Exercise Testing and Prescription Practical Assessments

Peripheral Pulse Rubric

• The carotid pulse was correctly identified and palpated. (2 pts)

• The brachial pulse was correctly identified and palpated (2 pts)

• The radial pulse was correctly identified and palpated (2 pts)

• The dorsalis pedis was pulse correctly identified and palpated (2 pts)

• The subjects heart rate was correctly reported from the radial pulse (± 4 bpm).

Carotid pulse

Medial to the sternomastoid muscle

Brachial Pulse

bicep tendon in the area of the antecubital fossa

Radial Pulse *this is the one you will take heart rate for the practical*

take on thumb side

Dorsalis Pedis Pulse

taken on the medial dorsum of the foot

Hip Waist Circumference Rubric

• The hip anatomical landmarks were correctly identified.

• The hip circumference was correctly measured.

• The waist anatomical landmarks were correctly identified.

• The waist circumference was correctly measured.

• Student correctly verbalized the method to calculate the H:W ratio.

Hip Anatomical Landmarks

widest portion of the buttocks from a side or sagittal view

Hip Circumference

measured from the side

• instruct the client to hold the tape while you measure around

Waist Anatomical Location

narrowest portion of the torso between the iliac crest and the lowest rib

Waist circumference

measured from the clients front

Method to calculate H:W ratio

Hip circumference divide by the waist circumference

Handgrip Dynamometry (Spring Loaded Dynamometer) Rubric

• The subject was placed in a standing position for the test.

• The subject’s arm was correctly positioned for the test

• The subject’s hand was correctly positioned for the test.

• Student correctly zeroed the hand dynamometer prior to each measurement.

• The correct value for the handgrip strength was reported (± 1kg)

Handgrip Dynamometry

• Have the client stand up straight for the test

• Adjust the dynamometer so the second joints of the fingers are under the handle

• Extend the elbow fully without the arm touching the body

• Make sure the handle with the dial is facing outwards and it is zeroed

• Have the participant squeeze as hard as they can for 1 second and record the value in kg

Push Up Rubric

• The position for the hands were correctly verbalized to the subject

• The position for the feet/legs were correctly verbalized to the subject (sex-specific).

• The top position form of a push up was correctly verbalized to the subject.

• The bottom position form of a push up was correctly verbalized to the subject.

• Test termination criteria was verbalized correctly to the subject.

Push-Up Instructions

• Instruct the client to lay on the mat in a prone position with the feet together and hands directly under shoulders

• They will then press up until the elbow is fully extended

• Standard pushup will be performed with straight legs and toes acting as the pivot point

• The upper arm must be internally rotated 45º from the body

• From the top position, the participant will then lower to the starting position on the floor to complete the repetition, keeping a straight line

• Proper form must be maintained throughout the test and if the client can’t maintain form after 2 reps, the test is concluded.

Queens College Rubric

• The steps were positioned at the correct height.

• The correct cadence was verbalized and set on the metronome (sex-specific).

• The subject was instructed on the correct step mechanics and foot position.

• The radial pulse was palpated at the correct time and duration.

• The subjects post-exercise heart rate was correctly reported (± 4 bpm)

Queens College Instructions

• Set the bench step to height of 16 inches or to where they can bend their knee and step up comfortably

• Male client will step to a rate of 24 steps/ min for 3 minutes continuously (set metro to 96)

• After the three minutes, ask client to stand still, wait 5 seconds then take HR using radial pulse for 15 seconds and multiply by 4

Electrocardiography Rubric

• (2pts) Required skin preparation prior to electrode placement was correctly verbalized.

• (4pts) The limb electrodes were placed in the correct anatomical locations.

• (10pts) The precordial(chest) electrodes were placed in the correct anatomical locations.

• (4pts) The wires were correctly attached to the electrodes.

