trunk should make a 30 degree angle with the mat). The fingertips slide along the mat out to the outer marker. The curl up should be slow and controlled, taking about 2-3 seconds per curl-up. If you have a metronome, set it for a pace of 40 beats/min and have the individual complete one full curl-up per two beats (rate of 20/ min). The fingertips of both hands should reach the outer marker. Do as many as possible without resting. Stop if you reach 75.
An alternative – with hands on thighs, curl-up until the fingertips slide all the way over the kneecaps and the back makes a 30-degree angle with the mat. Come back down until shoulders are fully on the floor. Do as many as you can do continuously in two minutes. This is a preferred method with most fit people.
4. Caution subjects not to over strain and to breathe normally, exhaling while curing up, and inhaling while relaxing back down.
Curl-upsTest Procedure
Equipment: gym mat masking tape (or Velcro tape)metronome or watch
Curl-Ups (# continuous)
56 32 4531
69 43283630 - 39
40 - 49
50 - 59
60+
51 28 42
35 16 30
19
75
69
33 19 30
20 - 29
Ages Good Excellent Good Excellent
Men Women
Partial Curl-up Norms2 (number of partial curl-ups completed in one minute)
30°
Flexibility
Sit-and-Reach TestTest Procedure
Equipment: flex bench or a meter stick (The meter stick should be attached or taped to the top of a bench or box with the toe line at the 26 cm mark.)
Flexibility is the ability to move a joint through its full range of motion. This is important to athletic performance, especially gymnastics, dance, and many sports. It is also important for carrying out activities of daily living. A muscle and joint is less likely to be injured if it has good flexibility.
One good measure of flexibility is the sit-and-reach test. It measures overall flexibility including the legs, back, arms and shoulders.
1. Test subject should be screened for lower back impairment or pain. Persons suffering back pain should not do this test. Have the test subject warm up by doing slow stretching while seated, reaching towards one foot for 15-20 seconds and then towards the other foot. Repeat twice on each leg. Caution the person to move slowly and hold each stretch. Avoid bouncing or dynamic stretches.
2. Be sure the subject has shoes removed. Have them sit on the floor or mat with legs extended out in front, and feet against the flex bench (or a box with a meter stick taped to the top). The feet should be at the 26 cm line on the meter stick with the zero end pointing toward the subject.
3. With hands together, have the subject slowly bend forward reaching as far as possible without discomfort, fingers on the ruler, and hold for 2 seconds. Be sure fingertips are together and one hand is not ahead of the other. Make sure the knees don’t flex, the subject stretches slowly, and doesn’t bounce. Record the better of two tries to the nearest centimeter.
Flexibility Sit-and-Reach (cm)
40 36 4133
38 41353230 - 39
40 - 49
50 - 59
60+
28 33 38
27 32 39
24
35
35
33 30 35
20 - 29
Ages Good Excellent Good Excellent
Men Women
Sit-and-Reach Norms (cm, distance reached with toe line at 26cm)
Blood Pressure
A resting blood pressure test is an important screen-ing test for cardiovascular health. Regular exercise is one good way to help keep blood pressure normal and avoid damage to the heart, brain, kidneys, eyes, and other organs damaged by high blood pressure.
1. The person being tested should avoid vigorous exercise and be free from smoking or drinking coffee in the 30-60 minutes before testing. Have the test subject sit quietly for 5 minutes. 2. Select the appropriate cuff size. The bladder in the cuff should encircle at least two-thirds of the upper arm. Persons with large arms should use the large cuff size for accurate tests. Children with small arms should have a child’s cuff. If using the wrist cuff, one size fits all. Be sure wrist is held at level of heart when testing.
3. Wrap the cuff firmly around the upper arm at the level of the person’s heart. Align the cuff so the arrow on the cuff lines up with the brachial artery (you can feel for the artery to locate its position). Place the bell of the stethoscope over the brachial artery in the antecubital space. Quickly inflate cuff pressure to at least 20 mm Hg above the estimated systolic blood pressure.
