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Princples Of Exercise, Fitness And Health Semester 2 Year 1 > Week 4 Health Appraisal And Fitness Assesments > Flashcards

Week 4 Health Appraisal And Fitness Assesments Flashcards

1
Q

Why test health-related physical fitness?

A
  1. To educate participants about their present health/fitness status relative to health-related standards & normative data
  2. To provide data to help develop individualized exercise prescriptions to address all health/fitness components
  3. To collect baseline and follow up data to allow the evaluation of progress by the participant
  4. To motivate the participant by establishing reasonable and attainable health/fitness goals
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2
Q

What do we need to consider?

A

• Test appropriateness
-Specific to the component of heath/fitness?
- Match the needs, goals and capacity of client?

• Testing order
1. Resting BP, HR & Body composition
2. Cardiorespiratory endurance
3. Muscular fitness
4. Flexibility

• Testing environment
-Friendly, quiet, private, safe and comfortable
-Temp & humidity should be consistent

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3
Q

What do we need to consider? Pt 2

A

• Test validity
-Ability of the test to measure accurately, with minimum error, a specific physical fitness component. Validity coefficient > 0.8

• Test reliability
-Ability to yield consistent and stable scores across trials and over time. Reliability coefficient > 0.9 – Intra-tester reliability

• Test objectivity
-Objective tests yield similar test scores for a given individual when the same test is administered by different exercise professionals. Inter-tester reliability
(Another tester)

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4
Q

Test Administration & Interpretation

A

You cannot obtain valid test score if you do not follow standardised testing procedures

Pre-test instructions: What instructions would you give?

• Wear suitable clothing
• Drink plenty of fluids during 24 hr period before the test
• Refrain from eating, smoking, drinking alcohol or caffeine 3hr prior to test
• Do not engage in strenuous physical activity the day of the test
• Get enough sleep (>6 hr) the night before the test

To classify your client’s health/fitness status, you should compare test scores to established, age and sex matched norms
Eg footballer on a footballer

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5
Q

Recap on static tests

A

• Resting heart rate
• Blood pressure
• Body composition
• Skinfold
• Body Mass Index (BMI)
• Waist circumference
• Waist-to-hip ratio
• Lung function

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6
Q

Resting CV function - HR

A

Bradycardia < 60 bpm
-high levels of CV fitness
-hypothermia
-hypothyroidism
-drugs (beta blockers)
Exercise increase stroke volume = lower heart rate

Tachycardia >100bpm at rest
Poor CV fitness
Alcohol, caffeine, nicotine
Stress, anxiety
Heart failure
Drugs (adrenaline)

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7
Q

Resting CV function - BP

A

Blood Pressure = Cardiac Output x Total Peripheral Resistance

-acute
-stress, anxiety, physical activity, caffeine, smoking

-chronic
Inactivity, obesity, high dietary salt intake/ low dietary potassium intake, excessive alcohol intake

Measurement error
Improper cuff width or length, too small cuff causes cuff hypertension

120/80
Systolic/ diastolic

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8
Q

Body composition

A

BC refers to body weight in terms of absolute and relative amounts of muscle, bone and fat tissue

How can we directly assess it?
• Dissolving a cadaver in a chemical solution to determine its mixture of fat
& fat-free components
• Dissecting the fat mass, muscle, bone and other organs to determine BC

Indirect
BMI
GIRTH MEAsures
Skinfold measures
BIA
Densitometry
X-ray
Absorba try (DXa)

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9
Q

Densitometry

A

• Density = Ratio of body mass to body volume (DB=BM/BV)
• Body volume determined from under water weighing and plethysmography
• % Body fat can be estimated once body density has been determined
• Two component model: divides body into fat & fat free mass

% fat =. 495/ body density - 450

• Assumes a constant density for fat and fat-free tissue among individuals which isn’t always the Case

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10
Q

Hydrostatic weighing

A

• Archimedes’ Principle
‘a submerged object is buoyed up by a force equal to the volume of water it displaces’

• BV = difference between BM measured in air and BM measured during water submersion

• BV = loss of weight in water

Bone & muscle has a greater density vs fat. Therefore, a person with more body fat will weigh less underwater and be more buoyant

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11
Q

Bod Pod

A

Uses air displacement rather than water displacement to estimate the volume of the body
• Pressure changes in the chamber are related to the size of the person
• BV = volume of the chamber without the client - volume of the chamber with the client

