Module 3

Health Related Physical Fitness Assessment and

Programme Design (HRPF)

Aims and Objectives

To equip the HFI with the knowledge, application of and experience in recognising and evaluating the health related physical fitness components, and with the appropriate skills for the development of a framework for planning, implementing and evaluating safe exercise programmes

To provide a basic understanding of the principles of training to enable the instructor to prescribe, plan and implement safe and effective exercise programmes

To define the health related fitness components and to describe and administer appropriate techniques for fitness assessments

To define the principles of training and to describe and demonstrate their application to exercise programming

Course ContentCourse Content

Unit 1: Components of fitness. Principles of training. Principles of overload.Unit 2: LME/strength. CV endurance. Intensity.Unit 3: Warm-up/cool-down. Flexibility. Body composition.

Unit 4 : Screening procedures. Stages of screening. Forms. Informed consent. Risk factors. Guidelines for referral.Unit 5: Fitness assessment: Body composition, skinfold measurement.Unit 6: Cardiovascular endurance: (1) Shuttle run. (2) Rockport walk test. (3) Bike test. (4) Treadmill test.

Unit 7: Testing for muscular strength/endurance. (1) Curl-ups. (2) Push-ups. (3) 1RM. (4) Estimated 1 RM. (5) 10 RMUnit 8: Flexibility tests: (1) Sit and reach. (2) Shoulder elevation. (3) Back extension.Unit 9: Programme planning: stages of planning. Case studies. Continuous Assessment: Practical 70%

Written 30%

Session 1

Objectives At the end of this session, students

will be able to:• describe the general aims and purpose of

module 4• understand the continuous assessment

procedures for module 4

Session 1

• list the health and skill related components of fitness

• define the health related components of fitness

• list and describe the principles of training and their application to the HR components of fitness

What is Fitness?

E S S M P

E = Emotional fitnessS = Social fitnessS = Spiritual fitnessM = Mental fitnessP = Physical fitness

TOTAL FITNESS

Components of Physical Fitness

Skill Related1. Agility2. Balance3. Co-ordination4. Reaction Time5. Power6. Speed

Health Related1. Body composition 2. Cardiovascular fitness3. Flexibility4. Muscular endurance5. Muscular StrengthThese are the five

components of fitness this course is concentrating on.

Health Related Components of Fitness

Cardiovascular Endurance: The ability of the heart and lungs to supply oxygen to the working muscles during continuous exerciseLocal Muscular Endurance: The ability of a muscle or a group of muscles to sustain exercise over a period of time without fatigue setting in

Strength: The ability to exert force in a single effortFlexibility: The ability to move or stretch through a large range of motion around a joint (ROM)Body Composition: Ratio of muscle and bone weight to fat weight

Principles of Training

Progression Specificity Reversibility Placement Individual

Differences Adaptation

Overload Frequency: How often?

Intensity: How hard?Time: How long?Type: Circuits, aerobics, weights etc

Principles of Training

• Overload: In order to improve your fitness levels, you must work the particular component against a load greater than normal.

• Progression: As a person becomes fitter, a higher intensity of exercise is needed to create an overload.

• Specificity: The result of the type of exercise performed is specific both to the muscle groups being used and to the energy system involved.

• Reversibility: Training effects gained are reversible if workouts stop.

• Placement: The scheduling of the training, both within a week/month etc. and within each session.

• Individual Differences: Each person will have different capabilities and will adapt in a different manner to an exercise programme. There is no ‘one for all’ programme.

• Adaptation: The way the body changes as a result of training, e.g. muscles may become stronger.

Principles of Training

Cardiovascular Endurance: The FITT Principles

Frequency: 3 to 5 times per week Intensity: 60% to 85% MHR Time: 20 min (minimum) Type: Aerobic: running, cycling, swimming etc.

Flexibility: The FITT Principles

Frequency: 3 times per week upwards Intensity: To the point of tension Time: 15 to 30 secs Type: Stretching: passive, static, active, active

assisted, PNF.

Muscular Endurance: The FITT Principles

Frequency : 3 to 5 times per week Intensity: 60% to 70% 1 RM Time: As long as it takes to do 15 to 30 reps Type: Weights, circuits etc.

