Chapter 8: Physiological Assessment Flashcards
Define Anaerobic Power
The amount of work performed in a given unit of time
Usually represents one single and explosive bout, event or repetition performed at maximal effort
Define Anaerobic Capacity
The ability to sustain high anaerobic activity
Define speed
The rate of motion or the rate of change of distance
Define agility
How accurately and rapidly a person can change direction
Involves acceleration, stabilization, and deceleration
Define reactivity
The rate at which a person responds to a stimulus
Define coordination
The ability to perform complex movements while providing accurate responses in both timing and intensity
What are the signs that it’s time to terminate a fitness assessment?
•Onset of Angina or chest pain •More than >10mmHg drop in systolic blood pressure •Excessive rise in BP >>SBP 250+ >>DBP 115+ •Excessive fatigue, shortness of breath, or wheezing •Signs of perfusion (lightheadedness) •Cyanosis (bluish color around mouth) •Nausea, cold or clammy skin •Dizziness/Confusion •Leg cramping or claudication •Client requests to stop •Physical or verbal manifestations of severe fatigue •Failure of testing equipment
What is cyanosis?
Cyan; turning a blue-ish color
What is Ataxia
Neurological dysfunction resulting in a lack of voluntary coordination of muscle movements
What is Syncope?
Fainting, loss of consciousness
What are some common methods of measuring body composition?
- Bioelectrical Impedance
- DEXA Scans
- Hydrostatic Weighing
- underwater weighing
- Near-infrared interactance
- skin fold measurements
- whole body air displacement plethysmography
What are some common methods of measuring body size?
- BMI
- Girth measurements, including waist to hip ratio
- Height
- Weight
What is lean body mass composed of?
- Muscle Tissue
- Organs
- Connective Tissue
- Bones
- Blood
- Nervous Tissue
- Skin
Essential Body Fat Functions to allow the body to…
Essential for:
- thermoregulation
- insulation
- hormone production
- cushioning of vital organs
- maintenance of certain bodily functions
What are the minimum percentages of body fat for men and women?
Men: 2-5%
Women: 10-13%
What are the main functions of visceral subcutaneous fat?
- Stored energy
- Cushion/protect vital organs
What are some diseases/health risks associated with having excess body fat?
- Heart Disease
- Osteoarthritis
- Coronary Artery Disease (CAD)
- Metabolic Disease
- Cancers such as (breast, colon, endometrial)
- Diabetes
- Sleep Apnea
- Low-Back Dysfunction
Define anthropometry
the scientific study of the measurements and proportions of the human body
What is the main characteristic of lean mass?
Lean body mass is metabolically active tissue that allows the body to perform work
What is Bioelectrical Impedance Analysis (BIA)?
BIA measures electrical signals as they pass through fat, lean mass, and water in the body
BIA machines are found primarily in laboratories
Less sophisticated BIA devices can be found in fitness settings
What is Air Displacement Plethysmography (ADP)?
Commonly as the “Bod Pod”
Egg shaped chamber that measures the amount of air that is displaced when the person sits in the machine
The two values needed to determine the body fat are air displacement and body weight
Machines are expensive and highly accurate
What is a DEXA scan?
Typically found in clinical settings
X-Rays scan the whole body, reading both bone and soft-tissue mass
Has ability to identify regional body fat distribution
Highly accurate
What is Hydrostatic weighing?
“Underwater Weighing” common in lab settings at colleges
Gold standard of body-fat assessment
Measures the amount of water a person displaces when completely submerged, completely exhale all air from lungs
What is Near-infrared interactance (NIR)?
NIR uses a fiber optic probe connected to a digital analyzer that indirectly measures tissue composition (fat and water)
Typically biceps are the assessment site
Calculations are plugged into a formula that includes height, weight, frame size, and level of activity
Inexpensive and fast method yet not as accurate as the other methods
What is Total Body Electrical Conductivity (TOBEC)?
TOBEC uses electromagnetic force field to assess relative body fat
Impractical and too expensive for fitness setting
What is the protocol for performing a skin fold measurement?
