ACSM CPT Chapter 12 Client Fitness Assesments

WALK/RUN performance tests--- 1.5 Mile-2.4km Test

1. FOR BEGINNERS : test is contraindicited for unconditioned beginners, individiduals with symptoms, 2. 15 MINUTES of jog should be done by client 3. PACE client 4. formula is vo2 MAX = 3.5 + 483/time time such as 14 min 20 seconds= 14.33

Body Composition - WAIST circumference

just waist measurement can also be indicator of health risk. HIGH RISK man > 102 woman > 88 LOW RISK man < 80 woman < 70

Muscular Strength Assesment : 1 RM

muscular strength is RATIO TO total body weight. - vigorous exertion - 1 rm - bench press - risk shoulde be evaluated for orthopedic limitations and older ages) PROCEDURES: 1. warm up 5-10 rep with %40-60 2. closed grip 3. free weight 4. 1 minute rest then 3-5 reps of %60-80 5. find 1 RM in 3-5 maximal efforts BP weight ratio man: Superior 99% = 1.63 for age 20-29 woman superior 99% = 1.01 for age 20-29

Measurement of EXERCISE Heart Rate

must be executed immediately afte rexercise, you should start time period and the count at zero at the first beat felt.

Measurement of Blood Pressure - Korotkoff Sounds

phase 1 SBP: clear , repetitive sound phase2 soft tapping, murmur phase 3 loud tapping, high pitch phase 4 DBP: less audible, blowing phase 5 : complete disapperance

Calculation of Ideal or Desired Body Weight

two input: BW and FAt Weight ideal body weight fat %15 IBW= ideal body weight = *(BW- FW) // 1- 0.15* = 147.63 lb/ 0.85 === 173.68 78.9 kg at %15 body fat

Body Composition - Skinfolds

useful for BODY FAT PERCENT estimation. PROCEDURES: 1. should be made on the right side of body 2. caliper should be placed directly on skin interface. 3. mark skin for duplicate measures. 4. SUM the mean or average of each skinfold site, to determine percent body fat. for man 20-29 age %99 VERY LEAN 4.2 for woman 20-29 age %99 VERY LEAN 11.4 MEASUREMENT SITES: abdominal, triceps, biceps, chest medial calf Subscapular ..

Measurement of Blood Pressure - Procedures

1. MANOMETER STETHOSCOPE placed on brachial artery - clear your throat to heat sounds 2. client - legs uncrossed - arm relaxed - back supported 3. 5 MINUTES at rest , - client must be free of stimulants 4. choose same ARM for resting and exercise measurement. Conventionally * left arm* is used 5. appropriate size of BP cuff 6. without clothing , measure arm. 7. support client arm 8. client upper arm on level of heart. 9. place stethoscope on brachial artery. 10. do not rapid deflation . 11. record measure of SBP and DBP , make sure to measure 5th phase. CONSIDERATIONs a) no tension drugs b) no any drıgs

Heart Rate - Resting, Exercise , Recovery

1. Resting HR 2.HR response: to a standart amount of exercise is an important fitness variable and foundation for many cardiorespiratory endurance tests. 3. Recovery HR: excellent index of CRF, used in some CRF tests( Queens College step test) MEDICATIONs: that can affect responses to HR

WALK/RUN performance tests

1. Walk/run 2. walk tests

WALK/RUN performance tests--- Rockport 1-mile Walk Test Procedure

1. for who unable to run. 2. client can run under 120 bpm 3. as FAST as client can walk.

Measurement of Blood Pressure - Instruments

1. manometer: a) mercury b) aneroid ( mostly used) 2. cuff: SPHYGOMANOMETER: how to measure: 1. CUFF positioned at the level of heart , ( if below BP falsely high) 2. CUFF must be tight

Measurement of Heart Rate

1. manual palpation at anatomical site 2. HR monitor/watch or electrocardiogram

Submaximal Cycle Ergometer Tests

Astrand-Rhyming PROCEDURES 1. EXPLAIN TEST 2. OBTAIN INFORMED CONSENT 3. RESTING BP and HR 4. Leg should be straight in pedal down position. 5. cadence of 50 rpm, metronome at 100 6. MAINTAIN 50 rpm 2th minute : measure HR for 10-15 seconds 3rd minute --- Measure BP at 5th - 6th minutes --- measure HR if difference less than 5, FINISH TEST. 8. RECOVERY PERIOD measure HR and BP in 3 minute interval. COMPLETION CRITERIA -- 5 bpm difference between 5th-6th minute HR -- HR between 125-170 -- if below 125 in 6 minutes, increase work rate by 300kg.m.min-1

Body Composition - BODY MASS INDEX

BMI = weight / height (m2) 68kg/ 2.99m2 = 22.8 kg/m2 1.73 metre=>> 2.99 m2 1. Uweight < 18.5 2. Normal 18.5- 24.9 3. Oweight 25-29 4. Obesity class1 30-34.9, class2 35-39.9 , class3 >40

Blood pressure: Resting and exercise

BP(mmHg) is dynamic variable with regard to location. b) ARTERIAL PT must concerned with *arterial* BP at the level of the heart. C) REST&DURING 1. SBP : contraction of heart, indicator of cardiovascular functon DURING exercise. 2. DBP: relaxtion of ventricles HYPERTENSION: *resting* BP, is above optimal or desired level. prehyper: 140>x>120 DBP: 90-80 *SBP > 140 DBP > 90 * HYPOTENSION signs: dizziness, light headedness

Norms for Cardiorespiratory Fitness V02 max

CRF is commonly expressed as v02Max. percentage %95 = at age 20-29 = 66.3 = superior for man percentage %95 = at age 20-29 = 56.0 = superior for man

