Peak Performance in Sport Practical 1
Health and Anthropometrics: The Basis of Performance Assessments
Learning Objectives:
By the end of this session you will:

Understand the process of collecting informed consent and assessing readiness to
participate in physical activity;

Be able to measure blood pressure using automated and manual techniques;

Be able to critically review the validity and reliability of the automated method of
blood pressure measurement;

Be able to measure skinfold measurements at various sites and use these and other
methods to predict body fat %;

Be able to critically review the validity and reliability of the methods of blood
pressure measurement;
Informed Consent and Physical Activity Readiness Questionnaire (PAR-Q):
Please read the information sheet provided by the lab tutor and complete both the consent
form and PAR-Q. The completed forms should be handed back to the tutor.
Blood Pressure
Background:
The measurement of blood pressure in clinical practice by the century-old technique of RivaRocci/Korotkoff (auscultatory method) is dependent on the accurate transmission and
interpretation of a signal (Korotkoff sound or pulse wave) from a subject via a device (the
sphygmomanometer) to an observer. This method is commonly accepted to provide an
accurate measurement of blood pressure assuming a standard methodology is followed and
is the predominant method of measuring blood pressure in clinical practice. Errors in
measurement can occur at each of these interactionary points of the technique, but by far
the most fallible component is the observer!
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Self-contained automatic blood pressure monitors provide a simple alternative to the
manual method (above) and allow patients to monitor their own blood pressure at home.
However, the accuracy of these devices has often been questioned and therefore the
validity and reliability of the measurements should be investigated before basing a clinical
diagnosis on results from an automatic monitor.
Experimental Design:
Get into pairs and obtain either manual or automatic blood pressure apparatus. Take turns
to take a measurement of blood pressure on each other until you have three measurements
for each individual and enter the data in Tables 1 and 2. Take one measurement from your
partner before he/she takes a measurement from you. Once you have completed 3
measurements for each person repeat for the other blood pressure measuring method
(randomised crossover design) and enter your data in the spreadsheet.
Procedures:
Anthropometrics: Record the age, gender, height and body mass of each individual using
standard methods.
Manual Method: The cuff should be wrapped around the arm ensuring that the bladder
dimensions are accurate. If the bladder does not completely encircle the arm its centre must
be over the brachial artery. The rubber tubes from the bladder are usually placed inferiorly,
often at the site of the brachial artery, but it is now recommended that they should be
placed superiorly or, with completely encircling bladders, posteriorly, so that the antecubital
fossa is easily accessible for auscultation. The lower edge of the cuff should be 2-3 cm above
the point of brachial artery pulsation.

Place the stethoscope gently over the brachial artery at the point of maximal
pulsation;

The stethoscope should be held firmly and evenly but without excessive pressure,
too much pressure might distort the artery producing sounds below diastolic
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pressure. The stethoscope end-piece should not touch the clothing, cuff, or rubber
tubes to avoid friction sounds.

The cuff should then be inflated rapidly to about 180 mmHg and deflated at a rate of
2-3 mmHg per pulse beat (or per second), during which the auscultatory phenomena
will be heard (See following page).

When all sounds have disappeared the cuff should be deflated rapidly

Record the systolic blood pressure (SBP) and the diastolic blood pressure (DBP)
Automatic Method: The cuff should be wrapped around either the wrist or the arm
depending on which machine you have. Ensure you place the microphone (often indicated
by a white circle) on the superior surface of the arm over either the radial (wrist) or brachial
(arm) artery.

