Principles & Guidelines for Health Related Physical Fitness Testing
Introduction
The basic principles and guidelines for health-related physical fitness testing allow individuals to achieve their health and fitness goals safely and efficiently. In order to carry out a successful health fitness evaluation, exercise professionals (EP) must receive informed consent, obtain medical clearance through a Physical Activity Readiness Questionnaire (PARQ), and gather the client's current level of fitness and desired level of intensity. Once all of these pretest guidelines are met, EP’s must organize the fitness test. All testing equipment for body composition, heart rate and blood pressure, cardiorespiratory fitness, and maximal or submaximal testing must be evaluated and recalibrated to ensure reliability and validity. Also, the facility where the client is being tested should be the correct temperature of 68-72 degrees Fahrenheit. Additionally, having a comfortable testing environment is ideal to ensure that the client feels safe and anxiety levels remain low, to remove any test inference (Liguori et al., 2021). Once all of these factors are checked off, a comprehensive health fitness evaluation can begin. When multiple tests are being given on the same day, the order of the tests and rest periods between each test must be taken into account to ensure test reliability; one test should not hinder the results of the subsequent test (Haff & Triplett, 2021).
Resting measurements and body composition
Once all pretesting requirements are done and the client appears to be comfortable and calm for at least five minutes, taking heart rate and blood pressure will be the first step. Heart rate can be taken through pulse palpation, auscultation with a stethoscope or use of a heart rate monitor (Liguori et al., 2021). Obtaining resting heart rate through heart rate monitors is becoming more popular amongst fitness facilities and individuals. However, if no equipment is provided, pulse palpation is the best method. By taking your index and middle finger, and placing it on the radial artery for 30 seconds, one can obtain the resting heart rate, by multiplying the number of beats by two. Once heart rate is recorded, blood pressure can be taken. Ensure the client has not had caffeine or smoked at least 30-minutes before taking their blood pressure. It’s important to take two measurements of blood pressure, at least one minute apart (Liguori et al., 2021).
Body composition can be obtained through several different methods. A popular anthropometric method of obtaining body composition is calculating one's body mass index (BMI), by dividing their body weight in kilograms by their height in meters. However, this method does not distinguish the difference between body fat, muscle mass and bone (Liguori et al., 2021). Some athletes or those with higher lean mass may be falsely recorded as obese; individuals with a lower amount of lean mass but higher body fat can also be falsely recorded as being a normal weight (Buss, 2014). Hence, other methods, such as skinfold measurements and densitometry measurements can be taken. Nosslinger et al. (2021) compared the results of skinfold measurements to ultrasonography (USG) and found a high correlation between the two methods, when obtaining accurate readings of body fat percentage. After body fat percentage is recorded, the EP must assess any risks or signs of disease from these results. Circumferences must also be taken to analyze body fat distribution. The EP will also analyze the waist-to-hip ratio and where the fat is located; this can help determine if the client is at risk for hypertension, cardiovascular disease, type 2 diabetes or other metabolic diseases (Liguori et al., 2021).
Cardiorespiratory Fitness
Once all body composition and resting measurements are taken, the EP can begin assessments related to cardiorespiratory fitness (CRF). The following assessments must take the current level of fitness, body composition, resting measurements, medical history, and medications being taken, into account when deciding on the tests to be given. Cardiorespiratory fitness assessments can also help determine signs of cardiorespiratory disease (CVD) or other diseases. The criterion method for measuring CRF is taking one's V02 max or maximal oxygen consumption. Equipment to measure V02 max can become costly and inconvenient, so taking maximal and submaximal exercise tests can help determine V02max. Performing a maximal exercise test is not appropriate for all populations, so using a submaximal exercise test may be a more feasible way of determining cardiorespiratory fitness. In order to do this, the EP must evaluate the heart rate response when giving the submaximal assessment. Heart rate response, as well as blood pressure and rate of perceived exertion should be evaluated on day one and also throughout the exercise program, to make any necessary adjustments to the prescribed exercise program. Some of these tests include using treadmills, cycle ergometers, and various field tests such as the Rockport One Mile Fitness Walking Test, 6-minute walk test, 12-minute run/walk test, and the YMCA test (Liguori et al., 2021). If the client is currently not active, performing a 6-minute walk test will be the more appropriate choice, to ensure that they complete the test, and the EP can get an accurate representation of their current V02max. It is important to note that aerobic capacity tests should be given after any flexibility, agility, balance or maximal strength testing to ensure the reliability of the assessment (Haff & Triplett, 2021). When giving any cardiorespiratory test, the EP must look out for signs of when to stop the test. For example, if the subject is experiencing extreme fatigue, nausea, dizziness or lack of rising heart rate while exercising, the EP should stop the test (Liguori et al., 2021).
