2. 2
Table of Contents
Introduction……………………………………………………………………….. Page 3
Description of Subject and Health Appraisal Risk………………………………...Page 5
Resting Heart Rate and Blood Pressure………………………………... …………Page 6
Muscular Fitness/Flexibility Assessment………………………………………….Page 7
Body Composition…………………………………………………………………Page 8
Prediction of Aerobic Capacity…………………………………………………….Page 11
Maximal GXT Interpretation………………………………………………............Page 15
Conclusions………………………………………………………………………..Page 16
References………………………………………………………………………….Page 17
Appendices…………………………………………………………………………Page 18
3. 3
Introduction
The capacity to perform aerobic exercise depends on the function of pulmonary, cardiovascular
and skeletal muscle systems. The combination of these systems work together to determine aerobic
capacity and physical fitness. Physical activity utilizes muscle groups to create cardiovascular adaptations
that increase aerobic capacity and improve the function of these systems. The better these systems work
the more physically fit a person is. On the contrary, a lack of physical activity leads to poor physical
fitness. Poor physical fitness is high risk for the development of disease and cancers. The risks of chronic
diseases such as Type 2 Diabetes, coronary artery disease,cardiovascular disease, osteoporosis and
obesity are associated with poor physical fitness. Exercise testing produces results that aid in diagnosing
any signs or symptoms of disease. Furthermore, exercise testing results are used in exercise prescription
to reduce risk of disease and improve an individual’s health and wellness.
There are many tests used to determine the overall health and fitness of an individual. Blood
pressure is one of the vital signs checked by the physician. It is the pressure placed on the arteries and
heart. High blood pressure puts a strain on these vital organs therefore it is necessary to test. This puts an
individual at risk for hypertension. An electrocardiogram is a test that measures the electrical activity of
the heartbeat. With each beat,an electrical wave travels through the heart. This wave causes the muscle to
squeeze and pump blood from the heart. By measuring time intervals on the EKG, we can determine how
long the electrical wave takes to pass through the heart. Finding out how long a wave takes to travel from
one part of the heart to the next shows if the electrical activity is normal or slow, fast or irregular. Heart
rate is the number of beats the heart makes per minute. This is assessed prior, during, and after almost any
fitness assessment. There are a few ways to determine heart rate. The physician may test heart rate
manually or electronically. Heart rate is used to ensure a normal working heart at rest and during exercise.
It also is used to determine proper exercise intensities and measuring VO2. There are multiple muscular
fitness tests to determine the strength and endurance of the musculoskeletal system. Each test helps to
establish a baseline for one’s fitness levels. The importance of muscular fitness testing relates to one’s
ability to function in everyday life performing daily movements. Poor muscular fitness directly affects the
musculoskeletal system leaving risk for osteoporosis, arthritis, muscle injury, joint injury, back pain, and
other injuries or diseases. Furthermore, flexibility assessments are an important aspect of exercise and
everyday life to fulfill tasks such as reaching, bending and completing active ranges of motion. Flexibility
often deteriorates with age thus it is important to partake in these assessments to prevent any limited
range of motion and protect the joints. Similar injuries and diseases from poor muscular fitness are also a
risk of poor flexibility. Muscular strength and endurance and flexibility test results are all absolute and
relative to the individual to most accurately interpret an individual’s functional fitness. An individual’s
health is not only a combination of vital signs, muscular fitness and flexibility fitness, but also what the
body is made up of. Body composition is the assessment of body fat percentage. This means the amount
of body fat versus lean muscle tissue. Knowing body composition helps identify healthy and unhealthy
ranges of body fat which are linked to cardiovascular and obesity related diseases. These results are
achieved through a variety of body comp tests including skinfold measurements,circumference
measurements,bioelectrical impedance analysis, BMI, relative weight, bod pod, and a variety of
equations calculated using height, weight, age,skinfolds, and circumference measurements. Lastly,
cardiorespiratory fitness tells us how healthy a person’s heart is by how much it has to work to deliver
oxygen to the body (Lippincott, Williams, & Wilkins p 111).VO2 is the milliliters of oxygen per body
weight per minute used by the body to do activity. This number reflects a person’s cardiovascular
strength. VO2 is assessed through submaximal and maximal exercise tests. Submaximal tests require the
client to stay within 85% of their predicted heart rate max. VO2 max can then be predicted using
calculations or tested through maximal exercise testing. This is only done for individuals who are in the
low to moderate risk categories as it requires maximal exertion on the body. VO2 values are used in
exercise prescription tracking fitness levels and progress. With this, realistic goals can be set and
improvement can be assessed. VO2 helps with choosing workouts at the right intensity to meet goals.
4. 4
Initial VO2 tests can determine the specific target heart rates that an individual should be exercising at.
This helps clients understand the importance and link between heart rate,intensity and duration of
exercise in regards to meeting their goals.
For this case study the client was told she needed to lose weight so she came in for an assessment.