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12
Q

Bioelectrical Impedance Analysis

A

Uses low-level electrical current
• Water and electrolyte content of lean tissue will facilitate flow of current
• Adipose tissue will oppose (impede) flow of current
• Voltage drop from point A to point B is used to calculate % body fat.
• Dependent on hydration status

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13
Q

BIA – Effect of prior exercise

A

Fluid shift by exercise

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14
Q

Dual x-ray absorptiometry (DXA)

A

Reliably and accurately quantifies bone mineral content, total fat mass & FFM

• Attenuation of x-rays dependent on the density & thickness of underlying tissue

• Analysis can include selective trunk regions for detailed study of tissue composition and its relation to disease risk

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15
Q

Body Mass Index

A

BMI = BM (kg) / stature (m2)
Doesn’t take into account muscle
Fine for general use, maybe use for athlete but need to note that it doesn’t take into account muscle

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16
Q

Waist Circumference

A

Abdominal obesity indicators such as WC and W:HR are stronger predictors for CVD risk than general obesity indicator i.e. BMI
Low risk. Males < 94 cm. Females < 80 cm
High risk. Males ≥ 102 cm. Females ≥ 88 cm

Public Health England – Adults with a large waist are 5x more likely to get type II diabetes
Song et al (2013); Public Health England (2014)

Hormonal changes could effect results

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17
Q

Waist-to-hip ratio

A

Waist measurement cm/ hip measurement

High risk. M > 1.0. F > 0.85
Mod risk. M 0.9 – 1.0. F 0.80 – 0.85
Low risk. M< 0.90. F< 0.80

3.5% error with mastered technique
Body fats can be calculated and used to determine the clients overall lean mean mass and body fat mass
Lean mass= higher metabolic rates

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18
Q

Skinfold measures

A

Body fat % can be calculated from this and used to determine the clients overall lean mass and body fat mass

% fat = 495/ body density - 450

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19
Q

Cardiorespiratory endurance

A

Reference of measure = Direct measurement of VO2max (ml.kg- 1min-1)

Lab or reference method = Maximal GXT

Indirect measures or field test = Submaximal GXT, distance run/walk tests, step tests

Group predicted error (SEE AND TE) = <5.0 ml.kg-1min-1

Db = total body density; FFM = fat-free mass, % BF = relative body fat; SEE = standard error of estimate; TE = total error; GXT = graded exercise tests; ROM = range of motion, RM = repetition maximum; NR = not reported, Nm = newton-meter

20
Q

BODY COMPOSITION

A

Reference of measure = Db (g.cc-1), FFM (kg), or % BF

Lab or reference method = Hydrodensitometry or dual-energy X-ray absorptiometry

Indirect measures or field test= Bioimpedance, skinfolds, anthropometry

Group predicted error (SEE AND TE) = <0.0080 g.cc-1

<3.5 kg FFM (men) <2.8 kg FFM (women) <3.5 %BF

Db = total body density; FFM = fat-free mass, % BF = relative body fat; SEE = standard error of estimate; TE = total error; GXT = graded exercise tests; ROM = range of motion, RM = repetition maximum; NR = not reported, Nm = newton-meter

21
Q

Muscular strength

A

Reference of measure = Maximal force (kg) or Torque (Nm)

Lab or reference method= Isokinetic or 1-RM tests

Indirect measures or field test= Submaximal tests (2 to 10-RM value)

Group predicted error (SEE AND TE) = <2.0 kg

Db = total body density; FFM = fat-free mass, % BF = relative body fat; SEE = standard error of estimate; TE = total error; GXT = graded exercise tests; ROM = range of motion, RM = repetition maximum; NR = not reported, Nm = newton-meter

22
Q

Flexibility

A

Reference of measure = ROM at joints (degrees)

Lab or reference method= X-ray or goniometry

Indirect measures or field test= Linear measures of ROM

Group predicted error (SEE AND TE) = <6o

Db = total body density; FFM = fat-free mass, % BF = relative body fat; SEE = standard error of estimate; TE = total error; GXT = graded exercise tests; ROM = range of motion, RM = repetition maximum; NR = not reported, Nm = newton-meter

23
Q

Cardiorespiratory Fitness

A

The ability of the heart, lungs and muscle to take in, transport and utilise oxygen during exercise

24
Q

Why test Cardiorespiratory Fitness?

A

Higher levels of aerobic fitness are associated with:
– Reduced risk of chronic disease
– Improved endurance performance

Reasons for testing include:
– Providing a basis for exercise programming
– Evaluating the effectiveness of a training program – Screening for diseases (CHD)
– Determining physical function

25
Q

How do we express Cardiorespiratory Fitness?