Strength: The FITT Principles

Frequency: 3 to 4 times per week Intensity: 70% to 90% 1 RM Time: As long as it takes to do between 2 and

10 reps Type: Resistance training (weights )

Body Composition:The FITT Principles

Frequency: 3 to 5 times per week Intensity: 55-65% MHR Time: 20 to 60 mins aerobic activity (continuous

or intermittent) Type: Aerobic (primarily), LME, any activity that

uses large muscle groups

Health Benefits of Improved Cardiovascular

EnduranceStronger heart rateLower heart ratePossible reduction in BPPossible resistance to arteriosclerosisPossible improved periphery circulationQuicker recovery after hard work

Improved coronary circulationLess chance of heart attackGreater chance of surviving heart attackIncreased protective HDLsIncreased O2 carrying capacity

of the blood

Health Benefits of Improved Muscular Strength and

EnduranceGreater work efficiencyLess chance of muscle injuryDecreased chance of low back problemsImproved performance in sports

Health Related Benefits of Improved Flexibility and Body

CompositionFlexibility

Good joint mobility Less chance of muscle

injury Prevents low back

problems Helps maintain good

posture alignment

Body Composition Improved

appearance Muscle is more

metabolically active than fat

Reasonable fat weight = less strain on heart/joints

What is Fitness Assessment?

Fitness Assessment is a vital part of the total professional service offered to clients and is the method used to evaluate the health fitness status of the client.

Uses and Purpose of

Fitness Assessment Individual diagnosis Exercise prescription Achievement of individual

goals Motivation Measure improvements Educational purposes

Programme evaluation Protect against

litigation Instructor credibility Lines of

communication - GP

Stages of Health/Fitness Assessment

Stage 1: Screening: Health history Health behaviours Risk factors Informed consent Stage 2: Physical measures: Resting heart rate Resting blood pressure Height Weight Cholesterol Stage 3: Fitness testing: Core tests

WHY SCREEN?1. Identify persons who need

special attention2. Identify persons who should

exercise in a special way3. Identify persons who should not

be exercising at all

4. Helps HFI gain knowledge of physical ability of clients

5. Enhances credibility of HFI as professional

6. Can help protect HFI - legal problems

7. Helps to open lines of communication between GP and HFI

Health/Fitness Assessment

Stage 1 - ScreeningScreening by questionnaire:Medical historyPhysical activity pattern in lifeRisk factors the client may be subject toInformed consent

Stage 2 Physical Measurements

A. Resting heart rateB. Resting blood

pressureC. HeightD. WeightE.Cholesterol (if possible)

ReferralACSM Guidelines page 134 of Student Manual

Cardiovascular Endurance

• The ability of the heart and lungs to supply oxygen to the working muscles during continuous exercise

Oxygen Uptake

Amount of oxygen taken up and used by the body.

Reflects total amount of work being done by the body.

During strenuous exercise, VO2 max increases linearly with increases in the intensity of exercise.

Approaching exhaustion, VO2 reaches a max above which it will not increase further: VO2 max - largest amount of oxygen body can use during maximal exercise

Measuring VO2 Max

Work Rate

Oxyg

en U

ptake

VO2 Max70ml-

60ml-

50ml-

40ml-

30ml-

20ml-

0 5 6 7 8 9 10 11 12 13 14 15 KPH

Maximum Oxygen Uptake (VO2 max)

VO2 max: the greatest rate at which oxygen can be consumed during exercise at sea level!

V: the volume of oxygen used per minute

O2:the oxygen

max: maximal exercise conditions

VO2 Max

VO2 max is the highest rate of oxygen consumption that a person is capable of using during maximal exercise

Referred to as maximal aerobic power or maximal oxygen uptake

Usually expressed in ml/kg/min

Best measured in lab during maximal exercise test in which the oxygen consumed is measured by a computerised metabolic chart

VO2 Max

OHP 8

Maximum Oxygen Uptake (VO2)

VO2 max is used as the most accurate measure of a person’s aerobic power or fitness

A higher VO2 maximum reflects an increased ability of:

heart to pump blood lungs to ventilate large volumes of air muscles to take up oxygen and remove carbon

dioxide

Laboratory measurement of VO2 max is: expensive time consuming requires highly trained personnel not practical for mass testing situations

Therefore, various tests have been developed as substitutes.

Steady State

Where oxygen supply equals demand

Lactate Threshold

……. is the highest exercise intensity or level of oxygen uptake beyond which there is an irregular rise in lactic acid production.

Lactate Threshold

Work Rate

Oxyg

en U

ptake

70ml-

60ml-

50ml-

40ml-

30ml-

20ml-

0 5 6 7 8 9 10 11 12 13 14 15 KPH

Heart Rate

Lactate Threshold

Types of Tests

Maximal: Begin at low intensity and gradually bring the subject to volitional exhaustion. Normally provides a more accurate estimation of VO2 max than sub-maximal tests, but they induce greater cardiovascular stress.

Sub-maximal: Based on the assumption that heart rate is a linear function of VO2 max. Induces less cardiovascular stress.

Linear Relationship

Work Rate

Oxyg

en U

ptake

70ml-

60ml-

50ml-

40ml-

30ml-

20ml-

0 5 6 7 8 9 10 11 12 13 14 15 KPH

Heart Rate

Types of Tests

Field tests: Suitable for use with large numbers. Performed outside the laboratory, are practical, inexpensive, less time-consuming and easy to administer.