The client’s history is described followed by each test performed, the values and their corresponding
interpretation. There is a final conclusion summing up each test value and the client’s overall fitness level.
This report can then be used for exercise prescription to meet the client’s fitness goals.
5. 5
Description ofSubject and Health Risk Appraisal
NoMo Phat is a 33 year old female with no signs and symptoms of disease. She has the goal to
run a 10k in four months. While she is considered physically active, she has been told she needs to lose
50lbs to reduce health risk. She hikes four days a week for an hour and is gone 8-10 hours on weekends
hiking and exploring. Furthermore, she performs vigorous and moderate gardening and yard work during
the week. Despite her activity level she is classified as overweight. She is a non-smoker and does not
drink alcohol. Her diet is fairly normal taking in 2200 kcals/day. Her mother and father are both living;
mother has type 2 diabetes at age 60 and her brother has pre-diabetes at age 27 while her sister and father
are healthy with no CV disease.
Test Value Normal Values
Total Cholesterol 178 mg/dl <200 mg/dl is good
HDL Cholesterol 57 mg/dl < 40 mg/dl is bad
> 60 mg/dl is good
LDL Cholesterol 44 mg/dl > 130 mg/dl is bad
Triglycerides 88 mg/dl <150 mg/dl is good
Glucose Level 78 mg/dl 70-99 mg/dl is good
Figure 1. This table shows the client’s blood chemistry tests and their corresponding value compared to
normal values.
Total cholesterol is the measure of all the cholesterol components. This value is considered good
if measured less than 200mgdl. NoMo’s total cholesterol measures at 178mgdl which means she is not at
risk for dyslipidemia. HDL cholesterol is known as the good cholesterol as it helps to remove the bad
LDL cholesterol from the blood. This value is considered healthy is if it between 40 and 60mgdl and
NoMo’s HDL is 57mgdl. LDL cholesterol is known as the clogging cholesterol. This value is considered
healthy if it measures less than 130mgdl and NoMo’s LDLis 44mgdl.Triglycerides are a fat stored in the
body for energy and high values can be linked to atherosclerosis (Guidelines for Exercise Testing and
Prescription p113). A healthy triglyceride value is measured at less than 150mgdl. NoMo’s levels are
88mgdl which means she is not at risk for atherosclerosis. Glucose is a sugar stored in the body for
energy. High levels of glucose are a risk for hyperglycemia. Healthy glucose levels measure between 70
and 99mgdl. NoMo’s levels measure at 78mgdl which means she is not at risk for hyperglycemia. In
conclusion NoMo’s blood chemistry is normal and she is not at risk for disease.
6. 6
Resting Heart Rate and Blood Pressure
Heart rate and blood pressure are vital signs checked by a physician to assess the circulatory
system’s functioning state. Blood pressure is the pressure placed on the arteries and heart. It is made up of
two values which are diastolic and systolic. Diastolic is the pressure placed on the heart while it is
relaxed. Systolic is the pressure placed on the heart while it is contracting. High blood pressure puts a
strain on these vital organs which can lead to hypertension, stroke or myocardial infarction and is
therefore necessary to test. A higher blood pressure is commonly associated with heavier set individuals
or those with higher body composition because the heart has to work harder to get the blood through the
body. Heart rate is the number of beats per minute by the heart. It can be read by palpating the most
common sites on the body such as the carotid artery and the radial artery. Heart rate can be palpated for a
full 60 seconds or by taking a 10, 15, or 30 second heart rate and multiplying. Normative values for a
resting heart rate are 60-100bpm. Heart rate is, however, affected by numerous factors including but not
limited to stress,anxiety, stimulants, exercise and temperature. Gender also affects heart rate as females
are typically smaller than men and have a higher heart rate. Resting heart rate determines a baseline for
exercise and proper intensity levels. Typically, the more fit an individual the lower their heart rate is. This
is beneficial to the heart as it means it is working less hard compared to an individual who is less fit with
a higher heart rate. It also is measured as a safety precaution to ensure the heart is working at an attainable
intensity and overall cardiovascular health. It is important to monitor heart rate and blood pressure during
exercise to ensure the safety of the client.
Figure 2a. EKG image showing the heart’s activity at rest.
Test Result Normal Values
Resting HR 68.1 bpm 60-100bpm
Resting Blood Pressure 118/74 mmHg <120/80 mmHg
Figure 2b. This table shows the client’s resting heart rate and blood pressure in comparison to normal
values.
NoMo’s resting heart rate and blood pressure values are both within normal values. This means she has a
healthy cardiovascular and circulatory system with no indication of abnormalities or signs of disease.
