Chapter: Fitness Assessment

Memorizing all of the below can be tough. Find out what you need to know in our Study Guide for the NASM CPT Exam.

Compare with Table 6.1 – Guidelines for Health and Fitness Professionals

This table shown in the book discusses the guidelines for health and fitness professionals by displaying what a trainer should do if the client’s health is of high-risk.

What should not be done:

• Counsel Clients
• Diagnose Injuries or Conditions
• Physical therapy or rehabilitation
• Give detailed diets / meal plans

What should be done:

• Coach Clients
• Identify past injuries and limit your exercises for the injury
• Recommend client to speak and get medical advice from physician
• General Nutrition Knowledge and refer them to a dietitian or nutritionist for detailed diets

Referenced from: http://www.exerciseismedicine.org/assets/page_documents/ExPro_Action_Guide.pdf

Compare to Figure 6.1 – Subjective vs. Objective information

Gathering information is very important before starting any kind of workout program with a client. You want to know about their current and past state of health. Ask questions and note their answers to determine subjective information and perform assessments to determine objective information.

Subjective Information

•  General Medical History
• Occupation
• Lifestyle (Hobbies, Diet, etc.)
• Personal Information

Objective Information

• Body Analysis
• Blood Pressure
• Performance Assessments
• Postural Assessments
• Cardiorespiratory Assessments

Referenced from: Sports Medicine Essentials, 3rd ed. by Glover

Compare with Figure 6.2 – Sample Physical Activity Readiness Questionnaire

The physical activity readiness questionnaire also known as the PAR-Q is design to get the clients to answer specific health history questions. It will also give you the information needed for you to determine the possible risk of exercising with the client. If a client answers yes to any of the 7 questions on this form, they must acquire a doctors written permission to begin exercising with you.

Check out a PAR-Q here: http://sportsmedicine.about.com/od/fitnessevalandassessment/qt/PAR-Q.htm

Compare with Figure 6.3 – Sample Questions: client occupation

Occupational questions are asked to determine the amount of influence someones job has on their posture.

• Sitting causes tightness in the hip flexors and rounding of the upper back.
• High heels cause tightness in the calf musculature.
• Repetitive movements refers to the shoulder impingement caused by doing physical work over head. (Construction, electrician, volleyball player)
• Stress may cause shortening of the scalenes and upper trapezius creating upper crossed syndrome.

Compare with Figure 6.4 – Sample Questions: client lifestyle

Lifestyle questions give the trainer a chance to note what interests the client has in their everyday life. Recreational activities and active hobbies can be included in their cardiorespiratory training program.

Compare with Figure 6.5 – Sample Questions: client medical history

Medical history allows the trainer to gauge the risk of any health related issues the client may be dealing with.

Pain should be noted and an exercise program should account for that pain.

Surgeries may limit range of motion or cause joint instability.

Chronic disease may need to be accounted for with all exercises.

Medications may affect exercise variables such as intensity.

Compare with Table 6.2 & Table 6.3 

Table 6.2 & Table 6.3 show how common medications effect blood pressure and heart rate as well as show you the basic functions of the medications. It is reminded that as a personal trainer this is not our job to educate the client on any usage and effects of these prescribed medications.

Common Medication you will come across with potential clients are:

Antidepressants, Beta-Blockers, Calcium-channel blockers, Digitalis, Thyroid Medication, Nitrates, Diuretics, Bronchodilators, Vasodilators

Learn More Here: http://www.exrx.net/ExInfo/Medications.html

Heart Rate and Blood Pressure Assessments

Heart Rate can be recorded on the thumb-side of the wrist (radial pulse; preferred) or on the neck (carotid pulse, use with caution).

Blood pressure is measured using an aneroid sphygmomanometer which consists of an inflatable cuff, a pressure dial, a bulb with a valve and a stethoscope. It is highly recommended that anyone including personal trainers take a professional course in blood pressure assessment before assessing blood pressure with any clients.

See examples of all assessments here: http://www.exrx.net/Testing.html

Target Heart Rate Training Zones & Max Heart Rate Formula

220 – age = Predicted max heart rate. Multiply by the suggested HR training zone of anywhere from 65-95% of Predicted HR max.

Training Zone One = Builds aerobic base and aids in recover

Training Zone Two = Builds aerobic endurance

Training Zone Three = Builds high end work capacity that is mainly anaerobic.

Reference: http://www.active.com/fitness/articles/calculate-your-training-heart-rate-zones?page=2

Body Composition Assessments 

There are many methods used to estimate one’s body composition.

