Name:
____________________________
__
Teacher:
____________________________
2
2
3
1. What are the physiological benefits of being physically active?
_________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
2. Why do I need to train (wt train, aerobics) to supplement my involvement in activities?
_________________________________________________________________________________________
_________________________________________________________________________________________
________________________________________________________________________________________
3. List the factors that influence the activities you get involved in.
_________________________________________________________________________________________
_________________________________________________________________________________________
________________________________________________________________________________________
4. What are the factors that affect your level of fitness? Can you control any of these factors? If so,
give suggestions as to how you might control these factors.
_________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
5. List as many ideas as you can in two columns; Physiological Factors improved by being fit, and
Psychological Factors improved by being fit.
_________________________________________________________________________________________
________________________________________________________________________________________
_______________________________________________________________________________________
6. Why is it important to have a high level of health related personal fitness?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
3
4
7. Reflect on your personal amount of physical activity you do outside of school. What challenges do
you face in keeping physically active? How might you overcome these challenges?
_________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
8. What activities are you interested in pursuing to maintain/improve your level of personal fitness?
_________________________________________________________________________________________
_________________________________________________________________________________________
________________________________________________________________________________________
9. What factors will affect whether or not you participate in these activities?
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
10. As you get out of the teenage years all of your fitness test results will start to decline. List ways
that you can counteract the effects of ageing and continue to maintain or improve your fitness level.
_________________________________________________________________________________________
_________________________________________________________________________________________
________________________________________________________________________________
11. What do you see yourself doing to stay active after high school is over?
_________________________________________________________________________________________
_________________________________________________________________________________________
________________________________________________________________________________
12. State ways that “being fit” or “being unfit” will help/hinder you throughout this school year.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
4
5
Lifestyle Questionnaire
Frequency
1-15
Duration
15-30
31-60
Walking for
Exercise
Bicycling
Swimming
Jogging/Running
Gardening
Home Exercises
Ice Skating
Cross Country
Skiing
Tennis
Golf
Popular Dance
Baseball/Softball
Alpine Skiing
Ice Hockey
Bowling
Exercise Classes
Racquetball/Squash
Curling
Other-Specify:
5
Perspiratio
n, Heavy
Breathing
Some
Perspiratio
n, faster
than
Normal
State
Heavy
Exercise Type
# of
Occasio
ns over
the Last
Month
Average # of Activity Minutes Spent
on Each Occasion
Slight
Change
from
Normal
State
1. Indicate the physical activities in which you have participated over the last month during you leisure
time.
Intensity
60+
LIGHT
MEDIUM
HEAVY
6
2. How long have you been doing some physical activity in your leisure time at least once a week?
 I don’t do an activity each week
 For less than 3 months
 From 3 months to just under 6 months
 6 months to just under1 year
 From 1 year to just under 3 years
 From 3 years to just under 5 years
 Five or more years
3. If you want to participate more in physical activities than you do now, why aren’t you able to?
(Check at most 3 reasons.)
 I don’t want to participate more
 Lack of time because of other leisure activities
 Requires too much self-discipline
 Ill health
 Cost too much
 Lack the necessary skills
 Injury or handicap
 No facilities nearby
 Lack of energy
 No leaders available
 Available facilities are inadequate
 Lack of time because of work/school
 Other___________________________
4. If you wanted to participate more in physical activities, which of he following would increase the
amount of physical activity you do? (Check at most 3.)
 Nothing
 Organized sports available
 More leisure time
 Better or closer facilities
 Organized fitness classes
 Having necessary equipment
 Different facilities
 Fitness test with personal activity program activity
 More energy
 Less expensive facilities
 People with whom to participate
More self-discipline
 More information on the benefits of doing physical activity
 Common interest of family
 Better health
 Common interest of friends
 Other____________________
6
7
5. From this list of reasons why some people do physical activities during their leisure time.
How important is each of these to you?
Very
Important
Of some
Importance
Of little
Importance
Of no
Importance
To feel better mentally and physically
To be with other people
For pleasure, fun or excitement
To control weight or to look better
To move better or to improve flexibility
As a challenge to my abilities
To relax or reduce stress
To learn new things
Because of fitness specialist’s advice
for improving health in general
Because of doctor’s orders for therapy
or rehabilitation
Other:
6. How important are each of the following to you in gaining a feeling of well being?
Very
Of no
Of some
Of little
Importance
Importance
Important
Importance
Adequate rest and sleep
A good diet
Low calorie snacks between meals
Maintenance of proper weight
Participation in social and cultural
activities
Control of stress
Regular physical activity such as
exercise, sports, or games
Using alcohol moderately or being a
non-drinker
Being a non-smoker
Adequate medical and dental care
