Chapter 6: Fitness Assessment Flashcards
physical inactivity exposes adults to unnecessary risk for developing what?
a variety of chronic diseases, disabilities, and even musculoskeletal pain
as little as how many hours per week of moderate aerobic physical activity can lead to significant health benefits?
2.5
what is one of the most important goals of the 2008 physical activity guidelines for Americans?
to promote the fact that even in small doses, regular physical activity can help prevent, treat, and in some cases even cure more than 40 of the most common chronic health conditions encountered by primary care physicians, as well as reduce health-care costs and improve the quality and quantity of life for millions of Americans
what percentage of US adults engage in regular leisure-time physical activity?
31%
the specific tests used in an assessment depend on what?
- the health and fitness goals of the individual
- the trainer’s experience
- the type of workout routines being performed
- the availability of fitness assessment equipment
what do fitness assessments provide?
an ongoing way of communicating information between the personal trainer and the client, ensuring that fitness program goals are constantly being monitored and evaluated to make sure the client’s individual health and wellness goals are achieves
what do fitness assessments allow for the fitness professional to do?
continually monitor a client’s needs, functional capabilities, and physiologic effects of exercise, enabling the client to realize the full benefit of an individualized training program
true or false: a health and fitness assessment is designed to diagnose medical and/or health conditions
FALSE
- it is designed to serve as a way of observing and documenting a client’s individual structural and functional status
- it is not intended to replace a medical examination
what should the personal trainer do if a client is identified as high-risk after a preparticipation health screening, or exhibits signs or symptoms of underlying health problems or extreme difficulty or pain with any observation or exercise?
they should refer the client to his or her physician or qualified health-care provider to identify any underlying cause
DO NOT do these things as a personal trainer…
- diagnose medical conditions
- prescribe treatment
- prescribe diets
- provide treatment of any kind for injury or disease
- provide rehabilitation for clients
- provide counseling services for clients
instead of diagnosing medical conditions, DO this…
- obtain exercise or health guidelines from a physician, physical therapist, or registered dietician
- follow national consensus guidelines of exercise prescription for medical disorders
- screen clients for exercise limitations
- identify potential risk factors for clients through screening procedures
- refer clients who experience difficulty or pain or exhibit other symptoms to a qualified medical practitioner
instead of prescribing treatment, DO this…
- design individualized, systematic, progressive exercise programs
- refer clients to a qualified medical practitioner for medical exercise prescription
instead of prescribing diets, DO this…
- provide clients with general information on healthy eating according to the food pyramid
- refer clients to a qualified dietician or nutritionist for specific diet plans
instead of providing treatment of any kind for injury or disease, DO this…
- refer clients to a qualified medical practitioner for treatment of injury or disease
- use exercise to help clients improve overall health
- assist clients in following the medical advice or a physician or therapist
instead of providing rehabilitation services for clients, DO this…
- design exercise programs for clients after they are released from rehabilitation
- provide post-rehabilitation services
instead of providing counseling services for clients, DO this…
- act as a coach for clients
- provide general information
- refer clients to a qualified counselor or therapist
what are some things a comprehensive fitness assessment provides?
- preparticipation health screening
- resting physiologic measurements (e.g., heart rate, blood pressure, height, weight)
- a series of measurements to help determine the fitness level of a client (health-related fitness tests)
in addition to documenting resting physiologic measurements and fitness assessment test results, what else should personal trainers discuss with their clients?
- past experiences with exercise
- current goals
- exercise likes or dislikes
subjective components of a fitness assessment
general and medical history: occupation, lifestyle, medical and personal information
objective components of a fitness assessment
- physiologic assessments
- body composition testing
- cardiorespiratory assessments
- static and dynamic postural assessments
- performance assessments
what are some cardiovascular disease risk factors?
- cigarette smoking
- dyslipidemia
- impaired fasting glucose
- obesity
- a sedentary lifestyle
what must personal trainers do before allowing a new client to participating in any physical activity, including fitness testing?
conduct a preparticipation health screening
what does a preparticipation health screening include?
- a medical history questionnaire (such as the PAR-Q)
- a review of their chronic disease risk factors and presence of any signs or symptoms of disease
low risk
individuals who do not have any signs or symptoms of cardiovascular, pulmonary, or metabolic disease and have ≤1 cardiovascular disease risk factor
moderate risk
individuals who do not have any signs or symptoms of cardiovascular, pulmonary, or metabolic disease but have ≥2 cardiovascular disease risk factors
high risk
individuals who have one ore more signs or symptoms of cardiovascular, pulmonary, or metabolic disease
Physical Activity Readiness Questionnaire (PAR-Q)
a questionnaire that has been designed to determine the safety or possible risk of exercising for a client based on the answers to specific health history questions
he PAR-Q primarily aimed at…
identifying individuals who require further medical evaluation before being allowed to exercise because they are at high risk for cardiovascular disease (CVD)
what happens when a client answers yes to one ore more questions on the PAR-Q?
the personal trainer should refer them to a physician for further medical screening before starting an exercise program
health history
a collection of information that is generally part of a medical physical or medical health history, which discuss relevant facts about the individual’s history, including biographic, demographic, occupational, and general lifestyle (physical, mental, emotional, sociocultural, sexual, and sometimes spiritual) data
what are two important areas for the personal trainer to focus on?
the relevant answers provided about a client’s occupation and general lifestyle traits
sample PAR-Q questions
- heart condition- only perform physical activity recommended by doctor?