A

Maximum Oxygen Uptake (VO2max)
•Maximum volume of oxygen consumed by the body each minute during large muscle group exercise at sea level

Units
• Litres of oxygen used by the body per min (L.min) absolute
• Millilitres of oxygen used per kilogram of body weight per
minute (ml.kg-1min-1)
Relative (take into account body weight)

Compare both

26
Q

How can we estimate VO2max?

A

Field based tests
• 20m Multistage Fitness Test (BleepTest)
• Coopers 12-min run [VO2 = 3.126(meters in 12min)-11.3]
• Rockport Fitness 1 mile Walking Test

Cycler ergometers
• Astrand-Rhyming (single stage test)
• YMCA (2-4 stage test)

Treadmill Tests
• Bruce (larger increments)
• Balke-Ware (smaller increments)

Step Tests
• McCardle / Siconolfi / Harvard / YMCA

Platu is VO2 Max

27
Q

Max vs. sub-max exercise test

A

You can use a maximal or submaximal graded exercise test (GXT) to assess cardiorespiratory fitness, the selection depends on:

• Your clients age and risk stratification

• Your reasons for administrating the test
— Physical fitness, performance or clinical testing?

• The availability of appropriate equipment and qualified personnel

28
Q

Assumptions of a sub-max test

A
  1. Linear relationship exist between VO2 and HR
    – True for light to moderate workloads but relationship becomes curvilinear at heavier workloads
  2. Efficiency /economy (VO2 at given work rate) during cycling or treadmill exercise is constant for all individuals
    – But untrained individuals are more inefficient so have a higher HR at given workload
    – Predicted VO2max tends to be overestimated for highly trained individuals and underestimated for untrained individuals
  3. HRmax for clients of a given age is similar
    1. But can vary as much as ± 11 bpm between people
    2. + inaccuracy of using age-predicted HRmax
    3. = error (± 10 – 15%) in estimating VO2max
29
Q

When should you stop a test?

A

General indications for stopping exercise tests with low-risk adults (ACSM, 2011)
• Onset of angina-like symptoms
• Drop in SBP of > 10 mmHg from baseline despite increased workload
• Excessive rise in BP: SBP > 260 mmHg or DBP > 115 mmHg
• Signs of poor perfusion (light-headedness; confusion; ataxia; pallor; cyanosis; nausea or cold clammy skin)
• Failure of the HR to rise with increased exercise intensity
• Noticeable change in the heart rhythm
• Client request to stop
• Physical or verbal manifestations of severe fatigue
• Failure of testing equipment

30
Q

Single-stage Treadmill Jogging Test (George et al. 1993)

A

~ 5 min (steady state) running at comfortable speed 4.3 – 7.5 mph, level gradient

• Steady state HR should not exceed 180 bpm and treadmill speed restricted to ≤7.5mph for males and ≤6.5mph for females

• Estimate VO2 max using an equation VO2 max = 54.07 + 7.062 * Gender (0=female, 1=male) – 0.1938 * weight (kg) + 4.47 * Speed (mph) – 0.1453 * Heart Rate (bpm). R=0.84

31
Q

Astrand-Rhyming Cycle Ergometer Submax test

A

~ 6 min cycling at 75 – 150 W
• Measure HR every min & record average HR in 5th and 6th min
• Estimate VO2 max using the Astrand-Ryhming nomogram.

32
Q

Muscular Fitness

A

Muscular Strength
• The ability of the muscles to exert a force

Muscular Endurance
• The ability of the muscles to perform successive exertion or many repetitions

Muscular Power
• The ability of the muscles to exert force per unit of time (i.e rate)

33
Q

Why test muscular fitness?

A

Muscular fitness is a health-related components of fitness that may improve or maintain the following:
• Bone mass, related to osteoporosis
• Glucose tolerance
• Musculotendinous integrity, related to lower risk of injury
• Physical Function
• FFM and resting metabolic rate, which are related to weight management

Muscular fitness test results can be compared to established standards, and be helpful in identifying weaknesses in certain muscle groups or imbalances that could be targeted in exercise training programmes

34
Q

Static ‘isometric’ strength test

A

• No overt muscular movement at the given joint or group of joints
• Maximal voluntary contraction (MVC)

35
Q

Dynamic strength test

A

Movement of an external load or body part in which the muscle changes length

• One-repetition maximum (1-RM): The maximum weight that can be lifted through the full range of motion, for one repetition, with proper form

• A multiple RM, such as 4 or 8 RM can also be used as measure of muscular strength