Positive thinking/meditation
7. Compare yourself to other of your own age and sex, would you say you are…
 More Fit
 Less Fit
 As fit
8. In the past year, what physical activities have you stopped doing? (Do not include those
stopped due to a change in the season.)
 None or
Activity_______________________________________________________________
Why did you stop doing this activity?
Activity_______________________________________________________________
Why did you stop doing this activity?
7
8
9. What physical activities would you like to start in order to improve you fitness and health?
 None or Activity_______________________________________________________________
What is the main reason you have not yet started this?
Activity_______________________________________________________________
What is the main reason you have not yet started this?
Activity_______________________________________________________________
What is the main reason you have not yet started this?
10. With who do you/would you usually do your physical activities in your leisure time?
 No-one
 Friends
 Immediate family or relatives
 Co-workers
 Classmates at school
 Others
11. At what time do you/would you usually do your physical activities? (Indicate more than one if
you usually do activities more than once a day.)
 In the morning
 At lunchtime
 In the afternoon
 In the evening
 At no special time
12. a) How would you describe your state of emotional well being?
 Very good
 Good
 Adequate
 Poor
 Very poor
b) How do you think this might affect your physical activity/fitness goals?
 Aid
 Hinder
 No effect
Please explain___________________________________________________________________
13. What do you usually eat for breakfast? (Usually means at least four day a week.) Check all that
apply.
 I don’t eat breakfast  Bread, Danish or donut
 Fruit or fruit juices  Yogurt
 Eggs
 At least 6 ounces of milk
 Tea or coffee
 Bacon or other meat,
fish or poultry
 Other cereals
 Cheese
 Granola
14. In the last year have you been eating
More
Sweet food and candies
Fruit and vegetables
Fats and fried foods
Salt and salty food
Meals on a regular basis
The same amount of food or calories
8
Less
Same Amount as Before
9
15.
a) About how many hours of sleep do you usually get each day?
 Six hours or less
 Eight
 Ten
 Seven
 Nine
 Eleven +
b) Do you think you are getting enough sleep?
 Always
 Usually
 Seldom
 Never
a) About how often do you usually drink alcohol?
 More than once a day
 1 to 3 times a week
 Less than once a month
 4 to 7 times a week
 1 to 3 times a month
 I don’t drink alcohol
Go to question 17
b) About how many drinks do you usually have at a time?
Where one drink is: One pint of beer – 12 ounces
One small glass of wine
One shot of liquor or spirits
 One
 Two or three  Four or five
 Six or seven
 Eight or more
16. Which of the following best describes your experience with tobacco. Check all that apply.
 I have not smoked
 I stopped smoking
 I currently smoke:
 cigarettes occasionally
 cigarettes recently
 cigarettes over a year ago
 less than half a pack of cigarettes daily
 about a pack of cigarettes daily
 two or more packs of cigarettes daily
 A pipe, cigars or cigarillos recently
 A pipe, cigars or cigarillos over a year ago
 a pipe, cigars or cigarillos occasionally
 a pipe, cigars or cigarillos daily
17. In general, how would you describe your state of health:
 Very good
 Good
 Average
 Poor
 Very Poor
9
10
Lifestyle Inventory Follow Up
Questions – Physical Activities
Review your responses in the Lifestyle Questionnaire for questions number 1, 2, 3, 4, and 5 in order to
help you put together your ideas for this section.
1.
What percentage of your physical activities is:
(a) Connected to school activities______% (b) Connected to activities outside of school_____%
2.
What intensity do you normally perform the majority of these physical activities at?
 Light
3.
 Medium
 Heavy
Will finishing high school change your level or intensity of physical activity? Why or
why not?
_________________________________________________________________________
_________________________________________________________________________
4.
Will your answer above have an impact on your overall level of health?
_________________________________________________________________________
_________________________________________________________________________
5.
List activities you could do to maintain a physically active lifestyle after grade 12.
________________________________
_________________________________
________________________________
_________________________________
6.
List possible barriers to maintaining a physically active lifestyle after grade 12.
________________________________
_________________________________
________________________________
_________________________________
7.
Explain how your activities have reflected a holistic balance of the social, emotional,
physical, and intellectual realm of personal fitness.
_________________________________________________________________________
_________________________________________________________________________
10
11
Lifestyle Inventory Follow Up Questions – Nutritional Fitness
Review your responses in the Lifestyle Questionnaire for questions number 13 and 14 in order to help
you put together your ideas for this section.
1.
What percentage of your food intake is controlled by:
(a) You ___________%
2.
(b) Family___________%
(c) Friends___________%
Do you feel these percentages will change in the next few years? Why or Why not?
___________________________________________________________________________
___________________________________________________________________________
3.
What do you feel is the worst part of your nutritional fitness?
__________________________________________________________________________
___________________________________________________________________________
4.
What do you feel is the best part of your nutritional fitness?
___________________________________________________________________________
___________________________________________________________________________
____________________________________________________________________________
5.
What changes do you feel you are capable of making to your nutritional fitness?
___________________________________________________________________________
___________________________________________________________________________
____________________________________________________________________________
6.
List possible barriers to maintaining nutritional fitness in a healthy active lifestyle after grade
