Module 3 Health Related Physical Fitness Assessment and Programme Design (HRPF) Aims and Objectives To equip the HFI with the knowledge, application of and experience in recognising and evaluating the health related physical fitness components, and with the appropriate skills for the development of a framework for planning, implementing and evaluating safe exercise programmes To provide a basic understanding of the principles of training to enable the instructor to prescribe, plan and implement safe and effective exercise programmes To define the health related fitness components and to describe and administer appropriate techniques for fitness assessments To define the principles of training and to describe and demonstrate their application to exercise programming Course Content Unit 1: Components of fitness. Principles of training. Principles of overload. Unit 2: LME/strength. CV endurance. Intensity. Unit 3: Warm-up/cool-down. Flexibility. Body composition. Unit 4 : Screening procedures. Stages of screening. Forms. Informed consent. Risk factors. Guidelines for referral. Unit 5: Fitness assessment: Body composition, skinfold measurement. Unit 6: Cardiovascular endurance: (1) Shuttle run. (2) Rockport walk test. (3) Bike test. (4) Treadmill test. Unit 7: Testing for muscular strength/endurance. (1) Curl-ups. (2) Push-ups. (3) 1RM. (4) Estimated 1 RM. (5) 10 RM Unit 8: Flexibility tests: (1) Sit and reach. (2) Shoulder elevation. (3) Back extension. Unit 9: Programme planning: stages of planning. Case studies. Continuous Assessment: Practical 70% Written 30% Session 1 Objectives At the end of this session, students will be able to: • describe the general aims and purpose of module 4 • understand the continuous assessment procedures for module 4 Session 1 • list the health and skill related components of fitness • define the health related components of fitness • list and describe the principles of training and their application to the HR components of fitness What is Fitness? TOTAL FITNESS E S S M E = Emotional fitness S = Social fitness S = Spiritual fitness M = Mental fitness P = Physical fitness P Components of Physical Fitness 1. 2. 3. 4. 5. 6. Skill Related Agility Balance Co-ordination Reaction Time Power Speed Health Related 1. Body composition 2. Cardiovascular fitness 3. Flexibility 4. Muscular endurance 5. Muscular Strength These are the five components of fitness this course is concentrating on. Health Related Components of Fitness Cardiovascular Endurance: The ability of the heart and lungs to supply oxygen to the working muscles during continuous exercise Local Muscular Endurance: The ability of a muscle or a group of muscles to sustain exercise over a period of time without fatigue setting in Strength: The ability to exert force in a single effort Flexibility: The ability to move or stretch through a large range of motion around a joint (ROM) Body Composition: Ratio of muscle and bone weight to fat weight Principles of Training Overload Frequency: How often?Intensity: How hard?Time: How long?Type: Circuits, aerobics, weights etc Progression Specificity Reversibility Placement Individual Differences Adaptation Principles of Training • Overload: In order to improve your fitness levels, you must work the particular component against a load greater than normal. • Progression: As a person becomes fitter, a higher intensity of exercise is needed to create an overload. • Specificity: The result of the type of exercise performed is specific both to the muscle groups being used and to the energy system involved. • Reversibility: Training effects gained are reversible if workouts stop. Principles of Training • Placement: The scheduling of the training, both within a week/month etc. and within each session. • Individual Differences: Each person will have different capabilities and will adapt in a different manner to an exercise programme. There is no ‘one for all’ programme. • Adaptation: The way the body changes as a result of training, e.g. muscles may become stronger. Cardiovascular Endurance: The FITT Principles Frequency: 3 to 5 times per week Intensity: 60% to 85% MHR Time: 20 min (minimum) Type: Aerobic: running, cycling, swimming etc. Flexibility: The FITT Principles Frequency: 3 times per week upwards Intensity: To the point of tension Time: 15 to 30 secs Type: Stretching: passive, static, active, active assisted, PNF. Muscular Endurance: The FITT Principles Frequency : 3 to 5 times per week Intensity: 60% to 70% 1 RM Time: As long as it takes to do 15 to 30 reps Type: Weights, circuits etc. Strength: The FITT Principles Frequency: 3 to 4 times per week Intensity: 70% to 90% 1 RM Time: As long as it takes to do between 2 and 10 reps Type: Resistance training (weights ) Body Composition: The FITT Principles Frequency: 3 to 5 times per week Intensity: 55-65% MHR Time: 20 to 60 mins aerobic activity (continuous or intermittent) Type: Aerobic (primarily), LME, any activity that uses large muscle groups Health