• Skin Fold: Measurements are taken at different site on the right side of the body whole person stands straight but relaxed. The width of the skin fold is measured in millimeters with a specially calibrated caliper. The total for each site in marked and its added up to determined the person overall body composition.
• Bioelectrical Impedance: Better known as a Body Fat Analysis is a device xenical orlistat that measures the strength and speed of the electrical signal sent through the body. It uses this measurement and information such as height, weight and gender to predict how much body fat a person has.
• Underwater Testing: Is a technique for measuring the mass per unit volume of a living person’s body.

Refer to http://www.exrx.net/Testing/BodyCompSites.html for great skinfold site description.

Circumference Measurements 

Circumference measurements measure the outer surface of the body which includes all tissue. They are some benefits in using the circumference measurement, which included tracking the progress of the clients loss (in inches), can be more comfortable to use on overweight clients, easy to afford, easy to record and not hard to learn the technique or make a mistake on it.

Measurements of the following areas are suggested:

1. Neck
2. Chest
3. Waist
4. Hips
5. Forearm
6. Thighs
7. Calves
8. Arms

References: http://www.exrx.net/Testing/Circumferences.html

Body mass index (BMI)

BMI can be used to screen patients because the test is simple, correlates to fatness, and applies to both men and women. The BMI may not apply to some individuals with more than normal muscle mass and acceptable levels of body fat.

Know the above ranges provided by http://www.exrx.net/Calculators/BMI.html

YMCA 3-Minute Step Test – [pg 130]

This is a cardiorespiratory assessment to estimate and individual’s cardiorespiratory fitness level. It is done in the time period of 3 min. The first thing you must have is 12-inch step and the client will begin to step up and down at 96 steps per minute. Having a metronome will come in handy to give the client a beat to follow along for the 3 minutes they will be performing this test. As the 3 minutes finish you must immediately find the recovery pulse, write it down and then refer to the text to determine the appropriate heart rate zone to start them at.

Rockport Walk Test – [pg 131]

This is another kind of cardiorespiratory assessment set to estimate a cardiovascular starting point. You will need to note your client’s weight, age, gender at first before starting. Once you got all that noted you will need to go to a treadmill in where you will explain to your client that they will need to walk and only walk a mile as fast as they can. No jogging or running, the must walk as fast as they can for a mile. As they do that take note at the time they finish and immediately have them step off to the side so that you may record the heart rate. Now you have everything you need to determine the clients V02 score by using the following formula.

132.853 – (0.0769 x Weight) – (0.3877 x Age) + (6.315 x Gender) – (3.2649 x Time) – (0.1565 x Heart Rate) = Vo2 score (Reference: http://www.brianmac.co.uk/rockport.htm)

Use the following calculator for a quick determination of the clients score: http://www.exrx.net/Calculators/Rockport.html

Compare with Table 6.9 – Pronation Distortion Syndrome

• gastrocnemius
• soleus
• paroneals
• adductors
• iliotibial band
• hip flexor comples
• bicep femoris (short head)

Lengthened Muscles

• Anterior and Posterior tibialis
• vastus medialus
• gluteus maximus/ medius
• hip external rotators

Probable Injuries

• Plantar fasciitis
• Posterior tibialis tendinitis (shin splints)
• low back pain

Reference: http://goldenfitness11.blogspot.com/2013/05/pronation-distortion-syndrome-and-how.html

Compare with Table 6.10 – Lower Crossed Syndrome Summary

Lower-Crossed Syndrome (LCS) is also referred to as distal or pelvic crossed syndrome. In LCS, tightness of the thoracolumbar extensors on the dorsal side crosses with tightness of the iliopsoas and rectus femoris. Weakness of the deep abdominal muscles ventrally crosses with weakness of the gluteus maximus and medius. This pattern of imbalance creates joint dysfunction, particularly at the L4-L5 and L5-S1 segments, SI joint, and hip joint. Specific postural changes seen in LCS include anterior pelvic tilt, increased lumbar lordosis, lateral lumbar shift, lateral leg rotation, and knee hyperextension. If the lordosis is deep and short, then imbalance is predominantly in the pelvic muscles; if the lordosis is shallow and extends into the thoracic area, then imbalance predominates in the trunk muscles.

Reference: Janda 1987, Human Kinetics

Compare with Table 6.11 – Upper Crossed Syndrome

(UCS) is described as a muscle imbalance pattern located at the head and shoulder regions. It is most often found in individuals who work at a desk or who sit for a majority of the day and continuously exhibit poor posture.

• TIGHT

  rear neck and side neck

  levator scapulae

  scalenes

  sternocleidomastoid

  upper trapezius

  shoulder internal rotators

  subscapularis

  teres major

  anterior deltoids

  pectoralis major

  pectoralis minor

• WEAK

  upper-arm external rotators

  infraspinatus

  posterior deltoids

  teres minor

  deep-neck flexors

  longus capitis

  longus colli

Reference: http://www.yogajournal.com/slideshow/fix-slouch-poses-upper-crossed-syndrome/