Individual Fitness Assessment

Protocols

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Table of Contents

Individual Fitness Assessment Description 2 Individual Fitness Assessment Appointment Description 3 Informed Consent 4 Informed Consent Script 5 Individual Fitness Assessment Personal Fitness Profile 6 Order of Procedures 7 Procedures for Assessment of Resting Heart Rate 8 Procedures for Assessment of Resting Blood Pressure 8 Procedures for Measurement of Height and Weight 9 Procedures for Measuring Body Mass Index 9 Procedures for Measuring Circumference and Body Composition

Circumference 10 Skinfold 11

Body Composition Charts 13 Procedures for Measuring Cardiovascular Endurance

The Modified Balke Protocol 15 The YMCA 3-Minute Step Test 19

Procedures for Measuring Muscular Strength and Endurance

Hand Grip Dynamometer Test 20 Push-up Endurance Test 20

Procedures for Measuring Flexibility

Trunk Flexion (Sit-and-Reach) Test 21

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Individual Fitness Assessment Description Preparation 1. The IFA requires 30-40 minutes to complete. This time does not include your personal time for

getting dressed before and after the appointment. 2. Please be dressed and ready to go at the designated appointment time. 3. Wear comfortable clothing: shorts, short-sleeve T-shirt, rubber-soled exercise shoes. Please do not

wear leggings, panty hose, or bike shorts. 4. Avoid strenuous exercise for 24 hours prior to the test. Try to avoid even moderate exercise for two

to four hours prior to testing. 5. Please ensure you are well hydrated prior to the test. 6. Please refrain from alcohol, caffeine, and nicotine at least 4 - 6 hours prior to testing. 7. Avoid a large meal within two hours of testing. Description: An Individual Fitness Assessment (IFA) is a group of tests to measure the five major components of physical fitness: Aerobic Fitness, Muscular Strength, Muscular Endurance, Flexibility, and Body Composition. The assessment serves two main purposes. The first is to aid in the design of your individualized exercise program. The second is to monitor your progress through comparison of results with future assessments. Following is a brief description of the components of fitness and the tests included in an IFA.

Body Composition refers to the relative amounts of fat and fat-free weight in the body. To estimate

the percentage of body weight that is fat weight, calipers may be used. Depending on your circumstances, we may substitute a bioelectrical impedance tool to measure percent body fat. Additionally, body mass index will be calculated and circumference measures will be performed.

Aerobic Fitness refers to the ability of the respiratory, circulatory, and musculoskeletal systems to

work efficiently over extended amounts of time. The total time you spend on the treadmill test is used to estimate maximal aerobic capacity. In some cases, participants may do a step test as an alternative to the treadmill test.

Muscular Strength refers to the maximal amount of force that a muscle group can exert at one time.

A handgrip dynamometer is used to estimate muscular strength. Research shows that the handgrip measure correlates well with overall body strength.

Muscular Endurance refers to the ability of a muscle group to exert a submaximal force numerous

times. A one-minute push-up test is used to measure muscular endurance.

Flexibility refers to the range of motion in and around a joint or joints. Low back pain and disability

are common ailments and are often associated with poor flexibility in the back of the legs (hamstrings), the hips, and the lumbar regions. A sit-and-reach test is used to measure your flexibility in these regions.

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Individual Fitness Assessment Appointment Description Name: _____________________________ Appointment Date & Time: ___________________

You will receive a confirmation call the day before your Individual Fitness Assessment (IFA). If for any reason you will be unable to make the appointment, please notify the staff as soon as possible. Preparation 1. The IFA requires 30-40 minutes to complete. This time does not include your personal time for

getting dressed before and after the appointment. 2. Please be dressed and ready to go at the designated appointment time. 3. Wear comfortable clothing: shorts, short-sleeve T-shirt, rubber-soled exercise shoes. Please do not

wear leggings, panty hose, or bike shorts. 4. Avoid strenuous exercise for 24 hours prior to the test. Try to avoid even moderate exercise for two

to four hours prior to testing. 5. Please refrain from alcohol, caffeine, and nicotine at least 4 - 6 hours prior to testing. 6. Avoid a large meal within two hours of testing. Description An IFA is a group of tests to measure the five major components of physical fitness: Aerobic Fitness, Muscular Strength, Muscular Endurance, Flexibility, and Body Composition. The assessment serves two main purposes. The first is to aid in the design of your individualized exercise program. The second is to monitor your progress through comparison of results with future assessments. Following is a brief description of the components of fitness and the tests included in an IFA.

Body Composition refers to the relative amounts of fat and fat-free weight in the body. To estimate

the percentage of body weight that is fat weight, calipers may be used. Depending on your circumstances, we may substitute a bioelectrical impedance tool to measure percent body fat. Additionally, body mass index will be calculated and circumference measures will be performed.