Press the start or go button on the device

Record the measurement

Record the SBP and the DBP
Measurements:
SBP is a measure of blood pressure while the heart is beating. DBP is a measure of blood
pressure while the heart is relaxed. Blood pressure is generally expressed as SBP/DBP, e.g.
120/80 mmHg. SBP and DBP are not static but undergo natural variations from one
heartbeat to another and throughout the day (in a circadian rhythm).
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Auscultatory sounds

Phase I
The first appearance of faint, repetitive, clear tapping sounds which
gradually increase in intensity for at least two consecutive beats is the systolic
blood pressure

Phase II
A brief period may follow during which the sounds soften and acquire
a swishing quality

Auscultatory gap
In some patients sounds may disappear altogether for a
short time

Phase III
The return of sharper sounds, which become crisper to regain, or
even exceed, the intensity of phase I sounds. The clinical significance, if any, to
phases II and III has not been established

Phase IV
The distinct abrupt muffling of sounds, which become soft and
blowing in quality

Phase V
The point at which all sounds finally disappear completely is the
diastolic pressure
What to note when measuring blood pressure

The blood pressure should be written down as soon as it has been recorded

Measurements of SDP and DBP should be made to the nearest mm Hg

The arm in which the pressure is being recorded and the position of the subject
should be noted