- chest pain during physical activity?
- chest pain when not performing physical activity?
- lose balance because of dizziness / lose consciousness?
- bone or joint problem that could be made worse with physical activity?
- any medications for blood pressure or for a heart condition?
- any other reason why you should not engage in physical activity?
collecting information about a client’s occupation helps personal trainers determine what?
- common movement patterns
- typical energy expenditure levels during the course of an average day
how does collecting occupation information help a personal trainer?
it helps them to begin to recognize important clues about the client’s musculoskeletal structure and function, potential health and physical limitations, and restrictions that could affect the safety and efficacy of an exercise program
sample occupation questions
- current occupation?
- extended periods of sitting?
- extended periods of repetitive movements?
- wear shoes with a heel?
- cause you anxiety / mental stress?
effects of extended periods of sitting
- hips flexed for prolonged periods of time, which can lead to tight hip flexors (rectus femoris, tensor fascia latae, iliopsoas) and postural imbalances within the human movement system
- tendency for the shoulders and head to fatigue under the constant effect of gravity, which can lead to postural imbalances including rounding of the shoulders and a forward head
- indicative of low energy expenditure throughout the day and potentially poor cardiorespiratory condition
repetitive movement
a persistent motion that can cause musculoskeletal injury and dysfunction
effects of repetitive movements
they can create a pattern overload to muscles and joints, which may lead to tissue trauma and eventually kinetic chain dysfunction, especially in jobs that require a lot of overhead work or awkward positions such as construction or painting
working with the arms overhead for long periods of time may lead to…
- shoulder and neck soreness that may be the result of tightness in the latissimus dorsi and weakness in the rotator cuff
- this imbalance does not allow for proper shoulder motion stabilization during activity
effects of wearing shoes with a heel
- puts the ankle complex in a plantarflexed position for extended periods
- can lead to tightness in the gastrocnemius, soleus, and Achilles tendon, causing postural imbalance, such as decreased dorsiflexion and overpronation at the foot and ankle complex, resulting in flattening of the arch of the foot
effects of mental stress of anxiety
- elevated heart rate, blood pressure, and ventilation at rest and exercise
- can lead to abnormal (or dysfunctional) breathing patterns that may cause postural or musculoskeletal imbalances in the neck, shoulder, chest, and low-back muscles, which collectively can lead to postural distortion and human movement system dysfunction
what do lifestyle or personal questions pertain to?
a client’s general lifestyle activities and habits
- smoking
- drinking
- exercise
- sleeping habits
- recreational activities
- hobbies
sample lifestyle questions
- recreational activities (gold, tennis, skiing, etc.)?
2. hobbies (reading, gardening, working on cars, etc.)?
recreation
refers to a client’s physical activities outside the work environment, also referred to as leisure time
how does finding out what recreational activities a client performs help personal trainers?
it allows them to better design an exercise program that fits the needs of the client
hobbies
refers to activities that a client might enjoy participating in on a regular basis, but are not necessarily athletic in nature
examples of hobbies
- gardening
- working on cars
- playing cards
- reading
- watching TV
- playing video games
true or false: hobbies do not need to be taken into account to create a training program
FALSE
-many common types of hobbies do not involve any physical activity, and yet still need to be taken into account to create a properly planned integrated exercise training program
why is obtaining a client’s medical history important?
- it provides personal trainers with information about known or suspected chronic diseases, such as coronary heart disease, high blood pressure, or diabetes
- provides information about the client’s past and current health status, as well as any past or recent injuries, surgeries, or other chronic health conditions
what can previous history of musculoskeletal injury predict?
future history of musculoskeletal injury during physical activity
effects of ankle sprains on the human movement system
- decrease the neural control to the gluteus medius and maximus
- lead to poor control of the lower extremities during many functional activities, which can eventually lead to injury
effects of knee injuries involving ligaments
- decrease in the neural control to muscles that stabilize the patella (kneecap) and lead to further injury
- knee injuries that are not the result of contact (noncontact injuries) are often the result of ankle or hip dysfunctions, such as the result of an ankle sprain
- the knee is caught between the ankle and the hip: if the ankle or hip joint begins to function improperly, this results in altered movement and force distribution of the knee
- with time, this can lead to further injury
sample medical history questions
- pain or injuries?
- surgeries?
- chronic diseases?
