ExSc Testing & Rx: Lecture 3: Health-Related Physical Fitness

Physical Activity

• Any movement made by skeletal muscle

  • Contractions of muscles that increases caloric requirements

• Increases calorie use above resting level

• Includes daily life activities: walking to class, cleaning, playing with pets

Exercise

• Type of physical activity

• Planned, structured & repetitive movement to improve/maintain fitness

• Examples: running, lifting weights, cycling workouts

Physical Fitness

• A set of attributes related to the ability to:

  • Perform physical activity 

  • Complete activities of daily living 

  • Associated with health promotion & disease prevention 

  • Determined independent living 

• Reflects how well the body functions 

• All exercise is physical activity, but not all physical activity is exercise 

4 Reasons for Assessing Health-Related Physical Fitness

1. Baseline data:

• Shows current fitness & health status

• Age & sex related standards

2. Exercise prescription:

• Shape an individualized program

• Addresses all fitness components

3. Progress tracking:

• Measures short & long term improvements

4. Motivation:

• Helps set realistic & achievable goals

• Huge motivating factor

Basic Principles & Guidelines for Before Testing

• Pretest instructions:

  • Explain clearly in written & verbal form

  • Make sure client understands expectations & responsibilities

• Informed consent:

  • Must be provided before testing

  • Client should have time to ask questions

  • Confirms they understand risks and benefits

  • They can withdraw at any point 

  • Obtain consent before preparticipation screening

• Preparticipation Screening

  • Identifies the need for medical clearance

  • Screens for:

    • Cardiovascular disease

    • Metabolic disease

• Renal disease

• Look for signs and symptoms that increase risk

Before the test, make sure which forms are ready?

Consent forms, screening forms, data sheets

How should the testing environment be?

• Temperature: 68–72°F (20–22°C)

• Humidity: < 60%

• Adequate airflow

Test Order Guidelines

• Always start with resting measurements first

• No optimal order determined fo the general population 

  • Make sure HR is back to normal before next test 

• Arrange tests to reduce interference

  • Follow same order when re-testing 

  • Record what medication patients use during test & re-test 

  • Avoid fatiguing the same muscle group repeatedly

Comprehensive Health Fitness Evaluation

Data has to be analyzed & explained clearly to patients and educate them 

*3-8 perform in any order 

1. Informed consent

2. Preparticipation screening

3. Resting measurements (HR, BP)

4. Body composition & circumference measurements

5. Cardiorespiratory fitness

6. Muscular fitness

7. Flexibility

8. Static & dynamic balance (sometimes included)

• Trans women have to wait 2 years to use female classification

• Trans men have to wait 3 years to use male classification 

• Use a baseline intrapersonal comparison instead

• Create short & long-term goals, assessments allow your to track progress over time

General Rules for Resting HR Measurements

• Client rests at least 5 minutes

• No talking, moving, or distractions

• Ensures HR and BP stabilize

Technique for Pulse Palpation

• Use index & middle fingers 

• Most common site: radial artery (thumb side of wrist)

• Do not use your thumb (has its own pulse) 

Counting Options for Pulse Palpation & Auscultation w/ Stethoscope

For practical, HR needs to be within 5 bpm

• 15 seconds × 4

• 20 seconds × 3

• 30 seconds × 2

• 60 secs

General Rules for Auscultation w/ Stethoscope

• Client relaxed for ≥ 5 minutes

• Place bell:

  • Left of the sternum, just above the nipple line

• Ensure torso is stable

Common Sources of Error in BP Measurement

• Wrong cuff size

• Client talking or moving

• Arm not supported

• Not allowing enough rest time

• Measuring over clothing

• Incorrect stethoscope placement

• BP errors usually come from technique, not equipment failure