Stop the test if ...

subject requests to stop dizziness, mental confusion, staggering or

unsteadiness angina - chest pain Nausea difficult or laboured breathing (dyspnea) pallor (paleness)

Stop the test if ...

cyanosis severe fatigue (facial distress) no steady state heart rate HR in excess of 85% maximum HR malfunction of equipment

CV Tests

Walk test Shuttle run test Bike test Treadmill tests Step tests

Testing for Flexibility

Flexibility can be measured by means of the following tests:

Sit and Reach Straight Leg Raise Shoulder Elevation Back Extension

Sit and Reach(Low back & Hamstrings) Specific warm up Remove shoes and place feet at the special

box where 23cms is at the level of the feet Keep knees straight and place one hand on

top of the other Bend forward at the trunk, keeping the

knees straight and reach forward as far as possible.

Three attempts and record the best. Check table for standards.

Straight Leg Raise (Hamstrings)

Lie flat on a table making sure that the low back is flat

Stabilise the leg that is not being lifted Lift one leg with knee straight and evaluate

the angle of the hip. Check Table for standards

Shoulder Elevation

Lie on tummy, keeping arms straight and shoulder width apart, raise a stick as high as possible while keeping the chin on the floor and wrists and elbows straight

Measure in inches from the bottom of the stick to the floor(best of three attempts)

Multiply result by 100 and divide by the arm length in inches(Hold stick in both hands and measure from the shoulder to the upper surface of the stick)

Back Extension (Extension of the spine)

Lie prone on the floor Place hands under shoulders.Keep hips

down all the time. Raise the chest slowly using the arms not

the back. Measure in cm from the suprasternal

notch to the floor. Check the table for standards.

Muscular Endurance

The ability of a muscle or group of muscles to exert a sub-maximal force repeatedly or continuously over time

Muscular Endurance Tests

New crunch curl-up Push up Modified push up Bench press

New Crunch Curl

The subject lies supine. Knees bent at 90. Finger tips touching strips of

masking tape placed perpendicular to the body. A second strip of tape is placed parallel to the

strip, 8 cm apart. A metronome is set at 40 beats per minute (3

secs per curl-up, 20 curl-ups per minute). Stomach is kept firm to keep lower back on

ground.

New Crunch Curl

Subject curls the upper spine until the finger tips touch the second strip of tape and returns to the starting position.

The movement is slow and continuous. The individual performs as many curl-ups as

possible to the set cadence without pausing, up to a maximum of 60 secs (3 mins).

Check table for scores.

Press Up

The subject starts in the up position, arms straight, hands just outside shoulder width.

For push-ups, your body is supported by your hands and feet. For modified press-ups, your body is supported by your hands and the thighs just above the knee.

Your back should be straight and fingers pointed forward.

Your body should be linear from shoulders to end point of contact with ground.

Press Up The subject lowers his/her body until the

chest touches the tester’s fist, which is on the ground, and then raises back to the ‘up’ position.

The back must be kept straight. The abdominal muscles need to be contracted to stabilise the back.

The client should breathe out on the effort and in on the way down.

The score is the maximum number of correctly completed push-ups.

Refer to the scoring table.

Bench Press Subject should have technique practice on previous

days Subject should warm up Subject lies supine on a bench - knees bent, feet on

floor Subject grips the bar - hands wider than shoulder

width, wrists straight and directly overhead the elbows - in the down position.

Subject then extends the arms, pressing the barbell up, and repeats the movement to the rhythm of the metronome.

Bench Press

Subject should breathe regularly. Score the number of successful

repetitions. The test is finished when the subject is

unable to reach full extension or breaks the rhythm.

Refer to the scoring tables.

Muscular Strength

Strength is measured by means of 1RM Strength to BW ratio Estimated 1RM 10RM

1RM Strength to BW Ratio

Select muscle group Subject should be familiar with technique Establish wt. that can only be lifted once Allow rest between trials Record wt. lifted in lbs and divide by subjects

wt. in lbs. Refer to table for standards

Estimated 1 RM Familiarise subject with technique Record subjects’ BW in lbs. Start loads at .25% to .33% of BW for upper body

and .55% to .66% for lower body Perform the lift aiming to lift between 2 and 10 reps.If

more than 10 lifts then increase the weight. Calculate the 1RM by the following equation :

Weight Lifted 1.0278 - .0278(x) X = No. of Reps

10 RM

Familiarise subject with technique Find a weight subject can lift no more

than 10 times 10RM = 75% 1RMEG. Subject lifts 75KG 10 times.

1Rm = 100KGs

Measuring Body Composition

Hydrostatic weighing Bioelectrical impedance Body mass index Waist to hip ratio Skinfold callipers

Body Composition

Hydrostatic weighing: Archimedes principle: fat is less dense than water/muscle and bone is more dense, so a person with more bone and muscle mass and less fat will weigh more in water and have a greater density i.e. a lower % body fat and a greater % FFM.