4. Slowly release pressure at a rate equal to 2-3 mm Hg per second. Listen carefully for the first Korotkoff sound. When you first hear a beat, note the Systolic blood pressure. Continue letting out the air until the sound disappears (or sounds significantly muffled). This is the diastolic blood pressure. Record blood pressure reading. On automatic cuffs this is all done automatically.
5. If the blood pressure reading is 140/90 or higher, have the person rest a few more minutes and check it again. If lower, record the lower reading.
Entering Blood Pressure• Write the value in the space provided and fill in the corresponding number bubble in each column. • Right justify. • Leading zeros are not required.
Source: NIH, HeartMemo, NIH, National High Blood Pressure Education Program, Update on High blood Pressure in Chil-dren
Resting Blood Pressure (mm/Hg)
Adults Children/Adolescents
112/70 or less115/75 or lessIdeal (excellent)
Desirable (good, or low risk)
Needs Improving
High Risk
116/76 - 119/79 113/71 - 119/79
120/80 - 139/89 120/80 - 131/85
140/90+ 132/86+
Blood Pressure and Pulse
Blood Pressure
systolic diastolicresting pulse
1 4 2 7 7 54
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PSA (Prostate-Specific Antigen) test results report the level of PSA detected in the blood. The test results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood. In the past, most doctors considered PSA values below 4.0 ng/mL as normal. However, recent research found prostate cancer in men with PSA levels below 4.0 ng/mL.
When prostate cancer develops, the PSA level usually goes above 4. But it is important to remember that about 15% of men with a PSA below 4 will have prostate cancer on biopsy. If your level is in the borderline range between 4 and 10, you have about a 25% chance of having prostate cancer. If it is more than 10, your chance of having pros-tate cancer is over 50% and increases more as your PSA level increases.”
PSA
Entering PSA• Write the value in the space provided and fill in the corresponding number bubble in each column. • Use decimal. When value is a whole number bubble the zero to the right of the decimal. A bubbled value is required to the right of all decimals.• Leading zeros are NOT required.
PSA
0 - 2.49 ng/mL
2.5 - 3.99 ng/mLBorderline Low
Desirable
Borderline High
Higher Risk
4 - 10 ng/mL
10.001 ng/mL or more
Blood Pressure and Pulse
Blood Pressure
systolic diastolicresting pulse
1 4 2 7 7 54
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Blood Tests
A1C PSA
4. 2. 09
Source: 2007 American Cancer Society www.cancer.org
A1C
A1C is a test that measures the amount of glycosylated hemoglobin in your blood. Glycosylated hemo-globin is a molecule in red blood cells that attaches to glucose (blood sugar). You have more glycosylated hemoglobin if you have more glu-cose in your blood. The test gives a good estimate of how well diabetes is being managed over the last 2 or 3 months.
Alternative Names: Glycosylated hemoglobin; Hemoglobin - glycosylated; A1C; GHb; Glycohemoglobin; Diabetic control index
Entering A1C• Write the value in the space provided and fill in the corresponding number bubble in each column. • Use decimal, when value is a whole number bubble the zero bubble to the right of the decimal. A bubbled value is required to the right of all decimals.• Leading zeros are NOT required.
Source: 2007 US National Library of Medicine; National Institute of Health www.nlm.nih.gov
Blood Pressure and Pulse
Blood Pressure
systolic diastolicresting pulse
1 4 2 7 7 54
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Blood Tests
A1C PSA
4. 2. 09
A1C
Adult - DiabeticAdult
Maximum MaximumMinimumMinimumRisk Category
Desirable
At Risk
0.1 4.9 0.1 6.9
5 >5 7 >7
Blood Tests
Entering blood test values:• Right justify values as shown. Leading zeros do not need to be added.
Blood Test Norms
Note: Total cholesterol is scored if it is the only value entered. If LDL cholesterol is available, cholesterol score risk is based on LDL level. If Total cholesterol and HDL cholesterol values entered, the non-HDL cholesterol values for risk analysis is scored. NCEP III (If no clinical Cholesterol values, program scores Person History of High Cholesterol)
* Risk values for children and adolescents (<18 years) are set by the National Cholesterol Program (NCEP) and are recommended for children with a family history of high cholesterol (cholesterol of 240+), or history of early CHD (MI before 55 yrs or angioplasty etc.)