Aerobic Fitness refers to the ability of the respiratory, circulatory, and musculoskeletal systems to

work efficiently over extended amounts of time. The total time you spend on the treadmill test is used to estimate maximal aerobic capacity. In some cases, participants may do a step test as an alternative to the treadmill test.

Muscular Strength refers to the maximal amount of force that a muscle group can exert at one time. A handgrip dynamometer is used to estimate muscular strength. Research shows that the handgrip measure correlates well with overall body strength.

Muscular Endurance refers to the ability of a muscle group to exert a submaximal force numerous

times. A one-minute push-up test is used to measure muscular endurance.

Flexibility refers to the range of motion in and around a joint or joints. Low back pain and disability

are common ailments and are often associated with poor flexibility in the back of the legs (hamstrings), the hips, and the lumbar regions. A sit-and-reach test is used to measure your flexibility in these regions.

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Individual Fitness Assessment Informed Consent

The staff recommends an evaluation of your initial physical condition when you become a member. Physical fitness can be divided into five major areas: cardiorespiratory endurance, muscular endurance, muscular strength, flexibility, and body composition. The Individual Fitness Assessment (IFA) will evaluate each of these areas which allows the staff to make recommendations for improving your level of physical fitness. The values reached for each component will be compared to established norms and you will be placed in a fitness category. We feel it is helpful to measure where you are now and then compare those measurements to regularly scheduled future assessments. Feel free to inquire about any part of the Individual Fitness Assessment (IFA) prior to testing. Please answer the following questions, read the Informed Consent, and sign below. Are you currently taking any medication? Yes No _________ If yes, please list medication(s), dosage, and reason taken. _____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Check Yes if you have had any of the following conditions, No if not.

Yes No Yes No

Heart Attack High Blood Pressure

Stroke Heart Disease

Diabetes Abnormal Resting ECG

I consent to voluntarily participate in the IFA and understand that these tests are not part of a medical diagnostic evaluation. I understand that shortness of breath, fatigue, or chest pain are signs that I should reduce my intensity or discontinue entirely. I will inform the staff person administering the test about these symptoms. I have been informed about risks such as change in blood pressure, feeling pain, heart arrhythmias, and possibly heart attack that may occur during the Assessment. I understand that all precautions have been taken to avoid these risks and should they arise the NIFS Staff is prepared for emergencies. Despite these risks I am still willing to undergo the IFA. I understand that any information gathered from the Assessment will be kept confidential. However, data which cannot identify me may be used for purposes of research. I have read the Informed Consent thoroughly or have had it read to me if unable to do so. I give my consent for procedures involved in the IFA. Participant Signature Date Witness Signature Date

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Individual Fitness Assessment Informed Consent Script Purpose: The purpose of the informed consent is to ensure that all attempts have been made to explain the inherent risks and discomforts, confidentiality of test information, and the voluntary nature of the testing procedures. The participant should be made aware that the staff is willing to answer any questions that he/she has concerning the exercise test or other procedures prior to the Informed Consent being signed. The participant must sign in ink on the designated line. The technician must sign as the witness and ensure that all appropriate spaces are completed. Informed Consent Script: There are two main reasons for doing a fitness assessment. First, the results will help in designing an exercise prescription specific to your needs. Second, this assessment will provide a baseline of your current fitness level to compare with results the next time you are tested. The next time we meet, I will have a packet of information that shows your results and how they compare to normative values. In addition, the packet will provide explanations for the components of fitness and how to improve them. During the IFA I will measure your cardiovascular endurance, muscular fitness, body composition, and flexibility. To measure your cardiovascular endurance, I will do a submaximal exercise test on a treadmill. I will also test your muscular fitness with push-up and grip strength tests. I will use a sit-and-reach test to measure your flexibility. I can also assess your body composition with skinfold calipers and I will use a tape measure to take your circumference measurements. If you have any physical limitations that will restrict you from performing these tests, please let me know. All portions of this test are optional. Information you possess about your health status or previous experiences of unusual feelings with exercise are very important to the safety and value of the test. During the fitness assessment, you have the responsibility to let me know if you feel anything unusual. It is very important that you report to me any feelings of lightheadedness, dizziness, trouble with your balance, pressure/pain/tightness in your chest, difficulty breathing, and/or discomfort in any of your joints. These are not normal responses to exercise, so I want to know right away if you experience any of those symptoms. If I see anything unusual, I will stop the test, but remember, you are free to stop any of the tests at any time. If you don’t like a particular test, just let me know and we will stop. There is the risk of injury during the fitness assessment, just like there is any time you exercise, whether you are shoveling snow, hunting, walking in your neighborhood, or exercising at home. Anything from a strain, to a sprain or a broken bone is possible. In cases of an underlying disease condition, there is the possibility that an abnormal heart rate or blood pressure response, a heart attack, a stroke or even death could occur. The exercise will not cause that to happen in a healthy person, but the combination of a disease and exercise can be dangerous. We cannot see these diseases from the outside, which is why we recommend that anyone at high risk for disease or anyone with any doubt about their own safety during exercise consult with his/her doctor prior to beginning an exercise program. Do you have any concerns about your safety for exercise? In the unlikely event that an emergency situation does arise during your assessment, we do have emergency procedures and policies in place. I am trained and prepared to respond to the emergency. Remember, this is your test:

