Copyright © 2010 American College of Sports Medicine Chapter 4 Health-Related Physical Fitness...

Copyright © 2010 American College of Sports MedicineCopyright © 2010 American College of Sports Medicine

Chapter 4Health-Related Physical Fitness

Testing and InterpretationWORDING IN RED WILL

DEFINITELY BE ON THE TEST

Chapter 4Health-Related Physical Fitness

Testing and InterpretationWORDING IN RED WILL

DEFINITELY BE ON THE TEST

Announcements• Labs next week (March 1, 3-4) will be in 213 MAC.• Remember next week is the ECG test during lab

times. • No labs March 8, 10-11.• Labs March 22, 24-25, and 28, 30-31 will be in 150

MAC• Labs starting April 5th will be back in 213 MAC.

The health-related components of physical fitness:

• have a strong relationship with good health, • are characterized by an ability to perform daily

activities with vigor, and • demonstrate the traits and capacities associated

with low risk of premature development of the hypokinetic diseases (e.g., those associated with physical inactivity)

Purposes of Health-Related Fitness Testing

• Educating participants about their present health-related fitness status relative to health-related standards and age- and sex-matched norms

• Providing data that are helpful in the development of exercise prescriptions to address all fitness components

• Collecting baseline and follow-up data that allow evaluation of progress by exercise program participants

• Motivating participants by establishing reasonable and attainable fitness goals

• Stratifying cardiovascular risk

Basic Principles and Guidelines• An ideal health-related physical fitness test:

– is reliable, valid, relatively inexpensive, and easy to administer, and

– should yield results that are indicative of the current state of fitness, reflect change from physical activity or exercise intervention, and be directly comparable to normative data.

Copyright © 2010 American College of Sports Medicine

Pretest Instructions

• A minimal recommendation is that individuals complete a questionnaire such as the Physical Activity Readiness Questionnaire (PAR-Q) or the ACSM/AHA form.

• A listing of preliminary instructions for all clients can be found in Chapter 3 (Patient Instructions). These instructions may be modified to meet specific needs and circumstances.


Test Order

• The following should be accomplished before the participant arrives at the test site:– Ensure that all forms, score sheets, tables, graphs,

and other testing documents are organized and available for the test’s administration.

– Calibrate all equipment a minimum of once each month to ensure accuracy (e.g., metronome, cycle ergometer, treadmill, sphygmomanometer, skinfold calipers).


Test Order – Organize equipment so that tests can follow in sequence

without stressing the same muscle group repeatedly.– Provide informed consent form.– Maintain room temperature of 68°F to 72°F (20°C to

22°C) and humidity of <60%.


Test Order (cont.)

• Testing CR endurance after assessing muscular fitness (which elevates HR) can produce inaccurate results about an individual’s CR endurance status, particularly when tests using HR to predict aerobic fitness are used.

• Dehydration resulting from CR endurance tests might influence body composition values if measured by bioelectrical impedance analysis (BIA).

• Because certain medications, such as beta-blockers, which lower HR, will affect some fitness test results, use of these medications should be noted.


Test Environment

• Test anxiety, emotional problems, food in the stomach, bladder distention, room temperature, and ventilation should be controlled as much as possible.

• To minimize anxiety, the test procedures should be explained adequately, and the test environment should be quiet and private.

• The room should be equipped with a comfortable seat and/or examination table to be used for resting BP and HR and/or ECG recordings.


Test Environment (cont.)

• The demeanor of personnel should be one of relaxed confidence to put the subject at ease.

• Testing procedures should not be rushed, and all procedures must be explained clearly prior to initiating the process.


Test Order• Resting measurements

should be obtained first– Heart rate – Blood pressure – Height– Weight – Body composition

• When all fitness components are assessed in a single session, resting measurements should be followed (in order) by tests of: - cardiorespiratory (CR) endurance,- muscular fitness, and - flexibility.

Body Composition• Before collecting data for body composition

assessment, the technician must be trained, routinely practiced in the techniques, and already have demonstrated reliability in his or her measurements, independent of the technique being used.

• Experience can be accrued under the direct supervision of a highly qualified mentor in a controlled testing environment.