- client should be hydrated and measure then prior to any exercise
- Make sure client is comfortable with the protocol (explain it to them)
- All measurements should be taken on the right side of the body while the client is standing
- Use washable pencil or eyeliner to mark them up
- Hold calipers in right hand while grasping skin fold with the left hand
- Grasp or pinch the skin fold site thus pulling the subcutaneous fat and skin away from the muscle tissue
- The pinch is maintained while calipers are positioned perpendicular to the site, on the marked site, midway between the top and base of the fold
- Slowly release caliper trigger, reading the dial to the nearest 0.5mm approximately 2-3 seconds after release
- After reading, gently squeeze calipers to remove caliper before releasing the skin
- Each of the 3 sites should be measured at least twice
- If subsequent readings differ more than 2mm then a third reading is necessary and the average of the two most similar scores should be taken
- Wait between 20-30 seconds between measurements to allow skin and fat to redistribute
- Record all measurements on a testing form
Skinfold Test for Men
Sites: Chest, Thigh, Abdominal
Body Density = (sum of skin folds) + (sum of three skin folds squared) - age
Skinfold Test for Women
Sites: Triceps, Thigh, Suprailium
What is the purpose of the Body Mass Index (BMI)?
It provides an objective ratio describing the relationship between body weight and height
*cannot determine body composition
What is the relevance of girth measurements?
- Waist circumference correlates to heart disease
- Decreased waist circumference is inspiring to obese clients
- Increased muscle girth will be inspiring to clients whose goal is hypertrophy
What are the at risk Waist to Hop Ratio numbers for men and women?
Men: greater than 0.95
Women: greater than 0.86
What are the implications of excess visceral fat in the abdominal region?
- Encroaches on vital organs
- Associated with insulin resistance, type 2 diabetes, hypertension, and hypercholesterolemia
What are Waist Circumference numbers considered too high for men and women
Men: 39.5 inches or greater
Women: 35.5 or greater
What are the reasons for administering a Cardiorespiratory Fitness Test (CRF Test)?
- Determine functional capacity, using predetermined formulas based on age, gender, and sometimes Bodyweight
- Determine VO2 max or metabolic equivalent (MET) that serves as a starting point for aerobic conditioning
- Determine any underlying Cardiorespiratory abnormalities that signify progressive stages of cardiovascular disease
- Periodically reassess progress following a structured fitness program
What is a VO2 max assessment?
- Conducted mainly in laboratories, involves collection and analysis of air exhaled during max exercise
- V02 max is an estimation of the body‘s ability to use oxygen for energy, and is closely related to the functional capacity of the heart
What is a sub maximal CRF Test?
-This assessment provides accurate values that can be extrapolated to determine expected maximal effort
What are some methods available to Trainers to determine max heart rate?
- Cycle Ergometer Tests
(YMCA Bike Test
-Ventilatory Threshold Testing
(Sub max talk test for VT1
VT2 Threshold Test)
-Field Test
(Rockport fitness walking test (1 mile)
(1.5 mile run test)
-Step Tests
(YMCA submaximal step test 12 inches)
What are the two ways of estimating max heart rate?
EKG Test (more accurate)
Formula (220 minus your age)
What are some common ways that Cardiorespiratory fitness is measured in the lab or a fitness center?
Treadmill: intensity is raised by increasing speed or elevation
Cycle or Arm Ergometer: the intensity is raised by increasing resistance, while the cadence is held constant
How do you explain to the lack of accuracy in estimated maximum oxygen uptake assessments?
The charts and equations which are used to determine max heart rate from sub max HR data are based on the assumption that everyone expends exactly the same amount of energy and uses the same amount of oxygen at any given work rate
This is why it’s necessary to remeasure a few months later and then compare the individuals test results
How to perform Cycle Ergometer (YMCA Bike Test)?