ECG Instructions

• Mark and identify sites for placement

• Use abrasive pad/ alcohol to clean skin at sites

• 4 Limb Electrodes (RL, RA, LL, LA)

• 6 Precordial Electrodes

  • V1 and V2 are placed on each side of the sternum in 4th intercostal space

  • V4 is next: find midpoint of left clavicle and draw imaginary line to fifth intercostal space

  • V3 goes between V2 and V4

  • V5 is place in line with V4 at the left anterior axillary line

  • V6 is placed directly in line with V5 in the left midaxillary line

ROM with Goniometer Rubric

Joint ROM1

• The subject was correctly positioned

• The goniometer axis was correctly positioned

• The goniometer stabilization arm was correctly positioned

• The goniometer movement arm was correctly positioned

• The ROM degree was correctly reported (± 5°)

  Joint ROM2

• The subject was correctly positioned

• The goniometer axis was correctly positioned

• The goniometer stabilization arm was correctly positioned

• The goniometer movement arm was correctly positioned

• The ROM degree was correctly reported (± 5°)

Goniometer Information

Stationary arm

Movement arm

Axis point/fulcrum

Joint: Ankle Flexibility

• Body position: seated

• Axis: lateral malleolus

• Stationary arm: head of fibula

• Movement arm: parallel to 5th metatarsal

• Joint movement: Plantar flexion/ dorsiflexion

Joint: Knee Flexibility

• Body position: supine

• Axis: lateral epicondyle of femur

• Stationary Arm: midline of femur

• Movement Arm: midline of fibula (alight with lateral malleolus)

• Joint movement: knee flexion

Joint: Hip Flexion and Extension

• Body position: supine/ prone

• Axis: greater trochanter

• Stationary Arm: midline of trunk

• Movement Arm: midline of femur

• Joint movement: hip flexion(supine) hip extension (prone)

Joint: Hip Abduction and Adduction

• Body position: supine

• Axis: ASIS

• Stationary Arm: opposite ASIS

• Movement Arm: Midline of Femur

• Joint movement: hip abduction (away from body) hip adduction (towards body)

Joint: Hip Internal and External Rotation

• Body position: seated

• Axis: center of patella

• Stationary Arm: vertically aligned

• Movement Arm: anterior midline of lower leg

• Joint movement: hip internal rotation (towards outside of body) hip external rotation (towards inside of body)

Joint: Shoulder Internal and External Rotation

• Body position: supine

• Axis: Olecranon process

• Stationary Arm: vertical alignment

• Movement Arm: styloid process of ulna

• Joint movement: shoulder internal rotation and shoulder external rotation

Joint: Shoulder Flexion

• Body position: supine

• Axis: center of humeral head

• Stationary Arm: midline of thorax

• Movement Arm: midline of humerus

• Joint movement: shoulder flexion

Joint: Shoulder Extension

• Body position: prone

• Axis: center of humeral head

• Stationary Arm: midline of thorax

• Movement Arm: midline of humerus

• Joint movement: shoulder extension

Joint: Shoulder Abduction

• Body position: supine

• Axis: center of humeral head

• Stationary Arm: midline of thorax

• Movement Arm: midline of humerus

• Joint movement: shoulder abduction

B.E.S.S Rubric

• (2pts) Correct pre-test instructions were verbalized to the subject. (footwear)

• (2pts) Correct equipment utilized for test trials.

• (2pts) Duration for each trial correctly verbalized and timed.

• (2pts) Trial errors correctly verbalized and identified during the test.

• (4pts) The correct position for the double leg stance was demonstrated.

• (4pts) The correct position for the single leg stance was demonstrated

• (4pts) The correct position for the tandem leg stance was demonstrated

BESS Instructions

• Consists of three stances tested on two different surfaces for 6 trials

• Each stance is performed with hands on the illiac crest and eyes closed for 20 secs

• All trials performed barefoot or wearings socks on flat surface and foam pad

• Errors include; opening eyes, stepping/stumbling/falling, lifting heel or forefoot, further flexion of the hip during the single leg stance trial (if they remain out of position for more than 5 secs, assign error score of 10 and end trial

BESS Stance 1

Narrow double leg

BESS Stance 2

Single Leg

BESS Stance 3

Tandem