12.
__________________________________
_________________________________
__________________________________
_________________________________
7.
List ideas to overcome these barriers to maintaining nutritional fitness after grade 12.
__________________________________
_________________________________
__________________________________
11
12
Lifestyle Inventory Follow Up Questions – Emotional Fitness
Review your responses in the Lifestyle Questionnaire for questions number 6, 12, 15, 16, and 17 in order to
help you put together your ideas for this section.
1. What do you feel are the three main factors that affect your emotional fitness? Rank these three
factors.
1._____________________
2.____________________
3.____________________
2. How will improved physical fitness help you “control” these emotional fitness factors?
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
3. What changes are you capable of making to social factors that affect your emotional fitness?
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
4. List possible barriers to maintaining emotional fitness in a healthy active lifestyle after grade 12.
__________________________________
_________________________________
__________________________________
_________________________________
5. List ideas to overcome these possible barriers to maintaining emotional fitness after grade 12.
__________________________________
_________________________________
__________________________________
_________________________________
12
13
Def.: The ability to do physical activity requiring oxygen without experiencing undue
fatigue.
NOTE: Use the standards below as an OPTION. Alternatively, students may choose to track their personal
results and improvement in a journal and to share results with a peer. Use standards if they are a positive,
MOTIVATING factor for fitness improvement.
Resting Heart Rate: _____ bpm
Target Heart Rate Zone: For exercise to be beneficial to your cardiorespiratory system, your heart rate
during exercise must be within your ‘ Target heart rate zone’.
220 – age= _______ (bpm)
Target Heart Rate Zone: _______ (bpm) x 85% = Upper Limit
_______(pbm) x 60% = Lower Limit
Teacher
-Shout - “GO”
-Starts stop watch
-Shout – “2 Minutes Left ”
(warning)
-Blow whistle - at end of
12 min
-Reset stop watch
-Blow whistle – to start
pulse count
-Blow whistle – at end of
15 seconds
(do not reset stopwatch)
-Shout – “Get Ready”
-Blow whistle – at end of
2 minutes
- start pulse count
-Blow whistle – after 15
seconds
- end of pulse count
Partner #1
-Lined up ready to
go
-Stop
-Find pulse
-Count pulse out
loud
-Walk towards
teacher
-Stop
-Find pulse
-Count pulse out
loud
13
Partner #2
-Records laps
-Head to anticipated
finish pt.
-Record pulse
-Walk with partner
to teacher
-Record pulse
14
Lap Information:
# of Laps: ________ x Distance of each lap (115 m) = Total Distance Covered
Fitness Index
%
Male
____
Female
Excellent
> 80
2800 m. or more
2400 m. or more
Very Good
> 60
2400 m. – 2799 m.
2000 m. - 2399 m.
Good
> 40
2000 m. – 2399 m.
1600 m. - 1999 m.
Fair
> 20
1600 m. – 1999 m.
1200 m. - 1599 m.
Needs
Improvement
> 10
1599 m. or less
1199 m. or less
Heart Rate Information
(Heart Beat at end of Run) – (Heart Beat at end of 2 min.) = Heart Rate Recovery
____ _____
=
______
Heart Rate
Recovery - Females
Total
Points
Fitness Index
Less than 4
4 to 6
7 to 8
9
10
More than 10
44
56
67
78
89
100
Poor
Fair
Good
Very Good
Excellent
Superior
14
Heart Rate
Recovery –
Males
Less than 5
5 to 7
8 to 9
10
11
More than 11
15
Teacher
Partner #1
-Shout - “Go”
-Start stopwatch
-Make sure students
stays on pace
-Begin Stepping
-Shout - “Stop” – at 5
min.
-Stop & stay
standing
-Shout – “Get Ready” at 5min. 50 sec.
-Shout – “Count” – at 6
min.
-Shout – “Stop” – at 6
min. 30 sec.
-Find Pulse
-Count out loud
Partner #2
-Sit on bench & encourage
partner
- Help with rhythm – “up,
up, down, down”
(clap or say the above out
loud)
-If they did not go full 5
min., record when they
stopped
-Record Pulse
Heart Beats during 6 min to 6 min. and 30 sec. : _____________
# of Heart
Beats
Total Points
Under
40
100
40 44
100
45 49
100
50 54
100
55 59
94
60 64
89
65 69
78
70 74
73
75 79
67
80 84
61
85 89
61
Over
90
56
**If a student was not able to complete the test for the full 5 minutes she receive a 44 for their Total Point
Score**
Female Results – Under 30
years of age
Total Points
Under 50
50 to 59
60 to 69
70 to 79
80 to 89
90 to 99
Over 99
Fitness Index
Needs
Improvement
Fair
Average
Good
Great
Excellent
Superior
Male Results – Under 30 years of age
Total Points
Under 50
Fitness Index
Needs Improvement
50 to 59
60 to 69
70 to 79
80 to 89
90 to 99
Over 99
Fair
Average
Good
Great
Excellent
Superior
15
16
-
Mark out a distance of 20 meters
Teacher puts in the tape & students listen to the voice instructions on the tape.
Level attained: _________
Fitness Index
%
Excellent
> 80
Very Good
60 – 80
Good
40 – 60
Fair
20 – 40
Needs
Improvement
> 20
Male
16
12.0
11.5
10.5
10.0
9.5
9.0
8.5
8.0
7.0
<7.0
Female
17
12.5
12.0
11.0
10.5
10.0
9.5
9.0
8.5
7.5
<7.0
16
>17
13.0+
12.5
11.5
11.0
10.5
10.0
9.5
9.0
8.0
<7.5
16
8.5
7.5
7.0
6.0
5.5
5.0
5.0
4.5
4.0
<4.0
17
8.5
8.0
7.0
6.0
5.5
5.0
5.0
4.5
4.0
<4.0
>17
7.0+
7.0
6.5
6.0
5.0
4.0
<3.5
17
Def.: The ability of a muscle to exert a maximal force against a resistance, one
time.
Have the participant grasp the dynamometer in the appropriate hand. The grip is taken between the fingers
and the palm at the base of the thumb. Adjust the grip of the dynamometer so the second join of the fingers
fits snugly under the handle and take the weight of the instrument. Lock the grip in place. The participant holds
the dynamometer in line with the forearm at the level of the thigh. The dynamometer is then squeezed
vigorously as to exert maximum force.
Have the participant exhale while squeezing (to avoid buld-up of intra-thoracic pressure).
During the test neither the hand nor the dynamometer should touch the body or any other object. Measure
both hands alternatively allowing two trials per hand. Combine the maximum score for each hand.
LH: ____ + RH: ____ = Total ______
Fitness Index
Excellent
Very Good
Good
Fair
Needs
Improvement
Percentile
95
90
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
Age 15 – 19
Females
Males
Above 71
64 – 70
59 – 63
54 58
Under 53
Age 15 – 19
Females
Males
78
74
71
69
67
65
64
63
61
60
59
58
57
56
54
53
51
49
45
17
Above 113
103 – 112
95 – 102
84 – 94
Under 83
125
119
113
110
108
105
103
101
99
97
95
93
90
87
84
81
77
73
67
18