Pre-Test
- Estimate sub max HR using formula
(206. 9- (0.67 x Age)) - Measure clients weight in lbs and convert to kg (divide the weight by 2.2)
- Discuss RPE with the client
- Adjust seat height (with a neutral ankle the leg should almost straighten at the bottom of the rotation)
- Client should ride at 50rpm or set a metronome to 100 bpm to coincide with each pedal stroke
- 2-3 minute warmup period at RPE 3 with very low tension
Test Protocol
- Each stage is 3 minutes long. The first workload is set at 150 kgm/min (15 watts) or .5 KG
- Coach client to stay at 50 rpm
- Measure HR and RPE at the end of each minute (last 15 seconds)
- Before progressing to the next stage, the HR of the third minute must be within 5bpm of the HR at the second minute or else perform another minute and record
- The next stage workload will be dependent on their heart rate in the completed stage
- Record HR, RPE, and BP for each stage
- Discourage talking during the test because it can increase HR
Ventilatory Threshold
Ventilatory Threshold increases linearly with oxygen consumption and carbon dioxide production. This occurs primarily through an increase in tidal volume (the volume of air inhaled and exhaled per breath)
Overcompensation in breathing frequency is a result of the body trying blow off excess CO2 produced by anaerobic glycolysis (which predominates near maximal intensity
VT1 represents the point when blood lactate accumulates faster than it can be cleared, resulting in a person breathing faster in effort to blow off the CO2
VT2 occurs when lactate is rapidly increasing with intensity and the body cannot keep up with blowing off CO2 adequately to reduce the increase in acidity that occurs with intense exercise
How to perform the Submaximal Talk Test?
This test is best performed using a HR Telemetry (HR Strap and Watch)
Can be performed using a treadmill, cycle Ergometer, or elliptical
Goal is to incrementally increase steady state HR by about 5bpm per stage (each stage is usually 1-2 minutes to reach steady state)
Total test time is 8-16 minutes
- Measure resting HR and BP sitting down and standing up before the test begins
- Explain to client how to perform the test
- Take client though a 3-5 minute warmup maintaining a heart rate below 120 bpm
- Once warmed up, adjust workload intensity so the client’s HR is approximately 120 bpm or at RPE 3-4
- Begin the test maintaining intensity until HRs is achieved.
- Last 20-30 seconds of each stage, measure HR
- Ask client to recite Pledge of Allegiance
- Ask & Record how difficult it is for them to talk
- If VT1 is not achieved then progress through to successive stages us VT1 is achieved
- Once HR and VT1 are identified proceed to cool down phase
How to Perform VT2 Threshold Test?
Aka Lactate Threshold Test
Estimate VT2 by identifying the highest sustainable intensity they can maintain for an extended duration (cycling is approximately 60 minutes and running is approximately 30 minutes)
To predict the VT2 using a 15-20 minute test, trainers can estimate that the HR at VT2 would be 95% of the 15-20 minutes HR average
This test is best performed using a HR telemetry for continuous monitoring
Ventilation vs. Perfusion
Ventilation (V) refers to the flow of air into and out of the alveoli, while perfusion (Q) refers to the flow of blood to alveolar capillaries. Individual alveoli have variable degrees of ventilation and perfusion in different regions of the lungs.
What is Tidal Volume?
The volume of air (LxWxH)
inhaled and exhaled per breath
What is Minute Ventilation?
The volume of air breathed per minute
What is ventilation ?
movement of air (breathing)
Ventilation, or breathing, is the movement of air through the conducting passages between the atmosphere and the lungs.
How are ventilatory thresholds identified?
In general, as exercise intensity increases, ventilation (breathing) increases in a somewhat linear manner.
There are points in which there are discrepancies (caused by metabolic changes for example switching from aerobic to anaerobic glycolysis).
These points are called ventilatory thresholds and there are ways to test at what HR or exercise intensity they occur
In well trained individuals, how long can exercise be sustained at VT1 and VT2?
VT1: 1-2 hours
VT2: 30-60 minutes
What is the purpose and protocol of the Rockport Fitness Walking Test (1 mile)?
Purpose: to estimate VO2 max from a client’s immediate post-exercise HR
Protocol:
- Need clients weight and age for formulas
- Walk as fast as possible for 1 mile
- Record how long it takes
- Record HR
- Plug data into formula
What is the 1.5 mile run test?
Used by the U.S. Navy, the purpose of this test is to measure cardiovascular endurance and muscular endurance of the legs. The goal is to pace oneself to run a 1.5 mile in the least amount of time. Not suitable for less-conditioned individuals
Walking is allowed if necessary but it will underestimate the VO2 max score
- Record Client’s weight and age
- Stopwatch; GO!
- Record time and immediate post-exercise HR
- Plug into formula
What is the YMCA Submaximal Step Test?