- medications?
effects of low-back injuries
- decreased neural control to stabilizing muscles of the core, resulting in poor stabilization of the spine
- this can further lead to dysfunction in the upper and lower extremities
effects of shoulder injuries
-altered neural control of the rotator cuff muscles, which can lead to instability of the shoulder joint during functional activities
other injuries that result from human movement system imbalances
- repetitive hamstring strains
- groin strains
- patellar tendonitis (jumper’s knee)
- plantar fasciitis (pain in the heel and bottom of the foot)
- posterior tibialis tendonitis (shin splints)
- biceps tendonitis (shoulder pain)
- headaches
effects of surgical procedures
- create trauma for the body
- may have similar effects on the functioning of the human movement system and safety and efficacy of exercise as those of injuries
common surgical procedures
- foot and ankle surgery
- knee surgery
- back surgery
- shoulder surgery
- caesarean section for birth (cutting through the abdominal wall to deliver a baby)
- appendectomy (cutting through the abdominal wall to remove the appendix)
what happens if a surgery is not rehabilitated properly?
-will cause pain and inflammation that can alter neural control to the affected muscles and joints
over what percentage of the American adult population does not engage in at least 30 minutes of low-to-moderate physical activity on most days of the week?
75%
examples of chronic diseases
- cardiovascular disease, coronary heart disease, coronary artery disease, or congestive heart failure
- hypertension (high blood pressure)
- high cholesterol or other blood lipid disorders
- stroke or peripheral artery disease
- lung or breathing problems
- obesity
- diabetes mellitus
- cancer
true or false: it is the role of the personal trainer to administer, prescribe, and educate clients on the usage and effects of any form of legally prescribed medication by a licensed physician or other health-care provider
FALSE- it is not their role
-personal trainers should always consult with their client’s physician or medical professionals regarding the client’s health information and which if any medications they may be currently taking
basic function of beta-blockers
generally used as antihypertensive (high blood pressure), may also be prescribed for arrhythmias (irregular heart rate)
basic function of calcium-channel blockers
generally prescribed for hypertension and angina (chest pain)
basic function of nitrates
generally prescribed for hypertension, congestive heart failure
basic function of diuretics
generally prescribed for hypertension, congestive heart failure, and peripheral edema
basic function of bronchodilators
generally prescribed to correct or prevent bronchial smooth muscle constriction in individuals with asthma and other pulmonary diseases
basic function of vasodilators
used in the treatment of hypertension and congestive heart failure
basic function of antidepressants
used in the treatment of various psychiatric and emotional disorders
effects of beta-blockers
decreased heart rate, decreased blood pressure
effects of calcium-channel blockers
increased heart rate, decreased blood pressure (or same or decreased heart rate)
effects of nitrates
increased heart rate, same blood pressure (or same heart rate, decreased blood pressure)
effects of diuretics
same heart rate, same blood pressure (or decreased blood presssure)
effects of bronchodilators
same heart rate, same blood pressure
effects of vasodilators
increased heart rate, decreased blood pressure (or same or decreased heart rate)
effects of antidepressants
increased or same heart rate, decreased or same blood pressure
the assessment of resting heart rate (HR) and blood pressure (BP) is a sensitive indicator of…
a client’s overall cardiorespiratory health as well as fitness status
resting HR is a ____ indicator of overall cardiorespiratory fitness
fairly good `
exercise HR is a ___ indicator of how a client’s cardiorespiratory system is responding and adapting to exercise
strong
how is a pulse created?
- by blood moving or pulsating through arteries each time the heart contracts
- each time the heart contracts or beats, one wave of blood flow or pulsation of blood can be felt by placing one or two fingers on an artery
- the artery contracts and relaxes periodically to rhythmically force the blood along its way circulating throughout the body
- this coincides with the contraction and relaxation of the heart as it pumps the blood through the arteries and veins
true or false: the pulse rate is also known as the heart rate
TRUE
how many pulse points are there?
7
pulse point
places where arteries come close enough to the skin to be able to have a pulse felt
2 most common pulse points
- radial arteries
2. carotid arteries
what is the preferred pulse?
radial pulse
radial arteries
inside of the wrist
carotid arteries
on the neck to the side of the windpipe
what should you teach clients in order to gather an accurate pulse reading?
- to record their resting HR on rising in the morning
- instruct them to test their resting heart rate 3 mornings in a row and average the 3 readings
how to find the radial pulse
- lightly place two fingers along the right side of the arm in line and just above the thumb
- once a pulse is felt, count the pulses for 60 seconds
- record the 60 second pulse rate and average over the course of 3 days
things to consider when taking the radial pulse
- the touch should be gentle
- the test must be taken when the client is calm
- all 3 test must be taken at the same time to ensure accuracy
how to find the carotid pulse
- lightly place two fingers on the neck, just to the side of the larynx
- once a pulse is identified, count the pulses for 60 seconds
- record the 60 second pulse rate and average over the course of 3 days
how many seconds should a pulse reading be?
60
how many pulse readings should you take before taking the average?