• Assessment of 10 – 15 RM recommended for some ‘at risk’ groups

36
Q

Isokinetic Dynamometry

A

Criterion measure of muscle strength

• Assessment of static (MVC) and dynamic muscle (isokinetic) strength & joint function

• Allows manipulation of joint angle, ROM & joint angle velocity

• Requires correct positioning/ stabilisation and joint axes alignment

37
Q

1-RM guidelines

A

Valid measures for upper body = Bench press & Shoulder press

• Valid measures for lower body = Leg press & Knee extension

• Warm-up by completing 5 – 10 repetitions of the exercise at 40 – 60% of the estimated 1-RM
• Follow this with 3 reps of the exercise at 70% of the estimated 1-RM
• Set the load at ~ 80% 1-RM and attempt repetition
• Progressively increase load in 5% increments until the participant cannot complete the selected repetition; all reps should be performed at the same speed of movement and ROM
• Determine the 1-RM (or multiples of 1-RM) within four trials with rest periods of 3 – 5 min between trials
• Record the 1-RM value as the maximum weight lifted for the last successful trial

38
Q

Muscle Endurance

A

Select an appropriate submaximal level of resistance (absolute [20kg] or relative [70% 1-RM]) and perform……..

Isometric muscle endurance tests
• Measuring the duration of static muscle action before fatigue
• Time to failure measures (Time Max in s)
• Simple field tests: Planks, Side Plank, Back / Prone Extension, V-sit hold.

Dynamic muscle endurance tests
• Measuring the number of repetitions before fatigue
• Repetition maximum (Rep Max)
• Simple field tests: Press up, curl-up, bridging, calf raise
• Use exercises proportional to body mass

39
Q

Muscle balance assessments

A

Maintaining a balance in strength between
Agonist and antagonist muscle groups
Contralateral (right vs left sides)
Upper and lower body

Is important because muscular imbalance may not only affect performance but also compromise joint stability it’s and increase risk of musculoskeletal injury

40
Q

Recommended ratios

A

Hip extensors & flexors. 1:1
Elbow extensors & flexors. 1:1
Trunk extensors & flexors. 1:1
Ankle inverters & evertors. 1:1
Shoulder flexors & extensors. 2:3
Knee extensors & flexors. 3:2
Shoulder internal & external rotators. 3:2
Ankle plantar flexors & dorsiflexors. 3:1

41
Q

Fitness Testing

A

Press Up Rep Max
• Prone/ Back Extension Time Max
• Single Leg Calf Raise Rep Max
• Single Leg Bridge Rep Max
• Side Plank Time Max
• Double Leg Lowering Rep Max

42
Q

Flexibility

A

The ability to move a joint through its complete ROM

Why test it?
• Adequate levels of flexibility required for Physical Function
• Individuals with too little (ankylosis) or too much (hypermobility) flexibility are at higher risk than others for musculoskeletal injuries

How do we test it?
• Flexibility is joint specific, so no single flexibility test can be used to evaluate total body flexibility
• ROM expressed in degrees

43
Q

Static flexibility and dynamic flexibility

A

Static flexibility is a measure of the total ROM at the joint, and it is limited by the extensibility of the musculotendinous unit

• ROM at the hip joint is influenced by tightness in the hip flexors & extensors
• Thomas Test - measure iliopsoas and quadriceps muscle flexibility
• Active knee extension test & sit and reach test - measure hamstring flexibility

Dynamic flexibility is a measure of the rate of torque or resistance developed during stretching throughout the ROM

44
Q

Comprehensive health-fitness evaluation

A

• Pre-screening / risk stratification
• Resting HR, BP, height, weight, BMI and ECG (if appropriate)
• Body composition
—Waist circumference
—Skinfold assessment
• Cardiorespiratory fitness
• Submaximal or maximal test typically on a cycle ergometer or treadmill
• Muscular strength
• 1- to multiple – RM upper body (bench press) and lower body (leg press)
• Muscular endurance
• Muscle conditioning tests: Push up, prone extension, side plank etc
• Flexibility
• Sit-and-reach or goniometric measures of isolated anatomic joints

45
Q

Take home points

A
  • consider test appropriateness, validity, reliability and objectivity and standardise pre-test procedures
  • resting measures of CV function, body composition and anthropometry can be used to asses health status and risk classification
  • criterion “ gold standard” direct measures of fitness components are more valid but not always feasible

Be aware of the assumptions/ limitations and sources of error with indirect field based measures

Princples Of Exercise, Fitness And Health Semester 2 Year 1 (8 decks)

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