The student sits on the ground with their feet behind a line.
Using one hand the student throws the basketball as far as they can.
Measure the distance of the the throw in meters.
Distance: _______




Distance for
Females
10.2
9.9
9.3
9.0
8.7
8.1
7.8
7.2
6.9
6.3
6.0
5.7
5.1
4.8
4.2
3.8
3.3
3
2.4
2.1
1.8
Percentile
Score
100
95
90
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
Fitness Index
Excellent
Very Good
Fair
Average
Keep Working on
It
Needs more
practice
It’s a start!
Student puts their feet at the end of the mat (feet should be slightly apart)
Bend hips, knees and ankles, push vigorously with legs while swinging arms forward.
Mark their jump to the back of the heel of the foot that is closest to the start line.
Give them one practice jump. Count the best of two jumps.
Distance: ______
Distance for
Females
220
215
210
202.5
197.5
192.5
185
180
175
167.5
162.5
157.5
150
145
140
132.5
127.5
122.5
115
Percentile
Score
100
95
90
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
110
105
5
0
18
Fitness Index
Excellent
Very Good
Fair
Average
Keep Working on
It
Needs more
practice
It’s a start!
19
Def.: The ability of the muscles to perform dynamic contractions or sustain a static
contraction repeatedly over a period of time.





Hands on shoulders
Knees flexed to 90 degrees
On up phase – one elbow must touch the leg
On down phase – fingers must touch the floor
Record the total number in 1 minute
Females
(# of Sit-Ups)
36
33
30
28
26
24
22
20
18
15
12