Benefits of Improved Cardiovascular Endurance Stronger heart rate Lower heart rate Possible reduction in BP Possible resistance to arteriosclerosis Possible improved periphery circulation Quicker recovery after hard work Improved coronary circulation Less chance of heart attack Greater chance of surviving heart attack Increased protective HDLs Increased O2 carrying capacity of the blood Health Benefits of Improved Muscular Strength and Endurance Greater work efficiency Less chance of muscle injury Decreased chance of low back problems Improved performance in sports Health Related Benefits of Improved Flexibility and Body Composition Flexibility Good joint mobility Less chance of muscle injury Prevents low back problems Helps maintain good posture alignment Body Composition Improved appearance Muscle is more metabolically active than fat Reasonable fat weight = less strain on heart/joints What is Fitness Assessment? Fitness Assessment is a vital part of the total professional service offered to clients and is the method used to evaluate the health fitness status of the client. Uses and Purpose of Fitness Assessment Individual diagnosis Exercise prescription Achievement of individual goals Motivation Measure improvements Educational purposes Programme evaluation Protect against litigation Instructor credibility Lines of communication - GP Stages of Health/Fitness Assessment Stage 1: Screening: Health history Health behaviours Risk factors Informed consent Stage 2: Physical measures: Resting heart rate Resting blood pressure Height Weight Cholesterol Stage 3: Fitness testing: Core tests WHY SCREEN? 1. Identify persons who need special attention 2. Identify persons who should exercise in a special way 3. Identify persons who should not be exercising at all 4. Helps HFI gain knowledge of physical ability of clients 5. Enhances credibility of HFI as professional 6. Can help protect HFI - legal problems 7. Helps to open lines of communication between GP and HFI Health/Fitness Assessment Stage 1 - Screening Screening by questionnaire: Medical history Physical activity pattern in life Risk factors the client may be subject to Informed consent Stage 2 Physical Measurements A. Resting heart rate B. Resting blood pressure C. Height D. Weight E.Cholesterol (if possible) ACSM Guidelines page 134 of Student Manual Referral Cardiovascular Endurance • The ability of the heart and lungs to supply oxygen to the working muscles during continuous exercise Oxygen Uptake Amount of oxygen taken up and used by the body. Reflects total amount of work being done by the body. During strenuous exercise, VO2 max increases linearly with increases in the intensity of exercise. Approaching exhaustion, VO2 reaches a max above which it will not increase further: VO2 max largest amount of oxygen body can use during maximal exercise Maximum Oxygen Uptake (VO2 max) VO2 max: the greatest rate at which oxygen can be consumed during exercise at sea level! V: the volume of oxygen used per minute O2:the oxygen max: maximal exercise conditions VO2 Max VO2 max is the highest rate of oxygen consumption that a person is capable of using during maximal exercise Referred to as maximal aerobic power or maximal oxygen uptake Usually expressed in ml/kg/min VO2 Max Best measured in lab during maximal exercise test in which the oxygen consumed is measured by a computerised metabolic chart Maximum Oxygen Uptake VO2 max is used(VO as the most 2) accurate measure of a person’s aerobic power or fitness A higher VO2 maximum reflects an increased ability of: heart to pump blood lungs to ventilate large volumes of air muscles to take up oxygen and remove carbon dioxide Laboratory measurement of VO2 max is: expensive time consuming requires highly trained personnel not practical for mass testing situations Therefore, various tests have been developed as substitutes. Steady State Where oxygen supply equals demand Lactate Threshold ……. is the highest exercise intensity or level of oxygen uptake beyond which there is an irregular rise in lactic acid production. Types of Tests Maximal: Begin at low intensity and gradually bring the subject to volitional exhaustion. Normally provides a more accurate estimation of VO2 max than sub-maximal tests, but they induce greater cardiovascular stress. Sub-maximal: Based on the assumption that heart rate is a linear function of VO2 max. Induces less cardiovascular stress. Types of Tests Field tests: Suitable for use with large numbers. Performed outside the laboratory, are practical, inexpensive, less time-consuming and easy to administer. Stop the test if ... subject requests to stop dizziness, mental confusion, staggering or unsteadiness angina - chest pain Nausea difficult or laboured breathing (dyspnea) pallor (paleness) Stop the test if ... cyanosis severe fatigue (facial distress) no steady state heart rate HR in excess of 85% maximum HR malfunction of equipment CV Tests Walk test Shuttle run test Bike test Treadmill tests Step tests Testing