Bioelectric Impedance

The resistance to an applied electric current is inversely related to the amount of the FFM. FFM has a greater water and electrolyte content and therefore greater conductivity than adipose tissue and bone. The greater the FFM, the greater the conductivity. % fat can be calculated by:

% fat = ((weight - FFM)/weight) .100

Body Mass Index

Measure body weight (kg)Measure body height (m), convert ins to cms by multiplying by 2.54. Divide by 100 to convert to metres.Square metres to convert to m2

Use formula kg/m2 and refer to tableDesirable range =20-25 kg/m2 Grade 1 Obesity =25-29.9 kg/m2

Grade 2 Obesity =30-40 kg/m2

Grade 3 Obesity=>40 kg/m2

Waist to Hip Ratio

Record measurements in cms or insWaist circ. (most narrow girth at umbilicus)Hip circ. (Largest girth of the buttocks)Waist circ./Hip circ.Standards: >.95(men) >.85(women) = increased risk of heart disease

Body Composition

Skinfold Measurement Procedures Take at right hand side of the body Grasp skinfold by the thumb and index finger Place calliper 1 cm below fingers Take two scores with a required accuracy of 1

mm; record average value Testers should have short nails Measure when skin is dry

PROGRAMME PLANNING

FOUR STAGES Needs analysis Programme prescription Programme implementation Programme evaluation

NEEDS ANALYSISScreening/informed

consent Medical history Current injuries Referral criteria Exercise history Medications Contact numbers Clients own goals What are the client’s

personal goals?

Fitness testing Motivation Relationship building Education Components (helps

identify) Appropriateness Accuracy Recording Age Experience (determines

test choice)

Needs Analysis contd.Time Available Time client is prepared to

prioritise components Start small Work at homePreferred Activities What client likes/dislikes Past experience

Education Explode myths and

misconceptions ‘Sell’ the programmeLifestyle Habits Smoking Diet/nutrition Stress Drinking habits

Programme PrescriptionExercise selection• List of activities• Adaptations/

progressionsEquipment/facilities Range Home equipment

Components of fitness Aerobic fitness LME Strength Flexibility Body composition

Programme Prescription

FITT PRINCIPLES Frequency Intensity Time Type

WARM-UP/COOL-DOWN

Elements of a good warm-up

Elements of a good cool-down

Programme Implementation

Motivation/adherence Physician support Individual needs Short-term goals Encourage groups Logging Emphasise fun Regular fitness testing Positive leaders

Safety/injury prevention Warm up and cool down Stress rest periods Check nutritionTeaching/safety points Small number at a time Meet the client to

reinforce Observation/correction

Programme Implementation

Discussion Exercise to go over Exercises client not

comfortable with How they feel about

the programme New aches/pains Time/length of

programme

Record keeping

Progression Does the client know

to progress? Have you set a target

for them?

Evaluation

Re-test Record and compare results Analyse results Evaluate programme Need for change Consult with client Part/whole change

Case Study Guidelines

Underline key words Identify component of fitness Be realistic - equipment, time, facilities,

lifestyle, accessibility Be systematic - FITT principles - change one at

a time Justify your answer - give reasons why Screening procedures - primary and secondary

risk factors Keep to the point - short & concise

Case Study Guidelines

Needs analysis - individual goals Risk factors - injuries Frequency/time Availability/accessibility Nutrition Lifestyle changes Use point form

Individual Case Study

Case StudyJohn (42) has just given up smoking and after a medical examination he hasbeen advised to take up exercise. His goals are to lose weight and improvehis overall health.

(a) Outline 3 fitness assessments that would be suitable to conduct on John. Give a detailed explanation why you consider your choice of assessments to be appropriate for John(Answer 15-20 lines approx) (20 marks)

Individual Case Study

Outline a 12-week programme using the FITT principles that will help him to achieve his goals.

(Answer 20-25 lines approx or table format) (25marks) Describe in detail one session in week 4 and

one session in week 8 of John's programme. (Answer 20-25 lines approx or table format)(30 marks)

Group Case Study

Group Case StudyA group of off-season hockey players male and female

wish to takepart in a circuit-training programme for general overall fitness. They range in agefrom 20 yrs - 35 yrs.

Describe the screening procedures you would conduct with this group. (Answer approx 15 lines) (15 marks)

Outline a series of 4 fitness tests suitable for this group and explain in DETAIL why you chose these tests for this particular group. (Answer approx 20-25 lines) (20 marks)

Group Case Study

Design a circuit suitable for this group under the headings: exercises, muscle groups, reps, work rest ratio, sequencing, adaptations.

(Table format may be used) (25 marks)

Show changes/progressions (can be given in

a table format) you would make in week 4 and week 8.

(15 marks)