I encourage you to ask questions before, during, and after the test.

You are free to stop any part of the test at any time, for any reason.

All of the information is confidential. I will not report your information to anyone but you unless you give me expressed consent to do so.

Do you have any questions? Let me ask you a few more questions before we begin. (Fill out the “yes/no” questions.) Please read the four paragraphs here; it is a summary of what we talked about. Sign and date it here (point out the signature line).

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Individual Fitness Assessment Personal Fitness Profile

Last Name First Name

Assessment Date

Resting Vitals

Age (yrs.)

Resting HR (bpm)

Resting BP (mmHg)

Height (in.)

Weight (lbs.)

BMI

Circumference (in) R L R L R L R L R L

Arm

Waist

Abdomen

Hips

Thigh

Calf

Skinfold Measurements (mm)

Triceps (w)

Chest (m)

Abdominal (m)

Suprailliac (w)

Thigh (w/m)

Sum of Site Averages

% Body Fat

Muscular Strength (kg) R L R L R L R L R L

Trial 1

Trial 2

Sum of Best R & L Score

Cardiovascular Endurance – Modified Balke Protocol

Estimated VO2 Max

Cardiovascular Endurance – Step Test (alternative to Modified Balke)

1-Minute Heart Rate

Estimated VO2 Max

Muscular Endurance

Push-Ups

Flexibility (in)

Sit-and-Reach (best of 3)

Technician Initials

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Individual Fitness Assessment Order of Procedures

Order of IFA Procedures

1. Reserve treadmill and private space for all testing besides the cardiovascular endurance test.

2. Have the participant sit down.

3. Review Informed Consent using the Script and have participant sign.

4. Take participant’s resting heart rate.

5. Take participant’s resting blood pressure.

6. Have participant take shoes off.

7. Take participant’s height.

8. Take participant’s weight.

9. Have participant put shoes on.

10. Take participant’s circumference measurements.

11. Measure participant’s body composition (preferably skinfold assessments).

12. Perform cardiovascular endurance test (preferably the Modified Balke treadmill test).

13. Measure participant’s muscular strength with the handgrip dynamometer.

14. Have participant perform push-ups.

15. Have participant take shoes off.

16. Measure participant’s flexibility.

17. Schedule follow-up consultation.

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Procedures for Assessment of Resting Heart Rate Purpose: To establish a resting heart rate Equipment: Stopwatch or watch with a second hand Procedures: 1. Have participant sit on chair with feet flat on the floor and hand supinated. 2. Palpate radial artery and gently compress with pads of forefinger and middle finger on lateral border

of wrist, approximately one inch below base of thumb. 3. Take heart rate for one minute and record.

Procedures for Assessment of Resting Blood Pressure Source: Modified from the Sixth Report from the Joint Committee on Prevention, Detection,

Evaluation, and Treatment of High Blood Pressure (JNCVI), Public Health Service, National Institutes of Health, National Heart, Lung and Blood Institute, NIH Publication No. 98-4080, November 1997.

Purpose: To establish a baseline measurement of blood pressure

Equipment: Sphygmomanometer or baumanometer, stethoscope Procedures:

1. Participants should be seated for at least 5 minutes in a chair with their back supported and their arms bared and supported at heart level. Participants should refrain from smoking cigarettes or ingesting caffeine during the 30 minutes preceding the measurement.

2. Wrap the cuff firmly around upper arm at heart level, aligning cuff with brachial artery. Left arm is preferred.

3. The appropriate cuff size must be used to ensure accurate measurement. The bladder within the cuff should encircle at least two-thirds of the upper arm. Many adults require a large adult cuff.

4. Place stethoscope bell below the antecubital space over the brachial artery. 5. Quickly inflate cuff pressure to 20 mmHg above estimated systolic BP [or 160-180 mmHg]. 6. Slowly release pressure at a rate equal to 2 to 3 mm Hg/second. Note the first Korotkoff sound

(denotes systolic pressure). Continue releasing pressure and note when sound becomes muffled (4 th phase diastolic BP) and when sound disappears (5th phase diastolic BP). For classification purposes, the latter is used to indicate diastolic pressure.