Cholesterol
Total HDL LDL Triglycerides Glucose
1 9 8 1 4 24 5
Blood Tests
5 5 9 8
Nonfasting
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Total Cholesterol (mg/dL)Persons with prior MI,
Stroke or DiabetesAdults (18+) Children/Adolescents*
150 or less<160<160Ideal (Excellent)
Desirable (Good, or Low Risk)
Needs Improving
High Risk
<200 <=160 <170
200+ >160 170+
240+ 200+ 200+
Blood Tests Continued
Blood Test Norms – LDL Cholesterol
Note: Cholesterol risk score is based on LDL levels when available.
Blood Test Norms – non-HDL CholesterolIf LDL is not available, then non-HDL cholesterol evaluates cholesterol risk.
Non-HDL = Total Cholesterol – HDL cholesterol Non-HDL cholesterol is a more accurate estimate of overall risk. The non-HDL cholesterol is all the “bad” or atherogenic portion, including LDL, IDL and VLDL cholesterol.
Blood Test Norms – HDL Cholesterol
LDL Cholesterol (mg/dL)Persons with prior MI,
Stroke or DiabetesAdults (18+) Children/Adolescents*
<100<100100 or lessIdeal (Excellent)
Desirable (Good, or Low Risk)
Needs Improving
High Risk
<130 100 or less <110
130+ 100+ 110+
160+ 130+ 130+
Non - HDL Cholesterol (mg/dL)Persons with prior MI,
Stroke or DiabetesAdults (18+)
<130130 or lessIdeal (Excellent)
Desirable (Good, or Low Risk)
Needs Improving
High Risk
<160 130 or less
160+ 130+
190+ 160+
HDL Cholesterol (mg/dL)
Adult Male Adult Female
60+60+Ideal (Excellent)
Desirable (Good, or Low Risk)
Needs Improving
High Risk
45+ 55+
<45 <55
<40 <40
Total Cholesterol – HDL cholesterol
= Non-HDL
Blood Tests Continued
Blood Test Norms – Triglycerides
Note: Accurate triglyceride levels require a 12-14 hour fast. Source: NIH, National Cholesterol Education Program III (for blood lipid values.)
Blood Test Norms – Glucose
Note: Standards based on fasting blood glucose levels. Non-fasting blood glucose of 200+ indicates diabetes or high risk. * Persons with existing diabetes are already at high risk.Source: American Diabetes Association definition of diabetes (fasting glucose of 126+ or non-fasting of 200+.)
Triglycerides (mg/dL)
100 or less
<150Desirable (Good, or Low Risk)
Ideal (Excellent)
Needs Improving
High Risk
150+
200+
Adults
Fasting Blood Glucose (mg/dL)
<90
<90 - 99.0Desirable (Good, or Low Risk)
Ideal (Excellent)
Needs Improving
High Risk *
100 - 125.9
126+
Adults
Cardiovascular Fitness
Aerobic CapacityAerobic capacity is the maximum ability of your heart, lungs, and arteries to deliver oxygen and other nutrients to the muscles for doing work. It is often called “peak aerobic capacity,” “maximum oxygen uptake,” and “VO2max.” It is measured in milliliter of oxygen delivered and utilized per kilogram of body weight per minute (ml•kg-1•min-1). The higher your aerobic capacity the more work or greater athletic performance you can do. A high aerobic capacity is also a strong predictor of good health and a long life.
Aerobic Capacity Norms1 (METs, one MET = 3.5ml • kg-1 • min-1)
METsPeak aerobic capacity is often expressed as METs (multiples of resting me-tabolism or metabolic equivalents). It is a measure of the rate of oxygen con-sumed based on exercise intensity. When sitting quietly, the body expends 1.0 MET of energy. A 4.0 Met activity, such as brisk walking, burns 4 times as many calories per minute as when sitting resting. Men in good health generally have a peak aerobic capacity of 10 METs or more, and women at least 9 METs. Highly fit persons may have peak aerobic capacities as high as 12-15 METs. Athletes can have peak aerobic capacities as high as 20 or more METs.