Cardio-respiratory Fitness Assessment

CRF is related to ability to perform muscle,dynamic , moderate to high intesnisty exercise for prolonged periods of time and relflect the functional capabilities of heart, blood, vessels, lungs and relevant muscles during various types of exercise demands. CRF can mean: - maximal aerobic capacity - functional capacity - physical work capacity - maximal oxygen uptake - cardiovascular endurance/fitness - cardiopulmonary endurance/fitness/capacity

Muscular Strength Assesment : 1 RM

LEG PRESS 1 rm man = %90 = 2.27 = 20-29 age woman = %90 = 1.82 = 20-29 age

Submaximal Cycle Ergometer Tests

Maximal testing is not always a feasible or desirable approach in some settings, thus PT need to be able to perform a submaximal exercise test on a client in a laboratary settings 1. 6 minute 2. SUBMAXIMAL exercise

Cardio-respiratory Fitness Assessment

Measurement usage: - exercise prespcription and programming - progress and motivation of client in a program - prediction of medical conditions TRUE MEASUREMENT of CRF: maximal exertion as a result of graded exercise with the collection of expired gases during exercise test. COLLECTION of expired gases is beyond scope of PT.

Body Composition - Bioelectrical Impedance

Non-invasive and easy to administer method for asessing body composition. LOGIC: volume of fat free tissue will be propotional to the electrical conductivity of the body. FAT TISSUE: no intense body water, therefore electric circulate is resisted on fat. Preconditions: 1. free bowel before 30 minutes 2. no alcohol before 48 hour 3. no drink and eat before 4 hours 4. no exercise in 12 hours SKINFOLD error rate : hard technic, small rate%3.5 BIA error rate: easy technic, lots of precondiitons and %5.0

Body Composition - Skinfolds

PERCENT BODY FAT PERCENTAGE: jackson pollock 3 site skinfold formula men: CHEST, ABDOMEN, THIGH WOMAN: triceps, thight, suprailium

STEP tests

Queens College Step Test Procedure 1. STEP HIGH: 41. 25 cm 2. DURATION: for 3 minutes 3. NORMS: men > 24 steps per minute woman 22 1 step = right and left separately 4. METRONOME: 4 times the step rate 24StepsX4= 96 bpm 5. RECOVERY HR, should be measured after interval of 5-20 seconds of exercise. 6. VO2 max = 65.81 - 0.1847xHR

Selection And Sequence of Assesments

Recommended order for performing assessments 1. HR :resting 2. BP : resting 3. Body composition: A. Height/weight B. BMI C Waist to hip ratio D. skinfolds 4. CRF Assesment a) 1 mile walk test b) 1.5 mile run test procedures c) Queens College Step d) Astrand Rhyming Submaximal Cycle Ergometer 5. MUSCULAR fitness: muscle strength - endurance 6. FLEXIBILITY: sit-and-reach

Body Composition - WAIST TO HIP RATIO

SHOWING: distribution of body weight, and perhaps body fat. INDICATOR: body weight distribution is predictor of health risks of obesity. WAIST: smallest circumference below xiphoid HIP: largest circumference around buttocks WHR man > 0.95 HIGH RISK woman> 0.89 HIGH RISK

Measurement of Blood Pressure

a) serial measurements on seperate days. b) 2-3 resting record: on seperate two or more visit.

Cardio-respiratory Fitness Assessment - PRETEST

abstain from 1. alcohol 24 2. caffeine 12 3. food intake 4 hour 4. exercise 24 hours 5 .nicotine 3 6. medication

Flexibility Assesment - Sit And Reach Test

actually only measures flexibility of hamstrings, lowerback and hip. ( because many people complain with low back pain) PROCEDURES: 1. WARM up 2. hold in reach position 2 seconds. 3. hands parallel 4. knee extended 5. exhale while reaching

Measurement of Heart Rate - Palpation of Pulse

anatomical sites: 1. RADIAL: press index and middle fingers to radial artery 2. BRACHIAL: medial side of arm, anterior to elbow, between triceps and biceps 3. CAROTID: medial border of the sternocleidomastoid muscle in lower neck. *use Carotid*, if *feeling failed* on Brachial or Radial. ACCURACY: increase with longer time measurement CONSIDERATIONS: tobacco and caffein restriction at least 30 minutes before - seated at least 5 minutes with back supported.

Assesments as a Motivational Device

assesment can be done in a periodic way, and can determine if established goals have been met or not. for example, flexibility test with a client have 3 month flexibility improving goal, can be done every 4-6 weeks.

Body Composition

body composition is defined as: relative proportion of fat and fat-free tissue in the body. there is strong correlation between obesity and increased risk of chronic disease - coronary artery disease - diabetes - hypertension - certain cancer - hyperlipidemia 1. HEIGHT AND WEIGHT 2. BMI 3. WHR 4. SKINFOLD 4. BIOelectrıcal impedance analysis

Assesment process

client can have uncomfortable moment such as skinfold measurement at abdomen for overweight. make them comfortable or ask them if you want finish or not. always RESPECT to client.

Muscular Endurance Assesment : Push up test

endurance: ability to apply a force repeatedly over time. PARTIAL CURL UP ( removed 1. PUSH UP excellent man > 36 push ups excellent woman > 30 push ups PROCEDURE 1. elbow straight in down position 2. back must be straight 3. chin touches the mat 4. maximum push ups without rest 5. until technique is broken between repetitions

Body Composition - HEIGHT AND WEIGHT

take shoes of client. 6 ft = 183 cm

Various Field Tests for Prediction of CRF

tests can be inappropriate for sedentary clients. two types A) timed completion of a set distance B) MAXIMAL DISTANCE for a set time. 1- WALK/RUN tests ( more accurate than Step tests) 2- STEP tests