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Procedures for Measurement of Height and Weight Purpose: To measure general body size and bone length and to screen for unusual growth, obesity, and malnutrition Equipment: Standard physician’s scale Procedures for Measuring Height:

1. Have participant remove shoes and stand on platform facing away from the scale, perpendicular to measuring rod, feet together.

2. Have participant’s arms hanging at sides, palms facing sides of leg, looking straight ahead. 3. Bring moveable rod into contact with most superior point of participant’s head, with enough pressure

to compress hair. 4. Measure to the nearest 1/2 inch. Procedures for Measuring Weight:

1. Have participant remove shoes. 2. Have participant stand facing scale with feet together and towards the front of platform. 3. Ask participant’s estimated weight in pounds and then adjust scale yourself. 4. Measure weight to nearest 1/2 pound.

Procedures for Calculating BMI To calculate BMI, use the following formula:

weight (lb) / [height (in)]2 x 703

Example = Participant is 155 lbs. and 5’8” tall o 155 / (68x68) = 155 / 4624 = 0.0335 o 0.0335 x 703 = 23.57

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Procedures for Measuring Circumference Source: ACSM’s Guidelines For Exercise Testing and Prescription. 5th ed. Williams & Wilkins,

p.58, 1995. Purpose: To obtain baseline circumference measurements for future reference.

Equipment: Tension-regulated tape

6.5.1.1.1.1.1.1.1 Procedures:

1. The participant should stand erect but relaxed. 2. Place the tape perpendicular to the long axis of the body part in each case. 3. Pull the tape to proper tension without pinching skin. 4. Take duplicate measures at each site and retest if duplicate measurements are not within 7 mm or

0.25 in. Circumference Sites: Calf At the maximum circumference between the knee and the ankle. Thigh With the participant’s legs slightly apart, at the maximal circumference of the thigh (below

the gluteal fold) Hips At the maximal circumference of the hips or buttocks region, whichever is larger (above

the gluteal fold). Abdomen At the level of the umbilicus. Waist At the narrowest part of the torso (above the umbilicus and below the xiphoid process). Arm With the participant’s arm to the side of the body, midway between the acromion and

olecranon processes.

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Procedures for Measuring Percent Body Fat using Skinfold Source: ACSM’s Guidelines for Exercise Testing and Prescription. 6th ed. Lippincott Williams &

Wilkins, pp. 65-66, 2000. Purpose: To estimate the total amount of body fat

Equipment: Skinfold calipers and a marker or pen Procedures: 1. All measurements should be made on the right side of the body 2. A caliper should be placed 1 cm away from the thumb and finger perpendicular to the skinfold, and

halfway between the crest and the base of the fold 3. Pinch should be maintained while reading the caliper; wait no more than 1 to 2 seconds before

reading the caliper 4. Take duplicate measures at each site and retest if duplicate measurements are not within 1 to 2 mm 5. Rotate through measurement sites or allow time for skin to regain normal texture and thickness

before taking duplicate measurements. 6. Find the average mm measurement per testing location and add all three averages together. Use

that score along with the participant’s age and gender in the tables that follow on pages 13 and 14 to determine the percent body fat.

NOTE: A BIA may be used as a substitute to this test when appropriate for the participant. Follow the procedures outlined by the manufacturer to accurately conduct the test. Skinfold Sites: Triceps Vertical fold; on the posterior midline of the upper arm, halfway between the acromion

and olecranon processes, with the arm held freely to the side of the body. Distance between lateral projection of acromial process and inferior margin of olecranon process is measured on lateral aspect of arm with elbow flexed 90 degrees using a tape measure. Midpoint is marked on lateral side of arm. Fold is lifted 1 cm above marked line on posterior aspect of arm. Caliper is applied at marked level.

Chest Diagonal fold; one-half the distance between the anterior axillary line and the nipple

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Abdominal Vertical fold; 2 cm to the right side of the umbilicus

Suprailiac Diagonal fold; in line with the natural angle of the iliac crest taken in the anterior axillary

line immediately superior to the iliac crest

Thigh Vertical fold; on the anterior midline of the thigh, midway between the proximal border of

the patella and the inguinal crease (hip).