3
things to consider when taking the carotid pulse
- the touch should be gentle
- excessive pressure can decrease HR and blood pressure, leading to an inaccurate reading, possible dizziness, and fainting
- the test should be taken when the client is calm
- all 3 tests should be taken at the same time to ensure accuracy
typical resting heart rate
between 70 and 80 beats per minute
average male resting heart rate
70 beats per minute
average female resting heart rate
75 beats per minute
what can personal trainers calculate with a client’s resting HR?
the target heart rate (THR) zones in which a client should perform cardiorespiratory exercise
2 most common ways to calculate THR
- use a percentage of the client’s estimate heart rate (straight percentage method)
- use a percentage of heart rate reserve (Karvonen method)
purpose of training zone one
builds aerobic base and aids in recovery
purpose of training zone two
increases aerobic and anaerobic endurance
purpose of training zone three
builds high-end work capacity
straight percentage method (peak maximal heart rate)
- a client’s estimated maximal heart rate is found by subtracting their age from the number 220
- once their HR max is determined, multiply the estimated HR max by the approximate intensity (65-95%) at which the client should work while performing cardiorespiratory exercise to calculate THR
hr reserve (hrr) method (karvonen method)
-a method of establishing training intensity on the basis of the difference between a client’s predicted maximal heart rate and their resting heart rate
percentage of HR max for zone one
65-75%
percentage of HR max for zone two
76-85%
percentage of HR max for zone three
86-95%
heart rate and oxygen uptake are ___ related during dynamic exercise
linearly
what is the most common and universally accepted method of establishing exercise training intensity?
selecting a predetermined training or target heart rate (THR) based on a given percentage of oxygen consumption
HRR method formula
THR + [(HRmax-HRrest x desired intensity] + HRrest
blood pressure (BP)
the pressure of the circulating blood against the walls of the blood vessels after blood is ejected from the heart
2 parts to a blood pressure measurement
- systolic
2. diastolic
systolic
- first/top number
- represents the pressure within the arterial system after the heart contracts
diastolic
- second/bottom number
- represents the pressure within the arterial system when the heart is resting and filling up with blood
acceptable systolic blood pressure measurement
≤120 mm Hg
acceptable diastolic blood pressure measurement
≤80 mm Hg
what is blood pressure measured with?
- aneroid sphygmomanometer
- consists of an inflatable cuff, a pressure dial, a bulb with a valve, and a stethoscope
steps to recording blood pressure
- instruct the client to assume a comfortable seated position and place the appropriate size cuff on their arm just above the elbow
- rest the arm on a supported chair and place the stethoscope over the brachial artery, using a minimal amount of pressure
- continue by rapidly inflating the cuff to 20-30 mm Hg above the point at which 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 a pulse
how to determine systolic pressure
listen for the first observation of the pulse
how to determine diastolic pressure
determined when the pulse fades away
true or false: you should measure blood pressure on the right arm
FALSE
-you should start on one arm and then move to the next for greater reliability
body composition
the relative percentage of body weight that is fat versus fat-free tissue, or more commonly reported as “percent body fat”
fat-free mass
- body weight except stored fat
- includes muscles, bones, water, connective and organ tissues, and teeth
fat mass
- essential fat (crucial for normal body functioning)
- nonessential fat (storage fat or adipose tissue)
benefits of body composition assessments
- 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
- to use as a motivational tool (for certain clients)
- to monitor changes in body composition that are associated with chronic diseases
- to assess effectiveness of nutrition and exercise choices
typical body fat range for men
10-20%
typical body fat range for women
20-30%
methods to estimate body composition
- skinfold measurement
- bioelectrical impedance
- underwater / hydrostatic weighing
essential body fat for men
3-5%
essential body fat for women
8-12%
athletic body fat for men
5-13%
athletic body fat for women
12-22%
recommended (34 years or less) body fat for men
8-22%
recommended (34 years or less) body fat for women
2-35%
recommended (35-55 years) body fat for men
10-25%
recommended (35-55 years) body fat for women
23-38%
recommended (more than 56 years) body fat for men
10-25%
recommended (more than 56 years) body fat for women
25-38%
skinfold measurement
- uses a caliper to estimate the amount of subcutaneous fat beneath the skin
- an indirect measure of the thickness of subcutaneous dipose tissue
bioelectrical impedance
- uses a portable instrument to conduct an electrical current through the body to estimate fat
- this form of assessment is based on the hypothesis that tissues that are high in water content conduct electrical currents with less resistance than those with little water (such as adipose tissue)
underwater / hydrostatic weighing
- the fact that bone, muscle, and connective tissue, collectively known as lean mass, sinks, whereas body fat floats, is the main principle behind hydrostatic testing
- in essence a person’s weight is compared with a person’s weight underwater to determine fat percentage
most common technique to determine body composition
underwater / hydrostatic weighing
what is denser: bones and muscles, or water?
bones and muscles
a person with a larger percentage of lean body mass will weigh ___ in the water and have a ____ body fat percentage versus someone with less lean body mass
more, lower
a person with more body fat will have a ___ body in water and a ___ percentage of body fat
less, higher
recommendations for assessing body composition using skinfolds
- train with an individual skilled in SKF assessment and frequently compare your results with theirs
- take a minimum of 2 measurements at each site, and each site must be within 1-2 mm to take average at each site
- open jaw of caliper before removing from the site
- be meticulous when locating anatomic landmarks
- do not measure SKFs immediately after exercise
- instruct the clients ahead of time regarding test protocol
- avoid performing SKFs on extremely obese clients
true or false: assessing body fat using skinfold calipers is the best option for very overweight individuals
FALSE
- the accuracy of the skinfold measurement in these situations typically decrease
- instead, use bioelectrical impedance, circumference measurements, scale weight, or even how clothes fit to evaluate one’s weight loss and body fat reduction progress
what formula does the NASM use to calculate a client’s percentage of body fat?
