Physical Fitness and Activity Assessment in Adults C H A P T E R 09 Physical Fitness and Activity Assessment in Adults Physical Fitness and Activity Assessment in Adults

Objectives Identify and define components of health- related physical fitness and the risks for fitness testing Use measurements of aerobic capacity, body composition, and muscular fitness Identify test items designed for older adults Understand the issues with measurement of physical activity in all populations

Physical Fitness Multifaceted objective with different meanings for different people Two factors provide the framework for defining physical fitness for any person Purpose of the tests Defined population

Populations and Purposes of Physical Fitness Testing

Health-Related Fitness Factors and Benefits

Supporting Evidence for Health-Related Fitness Epidemiology Examines the incidence, prevalence, and distribution of disease Relative risk The risk of mortality (death) or morbidity (disease) associated with one group compared to another (continued)

Supporting Evidence for Health-Related Fitness (continued) Physically active groups have lower relative risk of developing fatal cardiovascular disease (CVD) than sedentary groups (Caspersen 1989) Inverse relationship between death rates and cardiovascular endurance (Blair, Kohl, et al. 1989; Blair et al. 1996; Ekelund et al. 1988) (continued)

Supporting Evidence for Health-Related Fitness (continued) People who suffer from obesity have higher rates of CVD, cancer, and diabetes (ACSM 2010) Inverse relationship between muscular strength, obesity, and all-causes mortality after controlling for cardiovascular endurance (FitzGerald et al. 2004; Jackson et al. 2010; Ruiz et al. 2008)

Major Risk Factors and Classifications for Cardiovascular Disease

Physical Activity Readiness Questionnaire

Conditions Requiring Exercise Stress Test, Medical Exam, and Medical Supervision

Relationship Between Cardiorespiratory Endurance and Cardiovascular Death Rate

Measuring Aerobic Capacity Aerobic power The ability to supply oxygen to the working muscles during physical activity Laboratory vs. field methods

Laboratory Methods Maximal Oxygen Consumption (VO2max) Most reliable (rxx’ > .80) and valid measure Expired gases are monitored with a gas analysis system during a maximal exercise performance Can be difficult to measure due to expensive equipment, exhaustive exercise performance, and time restrictions

Other Laboratory Methods Estimating VO2max Maximal exercise performance Submaximal exercise testing Perceptual effort during exercise testing

Relative Intensity Scale

Important Facts Concerning Laboratory Testing Equipment should be calibrated and checked Test administrators should be trained and qualified Practice test Standardized testing procedures Treadmill VO2max values > cycle ergometer tests Cycle ergometer test can produce artificially low values (most people don’t ride bikes daily) Submaximal VO2max estimates typically have a SEE ≥ 5.0 ml ∙ kg−1 ∙ min−1

Field Methods Distance runs Step tests Rockport 1-Mile [1.6 km] Walk Test Predicting VO2max without exercise

Measuring Body Composition Obesity refers specifically to overfatness not overweight A well muscled athlete may be overweight but may actually be quite lean Measuring body composition involves estimating a person’s percent body fat Body composition can be looked at as two components: lean body mass and fat mass (continued)

Measuring Body Composition (continued) Hydrostatic weighting Dual-energy X-ray absorptiometry (DXA) Air displacement plethysmography CT scans and MRI Isotopic dilution Ultrasound Anthropometry (skinfold and girths) Bioelectrical impedance analysis (BIA) Total body electric conductivity (TBEC) Near-infrared interactance

Calculating Body Density and %Body Fat From Hydrostatic Weighting %fat = (495 ÷ BD) − 450 fat weight = (%fat ÷ 100) x body weight lean weight = body weight − fat weight target weight = lean weight ÷ [1 − (target %fat ÷ 100)]

Calculation of Fat, Lean, and Target Weights

Skinfold Assessment Most reliable, valid, and popular field method for estimating %body fat Uses skinfold calipers to measure skinfolds at multiple sites to estimate %body fat using prediction equations

Skinfold Calipers: Lange

Skinfold Calipers: Harpenden

Body Mass Index (BMI) Simple measure expressing the relationship of weight to height Commonly used in epidemiology research Acceptable for those people who are obese but may produce inaccurate results for people who are lean or of normal weight

Disease Risk Relative to Normal Weight and Waist Circumference

Measuring Muscular Strength and Endurance Work Result of physical effort work (W) = force (F) x distance (D) Power Amount of work performed in a fixed amount of time power (P) = (F x D) ÷ time (T) = W ÷ T (continued)

Measuring Muscular Strength and Endurance (continued) Force that can be generated by contracting muscles Torque The effectiveness of a force for producing rotation around an axis Muscular endurance Physical ability to perform work (continued)

Measuring Muscular Strength and Endurance (continued) Relative endurance Measurement of repetitive performance related to maximum strength Absolute endurance Measurement of repetitive performance at a fixed resistance

Types of Contractions Measured Concentric Muscle generates force as it shortens Eccentric Muscle generates force as it lengthens Isometric Muscle generates force but remains static in length and causes no movement Isotonic Muscle generates enough force to move a constant load at a variable speed through full range of motion (ROM) Isokinetic Muscle generates force at a constant speed through full range of motion (ROM)

Measuring Muscular Strength and Endurance Laboratory methods Generally assed by measuring force, torque, work, and power generated through concentric, eccentric, isokinetic, and isometric contractions Field methods Assessed with concentric and isotonic contractions Can be difficult to assess power, torque, etc. in the field due to lack of necessary equipment. Field assessments of muscular strength tend to be more subjective in nature.