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Body Composition Chart for Women Percent body fat estimation for women from age and triceps, suprailiac, and thigh skinfolds

SUM OF SKINFOLDS

(MM)

AGE TO THE LAST YEAR

Under 22

23-27 28-32 33-37 38-42 43-47 48-52 53-57 Over

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23-25 9.7 9.9 10.2 10.4 10.7 10.9 11.2 11.4 11.7 26-28 10.0 11.2 11.5 11.7 12.0 12.3 12.5 12.7 13.0 29-31 12.3 12.5 12.8 13.0 13.3 13.5 13.8 14.0 14.3 32-34 13.6 13.8 14.0 14.3 14.5 14.8 15.0 15.3 15.5 35-37 14.8 15.0 15.3 15.5 15.8 16.0 16.3 16.5 16.8 38-40 16.0 16.3 16.5 16.7 17.0 17.2 17.5 17.7 18.0 41-43 17.2 17.4 17.7 17.9 18.2 18.4 18.7 18.9 19.2 44-46 18.3 18.6 18.8 19.1 19.3 19.6 19.8 20.1 20.3 47-49 19.5 19.7 20.0 20.2 20.5 20.7 21.0 21.2 21.5 50-52 20.6 20.8 21.1 21.3 21.6 21.8 22.1 22.3 22.6 53-55 21.7 21.9 22.1 22.4 22.6 22.9 23.1 23.4 23.6 56-58 22.7 23.0 23.2 23.4 23.7 23.9 24.2 24.4 24.7 59-61 23.7 24.0 24.2 24.5 24.7 25.0 25.2 25.5 25.7 62-64 24.7 25.0 25.2 25.5 25.7 26.0 26.2 26.4 26.7 65-67 25.7 25.9 26.2 26.4 26.7 26.9 27.2 27.4 27.7 68-70 26.6 26.9 27.1 27.4 27.6 27.9 28.1 28.4 28.6 71-73 27.5 27.8 28.0 28.3 28.5 28.8 29.0 29.3 29.5 74-76 28.4 28.7 28.9 29.2 29.4 29.7 29.9 30.2 30.4 77-79 29.3 29.5 29.8 30.0 30.3 30.5 30.8 31.0 31.3 80-82 30.1 30.4 30.6 30.9 31.1 31.4 31.6 31.9 32.1 83-85 30.9 31.2 31.4 31.7 31.9 32.2 32.4 32.7 32.9 86-88 31.7 32.0 32.2 32.5 32.7 32.9 33.2 33.4 33.7 89-91 32.5 32.7 33.0 33.2 33.5 33.7 33.9 34.2 34.4 92-94 33.2 33.4 33.7 33.9 34.2 34.4 34.7 34.9 35.2 95-97 33.9 34.1 34.4 34.6 34.9 35.1 35.4 35.6 35.9 98-100 34.6 34.8 35.1 35.3 35.5 35.8 36.0 36.3 36.5

101-103 35.3 35.4 35.7 35.9 36.2 36.4 36.7 36.9 37.2 104-106 35.8 36.1 36.3 36.6 36.8 37.1 37.3 37.5 37.8 107-109 36.4 36.7 36.9 37.1 37.4 37.6 37.9 38.1 38.4 110-112 37.0 37.2 37.5 37.7 38.0 38.2 38.5 38.7 38.9 113-115 37.5 37.8 38.1 38.2 38.5 38.7 39.0 39.2 39.5 116-118 38.0 38.3 38.5 38.8 39.0 39.3 39.5 39.7 40.0 119-121 38.5 38.7 393.0 39.2 39.5 39.7 40.0 40.2 40.5 122-124 39.0 39.2 39.4 39.7 39.9 40.2 40.4 40.7 40.9 125-127 39.4 39.6 39.9 40.1 40.4 40.6 40.9 41.1 41.4 128-130 39.8 40.0 40.3 40.5 40.8 41.0 41.3 41.5 41.8

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Body Composition Chart for Men

Percent body fat estimation for men from age and chest, abdominal, and thigh skinfolds

SUM OF SKINFOLDS

(MM)