Muscular Fitness
Muscular fitness is a combination of muscular strength, endurance and power (Liguori et al., 2021). Several different assessments can be given based on the client's current level of activity, medical background and desired level of activity. Liguori et al. (2021), states that any form of strength exercise can aid in decreasing mortality risk. A component to keep in mind for older populations is the decline in skeletal muscle tissue, also called sarcopenia. Particularly in postmenopausal women, there is a decline in bone density, which can lead to osteoporosis. Mayer et al. (2011), states that there is a decrease in muscle strength of 15% by the age of 60. Once the EP has considered the population they are testing, some common procedures must take place to ensure that the test is accurate and safe. There should be a light aerobic warmup, familiarity with the equipment being used, execution of correct form and strict posture with each movement, consistent movement speed, execution of full range of motion with each movement, and finally have spotters available, if necessary. Many times, a 1-repetition maximum (RM) test is not appropriate for a given population, so the EP can give a multiple RM test, consisting of 5-10 repetitions. Tests performed for strength can be the bench press, shoulder press, leg press or squat. A muscular endurance test that does require any equipment is the pushup test. However, the test should be stopped when the individual loses correct form and begins forcing the movement. Finally, muscular power can be done through the countermovement vertical jump, or the sit-to-stand test for the older population. Muscular power is an important test to provide for any population because it declines faster than muscle strength and endurance. It is also a valuable predictor of functional independence (Liguori et al., 2021).
Balance and flexibility
Balance and flexibility are important components of a health evaluation. Proper balance can reduce the risk of falls and ankle sprains, while flexibility can allow an individual to move a joint through full range of motion and prevent muscular imbalances and potential injury (Liguori et al., 2021). Again, when considering the older population, balance and proprioception begin to decline, so it is essential to prevent these factors from taking place through balance and flexibility assessments. At 80 years of age, our sensorimotor functions start to decline by 30%, causing a large reduction in intermuscular and intramuscular coordination (Mayer et al., 2011). This can lead to balance and proprioceptive issues. Plus, athletes with poor balance are more susceptible to lower limb injuries (Haff & Triplett, 2021).
References
Buss, J. (2014). Limitations of body mass index to assess body fat. Workplace Health & Safety, 62(6), 264–264. https://doi.org/10.3928/21650799-20140514-04
Haff, G., & Triplett, N. T. (2021). Essentials of strength training and conditioning. Human Kinetics.
Liguori, G., Feito, Y., Fountaine, C. J., & Roy, B. (2022). Acsm's guidelines for exercise testing and prescription. Wolters Kluwer.
Mayer, F., Scharhag-Rosenberger, F., Carlsohn, A., Cassel, M., Müller, S., & Scharhag, J. (2011). The intensity and effects of strength training in the elderly. Deutsches Arzteblatt international, 108(21), 359–364. https://doi.org/10.3238/arztebl.2011.0359
Nösslinger, H., Mair, E., Toplak, H., & Hörmann-Wallner, M. (2022). Measuring subcutaneous fat thickness using skinfold calipers vs. high-resolution B-scan ultrasonography in healthy volunteers: A pilot study. Clinical Nutrition Open Science, 41, 19–32. https://doi.org/10.1016/j.nutos.2021.11.007