Aerobic Capacity Norms for Men
30 - 39
40 - 49
50 - 59
60 - 69
20 - 29
12.6 <11.311.314.5
13.5 <11.711.714.9
Excellent Good Needs Improving High Risk
Fitness Rating
14 10.3 <10.3
12.6 9.9 <9.9
11.7
12.6
11.3
10.3 9.0 <9.0
Ages
Aerobic Capacity Norms for Women
30 - 39
40 - 49
50 - 59
60 - 69
20 - 29
10.3 <9.09.011.7
11.3 <9.49.412.6
Excellent Good Needs Improving High Risk
Fitness Rating
11.3 8.5 <8.5
9.9 7.6 <7.6
9.4
9.9
9.0
8.1 6.7 <6.7
Ages
One-Mile Walk
The one-mile walk fitness test is a safe and effective means for estimating peak aerobic capacity.
This test requires:• A one-mile track or carefully measured course • An accurate heart rate in the last minute of the test or immediately upon completion of the walk• An accurate finish time measured to the nearest second
1. Only people in good health should complete this test and those who pass the Par-Q screening test with no problems. People with health problems should have permission and guidance from their doctor before completing this test.
2. Instruct test subjects to walk a one-mile course as quickly as possible without undo strain. No running is allowed. Walk at a brisk, steady pace that you can keep up to completion.
3. Time the test with a stopwatch to the nearest second.
4. Use a heart rate meter to check their heart rate in the last minute of the test or take an accurate heart rate immediately upon completion of the walk (take a 10 second count and multiply by 6 for beats per minute). A stethoscope on the chest over the apex of the heart is a good way to get an accurate pulse count. If pulse is taken at the end of the test, it must be started within 5 seconds of completion of the walk as the heart rate immediately begins to slow down.
5. Record the finish time and finish heart rate. Peak aerobic capacity is computed using a regression equation including weight, age, gender, walk time, and heart rate. Use the one-mile walk test calculator to compute peak aerobic capacity (included on the Fitness for Life CD and web site).
One-Mile WalkTest Procedure
Equipment: one-mile track or courseheart rate meterstop watch
Entering One Mile Walk• Enter Exercise Heart Rate in the space provided under Exercise HR. Fill in the corresponding bubbles completely.• Enter the time it took to complete the walk in minutes and seconds. Fill in the corresponding bubbles. • You do not need to fill in the METs value, the program will calculate METs if exercise heart rate and time are entered for the one mile walk.
Note: Enter METs if other exercise protocols are used. Calculate METs - VO2 max divided by 3.5.
TimeExerciseHR min : sec
METs =VO2 / 3.5
One-Mile Walk METs
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One-Mile Walk Worksheet
Name
10 seccount
Heartrate/min
Heart Rate Chart
29282726252423222120
174168162156150144138132126120
19181716
11410810296
Based on 85% of max heart rate
Heart Rate
Testing Dates /10 sec /min min : sec METs
1
2
3
4
5
6
7
One-Mile Walk Statistics
Time VO2 Peak
Instructions1. The one-mile walk is a safe test for healthy people to estimate peak aerobic capacity without a maximal effort.
This test requires:• A stop watch• A track or accurately measured one mile course• A heart rate meter or other means for taking an accurate heart rate at end of test
2. Complete Par-Q screening form.
3. Instruct the test subject to walk the one-mile course as quickly as possible without undue strain. No running is allowed. Walk at a brisk, steady pace.
4. Upon completing the one-mile walk immediately check the heart rate using a heart rate meter, a stethoscope, or by taking a pulse. If taking a pulse, start within 5 seconds of completing the walk. Take a 10 second pulse and multiply by 6.
5. Record final heart rate. Record the time to complete the walk to the nearest second. Compute peak aerobic capacity.
WeightDate
Age Gender (M/F)
One MET = 3.5ml of O2/kg body weight/min
Informed Consent for an Exercise Test1
(Sample from ACSM. To edit this document, open the Informed_Consent.doc file in the Resources section of your CD.)
1. Purpose and Explanation of the Test - You will perform an exercise test on a cycle ergometer or a motor-driven treadmill. The exercise intensity will begin at a low level and will be advanced in stages depending on your fitness level. We may stop the test at any time because of signs of fatigue or changes in your heart rate, electrocardiogram (ECG), or blood pressure, or symptoms you may experience. It is important for you to realize that you may stop when you wish because of feelings of fatigue or any other discomfort.