the Durnin-Womersley formula
-this formula was chosen for its simple four-site upper body measurement process
the Durnin formula’s four sites of skinfold measurement
- biceps
- triceps
- subscapular
- iliac crest
biceps skinfold measurement
a vertical fold on the front of the arm over the biceps muscle, halfway between the shoulder and the elbow
triceps skinfold measurement
- a vertical fold on the back of the upper arm, with the arm relaxed and held freely at the side
- the skin fold should also be taken halfway between the shoulder and the elbow
subscapular skinfold measurement
a 45-degree angle fold of 1 to 2 cm, below the inferior angle of the scapula
iliac crest skinfold measurement
a 45-decree angle fold, taken just above the iliac crest and medial to the axillary line
true or false: all skinfold measurements should be taken on the right side of the body
TRUE
what should happen after the 4 sites have been measured?
- add the totals of the 4 sites
- find the appropriate sex and age categories for the body composition on the Durnin-Womersley body fat percentage calculation table
fat mass formula
body fat % X scale weight = fat mass
lean body mass formula
scale weight - fat mass = lean body mass
circumference
a measure of the girth of body segments (e.g., arm, thigh, waist, and hip)
true or false: circumference methods are affected by both fat and muscle
TRUE
true or false: circumference measurements provide accurate estimates of fatness in the general population
FALSE
-they do not since they are affected by both fat and muscle
uses and benefits of circumference measurements
- can be used on obese clients
- good for comparisons and progressions
- good for assessing fat pattern and distribution
- inexpensive
- easy to record
- little technician error
- used for waist circumference
- used for waist-to-hip ratio (WHR)
- a source of feedback used with clients who have the goal of altering body composition
what are circumference measurements designed to do?
assess girth changes in the body
what is the most important factor to consider when taking circumference measurements?
consistency
things to remember when taking circumference measurements
-make sure the tape measure is taut and level around the area that is being measured
neck circumference measurement
across the Adam’s apple
chest circumference measurement
across the nipple line
waist circumference measurement
- measure at the narrowest point of the waist, below the rib cage and just above the top of the hipbones
- if there is no apparent narrowing of the waist, measure at the navel
hips circumference measurement
with feet together, measure circumference at the widest portion of the buttocks
thighs circumference measurement
measure 10 inches above the top of the patella for standardization
calves circumference measurement
at the maximal circumference between the ankle and the knee, measure the calves
biceps circumference measurement
at the maximal circumference of the biceps, measure with arm extended, palm facing forward
why is the waist-to-hip ratio important?
there is a correlation between chronic diseases and fat stored in the midsection
how is the waist to hip ratio computed?
by dividing the waist measurement by the hip measurement
steps to calculating the waist to hip ratio
- measure the smallest part of the client’s waist, without instructing the client to draw in the stomach
- measure the largest part of the client’s hips
- compute the waist-to-hip ratio by dividing the waist measurement by the hip measurement
a waist-to-hip ratio greater than ___ for women is a risk
0.80
a waist-to-hip ratio greater than ___ for men is a risk
0.95
body mass index (BMI)
a rough assessment based on the concept that a person’s weight should be proportional to their height
what is an elevated BMI linked to?
increased risk of disease, especially if associated with a large waist circumference
BMI formula
- BMI = Weight (kg) / Height (m^2)
2. BMI = [Weight (lbs) / Height (inch^2)] x 703
BMI range with lowest risk for disease
22-24.9
scientific evidence indicates that the risk for disease increases with a BMI of __ or greater
25
<18.5 BMI
increased disease risk, underweight
18.6-21.99 BMI
low disease risk, acceptable
22.0-24.99 BMI
very low disease risk, acceptable
25.0-29.99 BMI
increased disease risk, overweight
30.0-34.99 BMI
high disease risk, obese
35.0-39.99 BMI
very high disease risk, obesity II
> 40 BMI
extremely high disease risk, obesity III
weakness of BMI
it fails to differentiate fat mass from lean body mass
what to cardiorespiratory assessments help the personal trainer identify?
- safe and effective starting exercise intensities
- appropriate modes of cardiorespiratory exercise for clients
what is the most valid measurement for functional capacity of the cardiopulmonary (heart and lungs) system?
