chapter 6 fitness assessment. objectives after this presentation, the participant will be able to:...
TRANSCRIPT
Chapter 6Fitness Assessment
Objectives
• After this presentation, the participant will be able to:
• Understand the relationship between sales and the fitness assessment and its importance to building the value of the personal trainer.
• Understand how to administer a health history questionnaire and then from that 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, obtain subjective and objective information about clients, and how to use the information collected to help design an exercise program.
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
– Integrate sales techniques and utilize a chance to build value into your services.
Fitness Assessment Components
• Use a variety of observation methods to obtain a balanced overview of a client– Subjective Information
• General and medical history (ex. Past injuries and surgeries)
– Objective Information• Physiologic assessment HR BP*• 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
Physiologic Assessments
• Measuring Heart Rate– Radial Pulse
• Gently 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 after waking and average for 3 days
Physiologic Assessments• 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 two
• Record the 60-second pulse rate and average for 3 days
– Average resting heart rates• Males: 70 beats/min• Females: 75 beats/min
Physiologic Assessments
• Training Heart Rate– Calculate the client’s training heart rate zone for
cardiorespiratory exercise– Find estimated maximal heart rate (220 – age).* This is call
the Straight Percentage Method.*– 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
Maximum Heart Rate x 0.85• Zone Three: Maximum Heart Rate x 0.86
Maximum Heart Rate x 0.95
Physiologic Assessments
• Blood Pressure– Systolic and diastolic readings
• Systolic (top number)– The pressure produced by the heart as it contracts to
pump blood to the body – Normal systolic pressure is <120 mm Hg.
• Diastolic (bottom number)– The minimum pressure within the arteries or when the
heart is resting*– Normal diastolic pressure is <80 mm Hg.
Physiologic Assessments• 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 according to 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:
• To identify client’s health risk for excessively high or low levels of body fat– To promote client’s understanding of body fat– To monitor changes in body composition– To help estimate healthy body weight for
clients and athletes– To assist 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. This type of body composition method would be best for clients who are obese.*
– 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
• 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– Before the 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 Maximum Heart Rate x 0.79
• Zone Two: Maximum Heart Rate x 0.80 Maximum Heart Rate x 0.85
• Zone Three: Maximum Heart Rate x 0.86 Maximum Heart Rate x 0.95
Cardiorespiratory Assessments
• 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
Cardiorespiratory Assessments
• Step Test– Determine the appropriate starting program:
• Poor: Zone One• Fair: Zone One• Average: Zone Two• Good: Zone Two• Very Good: Zone Three
Cardiorespiratory Assessments
• 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 Maximum Heart Rate x 0.75
• Zone Two: Maximum Heart Rate x 0.76 Maximum Heart Rate x 0.85
• Zone Three: Maximum Heart Rate x 0.86 Maximum Heart Rate x 0.95
Cardiorespiratory Assessments
• Rockport Walk Test– Record the client’s weight and perform
assessment.• Have the client walk 1 mile, as fast as he or she
can control 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.V.
Cardiorespiratory Assessments
• 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.
MUSCLE IMBALANCE
Postural Distortions
• Predictable Patterns of Muscle Imbalance– Lower Crossed Syndrome– Upper Crossed Syndrome– Pronation Distortion Syndrome
Pronation Distortion Syndrome• Characterized by
– Feet• Flattened or externally
rotated– Knees
• Adducted and internally rotated
– Tight• Lateral 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.
Movement Observations• Overhead Squat
Assessment– Designed to assess
dynamic flexibility on both sides of the body as well as integrated total body strength. This assessment is possible for most clients to do even pregnant females.*
• 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.
Movement Observations
• Overhead Squat Assessment– Movement
• Instruct client to assume a comfortable, controllable squat position.
• Have the client repeat the movement.
Movement Observations
• Overhead Squat Assessment – Views
• Anterior– Foot
» Turns out– Knee *
» Moves inward or outward
Whats weak? VMO*vs.
Movement Observations
• Overhead Squat Assessment – Views
• Lateral– Lumbo-Pelvic-Hip
Complex» Excessive forward
lean
Whats weak? AT *» Low back arches
– Shoulder Complex» Arms fall forward
What is tight? *
vs.
Movement Observations• 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.
Movement Observations• 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.
Movement Observations
• Single-Leg Squat Assessment– Views
• Knee– Moves inward
Movement Observations• Pushing Assessment
– Position• Instruct client to drawn
abdomen in, feet shoulder width, and toes pointing forward.
– Movement• Instruct client to press
handles forward and return slowly.
• Perform up to 20 repetitions
Movement Observations
• Pushing Assessment– Lumbo-Pelvic-Hip
Complex• Lumbar spine
arches
– Shoulder Complex• Shoulders elevate
– Head• Head protrudes
forward while pushing
Movement Observations• 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
Movement Observations• Pulling Assessment
– Lumbo-Pelvic-Hip Complex• Lumbar spine arches
– Shoulder Complex• Shoulder elevates
– Head• Head protrudes forward
while pullingWhats weak? DCF*
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
Performance Assessments• 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.
Performance Assessments• 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
Performance Assessments
• 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
Performance Assessments
• 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
Performance Assessments
• 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 10 to 20 pounds (10–20% of initial load) and perform 3
to 5 repetitions then rest 2 minutes• Repeat this step into a true 1 rep maximum has been
achieved
Performance Assessments
• 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
Performance Assessments
• 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.