Yet another tool to assess Cardiorespiratory fitness; recommended for people who are not very fit because it’s too easy for fit individuals
Subject steps at a specific pace for about 3 minutes
- Set a metronome to 96 bpm
- Have them step Up-Up-Down-Down for 3 minutes on a 12-inch high step
- Measure HR for one full minute immediately after the exercise. Have them sitting down quietly to measure their pulse
- Plug into formulas and compare results to chart
How to perform the muscular fitness Push-up Test?
Measures upper body endurance (pecs, triceps, anterior delts)
Not appropriate for clients with elbow or wrist problems
The problem with this test is that to go to fatigue takes a lot of motivation which novice trainees might not have
- Explain test protocol and purpose and explain proper push-up form
- Test starts in the down position
- Count only proper push-ups (full elbow extension with a flat back on the up, and chest touching a rolled towel or block on the way down
- Test is terminated when client fails to maintain proper execution for 2 consecutive reps
- Record score on testing form
What is the protocol for performing the Curl Up test?
Curl up test is to measure abdominal strength and endurance
Safer than a full sit up because sit ups require recruitment of the hip flexors and put more load on the lumbar spine
Not for people with low back problems
- Explain protocol and purpose of test and explain/demonstrate proper form
- Lie supine on the ground with feet flat on the floor and legs at a 90 degree angle
- Curl up (lift shoulder blades off the mat with approximately 30 degree angle of trunk flexion)
- Exhale on the way up and inhale on the way down
- Perform reps to failure
- Clients head does not need to touch the mat on the way down
- No neck curls; movement is trunk flexion
- Record score and check how they did using the Norm chart for their age
What is the protocol for the Body weight Squat Test?
Measures muscular endurance of the lower extremity
Only suitable for people who can squat with proper form
- Explain purpose of test and demonstrate proper form
- Allow for adequate warm-up
- The client can extend their arms in front for stability
- They should aim to reach depth but if they can’t that’s okay just use it for comparison later on in the program
- The goal is to perform as many squats with good control and form
What variables contribute to muscular strength?
- Muscle Size (diameter)
- Limb Length
- Neurological Adaptations
Define absolute strength
The greatest amount of weight that can be lifted at one time
1 Rep Max
Define relative strength
The amount someone can lift taking into consideration the person’s body weight
Relative Strength = absolute strength/body weight
When is it acceptable to perform a 1 rep max test
- when the person has strength goals
- during phase 3 or 4 of the ACE IFT Model
- Submax strength testing can be used to estimate
What is the protocol for performing the 1 RM Bench Press Test for muscular strength?
- Explain and demonstrate proper form
- Client is supine with a neutral or flat back with both feet on floor
- Proper ROM: arms fully extended and touch chest on the way down
- Breathe in on the way down and out on the concentric
- Do not lock elbows or bounce bar off the chest
- Spot the client
- Warm up with one set of light resistance (approximately 50% of anticipated 1RM @ 5-10 reps) and then rest for one minute
- Second set at 75% of estimated 1 RM for 3-5 reps and rest for 1 min
- Third set have the client perform 2-3 reps at approximately 85-90% 1RM and rest for 2 minutes
- Calculate estimated 1RM and then have the client attempt this set
- If they succeed then increase the weight and have them attempt that after 2-4 minutes of rest
- Ideally the client achieves their 1 RM after 3-5 working sets
What is the protocol for the 1 RM Leg Press strength test?
Only suitable for people who can perform with proper form and do not have knee low back or knee pain
- Explain test and demonstrate proper technique
- Legs should fully extend but not hyper extended (locked-out)
- Legs should achieve 90 degrees in the bottom position
- Warm up with one set at 50% 1RM for 5-10 reps with one minute rest
- Second set 70-75% for 3-5 reps
- Third set 85-90% for 2-3 reps and two minutes rest
- Calculate 1RM and have client attempt that weight and rest 2-4 minutes
- Add weight until they achieve their 1 RM preferably within 3-5 working sets
- Record all the data from their warm ups and working sets to use for comparison later on in the program
- Any machine can be used as long it’s the same for all sets and tests at a later date for comparison
What are some benefits of muscular fitness (endurance and strength)?
- Enhances/maintains fat free mass
- Weight Management
- Guards against osteoporosis
- Enhances glucose tolerance
- Guards against Type 2 Diabetes
What is the protocol for the 1 RM Squat Test?