Cardiopulmonary Exercise Testing (CPET), also known as maximal oxygen uptake (VO2max)
cons of VO2max
- equipment required
- time involved
- willingness of clients to perform at maximal physical capacity
true or false: submaximal testing allows for the prediction or estimation of VO2max
TRUE
how are submaximal tests different from VO2max tests?
they are terminated at a predetermined heart rate intensity or time frame
2 common submaximal tests for assessing cardiorespiratory efficiency
- YMCA 3-minute step test
- Rockport Walk Test
YMCA 3-minute Step Test
designed to estimate an individual’s cardiorespiratory fitness level on the basis of a submaximal bout of stair climbing set at a pace for 3 minutes
steps of the YMCA 3-minute Step Test
- perform a 3-minute step test by having the client perform 96 steps per minute on a 12 inch step for a total of 3 minutes
- within 5 seconds of completing the exercise, the clients resting heart rate is measured for a period of 60 seconds and recorded as the recovery pulse
- locate the recovery pulse on the table
- determine the appropriate starting program
- determine the clients maximal heart rate and then determine the heart rate ranges for each zone
Rockport Walk Test
- designed to estimate a cardiovascular starting point
- the starting point is then modified based on ability level
Rockport Walk Test steps
- record the clients weight, have them walk 1 mile as fast as they can on a treadmill, record the time, and immediately record heart rate after the 1 minute mark, then determine the oxygen consumption scorer
- locate the VO2 score on the table
- determine the appropriate starting program
- determine the clients maximal heart rate and determine the heart rate ranges for each zone
neuromuscular efficiency
the ability of the nervous system and musculature system to communicate properly producing optimal movement
what does proper postural alignment allow for?
optimal neuromuscular efficiency, which helps produce effective and safe movement
what does proper posture ensure?
- that the muscles of the body are optimally aligned at the proper length-tension relationships necessary for efficiency functioning of force-couples
- this allows for proper arthrokinematics and effective absorption and distribution of forces throughout the human movement system, alleviating excess stress on joints
what may happen to the body without proper posture?
- the body may degenerate or experience poor posture, altered movement patterns, and muscle imbalances
- these dysfunctions can lead to common injuries such as ankle sprains, tendonitis, and low-back pain
true or false: a quick static postural observation can determine any gross deviations in overall posture
TRUE
static posture
- how an individual physically presents himself or herself in stance
- could be considered the base from which an individual moves
- reflected in the alignment of the body
what does static posture provide?
the foundation or the platform from which the extremities function
what is the basis for identifying muscle imbalances?
static postural assessment
true or false: the static postural assessment allows trainers to specifically identify whether a problem is structural in nature or whether it is derived from the development of poor muscular recruitment patterns with resultant muscle imbalances
FALSE
what does a static postural assessment provide?
- excellent indicators of problem areas that must be further evaluated
- a basis for developing an exercise strategy to target causative factors of faulty movement and neuromuscular inefficiency
3 postural distortion patterns to be assessed during a static postural assessment
- pronation distortion syndrome
- lower crossed syndrome
- upper crossed syndrome
pronation distortion syndrome
a postural distortion syndrome characterized by foot pronation (flat feet) and adducted and internally rotated knees (knock knees)
lower crossed syndrome
a postural distortion syndrome characterized by an anterior tilt to the pelvis (arched lower back)
upper crossed syndrome
a postural distortion syndrome characterized by a forward head and rounded shoulders
shortened muscles in pronation distortion syndrome
gastrocnemius, soleus, peroneals, adductors, iliotibial head, hip flexor complex, biceps femoris (short head)
lengthened muscles in pronation distortion syndrome
anterior tibialis, posterior tibialis, vastus medialis, gluteus medius / maximus, hip external rotators
altered joint mechanics in pronation distortion system
- increased knee adduction, knee internal rotation, foot pronation, foot external rotation
- ankle dorsiflexion, ankle inversion
possible injuries in pronation distortion syndrome
- plantar fasciitis
- posterior tibialis tendonitis (shin splints)
- patellar tendonitis
- low-back pain
shortened muscles in lower crossed syndrome
gastrocnemius, soleus, hip flexor complex, adductors, latissimus dorsi, erector spinae
lengthened muscles in lower crossed syndrome
anterior tibialis, posterior tibialis, gluteus maximus / medius, transversus abdominis, internal oblique
altered joint mechanics in lower crossed syndrome
- increased lumbar extension
- decreased hip extension
possible injuries in lower crossed syndrome
- hamstring complex strain
- anterior knee pain
- low-back pain
shortened muscles in upper crossed syndrome
upper trapezius, levator scapulae, sternocleidomastoid, scalenes, latissimus dorsi, teres major, subscapularis, pectoralis major / minor
lengthened muscles in upper crossed syndrome
deep cervical flexors, serratus anterior, rhomboids, mid-trapezius, lower trapezius, teres minor, infraspinatus
altered joint mechanics in upper crossed syndrome
- increased cervical extension, scapular protraction / elevation
- decreased shoulder extension, shoulder external rotation
possible injuries in upper crossed syndrome
- headaches
- biceps tendonitis
- rotator cuff impingement
- thoracic outlet syndrome
in general, what should one check for in a static postural assessment?
