Announcements

1. Chapter 4Health-Related Physical Fitness Testing and InterpretationWORDING IN RED WILL DEFINITELY BE ON THE TEST

2. 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.

3. 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)

4. 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

5. 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.

6. 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.

7. 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).

8. 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%.

9. 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.

10. 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.

11. 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.

12. Test Order • 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. • Resting measurements should be obtained first • Heart rate • Blood pressure • Height • Weight • Body composition

13. 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.

14. 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

15. 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.

16. Know: Body Type or Somatype

17. Know BMI categories below Pg. 63

18. Pg. 64

19. Android Vs. Gynoid

20. 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.

21. 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.

22. 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.

23. 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.

24. 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.

25. 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.

26. Skinfold Measurements 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.

27. 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.

28. 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.

29. 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.

30. 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).

31. 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.

35. 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).

37. Abdomen Skinfold Vertical fold 2 cm to the right of the umbilicus. Horizontal fold, one inch to the right side of and ½ inch below the navel. Alternate method -will not be done in 4315

38. 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.

39. 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

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

41. Subscapular Skinfold Diagonal fold just below the inferior angle of scapula.

42. 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.

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

45. 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

46. 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.

47. 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.

48. 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 100 Brozek Equation - % body fat = [(4.57 / Db) - 4.142] x 100

49. 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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