AGE TO THE LAST YEAR

Under 22

23-27 28-32 33-37 38-42 43-47 48-52 53-57 Over

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8-10 1.3 1.8 2.3 2.9 3.4 3.9 4.5 5.0 5.5 11-13 2.2 2.8 3.3 3.9 4.4 4.9 5.5 6.0 6.5 14-16 3.2 3.8 4.3 4.8 5.4 5.9 6.4 7.0 7.5 17-19 4.2 4.7 5.3 5.8 6.3 6.9 7.4 8.0 8.5 20-22 5.1 5.7 6.2 6.8 7.3 7.9 8.4 8.9 9.5 23-25 6.1 6.6 7.2 7.7 8.3 8.8 9.4 9.9 10.5 26-28 7.0 7.6 8.1 8.7 9.2 9.8 10.3 10.9 11.4 29-31 8.0 8.5 9.1 9.6 10.2 10.7 11.3 11.8 12.4 32-34 8.9 9.4 10.0 10.5 11.1 11.6 12.2 12.8 13.3 35-37 9.8 10.4 10.9 11.5 12.0 12.6 13.1 13.7 14.3 38-40 10.7 11.3 11.8 12.4 12.9 13.5 14.1 14.6 15.2 41-43 11.6 12.2 12.7 13.3 13.8 14.4 15.0 15.5 16.1 44-46 12.5 13.1 13.6 14.2 14.7 15.3 15.9 16.4 17.0 47-49 13.4 13.9 14.5 15.1 15.6 16.2 16.8 17.3 17.9 50-52 14.3 14.8 15.4 15.9 16.5 17.1 17.6 18.2 18.8 53-55 15.1 15.7 16.2 16.8 17.4 17.9 18.5 19.1 19.7 56-58 16.0 16.5 17.1 17.7 18.2 18.8 19.4 20.0 20.5 59-61 16.9 17.4 17.9 18.5 19.1 19.7 20.2 20.8 21.4 62-64 17.6 18.2 18.8 19.4 19.9 20.5 21.1 21.7 22.2 65-67 18.5 19.0 19.6 20.2 28.8 21.3 21.9 22.5 23.1 68-70 19.3 19.9 20.4 21.0 21.6 22.2 22.7 23.3 23.9 71-73 20.1 20.7 21.2 21.8 22.4 23.0 23.6 24.1 24.7 74-76 20.9 21.5 22.0 22.6 23.2 23.8 24.4 25.0 25.5 77-79 21.7 22.2 22.8 23.4 24.0 24.6 25.2 25.8 26.3 80-82 22.4 23.0 23.6 24.2 24.8 25.4 25.9 26.5 27.1 83-85 23.2 23.8 24.4 25.0 25.5 26.1 26.7 27.3 27.9 86-88 24.0 24.5 25.1 25.7 26.3 26.9 27.5 28.1 28.7 89-91 24.7 25.3 25.9 26.5 27.1 27.6 28.2 28.8 29.4 92-94 25.4 26.0 26.6 27.2 27.8 28.4 29.0 29.6 30.2 95-97 26.1 26.7 27.3 27.9 28.5 29.1 29.7 30.3 30.9 98-100 26.9 27.4 28.0 28.6 29.2 29.8 30.4 31.0 31.6

101-103 27.5 28.1 28.7 29.3 29.9 30.5 31.1 31.7 32.3 104-106 28.2 28.8 29.4 30.0 30.6 31.2 31.8 32.4 33.0 107-109 28.9 29.5 30.1 30.7 31.3 31.9 32.5 33.1 33.7 110-112 29.6 30.2 30.8 31.4 32.0 32.6 33.2 33.8 34.4 113-115 30.2 30.8 31.4 32.0 32.6 33.2 33.8 34.5 35.1 116-118 30.9 31.5 32.1 32.7 33.3 33.9 34.5 35.1 35.7 119-121 31.5 32.1 32.7 33.3 33.9 34.5 35.1 35.7 36.4 122-124 32.1 32.7 33.3 33.9 34.5 35.1 35.8 36.4 37.0 125-127 32.7 33.3 33.9 34.5 35.1 35.8 36.4 37.0 37.6

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Procedures for Measuring Cardiovascular Endurance using the Modified Balke Protocol

Purpose: To predict/estimate VO2 max

Equipment: Treadmill, Heart Rate Monitor, Log Sheet, HR/ VO2 max chart, 6-20 RPE Scale

Procedures:

1. Prior to starting the test, calculate the participant’s estimated maximal heart rate (HRmax) using the formula: 220 – age; then calculate 85% of that max to be used as a stopping point for this test. The HRmax formula is only accurate in those subjects who do not take heart rate influencing medications (such as beta blockers, calcium channel blockers, inhaled bronchodilators, etc.). If the individual is on such medications, you will follow a 6-20 RPE scale, AND collect their HR at each stage.

2. Attach the HR monitor to the participant. 3. If the participant is unfamiliar with walking on a treadmill allow him/her to spend a few minutes

getting acclimated to the feel of the treadmill under his/her feet. Prediction of VO2 during this test is most accurate when the participant does NOT hold the handrails during the test.

4. Start the test following the Modified Balke Walking Protocol provided. At each stage of exercise the subject’s heart rate should be taken and recorded during the final 10 seconds of the stage. Alternatively, if you’re using RPE, collect that information from the participant at the 10 second interval. Record the data next to the protocol.

5. The participant should continue to exercise until: a. He/she reaches 85% of age-predicted heart rate (HRmax), OR b. He/she reaches an RPE of 16, OR c. He/she completes the protocol.

NOTE: The individual should complete the full two-minute stage during which the reach the 85% of max heart rate or an RPE of 16. Standard cool-down procedures should follow the test.