Pressures should be recorded in both arms on first attendance

In clinical practice the diastolic pressure should be recorded as phase V, except
in those patients in whom sounds persist greatly below muffling; this should be
clearly indicated
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Calculations:
Mean Arterial Blood Pressure (MAP):
MAP measurement indicates the average blood pressure within the cardiovascular system.
It’s clinical significance lies in that it represents the perfusion pressure for the body’s
internal organs. MAP can be deduced using the following equation
MAP = DBP + 1/3(SBP-DBP)
Pulse Pressure:
The up and down fluctuation of the arterial pressure results from the pulsatile nature of the
cardiac output i.e. the heartbeat. Pulse is determined by the interaction of the stroke
volume of the heart, compliance (ability to expand) of the aorta, and the resistance to flow
in the arterial tree. By expanding under pressure, the aorta absorbs some of the force of the
blood surge from the heart during a heartbeat. In this way the pulse pressure is reduced
from what it would be if the aorta wasn't compliant.
The pulse pressure can be simply calculated from the difference of the measured systolic
and diastolic pressures:
PP = SBP – DBP
Calculate the MEAN of each individual’s three measurements of SBP, DBP, MAP and PP and
record them in Tables 1 and 2.
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Table 1: Measurements of SBP, DBP, MAP and PP for Subject 1 using manual and
automatic methods
Manual Method
1st
2nd
3rd
Automatic Method
Mean
1st
2nd
3rd
Mean
SBP
DBP
MAP
PP
Subject 1: Age................. Height................. Gender..................... Weight.................
Table 2: Measurements of SBP, DBP, MAP and PP for Subject 2 using manual and
automatic methods
Manual Method
1st
2nd
3rd
Automatic Method
Mean
1st
2nd
3rd
Mean
SBP
DBP
MAP
PP
Subject 1: Age................. Height................. Gender..................... Weight.................
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Questions:
1) What factors may affect blood pressure measurements at rest in a healthy individual?
2) Given your responses above, what advantages may the automatic blood pressure
device offer?
3) What disease states could affect blood pressure? Why?
4) How do your blood pressure results (and those of your partner) compare to the
standard classifications (See Table 3 below)?
5) How does exercise affect blood pressure? Provide a physiological explanation for your
observations.
Table 3: Classification of blood pressure for adults
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Category
systolic, mmHg
diastolic, mmHg
Hypotension
<90
or <60
Normal
90–119
and 60–79
Prehypertension
120-139
80-89
Stage 1 Hypertension
140–159
or 90–99
Stage 2 Hypertension
≥160
or ≥100
From: Classification of Blood Pressure
National Heart, Lung, and Blood Institute (2004). The Seventh Report of the Joint National
Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
National
High
Blood
Pressure
Education
Program.
Available
at:
http://www.ncbi.nlm.nih.gov/books/NBK9633/
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Anthropometry and Body Fat%
Knowledge of body fat percentage and how it might be calculated is a valuable tool for the
assessment of health and fitness.
Apparatus
Scales, stadiometer, Tape Measure, skinfold callipers, TANITA bioelectrical impedance
Procedure
Using the balance beam scales and the stadiometer assess each other’s stature and mass.
Mass = …………………………Kg.
Stature = ……………………….cm
Use the TANITA bioelectrical impedance analyser to provide a prediction of body fat %:
TANITA Body Fat = …………………………%
Skinfold Instructions
A double layer of skin is grasped with the thumb and forefinger. The fold being large enough to get
a complete double layer, but not so large that excessive tension is felt at the fingertips. The fold of
skin is held loosely between the fingers at all times during the measurement. The faces of the
calliper are applied 1 cm below the thumb and closer to the body than the grasping hand. The
reading on the dial is taken after allowing full spring pressure of the device by a complete release of
the grip on the trigger levers. The experimenter must allow adequate time for full pressure, but not
too much time so that the fat is squeezed out of the skinfold. The measurement is taken to the
nearest mm.
All skinfolds for the Durnin & Womersley should be measured on the right side of the body. A
minimum of three measurements must be taken, but not consecutively. If the value increases with
measurement keep measuring until you obtain a stable measure.
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Use the ISAK guide if you are unsure of the location of the skinfold sites.
Locations of skinfold sites
Pectoral: (Men Only) An oblique fold along the border of the pectoralis major between the anterior
axillary fold and the nipple.
Suprailiac: Diagonal fold 3 cm above the crest of the ilium on a vertical line from the midaxilla
Abdomen: Horizontal fold 2cm from the umbilicus.
Subscapula: Oblique skinfold 1cm below the inferior angle of the scapula following natural line of
the skin.
Triceps: vertical skinfold exactly halfway between olecranon and the acromion process with the
hand supinated.
Biceps: vertical skinfold exactly halfway between olecranon and the acromion process with the hand
supinated.
Midthigh: Vertical skinfold midway between the inguinal crease and the proximal border of the
patella.
Calf: (For practical 3) The participant sits on a chair with the foot on the floor and relaxed. The
measurement is taken at the medial side of the right calf just above the level of maximum girth using
a vertical fold.
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Figure 1. A picture representation of skinfold sites.
NB Check the instructions and tables overleaf to ensure you only measure what you need to
measure, not all the skinfolds on this diagram need to be measured.
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Record all measurements into the following Tables.
SUM = the addition of the median skinfold (from 3 measurements) taken for each body part.
Table for Men/women
Durnin & Womersley (mm)
1
2
3
M
Bicep
Tricep
Sub
Sup
SUM
Procedure (Durnin & Womersley)
Calculate body fat using the Durnin and Womersley skinfold equations:
Equation = Db = c - ( m x log10SUM )
% body fat (using the Siri equation)
% fat =
495
- 450
Db
where Db = body density in gml-1
where SUM = sum of biceps, triceps, subscapular and suprailiac skinfolds (mm)
where m and c are obtained from Table 2 for the appropriate age and sex
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Table 2
AGE
17-19
20-29
30-39
40-49
50+
c
1.1620
1.1631
1.1422
1.1620
1.1715
m
0.0630
0.0632
0.0544
0.0700
0.0779
c
1.1549
1.1599
1.1423
1.1333
1.1339
m
0.0678
0.0717
0.0632
0.0612
0.0645
MALES
FEMALES
Calculations
Percent Body Fat
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Validity and Reliability
Using blood pressure as the example, discuss how you would process your data to
determine the validity of a measurement technique (e.g. automated method) and the
reliability of a measurement technique (e.g. manual and automated methods).
References
Wagner, D.R. & Heyward, V.H. (1999). Techniques of Body Composition Assessment: A
Review of Laboratory and Field Methods. Research Quarterly for Exercise and Sport, 70(2),
135-149
Winter, E.M. et al (2007). Sport and Exercise Physiology Testing Guidelines. The BASES
Guide. Volume: Sport Testing. Routledge, Taylor & Francis Group.
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