Total Sit-ups: _______
Percentile
Fitness Index
95
90
80
70
60
50
40
30
20
10
5
Superior
Excellent
Very Good
Good
Fair
Keep Working!
Needs
Improvement
Males
(# of Sit-Ups)
50
47
44
41
39
37
35
33
30
27
24
From a standard push-up position, lower the body until the elbow is flexed at 90 degrees or less
Record the number of seconds this position can be maintained without the body touching the floor or
losing the proper form
Time: _____
Females
(# of seconds)
38
35
32
30
28
26
24
22
20
17
14
Percentile
95
90
80
70
60
50
40
30
20
10
5
Fitness Index
Superior
Excellent
Very Good
Good
Fair
Keep Working!
Needs
Improvement
19
Males
(# of seconds)
97
72
67
63
60
57
54
51
47
42
37
20
Flexed-Arm Hang (Females)
 Using an overhand grip, raise the
body until the chin is above the bar
 Record the number of seconds the
chin can be held above the level of
the bar
Push-Ups (Males)
 Standard push-up position
 Chest must touch floor during each
repetition
 Record total number performed
consecutively
Total seconds: _____________
Females
(# of seconds)
34
28
19
14
10
8
6
4
2
1
0
Total Push-ups: __________
Percentile
Fitness Index
95
90
80
70
60
50
40
30
20
10
5
Modified Pull-Ups (Females)
 The chinning bar is lowered to the
height of the chest
 Heels remain in contact with the
floor underneath the bar
 Arms are fully extended
 Then pull up until chin touches the
bar
 Record maximum number of
repetitions
Superior
Excellent
Very Good
Good
Fair
Keep Working!
Needs Improvement
Needs Improvement
Needs Improvement
Needs Improvement
Needs Improvement
Pull-Ups (Males)
 Subject grasps bar with an
overhand grip
 The body is raised until the chin is
above the bar
 Then lowered until arms are fully
extended
 Record the maximum number of
repetitions until failure
Total #: ___________
Females
(# of pull-ups)
43
40
36
33
30
28
26
23
20
16
13
Males
(# of Push-Ups)
53
49
44
41
38
35
32
29
26
21
17
Total #: _________
Percentile
Fitness Index
95
90
80
70
60
50
40
30
20
10
5
Superior
Excellent
Very Good
Good
Fair
Keep Working!
Needs Improvement
Needs Improvement
Needs Improvement
Needs Improvement
Needs Improvement
20
Males
(# of pull-ups)
14
12
10
9
8
7
6
5
4
2
0
21

Using a 16-inch bench, record the number of times the subject can either jump or step up onto the
bench in a 1-minute period
Total number of steps or jumps: _______
Females
(# of Jumps)
28
26
24
22
21
20
19
18
16
14
12
Percentile
95
90
80
70
60
50
40
30
20
10
5
Fitness Index
Superior
Excellent
Very Good
Good
Fair
Keep Working!
Needs Improvement
Needs Improvement
Needs Improvement
Needs Improvement
Needs Improvement
Needs Improvement
21
Males
(# of Jumps)
38
36
34
33
31
30
29
27
26
24
22
22
Def.: The ability to move your joints through a full range of
motion.






Sit on the floor with knees together & the feet flat against a bench turned on its side
With a partner holding the knees straight, reach forward with the arms fully extended
Hands should be placed on top of one another to avoid twisting the spine
Measure the distance the fingertips reach on the metre stick
NOTE – position of maximum flexibility should be held at least two seconds
THIS TEST SHOULD NOT BE DONE WITH A PERSON EXHIBITING LOWER BACK PAIN
Distance: _____ (cm)








Females
# of centimeters
Percentile
Score
Fitness Index
Males
# of centimeters
17
14
12
9
7
4
0
-2
-4
95
80
70
60
50
35
20
10
0
Excellent
Very Good
Good
Fair
Keep Working!
Needs Improvement
Needs Improvement
Needs Improvement
Needs Improvement
17
13
11
8
6
4
0
-2
-4
Stand with nose, chest and abdomen against a projecting corner or vertical pole
Raise right arm, bend elbow & reach down across the back as far as possible
At the same time, extend left arm down and behind the back, bend the elbow up the back & try to
cross the fingers over those of the right hand
Measure the distance to the nearest centimeter.
If fingers overlap – the score is positive
If fingers fail to overlap – the score is negative
If fingers just touch – the score is zero
REPEAT with arms crossed in the opposite direction (Left Arm Up)
Distance: ____ (cm)
Females
Right Up
(# of cm.)
8
7
6
5
3
0
-2
-4
-6
Females
Left Up
(# of cm.)
8
6
4
2
0
-2
-4
-6
-8
Percentile
Score
Fitness Index
95
80
70
60
50
35
20
10
0
Excellent
Very Good
Good
Fair
Keep Working!
Needs Improvement
Needs Improvement
Needs Improvement
Needs Improvement
22
Males
Right Up
(# of cm.)
7
6
6.5
5
3
0
-1
-2
-4
Males
Left Up
(# of cm.)
7
5
3.5
2
0
-2
-4
-5
-7
23



Place elbows on knees
Slowly stretch the groin muscles in an attempt to touch the floor with the knees
With the help of a friend measure the angle between the floor & your leg
Angle: ____