- neutral alignment
- symmetry
- balance muscle tone
- specific postural deformities
how should the client be positioned in a static postural assessment?
in a weight-bearing position (standing) from multiple vantage points (anterior, posterior, lateral)
5 kinetic chain checkpoints
- foot and ankle
- knee
- lumbo-pelvic-hip complex (LPHC)
- shoulders
- head and cervical spine
anterior view - static postural assessment
- foot/ankles: straight and parallel, not flattened or externally rotated
- knees: in line with toes, not adducted or abducted
- LPHC: pelvis level with both anterior superior iliac spines in same transverse plane
- shoulders: level, not elevated or rounded
- head: neutral position, not tilted nor rotated
lateral view - static postural assessment
- foot/ankle: neutral position, leg vertical at right angle to sole of foot
- knees: neutral position, not flexed nor hyperextended
- LPHC: pelvis neutral position, not anteriorly (lumbar extension) or posteriorly (lumbar flexion) rotated
- shoulders: normal kyphotic curve, not excessively rounded
- head: neutral position, not in excessive extension (“jutting” forward)
posterior view - static postural assessment
- foot/ankle: heels are straight and parallel, not overly pronated
- knees: neutral position, not adducted or abducted
- LPHC: pelvis is level with both superior iliac spines in same transverse plane
- shoulders/scapulae: level, not elevated or protracted (medial borders essentially parallel and approximately 3 to 4 inches apart)
- head: neutral position, neither tilted nor rotated
what is often the quickest way to gain an overall impression of a client’s functional status?
a dynamic postural assessment
purpose of overhead squat assessment
designed to assess dynamic flexibility, core strength, balance, and overall neuromuscular control
what has the overhead squat test been shown to reflect?
lower extremity movement patterns during jump-landing tasks
knee valgus (knock-knees) during the overhead squat and single-leg squat is influenced by what?
- decreased hip abductor and hip external rotation strength
- increased hip adductor activity
- restricted ankle dorsiflexion
overhead squat position
- feet shoulder width apart and pointed straight ahead, foot and ankle complex in neutral position (shoes off for better view)
- raise arms overhead with elbows fully extended (upper arms should bisect the torso)
overhead squat movement
- squat roughly to the height of a chair seat and return to starting position
- repeat the movement for 5 reps, observing from each position (anterior and lateral)
overhead squat views
- view feet, ankles, and knees from the front- the feet should remain straight with the knees tracking in line with the foot
- view the LPHC, shoulder, and cervical complex from the side- the tibia should remain in line with the torso while the arms also stay in lien with the torso
overhead squat compensations: anterior view
- feet: do the feet flatten and/or turn out
2. knees: do the knees move inward (adduct and internally rotate)
overhead squat compensations: lateral view
- LPHC: does the low back arch? does the torso lean forward excessively?
- shoulder: do the arms fall forward
OHS excessive forward lean - overactive muscles
- soleus
- gastrocnemius
- hip flexor complex
- abdominal complex
OHS excessive forward lean - underactive muscles
- anterior tibialis
- gluteus maximus
- erector spinae
OHS low back arches - overactive muscles
- hip flexor complex
- erector spinae
- latissimus dorsi
OHS low back arches - underactive muscles
- gluteus maximus
- hamstring complex
- intrinsic core stabilizers (transverse abdominis, multifidus, transversospinalis, internal oblique pelvic floor)
OHS arms fall forward - overactive muscles
- latissimus dorsi
- teres major
- pectoralis major / minor
OHS arms fall forward - underactive muscles
- mid / lower trapezius
- rhomboids
- rotator cuff
OHS feet turn out - overactive muscles
- soleus
- lateral gastrocnemius
- biceps femoris (short head)
OHS feet turn out - underactive muscles
- medial gastrocnemius
- medial hamstring complex
- gracilis
- sartorius
- popliteus
OHS knees move inward - overactive muscles
- adductor complex
- biceps femoris (short head)
- TFL
- vastus lateralis
OHS knees move inward - underactive muscles
- gluteus medius/maximus
- vastus medialis oblique (VMO)
single-leg squat assessment purpose
assesses dynamic flexibility, core strength, and overall neuromuscular control
what is the single-leg squat assessment a reliable and valid measure of?