2. Attendant Risks and Discomforts - There exists the possibility of certain changes occurring during the test. These include abnormal blood pressure, fainting, irregular, fast or slow heart rhythm, and in rare instances, heart attack, stroke, or death. Every effort will be made to minimize these risks by evaluation of preliminary information relating to your health and fitness and by careful observations during testing. Emergency equipment and trained personnel are available to deal with unusual situations that may arise.
3. Responsibilities of the Participant - Information you possess about your health status or previous experiences of heart-related symptoms (such as shortness of breath with low-level activity, pain, pressure, tightness, heaviness in the chest, neck, jaw, back and/or arms) with physical effort may affect the safety of your exercise test. Your prompt reporting of these and any other unusual feelings with effort during the exercise test itself is of great importance. You are responsible for fully disclosing your medical history, as well as symptoms that may occur during the test. You are also expected to report all medications (including non-prescription) taken recently and, in particular, those taken today, to the testing staff.
4. Benefits to be Expected - The results obtained from the exercise test may assist in the diagnosis of your illness, in evaluating the effect of your medications or in evaluating what type of physical activities you might do with low risk.
5. Inquiries - Any questions about the procedures used in the exercise test or the results of your test are encouraged. If you have any concerns or questions, please ask us for further explanations.
6. Use of Medical Records - The information that is obtained during exercise testing will be treated as privileged and confidential. It is not to be released or revealed to any person except your referring physician without your written consent. The information obtained, however, may be used for statistical analysis or scientific purposes with your right to privacy retained.
7. Freedom of Consent - I hereby consent to voluntarily engage in an exercise test to determine my exercise capacity and state of cardiovascular health. My permission to perform this exercise test is given voluntarily. I understand that I am free to stop the test at any point, if I so desire. I have read this form, and I understand the test procedures that I will perform and the attendant risks and discomforts. Knowing these risks and discomforts, and having had an opportunity to ask questions that have been answered to my satisfaction, I consent to participate in this test.
Date Signature of Patient
Date Signature of Witness
No changes permitted. You are encouraged to photocopy the PAR-Q but only if you use the entire form.
1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
2. Do you feel pain in your chest when you do physical activity?
3. In the past month, have you had chest pain when you were not doing physical activity?
4. Do you lose your balance because of dizziness or do you ever lose consciousness?
5. Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart con-dition?
7. Do you know of any other reason why you should not do physical activity?
PLEASE NOTE: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional.
Ask whether you should change your physical activity plan.
Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active.
If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor.
Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check YES or NO.
Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.
• You may be able to do any activity you want — as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.
• Find out which community programs are safe and helpful for you.
PAR-Q & YOU
➔
Physical Activity ReadinessQuestionnaire - PAR-Q (revised 2002)
DELAY BECOMING MUCH MORE ACTIVE:• if you are not feeling well because of a temporary illness such as
a cold or a fever – wait until you feel better; or• if you are or may be pregnant – talk to your doctor before you
start becoming more active.
If
you
answered
If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can:• start becoming much more physically active – begin slowly and build up gradually. This is the
safest and easiest way to go.
• take part in a fitness appraisal – this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively. It is also highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.
NOTE: If the PAR-Q is being given to a person before he or she participates in a physical activity program or a fitness appraisal, this section may be used for legal or administrative purposes.
"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."
NAME ________________________________________________________________________
SIGNATURE _______________________________________________________________________________ DATE______________________________________________________
SIGNATURE OF PARENT _______________________________________________________________________ WITNESS ___________________________________________________or GUARDIAN (for participants under the age of majority)
Informed Use of the PAR-Q: The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.
continued on other side...
(A Questionnaire for People Aged 15 to 69)
YES NO
YES to one or more questions
NO to all questions
Note: This physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if your condition changes so that you would answer YES to any of the seven questions.
© Canadian Society for Exercise Physiology Supported by:HealthCanada
SantéCanada
Before you start an exercise program, complete this Physical Activity Readiness Questionnaire (PAR-Q).