for Flexibility Flexibility can be measured by means of the following tests: Sit and Reach Straight Leg Raise Shoulder Elevation Back Extension Sit and Reach (Low back & SpecificHamstrings) warm up Remove shoes and place feet at the special box where 23cms is at the level of the feet Keep knees straight and place one hand on top of the other Bend forward at the trunk, keeping the knees straight and reach forward as far as possible. Three attempts and record the best. Check table for standards. Straight Leg Raise (Hamstrings) Lie flat on a table making sure that the low back is flat Stabilise the leg that is not being lifted Lift one leg with knee straight and evaluate the angle of the hip. Check Table for standards Shoulder Elevation Lie on tummy, keeping arms straight and shoulder width apart, raise a stick as high as possible while keeping the chin on the floor and wrists and elbows straight Measure in inches from the bottom of the stick to the floor(best of three attempts) Multiply result by 100 and divide by the arm length in inches(Hold stick in both hands and measure from the shoulder to the upper surface of the stick) Back Extension (Extension of the spine) Lie prone on the floor Place hands under shoulders.Keep hips down all the time. Raise the chest slowly using the arms not the back. Measure in cm from the suprasternal notch to the floor. Check the table for standards. Muscular Endurance The ability of a muscle or group of muscles to exert a sub-maximal force repeatedly or continuously over time Muscular Endurance Tests New crunch curl-up Push up Modified push up Bench press New Crunch Curl The subject lies supine. Knees bent at 90. Finger tips touching strips of masking tape placed perpendicular to the body. A second strip of tape is placed parallel to the strip, 8 cm apart. A metronome is set at 40 beats per minute (3 secs per curl-up, 20 curl-ups per minute). Stomach is kept firm to keep lower back on ground. New Crunch Curl Subject curls the upper spine until the finger tips touch the second strip of tape and returns to the starting position. The movement is slow and continuous. The individual performs as many curl-ups as possible to the set cadence without pausing, up to a maximum of 60 secs (3 mins). Check table for scores. Press Up The subject starts in the up position, arms straight, hands just outside shoulder width. For push-ups, your body is supported by your hands and feet. For modified press-ups, your body is supported by your hands and the thighs just above the knee. Your back should be straight and fingers pointed forward. Your body should be linear from shoulders to end point of contact with ground. Press Up The subject lowers his/her body until the chest touches the tester’s fist, which is on the ground, and then raises back to the ‘up’ position. The back must be kept straight. The abdominal muscles need to be contracted to stabilise the back. The client should breathe out on the effort and in on the way down. The score is the maximum number of correctly completed push-ups. Refer to the scoring table. Bench Press Subject should have technique practice on previous days Subject should warm up Subject lies supine on a bench - knees bent, feet on floor Subject grips the bar - hands wider than shoulder width, wrists straight and directly overhead the elbows - in the down position. Subject then extends the arms, pressing the barbell up, and repeats the movement to the rhythm of the metronome. Bench Press Subject should breathe regularly. Score the number of successful repetitions. The test is finished when the subject is unable to reach full extension or breaks the rhythm. Refer to the scoring tables. Muscular Strength Strength is measured by means of 1RM Strength to BW ratio Estimated 1RM 10RM 1RM Strength to BW Ratio Select muscle group Subject should be familiar with technique Establish wt. that can only be lifted once Allow rest between trials Record wt. lifted in lbs and divide by subjects wt. in lbs. Refer to table for standards Estimated 1 RM Familiarise subject with technique Record subjects’ BW in lbs. Start loads at .25% to .33% of BW for upper body and .55% to .66% for lower body Perform the lift aiming to lift between 2 and 10 reps.If more than 10 lifts then increase the weight. Calculate the 1RM by the following equation : Weight Lifted 1.0278 - .0278(x) X = No. of Reps 10 RM Familiarise subject with technique Find a weight subject can lift no more than 10 times 10RM = 75% 1RM EG. Subject lifts 75KG 10 times. 