Angle Between Leg &
Floor
Percentile
Score
Fitness Index
More than 45
30 - 45
15 - 29
0 - 14
30
50
70
85
Needs Improvement
Fair
Good
Very Good
Lie on back with both legs bent
Slowly raise one leg at a time trying to touch knee to chest
Do not pull leg with hands
With the help of a friend measure the angle between your chest & your leg
Angle: ____
Angle Between Leg &
Chest
Percentile
Score
Fitness Index
More than 45
30 - 45
15 - 29
0 - 14
30
50
70
85
Needs Improvement
Fair
Good
Very Good
23
24
Def.: The relative percentage of muscle, fat, bone and other tissue that
the body is composed of.
Students should take the following measurements:
 Height
 Weight
 Chest (beneath armpits with chest relaxed
 Waist (at the navel)
 Hips (at the widest point)
 Thigh (at the widest point)
left:
right:
 Calf (at the widest point)
left:
right:
 Bicep (at the middle point)
left:
right:
cm. ___ m. ___
kg. ___
cm. ___
cm. ___
cm. ___
cm. ___
cm. ___
cm. ___
cm. ___
cm. ___
cm. ___
feet & inches___
lbs.____
nches___
inches___
inches___
inches___
inches___
inches___
inches___
inches___
inches___
Input personal data in the hand held device. Hold out in front of your body with your arms straight. Press
‘Start’. Record % of body fat. _______
Use the following formula to determine your BMI:
BMI (%)= weight (kg)
height (m2)
BMI ____% = _____(kg) ÷ (_____(m) X _____(m))
BMI (Kg/M2)
Fitness Index
<18.5
Underweight
18.5-24.9
Normal
25-29.9
Overweight
30-35
Obese
>35
Morbidly Obese
24
25
BMI by itself is not a reliable manner of determining body composition. Think of two people who are the same
height and the same weight; however, one person has a lot of body fat and the other is very muscular. Both
would have the same BMI based on the above formula. Therefore, it is necessary to add ‘waist measurement’
to make the result more reliable. Think of the same two individuals above. The person who has a lot of body
fat would have a much larger waist and his/her body composition would not be as healthy.
BMI + Waist Circumference = ______
___ (%) + _____ (cm) = ______
BMI (kg/m2)
<18.5
18.5-24.9
25-29.9
30-32.4
32.5-35
>35
Waist Circumference
Males
<94
94-101
>101
<94
94-101
>101
<94
94-101
>101
<94
94-101
>101
<94
94-101
>101
Waist Circumference
Females
All Girths
<80
80-87
>87
<80
80-87
>87
<80
80-87
>87
<80
80-87
>87
<80
80-87
>87
Calculations:



