NASM: Chapter 11 - Health, Wellness, and Fitness Assessment

A series of measurements that help to determine the current health and fitness levels of clients

• Helps maintain and monitor fitness goals if a baseline is set

• Trainer must observe and document structural and functional status

• Specific tests used in fitness assessment depends on health and fitness goals of individual, the trainer’s experience, the type of workout routines being performed and the availability of equipment

• Diagnose medical conditions

• Prescribe treatment

• Prescribe diets

• Provide treatment of any kind for injury or disease

• Provide rehabilitation services for clients

• Provide counseling services for clients

• Obtain exercise or health guidelines from a physician, physical therapist, or registered dietitian

• Follow national consensus guidelines of exercise prescription for medical disorders

• Screen clients for exercise limitations

• Identify potential risk factors for clients from screening procedures

• Refer clients who experience difficulty or pain or exhibit other symptoms to a qualified medical practitioner

General and Medication History including:
Occupation, Lifestyle, and Medical History
PAR-Q questionnaire

• Common movement patterns

• Energy expenditure levels during an average day

• Helps understand musculoskeletal structure and function

• Helps determine potential health and physical limitation and restrictions

1. Extended Periods of Sitting:
   - Hips are flexed for long periods of time = tight hip flexors and postural imbalances within HMS
   - Shoulder and head fatigue easily because under constant effect of gravity = postural imbalances (rounded shoulders and forward head)

2. Low Energy Expenditure: most likely poor cardiorespiratory conditioning

3. Repetitive Movements: can cause musculoskeletal injury and dysfunction

4. Shoes (example: High heels = plantar flexed position for a long period of time = tightness, postural imbalance, decreased motion)

5. Mental Stress:
   - Elevated heart rate
   - Effects Blood pressure and ventilation at rest and exercise
   - Abnormal breathing patterns = musculoskeletal and postural imbalances in neck, shoulder, chest and lower back

1. Resting and exercise physiological measurements ( blood pressure and heart rate)

2. Resting anthropometric measurements (height, weight, body fat %, circumference measurements)

3. Specific measures of fitness (muscular endurance, flexibility, cardiorespiratory fitness)

1. Recreation: physical activities outside of the work environment “leisure time” - golf, ski, tennis, etc - gives general idea about other athleticism outside of gym / motivation towards enhancing performance - example: “better golf swing”

2. Hobbies: not necessarily athletic in nature (gardening, working on cars, playing cards, watching TV, videogames, etc) - may help as a motivational tool

1. Past Injuries: strong predictor of future musculskeletal injury during physical activity

2. Past Surgeries: surgical procedures create trauma and may have similar effects on the functioning of the HMS as that of an injury (can cause pain an inflammation that can alter neural control to the affected muscles and joints if not rehabilitated properly

3. Chronic Conditions: risk of chronic disease dramatically increase with lack of physical fitness

4. Medications: meds may have an effect on the way the body (heart rate and blood pressure) as well as the way it may react to exercise

1. Decreases the neural control to the gluteus medius and gluteus maximus muscles

2. Can lead to poor control of the lower extremities during functional activities (which can lead to injury)

1. Decreases the neural control to muscles that stabilize the patella (kneecap) and lead to further injury

2. Non-contact knee injuries are often the result of ankle or hip dysfunctions, (example: result of ankle sprain)

3. Can result in altered movement and force distribution o the knee

What effect do low back injuries have on the functioning of the HMS?

Cause altered neural control of the rotator cuff muscles which can lead to instability of the shoulder joint during functional activities

Repetitive Hamstring Strains, Groin Strains, Patellar Tendonitis (jumper’s knee), Plantar Fasciitis (pain in the heel and bottom of the foot), Posterior Tibialis Tendonitis (shin splint), Biceps Tendonitis (shouder pain), and headaches

1. Anti-hypertensive (high blood pressure) and Arrhythmias (irregular heart beat)

2. HR: decreases

3. BP: decreases

1. 
   Hypertension and angina (chest pain)

2. HR: may increase or decrease or no effect?

3. BP: decreases

1. Hypertension and congestive heart failure

2. HR: may increase or have no effect

3. BP: may decrease or have no effect

1. Hypertension, congestive heart failure, peripheral edema

2. HR: no effect

3. BP: may decrease or have no effect

1. To correct prevent bronchial smooth muscle constriction in individuals with asthma and other pulmonary diseases

2. HR: no effect

3. BP: no effect

1. Hypertension and Congestive Heart Failure

2. HR: increases

3. BP: decrease

1. Various psychiatric and emotional disorders

2. HR: may increase or have no effect

3. BP: may decrease or have no effect

How should a resting heart rate be tested?

Builds aerobic base and aids in recovery

Increases aerobic and anaerobic endurance

Builds high-end work capacity

• Subtract client's age by 220

| example: 220 - 31 = 189

• HRmax multiplied by appropriate intensity (65-95%)

| example: 189 (x) 0.75 (zone 1) = 141.75 THR

Based off of "3-Minute Step Test" results

Zone 1: 0.65-0.75
Zone 2: 0.76-0.85
Zone 3: 0.86-0.95

A method of establishing training intensity on the basis of the difference between a client's predicted maximal heart rate and their resting heart rate.

THR = [ (HRmax - HRrest) x desired intensity] + HRrest
example:
THR = [(189 - 63) x 0.75] + 63
THR = [126 x 0.75] + 63
THR = [94.5] + 63
THR = 157.5 bpm

1. Skinfold Measurment

2. Bioelectrical Impedance

3. Underwater Weighing (hydrostatic weighing)

4. Circumference Measurements

5. Waist-To-Hip

6. BMI

• Uses a caliper to estimate the amount of subcutaneous fat beneath the skin

• 4 locations: Biceps (vertical), Triceps (vertical), Subscapular (45* angle), Iliac Crest (45* angle)

• Recorded on the right side of the body

A portable instrument used to conduct an electrical current through the body to estimate fat

Neck, Chest, Waist, Hips, Thighs, Calves, Biceps

There is a correlation between chronic diseases and fat stored in the midsection.

0. 0.80 for women

| 0. 95 for men

BMI = [weight (lbs) / Height (inches squared)] x 703
or
BMI = Weight (kg) / Height (meters squared)

EXAMPLE:
BMI = [108 / (64)x(64)] x 703
BMI = [108 / 4096] x 703
BMI = 0.2636719 x 703
BMI = 18.5361328
BMI = 18.54

• Increased risk for disease

| - "Underweight"

• Low risk for disease

| - "Acceptable"

• Very low risk for disease

• "Acceptable"

• Ideal BMI range

• Increased risk for disease

| - "Overweight"

• High risk for disease

| - "Obese"

• Very high risk for disease

| - "Obesity II"

• Extremely high risk for disease

| - "Obesity III"

1. YMCA 3-Minute Step Test

| 2. Rockport Walk Test

Step 1: have client perform 96 steps/minute on a 12-inch step for a total of 3 minutes. It is important to stay consistent with steps (metronome or counting out loud may be necessary)
Step 2: Within 5 seconds of completing the exercise, measure client's resting heart rate for a period of 60 seconds and record it as the "recovery pulse"
Step 3: Locate the recovery pulse number on designated chart based off correct categories