Calculation:

Using the 85% HRmax method: 1. Draw a horizontal line across the graph at the level of the predicted maximal heart rate you

calculated at the beginning of the test 2. Plot the heart rate values recorded during the test against the VO2 values provided for each stage

of exercise, beginning with minute 4 and continuing to the end of the test. Refer to the testing protocol for the heart rate and VO2 values.

3. With a ruler draw a line-of-best-fit through the points plotted for each stage of exercise and extend it until it intersects the horizontal predicted maximal heart rate line.

4. Draw a vertical line down from the intersection point of your line-of-best-fit and the HRmax lined to the x-axis and identify the VO2 value associated with the predicted maximal heart rate. This is an estimate of the VO2max.

5. If the participant completes the test without reaching their HRmax, follow the above steps with your available participant data knowing that your line of best fit will be more gradual and will thus result in a higher estimated VO2max which is appropriate given the individual’s performance.

Using the RPE method:

1. To estimate HRmax using RPE, divide the individual’s measured HR at the RPE of 16 by .85. Draw a horizontal line on the graph at this value.

2. Plot the heart rate values recorded during the test against the VO2 values provided for each stage of exercise, beginning with minute 4 and continuing to the end of the test. Refer to the testing protocol for the heart rate and VO2 values.

3. With a ruler draw a line-of-best-fit through the points plotted for each stage of exercise and extend it until it intersects the horizontal predicted maximal heart rate line.

4. Draw a vertical line down from the intersection point of your line-of-best-fit and the HRmax lined to the x-axis and identify the VO2 value associated with the predicted maximal heart rate. This is an estimate of the VO2max.

16

5. If the participant completes all of the test stages and does not reach an RPE of 16, use the following table to predict HRmax and proceed with the calculations as noted in the steps above.

RPE Divide HR by this factor to predict HRmax

11 .64 12 .70 13 .76 14 .79 15 .82 16 .85

17

Modified Balke Walking Protocol and RPE Chart

Stage Time (Minutes)

Speed (MPH)

Grade (%)

Estimated VO2

Heart Rate

RPE

0-2 2.0 0 8.8

2-4 3.0 0 11.6

4-6 3.0 3 15.8

6-8 3.0 6 20.3

8-10 3.0 8 23.1

10-12 3.0 10 25.9

12-14 3.0 13 30.1

14-16 3.0 15 33.3

16-18 3.4 15 37.1

18-20 3.7 15 40.3

6

7 Very, very light

8

9 Very light

10

11 Fairly light

12

13 Somewhat hard

14

15 Hard

16

17 Very hard

18

19 Very, very hard

20 Maximal effort

Participant Heart Rate Information Estimated HRmax 85% HRmax

1. 2. E

stimated

8

5

%

H

R

18

Predictive Plot for Determining VO2max Name ___________________________________________ Age _______ Date _____________ Estimated HRmax (220-age) ____________

85% of HRmax ____________

Estimated VO2max ____________

HR

200

190

180

170

160

150

140

130

120

110

19

Procedures for Measuring Cardiovascular Endurance using the YMCA 3-Minute Step Test

Purpose: To predict/estimate VO2 max

Equipment: 12-inch bench, metronome, clock or stopwatch, chair

Important Notes:

The stepping technique is four counts where (a) right foot up onto the bench = 1, (b) left foot up onto the bench = 2, (c) right foot down onto the floor = 3, and (d) left foot down onto the floor = 4. Procedures:

1. Place four risers beneath the step bench. The step height should equal 12 inches. 2. Set the metronome at 96 beats per minute. 3. Have the participant practice stepping to the metronome before beginning the test. 4. The participant should be well rested before the test. 5. Have the participant step up and down on the 12-inch bench for three minutes according to the

aforementioned stepping technique. 6. Have the participant sit down immediately after the test. 7. Within five seconds of stopping the test, begin counting the radial pulse and count for one full

minute. 8. Record the one minute post-test heart rate and use that score along with the participant’s age to

determine cardiovascular fitness using the tables below. Test Selection: This test is only to be used as SECONDARY to the Balke protocol. This test should not be used on participants who have reported balance problems or who are deconditioned.