2.5 cm = 1 in
100 cm = 1 m
2.2 lbs = 1 kg
25
Fitness Index
Very Good
Excellent
Very Good
Fair
Excellent
Very Good
Fair
Excellent
Very Good
Needs Improvement
Excellent
Very Good
Needs Improvement
Excellent
Very Good
Needs Improvement
26
Def.: The ability to do physical
activity requiring oxygen without
experiencing undue fatigue.
12 Minute Walk / Run
Def.: The ability of a muscle
to exert a maximal force
against a resistance, one
time.
Hand Grip Strength
Def.: The ability of the
muscles to perform dynamic
contractions or sustain a
static contraction repeatedly
over a period of time.
Bent Leg Sit-ups
Def.: The ability to
move your joints
through a full range of
motion.
Sit & Reach
A - Right Hand
Total in 1 min.
# of cm.
B - Left Hand
FITNESS INDEX ________
PERCENTILE
PERCENTILE
FITNESS INDEX
_________
Distance
FITNESS INDEX
____________
Heart Beat – End of Run
A + B=
FITNESS INDEX
__________
Static Push-ups
Heart Beat – After 2 min.
Total # of seconds
Shoulder Test
PERCENTILE
Heart Rate Recovery
PERCENTILE
FITNESS INDEX ____________
Basketball Throw
Distance
FITNESS INDEX ________
Rt. Shoulder Up cm
PERCENTILE
Lt. Shoulder Up cm
Flexed Arm Hang
PERCENTILE Score
Total # of seconds
FITNESS INDEX
__________
FITNESS INDEX ________
Harvard Step Test
-
Heart Beats: (30 sec.) .
PERCENTILE
FITNESS INDEX
_________
Groin Flexibility
PERCENTILE
Total Time
Angle btw. legs & floor
Standing Long Jump
Modified Pull-ups
TOTAL POINTS
FITNESS INDEX ____________
-
Beep Test
Maximum # of reps
PERCENTILE
FITNESS INDEX ________
FITNESS INDEX
_________
Distance
PERCENTILE Score
PERCENTILE
Level Achieved
FITNESS INDEX
__________
Bench Jumps
Lower Back
PERCENTILE
Total in 1 min.
Angle btw. leg & chest
FITNESS INDEX ____________
FITNESS INDEX ________
PERCENTILE
PERCENTILE
FITNESS Index
__________
26
27
Def.: The relative percentage of
muscle, fat, bone and other tissue that
the body is composed of.
Anthropometric
measurements
Height:
Weigh:
Chest:
Waist:
Hips:
Thigh: left:
right:
Calf: left:
right:
Bicep: left:
right:
cm. ___feet & inches___
kg. ___lbs.____
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
Body Fat – Hand
held
Body Fat %
BMI (kg/m2)
BMI
PERCENTILE
FITNESS INDEX _________
BMI+Waist
Circumference
WC (cm)
BMI+WC
PERCENTILE
FITNESS INDEX ________
27
28
Def.: The ability to do physical
activity requiring oxygen without
experiencing undue fatigue.
12 Minute Walk / Run
Def.: The ability of a muscle
to exert a maximal force
against a resistance, one
time.
Hand Grip Strength
Def.: The ability of the
muscles to perform dynamic
contractions or sustain a
static contraction repeatedly
over a period of time.
Bent Leg Sit-ups
Def.: The ability to
move your joints
through a full range of
motion.
Sit & Reach
A - Right Hand
Total in 1 min.
# of cm.
B - Left Hand
FITNESS INDEX ________
PERCENTILE
PERCENTILE
FITNESS INDEX
_________
Distance
FITNESS INDEX
____________
Heart Beat – End of Run
A + B=
FITNESS INDEX
__________
Static Push-ups
Heart Beat – After 2 min.
Total # of seconds
Shoulder Test
PERCENTILE
Heart Rate Recovery
PERCENTILE
FITNESS INDEX ____________
Basketball Throw
Distance
FITNESS INDEX ________
Rt. Shoulder Up cm
PERCENTILE
Lt. Shoulder Up cm
Flexed Arm Hang
PERCENTILE Score
Total # of seconds
FITNESS INDEX
__________
FITNESS INDEX ________
Harvard Step Test
-
Heart Beats: (30 sec.) .
PERCENTILE
FITNESS INDEX
_________
Groin Flexibility
PERCENTILE
Total Time
Angle btw. legs & floor
Standing Long Jump
Modified Pull-ups
TOTAL POINTS
FITNESS INDEX ____________
-
Beep Test
Maximum # of reps
PERCENTILE
FITNESS INDEX ________
FITNESS INDEX
_________
Distance
PERCENTILE Score
PERCENTILE
Level Achieved
FITNESS INDEX
__________
Bench Jumps
Lower Back
PERCENTILE
Total in 1 min.
Angle btw. leg & chest
FITNESS INDEX ____________
FITNESS INDEX ________
PERCENTILE
PERCENTILE
FITNESS Index
__________
28
29
Def.: The relative percentage of
muscle, fat, bone and other tissue that
the body is composed of.
Anthropometric
measurements
Height:
Weigh:
Chest:
Waist:
Hips:
Thigh: left:
right:
Calf: left:
right:
Bicep: left:
right:
cm. ___feet & inches___
kg. ___lbs.____
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
cm. ___inches___
Body Fat – Hand
held
Body Fat %
BMI (kg/m2)
BMI
PERCENTILE
FITNESS INDEX _________
BMI+Waist
Circumference
WC (cm)
BMI+WC
PERCENTILE
FITNESS INDEX ________
29
30
30
31
Name:
____________________________
__
Teacher:
____________________________
31
32
Health and Physical Education
Personal Fitness Goal Setting Action Plan
I. Future Direction
List three realistic goals that you could implement to help you improve you current health
status. Look at your present fitness level and write your goals based on the performance
of your three weakest areas.
1.__________________________________________________________
2.__________________________________________________________
3.__________________________________________________________
II. Priorities
Using the above list, select your top two goals in order of importance.
1.__________________________________________________________
2.__________________________________________________________
III. The Most Important Priority
Select one of the above goals which you consider as the most important health-related
fitness priority for you, and one which you would really like to work on during the current
semester of school. Write that goal below and set dates for starting towards and
reaching that goal.
Goal_________________________________________________________
Target Date: Start _______________ Completion_______________
IV. Helps and Hindrances
What will help you reach your goal. What will stand in the way?