Body Composition67% and 32% of American adults are classified as overweight and

obese. • Anthropometric methods

– Body mass index– Circumferences– Skinfold measurements

• Densitometry– Hydrodensitometry (underwater)

weighing– Plethysmography

• Other techniques– Dual energy x-ray

absorptiometry– Total body electrical conductivity– Bioelectrical impedance analysis – Near-infrared intercadence

Body Mass Index (BMI)• The BMI is used to assess weight relative to height

and is calculated by dividing body weight in kilograms by height in meters squared (kg·m-2)

• For most people, obesity-related health problems increase beyond a BMI of 25, and the Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults lists a BMI of 25.0 to 29.9 kg·m-2 for overweight and a BMI of ≥30.0 kg·m-2 for obesity.

Know: Body Type or Somatype

Pg. 63

Know BMI categories below

Pg. 64

Android Vs.

Gynoid

The ratio of waist-to-hip circumference (WHR) has been used to determine android vs. gynoid type of obesity. The waist circumference is the smallest circumference below the rib cage and above the umbilicus. The hip circumference is the largest circumference of the buttocks-hip area. The waist circumference alone is also used than the WHR.

Circumferences• The pattern of body fat distribution is recognized as

an important predictor of the health risks of obesity.

• Android obesity, which is characterized by more fat on the trunk (abdominal fat), provides an increased risk of hypertension, metabolic syndrome, type 2 diabetes, dyslipidemia, coronary artery disease, and premature death compared with individuals who demonstrate gynoid or gynecoid obesity (fat distributed in the hip and thigh).

• Significant amounts of waist circumference are:40 inches for males and 35 inches for females. Above these values disease risk increases.

Circumferences (cont.)• Procedures

– All measurements should be made with a flexible yet inelastic tape measure.

– The tape should be placed on the skin surface without compressing the subcutaneous adipose tissue.

– If a Gulick spring-loaded handle is used, the handle should be extended to the same marking with each trial.

Circumferences (cont.)• Procedures (cont.)

– Take duplicate measures at each site and retest if duplicate measurements are not within 5 mm.

– Rotate through measurement sites or allow time for skin to regain normal texture.

• Waist-to-hip ratio (WHR)– The waist-to-hip ratio is the circumference of the waist

divided by the circumference of the hips (buttocks/hips measure) and has been used as a simple method for determining body fat distribution.

– Health risk increases with WHR, and standards for risk vary with age and sex.

• Waist-to-hip ratio (cont.)– Health risk is very high for young men when WHR is

>0.95 and for young women when WHR is >0.86. – For people 60 to 69 years old, the WHR values are >1.03

for men and >0.90 for women for the same risk classification.

When performed correctly, skinfold measures provide an fairly good estimate of percent body fat (r = 0.70-0.90 with underwater weighing). The goal is to measure a double fold of skin and subcutaneous tissue (with sides of skinfold approximately parallel). The thicker the fat layer, the wider the fold.Technician error is the greatest source of error.

Skinfold Measurements

• Skinfolds measure subcutaneous fat. • Amount of subcutaneous fat is proportional to

the total amount of body fat. • It is assumed that close to one-third of the

total fat is located subcutaneously.

• The exact proportion of subcutaneous to total fat varies with sex, age, and ethnicity.

• Regression equations used to convert sum of skinfolds to percent body fat must consider these variables for greatest accuracy.

• Skinfold Procedures – page 67, Box 4.2– All measurements should be made on the right side

of the body with the subject standing upright.– Caliper should be placed directly on the skin surface,

1 cm away from the thumb and finger, perpendicular to the skinfold, and halfway between the crest and the base of the fold.

– Pinch should be maintained while reading the caliper.

• Skinfold Procedures (cont.)– Wait 1 to 2 seconds (not longer) before reading

caliper.– Take duplicate measures at each site and retest if

duplicate measurements are not within 1 to 2 mm.– Rotate through measurement sites or allow time for

skin to regain normal texture and thickness (at least 15 seconds apart).


• Do not take measurements when the subject's skin is moist (ensure that the skin is dry, and has no lotion). Also do not take measurements immediately after exercise or when the person being measured is overheated because the shift of body fluid to the skin will inflate normal skinfold size.

• Factors that may contribute to measurement error within skinfold assessment include: – poor technique, – an inexperienced evaluator,– an extremely obese or extremely lean subject, and– an improperly calibrated caliper (tension should

be set at ~12 g·mm-2).

Abdomen Skinfold

Vertical fold 2 cm to the right of the umbilicus.

Alternate method -will not be done in 4315

Horizontal fold, one inch to the right side of and ½ inch below the navel.

Triceps Skinfold

Vertical fold on posterior midline of the upper arm, halfway between the acromion and olecranon process, with the arm held freely to the side of the body.