- Explain purpose of test and demonstrate
- Get an additional spotter
- Using the barbell rack, client stands behind the racked bar which is below their shoulders yet above the nipple line. Closed, pronated grip, arms wider than shoulder width and legs split stance to unrack the bar
- Brace core and unrack the bar
4b. Inhale during lowering phase; exhale during upward phase - Initiate flexion with the hips prior to bending the knees
- Client should try to hit 90 degrees
- Upward phase is performed by pushing through the heels
- Don’t lock out knees or go too far below parallel
Rep progression: - 50% of estimated 1 RM for 10 reps
- 75% for 3-5 reps; 1 minute rest
- 85-95% for 2-3 reps; rest 2 minutes
- Attempt estimated 1 RM; rest 2-4 minutes and go up in weight until they hit 1 RM
- Record weight, progress, sets, reps and calculate relative strength (client’s weight (lbs) divided by weight lifted (lbs) = relative strength ratio
- Save results to measure for future progress
6.
Special Considerations for 1 RM Testing with inexperienced clients
When working with an experienced exercisers or individuals with health considerations, it is appropriate to assess strength using submaximal efforts that do not exceed 10 repetitions. Some maximal test that exceed 10 repetitions assess muscular endurance and muscular strength
What are the three muscular endurance tests?
- Push Ups
- Curl Ups
- Body weight Squat
What are the four muscular strength tests?
- 1 RM Bench Press
- 1 RM Leg Press
- 1 RM Back Squat
- Submaximal Strength Tests
How to perform Submaximal strength test for any exercise
- Warm up: 1-2 sets at a lower intensity than target (1-2 minutes rest)
- Instruct the client to perform the first attempt at a personal best; completing the targeted number of reps consistent with their usual training
- If successful, rest for 2 minutes and repeat with a heavier load
- If unsuccessful, use the actual number completed to estimate the 1 RM
What are the common causes of muscle imbalances
- Improper Training
- Overuse of One Side
- Structural Imbalances from injury or poor posture or body mechanics
What two tests are used to assess anaerobic power?
- standing long jump test
2. vertical jump test
How to perform the standing long jump test?
- Place a strip of tape across the floor and instruct the client to stand with feet slightly apart with toes behind the tape
- Using the arms and legs for propulsion, jump as far as possible, landing on both feet
- Measure the distance between the takeoff and rear-most point of contact
- Allow 3 attempts
- Compare with average chart for their gender
How to perform the vertical jump test?
- The client stands adjacent to a wall, 6 inches away from the wall with both arms extended and feet flat on the floor. Mark the clients starting point with chalk
- The client lowers arms and without pause or step, drops into a squat movement before exploding upward into a vertical jump
- Mark the highest point where the client touches the wall with chalk
- Measure the distance between the chalk marks
- Allow 3 repetitions
What is the protocol for the Pro Agility Test?
Also called the 20 yard agility test or 5-10-5 shuttle
This test measures a client’s ability to accelerate, deceleration, and change direction, then accelerate again
- Decribe and demonstrate the proper route of the test
- Will need comes, tape, stopwatch, and marked floor or field
- The trainer is positioned at the center cone or line marker
- Ask client to straddle the middle cone and face the trainer
- On command, client turns and sprints to the cone to the left, making foot contact with the marker before changing direction and sprinting 10 yards across the center marker, then changes direction once again and sprints back to the center line
- Record the time it took to complete to the nearest hundredth of a second
- Repeat two more times
- Fastest time is the final score
How to perform the 40 Yard Dash Speed and Agility Test?
The purpose of this test is to measure acceleration and speed
Requires stopwatch, cones or a marked football field
- Explain the purpose of the test
- Client should do a warm-up
- Client starts with their foot behind the starting line in a 3 or 4 point stance
- Start the stopwatch at the first movement and stop when the clients chest crosses the finish line
- Have the client perform two trials with 2 minutes recovery in between
- Record the average of the two trials
- Compare their score to the charts
What is the main purpose of the various physiological assessments?
- Goal Setting/Programming
- Determining Health Risks
- Establishing Rapport
- Point of reference for future progress
What is the formula for relative strength?
Relative Strength = absolute strength/body weight
What blood pressure changes (ranges) warrant immediate termination of fitness assessment?
Decrease Systolic BP: >10mm/Hg
RISE…
- SBP reaches >250mmHg
- DBP reaches >115mmHg