Laboratory Methods Computerized dynamometers Biodex Back extension strength test Noncomputerized dynamometers Handheld dynamometers (HHD)

Manual Muscle Test Precursor to HHD testing Most often used in clinical situations to assess muscle strength Patients are given a rating from 0 to 5 based on their ability to move a joint through a full range of motion against gravity (0: no movement; 5: muscle contracts normally against full resistance)

Field Measures for Strength and Endurance Involves lifting external weights or the repetitive movement of the body Muscular Strength = 1-repetition maximum (1RM) Muscular Endurance = Maximum number of repetitions with a submaximal weight load

Field Measures for Strength and Endurance 1RM values of the bench press and the leg press (upper- and lower-body strength) YMCA Bench Press Test (upper-body endurance) Push-up test (upper-body endurance) (continued)

Field Measures for Strength and Endurance (continued) Trunk Endurance YMCA Half Sit-up Test Curl-up test (Robertson & Magnusdottir 1987)

Measuring Flexibility Range of motion of a joint or group of joints (flexibility is joint specific) Laboratory methods Goniometry, visual estimation, radiography, photography, linear measurements, trigonometry Field methods Trunk flexion (sit-and-reach) test, trunk extension

The Sit-and-Reach Test

Health-Related Fitness Batteries YMCA Physical Fitness Test Battery Canadian Standardized Test of Fitness The President’s Challenge: Adult Fitness Test

YMCA Physical Fitness Test Battery Used by the YMCA to assess physical fitness of its members (Golding 2000) Easily adaptable to many adult physical fitness testing situations Test battery includes the following components: Height, weight, resting heart rate, resting blood pressure, body composition, cardiorespiratory endurance, flexibility, and muscular strength and endurance

Canadian Standardized Test of Fitness Canadian Fitness Survey conducted in 1981 to develop an understanding of the fitness level of the Canadian population Test battery includes the following components: Resting heart rate, resting blood pressure, body composition (skinfolds), cardiorespiratory endurance, flexibility, abdominal endurance, and upper-body strength and endurance

The President’s Challenge: Adult Fitness Test Online adult fitness self-test www.adultfitnesstest.org Designed to be self-administered; however, a partner is needed to complete Test battery includes the following components: Aerobic fitness, body composition, muscular strength and endurance, and flexibility

Physical Fitness Assessment in Older Adults Defined as persons aged 65 years and over Highest rates of chronic diseases Health care costs for older adults are contributing to health financing problems Studies show that older adults respond to appropriate endurance and strength training programs similar to younger adults

Fitness Parameters and Items of the Older Adult Fitness Test

Special Populations Include people with physical or mental disabilities or both Valid and reliable fitness assessment of adults with disabilities is not a well- researched or well-understood topic Fitness assessment should include these: Anaerobic power, aerobic capacity, electrocardiographic response to exercise, muscular fitness, and body composition

Measuring Physical Activity Physical activity (PA) The behavior of bodily movement that requires the contraction of muscles and the expenditure of energy Roles of measurement in PA Amount of PA, amount of sedentary behavior, role of PA in health status, factors that relate to PA behavior, and the effect of interventions to promote PA

The Relationship of Health-Related Fitness to the Physical Activity Pyramid

Physical Activity Assessment in Age Groups of the Population

Single-Response Physical Activity Scale (Five Levels)

Steps per Day as Indices for Public Health for Adults (Tudor-Locke & Bassett 2004) <5000 Sedentary lifestyle index 5000-7499 Low active 7500-9999 Somewhat active ≥10,000 Active ≥12,000 Very active

Measuring Muscle-Strengthening Physical Activity Adults should engage in moderate- or high- intensity muscle-strengthening activities on 2 or more days a week in seven major muscle groups (Healthy People 2020 & 2008 Physical Activity Guidelines) Muscle-strengthening activities have numerous health benefits in addition to those provided by regular physical activity: Increased bone mass, improved posture, improved glucose tolerance, ability to conduct daily activities, and increased resting metabolism

Certification Programs Health Fitness Certifications ACSM Certified Group Exercise Instructor ACSM Certified Personal Trainer (CPT) ACSM Certified Health Fitness Specialist (HFS) Clinical Certifications ACSM Certified Clinical Exercise Specialist (CES) ACSM Registered Clinical Exercise Physiologist (RCEP) National Strength and Conditioning Association Certified Strength and Conditioning Specialist (CSCS) NSCA-Certified Personal Trainer (NSCA-CPT)

Summary Various factors are involved in assessing adult fitness and physical activity reliably and validly Mastering the material does not make you qualified to administer (but it’s an important step) Seek out appropriate education and training to obtain certifications