CARDIOVASCULAR FITNESS IN WOMEN

18-25 26-35 36-45 46-55 56-65 65+

EXCELLENT 52-81 58-80 51-84 63-91 60-92 70-92

GOOD 85-93 85-92 89-96 95-101 97-103 96-101

ABOVE AVERAGE 96-102 95-101 100-104 104-110 106-111 104-111

AVERAGE 104-110 104-110 107-112 113-118 113-118 116-121 BELOW AVERAGE 113-120 113-119 115-120 120-124 119-127 123-126

POOR 122-131 122-129 124-132 126-132 129-135 128-133

VERY POOR 135-169 134-171 137-169 137-171 141-174 135-155

CARDIOVASCULAR

FITNESS IN MEN 18-25 26-35 36-45 46-55 56-65 65+

EXCELLENT 50-76 51-76 49-76 56-82 60-77 59-81 GOOD 79-84 79-85 80-88 87-93 86-94 87-92

ABOVE AVERAGE 88-93 88-94 88-92 95-101 97-100 94-402

AVERAGE 95-100 96-102 100-105 103-111 103-109 104-110

BELOW AVERAGE 102-107 104-110 108-113 113-119 111-117 114-118 POOR 111-119 114-121 116-124 121-126 119-128 121-126

VERY POOR 124-157 126-161 130-163 131-159 131-154 130-151

20

Procedures for Measuring Muscular Endurance using the Hand Grip Dynamometer Test Source: Canadian Standardized Test of Fitness Operations Manual. 3rd ed. Ottawa: Fitness and

Amateur Sport Canada Purpose: To measure the static strength of the grip squeezing muscles. Equipment: Handgrip dynamometer, towel Procedures: 1. Have participant dry his/her hands. 2. The gripping mechanism of the dynamometer should be adjusted and placed comfortably in the hand

to be tested. The second joint of the hand should fit snugly under the handle. The dynamometer should be gripped between the fingers and the palm at the base of the thumb.

3. The hand being tested should be held out slightly in front of the hip, free from contact with the body. The participant may bend slightly forward from the waist and keep the arm in a slightly flexed position at the elbow joint.

4. An all-out gripping of the dynamometer should occur for 2-3 seconds. The arm should remain still so as to not pump or swing.

5. The test is scored as the sum of the best scores for each hand for 2-4 trials each. The scale is read in kilograms.

Test Selection:

This test is appropriate for most apparently healthy individuals. Caution should be used with those individuals having high blood pressure, and injuries or problems with their arms, wrists, hands, or fingers.

Procedures for Measuring Muscular Endurance using the Push-Up Endurance Test Source: ACSM’s Guidelines for Exercise Testing and Prescription. 6th ed. Lippincott Williams &

Wilkins, pp. 84-85, 2000. Purpose: To measure muscular endurance of the upper body. Equipment: Exercise mat Procedures: 1. The push-up test is administered with male participants in the standard “up” position (hands

shoulder-width apart, back straight, head up using the toes as the pivotal point) and female participants in the modified “knee push-up” position (legs together, lower leg in contact with mat with ankles planter-flexed, back straight, hands shoulder-width apart, head up).

2. The participant must lower the body until the chin touches the mat. The stomach should not touch the mat.

3. For both men and women, the participant’s back must be straight at all times and the participant must push up to a straight arm position.

4. The maximal number of push-ups performed consecutively without rest is counted as the score. Test Selection:

Considerations should be taken for clinically obese participants or those individuals with back, shoulder, or wrist injuries.

21

Procedures for Measuring Muscular Endurance using the Trunk Flexion (Sit-and-Reach) Test Source: ACSM’s Guidelines for Exercise Testing and Prescription. 6th ed. Lippincott Williams &

Wilkins, pp. 87-88, 2000. Purpose: To measure trunk forward flexion and determine hip, low back, and hamstring range of

motion. Equipment: A standard Sit-and-Reach box or yardstick, tape to keep the yardstick on the floor,

exercise mat. Procedures: 1. Participant should perform a short warm-up prior to this test and include some stretches (e.g.,

modified hurdler’s stretch). It is also recommended that the participant refrain from fast, jerky movements, which may increase the possibility of an injury. Shoes should be removed.

2. For the YMCA sit-and-reach, a yardstick is placed on the floor and tape is placed across it at right angles to the 15-inch mark. The participant sits with the yardstick between the legs, with legs extended at right angles to the taped line on the floor. Heels of the feet should touch near the edge of the taped line and be about 10 to 12 inches apart. If a standard sit-and-reach box is available, heels should be placed against the edge of the box.

3. The participant should slowly reach forward with both hands as far as possible, holding the position momentarily. Be sure that the participant keeps the hands parallel and does not stretch or lead with one hand. Fingertips can be overlapped and should be in contact with the yardstick or measuring portion of the sit-and-reach box.

4. The score is the most distant point (in inches or centimeters) reached with the fingertips. The best of three trials should be recorded. To assist with the best attempt, the participant should exhale and drop the head between the arms when reaching. Testers should ensure that the knees of the participant stay extended; however, the participant’s knees should not be pressed down. The participant should breathe normally during the test and should not hold his or her breath at any time.

Limitations:

1. Hyperflexibility in one area may mask inflexibility in another area (for example hyperflexibility of the hamstrings may mask inflexibility of the lower back).

2. Test cannot assess differences in flexibility on right vs. left side. 3. Test not necessarily valid in obese populations.