Maybe it's been awhile since you took your certification test. Maybe the club you work at doesn't require comprehensive assessments before you bring on a new client. Or maybe you'd be hard-pressed to define RMR or VO2 max. Sounds like a good time to review the pieces of the fitness assessment! Recommit to bringing currently unused portions back into your own assessment repertoire, if for nothing more than to prove, on paper, that your services really have improved the health and appearance of your clients.
Fitness Forms 101
Prior to beginning any fitness assessment, have your client complete a basic health screening to make sure that he/she is capable of completing the resting, submaximal and maximal assessment. Commonly used forms are both the Physical Activity Readiness Questionnaire (PAR-Q) and the Informed Consent/Release of Liability forms.
The PAR-Q creates some conflict and potential liability for the fitness professional as the PAR-Q was originally intended for those who plan on participating in a moderate level of exercise, which is well below the focus of most fitness assessments. Within the past few years, a collaboration between the American Heart Association and the American College of Sports Medicine yielded a more comprehensive "AHA/ACSM Health/Fitness Facility Pre-participation Screening Questionnaire€VbCrLf that creates a better blanket of preventative coverage for the trainer.
The Informed Consent/Release of Liability form is subjective to the interpretation of the individual, the state and sometimes the county, so be sure to seek local legal consultation in preparation of this form. And be sure that whatever form you use, make sure it requires clients to list all supplements and medications they take as these items could affect blood pressure, pulse and energy levels.
| BASIC COMPONENTS OF A FITNESS ASSESSMENT |
| 1. The pre-participation screening 2. Basic vital signs 3. Body composition 4. Limit or power strength 5. Agility 6. Speed 7. Muscular endurance 8. Cardiovascular endurance 9. Flexibility 10. A functional movement |
Checking Vital Signs
Once a health history, physical readiness and release of liability is documented, begin the assessment with the measurement of vital signs. Conduct vital signs measurements first at rest as both a screening for cardiovascular risk factors and as a baseline against current norms. You'll also use this measurement as reflection for future comparison. These consist of three basic components: blood pressure, pulse and breathing patterns. For better accuracy, make sure clients haven't used tobacco and/or caffeine products at least three hours prior to the measurements.
The screening for blood pressure is essentially to figure out if the client could be classified as normal, pre-hypertensive or in one of two grades of hypertension. The cardiac rate or pulse is most commonly obtained either via the carotid or radial pulse with a slight palpation with the index and middle fingers for periods of 10 to 60 seconds to determine if the client has a slow, normal or fast heart rate. The respiratory rate is generally obtained by observing the chest and/or abdomen rise and fall over a one-minute period with the goal of determining if the breathing rate is slow, normal or fast.
The vital signs measurements are critical in determining exercise prescription and knowing when it is appropriate to refer the client to a primary care provider or specialist due to possible underlying medical conditions.
Body Composition
Next are the morphologic assessments in relation to the body composition. The objective of these assessments is to rule out any kind of cardiovascular risk factors and provide a baseline to reflect against. The basic areas are height, weight, circumference and body fat measurements.
The height and weight measurements can be used for the BMI, which is a basic screening tool for cardiovascular risk factors, although not totally accurate for actual body composition. The circumference measurements can be broken down to two basic uses: baselines for general girth and cardiovascular risk factor identification. Both can be reflected against at a later time.
Body fat composition is an essential tool in determining health risk factors, showing client body composition change, even when weight hasn't necessarily changed, and indicating program readjustment. The body fat analysis uses methods such as calipers, BIA, hydrostatic, air displacement and circumference.
Submax and Maximal Effort Assessments
The following valid assessments require effort at the submaximal to maximal levels. These will depend on the goal of the target population, require more than the standard PAR-Q screening and can include but not be limited to muscular power, muscular limit strength, local muscular endurance, agility, speed, cardiovascular endurance and flexibility.
Muscular power relates to movements that require a high volume of weight moved rapidly in a short period of time. Examples include the classic Olympic lifts of the snatch and cling to press.
Muscular limit strength refers to the maximum amount of weight that can be moved at one time without regard to speed. Some examples are one-repetition max movements that are associated with the traditional power lifts of the bench press, deadlift and squat; however, there are some additional norms available for the general populations in use with a standard leg press or a hand grip dynamometer.
Local muscular endurance movements involve assessments that have larger muscle groups performing repetitive movements in a given time frame or to failure. Some example movements are the abdominal curl-up, push-ups and pull-ups. There are additional movements using a fraction of body weight, such as the bench press.
The agility tests are primarily indicated for athletes, measuring how quickly the individual reacts to a given multi-plane task. Some of the more common assessments are the T-test, Hexagon and tennis court agility.
Speed tests are also generally intended for the athletic population, measuring how quickly an individual can cover a given distance in a period of time. Some examples of this kind of assessment this can be the 40-, 50- and up to a 110-yard dash.
The cardiovascular endurance assessment tests the capacity of the cardiorespiratory system in which the norms can be interpreted as VO2 or MET levels and used to estimate kcal expenditure during exercise. Some examples of these modes of exercises are a modified treadmill walk, seated stationary bicycle or a 1.5-mile run.
Flexibility testing measures the elasticity of certain muscle groups, ligaments and tendons that cross at least one joint. One of the most common movements is the sit-and-reach, which measures the available range of motion of the lumbar extensors, hip extensors and knee flexors.
Metabolic Testing
Resting metabolic rate (RMR) is used to determine the basic caloric metabolism requirement during rest; it is highly individualized and very helpful when estimating daily energy expenditure. Some items associated with this require an individual to sit and rest while breathing into a device that conducts the measurements.
Functional Movement
The objective here is to have the client complete a movement pattern, allowing the observer to estimate which muscle groups are overly tight and which ones are weak, then adjust programming as needed. Some examples are the overhead squat, single-leg squat or observation of the client's gait while walking on a treadmill.
For more info, see ACSM's Guidelines to Exercise Testing and Prescription, Seventh Edition, NASM Essentials of Personal Fitness Training, Third Edition, and Essentials of Strength Training and Conditioning, Second Edition by NSCA.
Geoffrey Miller, MS, CSCS, HFI, CPT, SPN (millergb@hotmail.com) has spent four years in the fitness industry, two years in health promotions and clinical weight management, and he has participated in two bodybuilding competitions.