1Rm = 100KGs Measuring Body Composition Hydrostatic weighing Bioelectrical impedance Body mass index Waist to hip ratio Skinfold callipers Body Composition Hydrostatic weighing: Archimedes principle: fat is less dense than water/muscle and bone is more dense, so a person with more bone and muscle mass and less fat will weigh more in water and have a greater density i.e. a lower % body fat and a greater % FFM. Bioelectric Impedance The resistance to an applied electric current is inversely related to the amount of the FFM. FFM has a greater water and electrolyte content and therefore greater conductivity than adipose tissue and bone. The greater the FFM, the greater the conductivity. % fat can be calculated by: % fat = ((weight - FFM)/weight) .100 Body Mass Index Measure body weight (kg) Measure body height (m), convert ins to cms by multiplying by 2.54. Divide by 100 to convert to metres. Square metres to convert to m2 Use formula kg/m2 and refer to table Desirable range =20-25 kg/m2 Grade 1 Obesity =25-29.9 kg/m2 Grade 2 Obesity =30-40 kg/m2 Grade 3 Obesity=>40 kg/m2 Waist to Hip Ratio Record measurements in cms or ins Waist circ. (most narrow girth at umbilicus) Hip circ. (Largest girth of the buttocks) Waist circ./Hip circ. Standards: >.95(men) >.85(women) = increased risk of heart disease Body Composition Skinfold Measurement Procedures Take at right hand side of the body Grasp skinfold by the thumb and index finger Place calliper 1 cm below fingers Take two scores with a required accuracy of 1 mm; record average value Testers should have short nails Measure when skin is dry PROGRAMME PLANNING FOUR STAGES Needs analysis Programme prescription Programme implementation Programme evaluation NEEDS ANALYSIS Screening/informed consent Medical history Current injuries Referral criteria Exercise history Medications Contact numbers Clients own goals What are the client’s personal goals? Fitness testing Motivation Relationship building Education Components (helps identify) Appropriateness Accuracy Recording Age Experience (determines test choice) Needs Analysis contd. Time Available Time client is prepared to prioritise components Start small Work at home Preferred Activities What client likes/dislikes Past experience Education Explode myths and misconceptions ‘Sell’ the programme Lifestyle Habits Smoking Diet/nutrition Stress Drinking habits Programme Prescription Exercise selection • List of activities • Adaptations/progres sions Equipment/facilities Range Home equipment Components of fitness Aerobic fitness LME Strength Flexibility Body composition Programme Prescription FITT PRINCIPLES Frequency Intensity Time Type WARM-UP/COOLDOWN Elements of a good warm-up Elements of a good cool-down Programme Implementation Motivation/adherence Physician support Individual needs Short-term goals Encourage groups Logging Emphasise fun Regular fitness testing Positive leaders Safety/injury prevention Warm up and cool down Stress rest periods Check nutrition Teaching/safety points Small number at a time Meet the client to reinforce Observation/correction Programme Implementation Discussion Exercise to go over Exercises client not comfortable with How they feel about the programme New aches/pains Time/length of programme Record keeping Progression Does the client know to progress? Have you set a target for them? Evaluation Re-test Record and compare results Analyse results Evaluate programme Need for change Consult with client Part/whole change Case Study Guidelines Underline key words Identify component of fitness Be realistic - equipment, time, facilities, lifestyle, accessibility Be systematic - FITT principles - change one at a time Justify your answer - give reasons why Screening procedures - primary and secondary risk factors Keep to the point - short & concise Case Study Guidelines Needs analysis - individual goals Risk factors - injuries Frequency/time Availability/accessibility Nutrition Lifestyle changes Use point form Individual Case Study Case Study John (42) has just given up smoking and after a medical examination he has been advised to take up exercise. His goals are to lose weight and improve his overall health. (a) Outline 3 fitness assessments that would be suitable to conduct on John. Give a detailed explanation why you consider your choice of assessments to be appropriate for John (Answer 15-20 lines approx) (20 marks) Individual Case Study Outline a 12-week programme using the FITT principles that will help him to achieve his goals. (Answer 20-25 lines approx or table format) (25marks) Describe in detail one session in week 4 and one session in week 8 of John's programme. (Answer 20-25 lines approx or table format)(30 marks) Group Case Study Group Case Study A group of off-season hockey players male and female wish to take part in a circuit-training programme for general overall fitness. They range in age from 20 yrs - 35 yrs. Describe the screening procedures you would conduct with this group. (Answer approx 15 lines) (15 marks) Outline a series of 4 fitness tests suitable for this group and explain in DETAIL why you chose these tests for this particular group. (Answer approx 20-25 lines) (20 marks) Group Case Study Design a circuit suitable for this group under the headings: exercises, muscle groups, reps, work rest ratio, sequencing, adaptations. (Table format may be used) (25 marks) Show changes/progressions (can be given in a table format) you would make in week 4 and week 8. (15 marks)