Chest Skinfold

the chest/pectoral skinfold site is one half the distance between the anterior axillary line and the nipple for men, and one third of this distance for women

Midaxillary Skinfold

Vertical fold taken on midaxillary line at level of xiphisternal junction.

Subscapular Skinfold

Diagonal fold just below the inferior angle of scapula.

Suprailiac Skinfold a diagonal fold is taken with the natural angle of the iliac crest at the anterior axillary line immediately superior to the iliac crest

Alternate method: Diagonal fold just above iliac crest at the

midaxillary line.

Thigh Skinfold Vertical fold on anterior thigh, midway between inguinal crease and proximal border of patella.

Densitometry• Whole-body density, using the ratio of body mass

to body volume – In this technique, the body is divided into two

components: the fat mass (FM) and the fat-free mass (FFM). TWO COMPARTMENT MODEL.

– The limiting factor in the measurement of body density is the accuracy of the body volume measurement because body mass is measured simply as body weight.

– RESIDUAL VOLUME is the issue

• Hydrodensitometry (underwater) weighing– Based on Archimedes’ principle

• When a body is immersed in water, it is buoyed by a counterforce equal to the weight of the water displaced.

• Bone and muscle tissue are denser than water, whereas fat tissue is less dense. Therefore, a person with more FFM for the same total body mass weighs more in water and has a higher body density and lower percentage of body fat.


• Subjects must follow pre-test guidelines completely. (no food ingestion 4 hrs prior, smoking, caffeine, exercise).

• 5-10 trials necessary • light weight clothing needed, removal of air

bubbles from suit, hair, and skin while underwater.

Body Density (Db) = body mass (g) / body volume (mL)

Db = Wa / {[(Wa - Ww) / Dw] - (RV + 100 mL)}where; Db = body density (g/mL)

Wa = body mass out of water

Ww = body mass underwater

Dw = density of water (g/mL)

RV = residual lung volume (mL)

100 mL = volume of air trapped in gastrointestinal tract that cannot be

measured.

Siri Equation - % body fat = [(4.95 / Db) - 4.50] x 100Brozek Equation - % body fat = [(4.57 / Db) - 4.142] x

100

Plethysmography• Measured by air rather than water displacement• Based on 2 compartment model as well. • Uses a dual-chamber plethysmograph that

measures body volume by changes in pressure in a closed chamber

• This technology shows promise and generally reduces the anxiety associated with the technique of hydrodensitometry.

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Other Techniques• Dual energy x-ray absorptiometry (DEXA) and total body

electrical conductivity (TOBEC) are reliable and accurate measures of body composition, but these techniques are not popular for general health fitness testing because of cost and the need for highly trained personnel.

• BIA and near-infrared intercadence are used for general health fitness testing. The accuracy of BIA is similar to skinfolds, as long as a stringent protocol is followed and the equations are valid and accurate for the populations being tested. Near-infrared intercadence requires additional research to substantiate the validity and accuracy for body composition assessment.

Bioelectrical Impedance• Bioelectrical impedance (BIA)

Based on the premise that the volume of fat fee tissue will be proportional to the electrical conductivity of the body

• Passes a small electrical current into the body and measures resistance

–Fat is a poor conductor of electricity–Lean body tissue (mostly water) will be a

good electrical conductor• BIA is acceptable when measuring total body water• BIA is not as accurate for % of body Fat (Hydration levels)


Techniques• BIOELECTRICAL IMPEDANCE (BIA)

Relatively new technique Dependent upon several assumptions (State of hydration) Standard Error about the same as skinfold technique

• More costly• Quicker than skinfolds• Privacy less of a problem

Looks more high tech than other methods

BIA Problems• Electrolyte status may be altered due to:

• alcohol consumption (48 hrs)• food or eating consumption (4 hrs)• recent exercise (12 hrs)• Urination 30 minutes of the test

BIA Problems• Electrolyte status may be altered due to:

• diuretic therapy (Physician approved) within 7 days of the test

• menstrual cycle (avoid 3 days prior through three days following or belief of water retention. )

• Oil and lotions should be removed from the skin

• Room should have normal ambient temperature.


Body Composition Norms

Table 4-5


Body Composition Norms (cont.)

Table 4-6


• A consensus opinion for an exact percentage body fat value associated with optimal health risk has yet to be defined.– A range of 10% to 22% and 20% to 32% for men

and women, respectively, is considered satisfactory for health.

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Copyright © 2010 American College of Sports Medicine Chapter 4 Health-Related Physical Fitness...

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