lower extremity movement patterns when standard application protocols are applies
single-leg squat position
- stand with hands on hips and eyes focused on an object straight ahead
- foot pointed straight ahead, and the foot, ankle, and knee and the LPHC should be in a neutral position
single-leg squat movement
- squat to a comfortable level and return to the starting position
- perform up to 5 reps before switching sides
single-leg squat views
- view the knee from the front
- the knee should track in line with the foot
single-leg squat compensation
- knee: does the knee move inward (adduct and internally rotate)
overhead squat checkpoints
- LPHC (lateral)
- upper body (lateral)
- feet (anterior)
- knees (anterior)
single leg squat checkpoints
- knee (anterior)
single-leg squat knees move inward - overactive muscles
- adductor complex
- biceps femoris (short head)
- TFL
- vastus lateralis
single-leg squat knees move inward - underactive muscles
- gluteus medius / maximus
- vastus medialis oblique (VMO)
pushing assessment purpose
assesses movement efficiency and potential muscle imbalances during pushing movements
pushing assessment position
- stand with abdomen drawn inward, feet in a split stance and toes pointing forward
pushing assessment movement
- view from the side, instruct client to press handles forward and return to starting position
- perform up to 20 reps in a controlled fashion - the lumbar and cervical spines should remain neutral while the shoulders stay level
pushing assessment compensations
- low back: does the low back arch
- shoulders: do the shoulders elevate
- head: does the head migrate forward
pushing assessment checkpoints
- LPHC
- shoulder complex
- head
pushing assessment low back arches - overactive muscles
- hip flexors
- erector spinae
pushing assessment low back arches - underactive muscles
-intrinsic core stabilizers
pushing assessment shoulders elevated - overactive muscles
- upper trapezius
- sternocleidomastoid
- levator scapulae
pushing assessment shoulders elevated - underactive muscles
-mid/lower trapezius
pushing assessment head migrates forward - overactive muscles
- upper trapezius
- sternocleidomastoid
- levator scapulae
pushing assessment head migrates forward - underactive muscles
-deep cervical flexors
pulling assessment purpose
to assess movement efficiency and potential muscle imbalances during pulling movements
pulling assessment position
- abdomen drawn inward, feet shoulders-with apart, toes pointing forward
pulling assessment movement
- viewing from the side, instruct the client to pull handles toward the body and return to the starting position (lumbar and cervical spines should remain neutral while the shoulders stay level)
- perform up to 20 reps in a controlled fashion
pulling assessment compensations
- low back: does the low back arch
- shoulders: do the shoulders elevate
- head: does the head migrate forward
pulling assessment low back arches - overactive muscles
- hip flexors
- erector spinae
pulling assessment low back arches - underactive muscles
-intrinsic core stabilizers
pulling assessment shoulders elevate - overactive muscles
- upper trapezius
- sternocleidomastoid
- levator scapulae
pulling assessment shoulders elevate - underactive muscles
-mid/lower trapezius
pulling assessment head protrudes forward - overactive muscles
- upper trapezius
- sternocleidomastoid
- levator scapulae
pulling assessment head protrudes forward - underactive muscles
-deep cervical flexors
posture
the alignment and function of all parts of the kinetic chain
what is the main purpose of posture?
to overcome constant forces placed on the body by maintaining structural efficiency
what does the kinetic chain require?
constant postural equilibrium
what does a dynamic postural observation provide?
- crucial information about how muscles and joints interact
- searches for any imbalances in anatomy, physiology, or biomechanics
purpose of performance assessments
used for clients looking to improve athletic performance
what do performance assessments measure?
- upper extremity stability and muscular endurance
- lower extremity agility
- overall strength
5 basic performance assessments
- push-up test
- Davies test
- shark skill test
- bench press strength assessment
- squat strength assessment
push-up test purpose
measures muscular endurance of the upper body, primarily the pushing muscles
push-up test position
- in push-up position, lower the body to touch a partner’s closed fist placed under the chest, and repeat for 60 seconds or exhaustion without compensating
- record number of actual touches reported from partner
- client should be able to perform more push-ups when reassessed
Davies test purpose
measures upper extremity agility and stabilization
who may the Davies test not be suited for?
those who lack shoulder stability
Davies test position
- place two pieces of tape on the floor, 36 inches apart
2. have client assume push-up position, with one hand on each piece of tape
Davies test movement
- instruct client to quickly move right hand to touch left hand
- perform alternating touching on each side for 15 seconds
- repeat for 3 trials
- reassess in the future to measure improvement of number of touches
- record the number of liens touched by both hands
shark skill test purpose
designed to assess lower extremity agility and neuromuscular control
shark skill test position
- position client in the center box of a grid, with hands on hips and standing on one leg
shark skill test movement
- instruct client to hop to each box in a designated pattern, always returning to the center box (be consistent with patterns)
- perform one practice run through the boxes with each foot
- perform test twice with each foot (4 times total), keep track of time
- record times
- add 0.10 seconds for the following faults: non-hopping leg touches ground, hands come off hips, foot goes into wrong square, foot does not return to center square
the shark skill test is viewed as a progression from what?
single-leg squat
bench press assessment purpose
- designed to estimate the one-rep maximum on overall upper body strength of the pressing musculature
- can also be used to determine training intensities on the bench press
bench press assessment position
- position client on a bench, lying on his or her back (feet should be pointed straight ahead, low back should be in a neutral position)
bench press assessment movement
- warm up with a light resistance that can be easily performed for 8-10 reps
- take a 1 minute rest
- add 10-20 lbs (5-10% of initial load) and perform 3-5 reps
- take a 2 minute rest
- repeat steps 3 and 4 until the client achieves failure between 2 and 10 reps (3-5 reps for greater accuracy)
- estimate one-rep max using the chart
true or false: the bench press and squat assessments should be used for clients with general fitness or weight loss goals
FALSE
-these are advanced assessments and may not be suitable for many clients
squat assessment purpose
- designed to estimate the one-repetition squat maximum and overall lower body strength
- can also be used to determine training intensities for the squat exercise
squat assessment position
- feet should be shoulders-width apart, pointing straight ahead, and with knees in line with the toes + low back should be in a neutral position
squat assessment movement
- warm up with a light resistance that can be easily performed for 8-10 reps
- take a 1 minute rest
- add 30-40 pounds (10-20% of initial load) and perform 3-5 reps
- take a 2 minute rest
- repeat steps 3 and 4 until the client achieves failure between 2 and 10 reps (3-5 reps for greater accuracy)
- estimate one-rep max using the chart