__________________________
__________________________
__________________________
__________________________
__________________________
___________________________
___________________________
___________________________
___________________________
___________________________
V. How Do You Get There?
Establish a mental model. Think about the people, steps, and dates you must consider
to reach your goal. In order to design a personal fitness program you should follow your
specific steps.
32
33
Health and Physical Education
Benefits of Personal Fitness
Purpose: To emphasize the physical and health benefits received from a personal
fitness program.
1. Physical activity that contributes to all health related components of
physical fitness could develop and maintain certain aspects of one's
health. Identify three health problems less likely to occur as a result of a
personal fitness program.
A.________________________________________________________
B.___________________________________________________________
C.___________________________________________________________
2. With one (1) being most important and six (6) the least important, rank the
following contributions of a personal fitness program, in terms of their
importance to you.
_____A. Appearance
_____D. Health
_____B. Enjoyment and satisfaction _____E. Relaxation
_____C. Slowing the ageing process _____F. More energy
3. As a result of participation in a personal fitness program, which of the
following improvements would you expect in you appearance.
_____Improved posture
_____Muscle tone
_____Efficient body movement
_____Less fat tissue
_____Improved complexion
4. List TWO goals of personal fitness you would like to achieve in the next
three months.
A.__________________________________________________________
__________________________________________________________
B.__________________________________________________________
___________________________________________________________
33
34
SMART FORMULA
GOAL SETTING
S
Specific
M
Measurable
A
Attainable
R
Realistic
T
Time Framed
Is it clear
Clarify exactly what you want to accomplish or be able
to do
Identify the exact target
How will you know when you get there
Goals need to be progressive or made in a series of
small steps so that you know whether there has been
change
Have a starting point
Is it possible?
Must be a goal that can be accomplished and is within
your abilities and control
Must be personally owned and not imposed by others
Is it probable or likely?
Must not be too easy or difficult or you could be
discouraged and give up
What are the timelines?
This will help to promote commitment to the goal and
helps you pace your efforts
34
35
FITNESS GOALS
WORKSHEET
Complete the following goal sheet on a monthly basis then at the end of the month complete your self-assessment, which will help
you revise or add to your goals.
I’ll start
Specific?
Measurable?
Attainable?
Realistic?
It will take ___
weeks to achieve
I’ll start
Specific?
Measurable?
Attainable?
Realistic?
It will take ___
weeks to achieve
Goal #1:
I will take the following
specific actions
towards fulfilling goal
#1:
Potential barriers or
obstacles that might
get in the way of
achieving this goal
are:
Goal #2:
I will take the following
specific actions
towards fulfilling goal
#2:
Potential barriers or
obstacles that might
get in the way of
achieving this goal are
35
37
Fitness Goals
Self-Assessment
(complete at end of semester)
Date: ________________________
Statement
Not Yet
Getting
Started
Almost
There
Made it
Happen
I set realistic goals for my fitness level
I worked on my fitness goals on a regular
basis
I was able to reassess my goals and set more
appropriate goals or more challenging goals
I feel that I am able to assess my fitness level
and set appropriate plans for myself and could
do this in the future
I feel that I demonstrate a level of fitness that
is healthy for me
On the continuum below, place an “X” showing where your fitness level was at the start
of the semester, and place a “Y” where you are now.
Cardiovascular endurance:
0
1
2
Muscular endurance:
3
4
5
6
7
8
9
10
0
1
2
Muscular Strength:
3
4
5
6
7
8
9
10
0
Flexibility:
0
1
2
3
4
5
6
7
8
9
10
1
2
3
4
5
6
7
8
9
10
Comment on your fitness improvement:
Reflect on your month (or unit) by commenting on some of your experiences so far.
Include obstacles you had to overcome, highlights for you, observations about yourself,
habits and things you may change for next month
37
38
38
Mrs. A. McFadden – Sept. 09
PAF 40F
Fitness Booklet
Rubric
Name: ___________________________
Date: ___________
On-Time:
Late:
This is worth 5% of your overall grade.
Thinking & Inquiry
Marks
Data Collection and
completion
Below
Level
0-4
Level 1
Level 2
Level 3
Level 4
5, 5.5
6, 6.5
7, 7.5
8,9, 10


Analysis &
Evaluation



Records little required
data and info.
Little thought to
presentation
Analyzes and evaluates
program with limited
effectiveness
Identifies personal
thoughts and areas for
growth with limited
effectiveness
Limited personal
analysis and critical
thought





Records some required
data and info
Some thought to
presentation
Analyzes and evaluates
program with moderate
effectiveness
Identifies personal
thoughts and areas for
growth with moderate
effectiveness
Some personal analysis
and critical thought





Records most required
data and info
Considerable thought
to presentation
Analyzes and evaluates
program with
considerable
effectiveness
Identifies personal
thought and areas for
growth with
considerable
effectiveness
Considerable personal
analysis and critical
thought





Records all required
data and info
A high degree of
thought to presentation
Analyzes and evaluates
program with a high
degree of effectiveness
Identifies personal
thoughts and areas for
growth with a high
degree of effectiveness
Excellent personal
analysis and critical
thought
___
10
39