Fitness Assessment Practical Exam

Explain maximal and sub-maximal tests

**Maximal Test**: exercise intensity is continually increased with a greater workload resulting in an increasing cardiopulmonary and metabolic response. Predicting maximal oxygen uptake (VO2 max). The test provides data on how much oxygen you use as you exercise and determines the maximal oxygen you can consume during exercise

**Submaximal Test:** exercise testing that is utilized with a variety of populations to assess fitness level and predict maximal oxygen uptake (VO2 peak) when a maximal test is not possible or preferable.

explain the measurement of HR and BP during exercise 

**HR** records the number of times that your heart beats per minute.

**BP** says how strong your blood moves through the blood vessels.

__Measuring HR__ by a watch or placing your index and middle finger over patient's wrist and feeling the pumps.

__Measuring BP__ is done by using an arm cuff and a stethoscope.

explanation/ achieve steady state heart rate during sub-maximal exercise stage

During steady state, the person reaches a state where the heart rate and oxygen tend to remain constant. Patient can achieve sub-max intensity by increased workload or intensity.

Explanation/ administration of BMI

\- BMI (body mass index) is a measure of body fat based on height and weight that applies to men and women

\- __calculating__ BMI needs person's weight (kg) divided by the squared height (meters)

Explanation of skin fold measurements

a technique to estimate how much fat is on the body

\- Procedure:

\- mark measurement at appropriate anatomical landmark on the right side of the body 

\- using thumb and index finger, a fold should be made 1 cm above the marked site 

\- the caliper tips should be placed on the marked, halfway between the base and the crest of fold

Location, marking and measurement of skin fold sites

\- 7 locations

\- chest - diagonal fold, between armpit and nipple

\- Tricep - vertical fold, halfway between acromion and olecranon process

\- Midaxillary - vertical or horizontal fold, midaxillary line level of the xiphoid process

\- Subscapular - diagonal fold, 1 to 2 cm below the inferior angle of the scapula

\- Supriliac - diagonal fold, superior to the iliac crest 

\- Abdomen - vertical or horizontal fold, 2 cm to the ride side of the belly button

\- thigh - vertical fold, anterior midline of the thigh between top of patella and inguinal crease

Explanation / administration of bioelectrical impedance analysis (inbody)

\- measures body composition based on the rate at which an electrical current through the body

\- measures fat-free mass, total body water, percent fact, body cell mass, intracellular water, and extracellular water

\- patient stands on the machine and follows the directions of the machine

Explanation / administration of one repetition maximum test

\- one rep max is doing the max amount of weight you can lift for one full rep of a given exercise

\- commonly used for determining max strength for a specific movement

\- allows for the determination of: strength and weakness, specific attainable goals, and tracking strength over time

\-PROCEDURE:

\- allow warm up 5-10 reps 

\- 1 min rest

\- 3-5 reps (60-80% max)

\- 2 min rest 

\- 2-3 reps (90-95% of max)

\- 2-4 min rest

\- 1 rep (successful than increase weight, failure decrease weight)

How to calculate estimated 1 rep max:

100 x ( rep weight) / (102.78 - 2.78 x reps) 

Explanation / administration of YMCA Bench Press test

\- standardized, field-based assessment of upper body muscular endurance. It can be an alternative to the push-up test 

\- Procedure: 

\- female 35 lb bar, male 80 lb bar

\- metronome at 60 bpm 

\- one minute

\- count the number of reps completed until client is unable to maintain the exercise to cadence

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Explanation / administration of FMS

Functional Movement Screen

\- a tool used to evaluate seven fundamental patterns is individuals with no current pain complaint or musculoskeletal. FMS is used to demonstrate opportunities for improved movement in individuals

\- taking the rod and holding it with both hands above the head, patient squats down

\- 7 total test

Explanation / administration of grip strength test

measures grip strength

\- uses an instrument called a dynamometer.

\- Procedure:

\- hold arm with elbow at a 90 degree angle

\- squeeze the dynamometer as hard as possible 

Explanation / administration of sit and reach

\- measuring hamstring and lower back flexibility

\- can indicate if there is lower back pain

\- Procedure:

\- have patient take off shoes, sitting down at the box, legs out straight 

\- reaching as far as the patient can without bending the knees

Explanation / administration of ROM measurement using goniometer

\- measure how far one can move a muscle or joint

\- Range of motion is measured with a goniometer

Explanation/administration Ober’s

\- testing IT band and TFL tightness

\- have patient to lay on their side, laying on the edge. Administrator supporting the body and hold the leg up by their hip

\- Administrator hold leg at 90 degrees and pulls leg back

\- positive tests = leg stays up and doesn't fall

Explanation / administration 90/90 Hamstring

90/90 test:

\- testing hamstring flexibility

\- ask the patient to lie on their back and bend their hip to 90 degrees so the knee is pointing straight up at the ceiling. other leg should be straight

\- in that position, extend the knee bringing your foot up towards the ceiling. do not stretch to point of pain.

\- if the angle in step 2 is greater than 20 degrees then the patient has tight hamstrings

Modified Thomas Test

\- testing hip flexor and quad flexibility 

\- Place the patient in the supine position with the ischial tuberosities at the end of the table, legs able to hang off

\-The unaffected thigh is flexed with the knee bent toward the abdomen

\-Lumbar spine does not remain flattened or the __knee remains extended__=positive for Iliopsoas Contracture if the __thigh elevates__ or Rectus Femoris Contracture if the knee remains extended

Explanation / administration of Y balance

patient balances on one leg while simultaneously reaching as far as possible with the other leg in three separate directions: anterior, posterolateral, and posteromedial. 

\- before patient starts test both leg lengths are measures

Explanation / administration of BESS test

\- tests one's postural control 

\- 6 tests (3 on hard surface and 3 on foam board)

\- feet together stance, tandem stance, and one leg stance

\- score is counted as the patient does a number of errors

Explanation / administration of stork test

\- person stands on one leg, up on the ball of the foot, for as long as possible.

\- Assess whole body balance ability.

Location / placement of limb leads

4 limb leads: 

\- 1 is right shoulder, closes to clavicle

\- 2 left shoulder 

\- 3 right foot (on right hip)

\- 4 left foot (on left hip)

Location / placement of chest leads

V1: fourth intercostal left side of sternum

V2: Fourth intercostal, ride side of sternum

V3: placed diagonally between 2 and 4

V4: 5th intercostal , mid clavicular line

V5: between 4 and 6 V6: placed on the same horizon, 5th intercostal space, mid-axillary