7. 7
Muscular Fitness/ Flex assessment
Muscular fitness is a reflection of the overall health of the musculoskeletal system. There are two
components to muscular fitness including strength and endurance. Muscular strength is the ability to exert
force while muscular endurance is the ability to perform continuously without fatigue (Lippincott,
Williams, & Wilkins p 349). These two things can be evaluated by a series of physical strength tests to
determine overall muscular fitness. The test movements performed are similar to that of the way the body
moves during physical activity. There are multiple muscular fitness tests that will be performed. Each test
helps to establish a baseline for fitness levels. The importance of muscular fitness testing relates to one’s
ability to function in everyday life performing daily movements. Poor muscular fitness affects an
individual by limiting their capability to perform daily living activities. Muscular fitness testing is
necessary prior to exercise prescription by identifying and preventing potential health issues related to
poor muscular fitness. The client’s baseline for overall muscular fitness is established via muscular fitness
testing and in turn used to determine the development and maintenance of an exercise prescription
program. Flexibility is important not only in exercise but in everyday life to fulfill daily tasks such as
reaching over head, bending down, reaching behind, and completing any necessary active range of
motions. Flexibility often deteriorates with age or a sedentary lifestyle. Without flexibility, posture
becomes compromised, joints become painful, and it may be impossible to daily activities. This is why it
is important to stay active and stretch frequently to prevent loss of mobility. The purpose of flexibility
training is to decrease the likelihood of injury to muscles and joints. It enhances performance in strength
and resistance training, cardiovascular training, and sport conditioning. Flexibility also corrects muscle
imbalances, decreases muscle soreness,relieves stress on joints, maintains the normal functional length of
all muscles, and decreases unnecessary friction in joint structures. Flexibility testing is conducted to see a
client’s range of motion of different joints which is then used in determining the ability to perform certain
exercises and movements. There are multiple flexibility tests that will be performed. Each test helps to
establish a baseline for fitness levels. Flexibility often deteriorates with lack of use and age thus it is
important to partake in these assessments.
Test Absolute Relative Interpretation
Bench Press 1- RM 122 lbs 0.67 Excellent
Leg Press 1- RM 228 lbs 1.26 Average
Push Ups (knee bent) 26 26 Very Good
Partial Curl Ups 58 58 Well Above Average
Flexibility
Sit and reach (0 @26 cm)
35 cm 35 cm Good
Figure 3. This table shows the client’s muscular fitness and flexibility assessments in absolute and
relative terms and interpreted for age and gender.
NoMo’s values were recorded in absolute and relative terms and then compared to a table of
normal values arranged gender and age. Her absolute values were compared to the data of norms and
interpreted into a classification of her muscular and flexibility fitness. Her upper body strength was tested
by the 1-rm bench press. She pressed122lbs, classified as excellent. Her lower body strength was tested
by the1-rm leg press. She pressed 228lbs, classified as average. Her upper body endurance was tested by
the female pushup position test. She did 26 pushups, classified as very good. Her endurance was further
tested by curl-ups. She did 58 curl-ups, classified as well above average. Her flexibility was assessed by
the sit and reach test. She reached 35cm, classified as good. In conclusion she has great muscular
strength, good muscular endurance, and good flexibility.
8. 8
Body Composition
Body composition is used to determine percentages of fat, muscle, bone and water in the body.
Regarding overall health, body composition is more important in understanding what the body is made of
compared to using body weight because our weight does not break down the body’s composition. Body
composition is used to assess body fat percentage. This means the amount of body fat versus lean muscle
tissue. Not only is body composition a physical component, but an assessment of the tissues inside the
body. Knowing body composition helps identify healthy and unhealthy ranges of body fat which is linked
to cardiovascular and obesity related diseases (Lippincott, Williams, & Wilkins p 311). There are
recommended ranges for body composition arranged by factors including age,height, weight, and gender.
Having a body composition within your recommended range suggests less risk of developing disease
related to obesity such as diabetes, dyslipidemia, cardiovascular disease, hypertension and some cancers.
Likewise, having a body composition outside the recommended range increases risk for either obesity
related diseases or having too low of a body composition increases risk of organ function, delivery of
vitamins throughout the body, reproductive system’s function and overall well-being. There are multiple
ways to test body composition including BMI, Bod Pod, Waist to hip ratio, BIA, skinfolds, relative
weight, and a variety of mathematical equations. Each test description and its procedures are as follows:
Body Mass Index
1. Measure height without shoes (Cm)
2. Measure weight (kg)
3. Calculate BMI
4. Interpret results
Bod Pod
1. Don’t eat or drink for at least 3 hours prior to the test.
2. Don’t exercise for at least 3 hours prior to the test.
3. Wear form fitting clothing.
4. Don’t wear any jewelry.
5. Note how much body hair you have. If you shave any of your body or facial hair the day before
your first test, make sure you shave it again the day before your follow-up tests.
6. Sit in bod pod while tester performs the test.
Circumference Measurements
1. Perform circumference measurements (in cm) for waist and hips following the procedures in the
lab manual
2. Calculate Waist-to-Hip (WHR) ratio
3. Determine disease risk for both waist circumference and WHR
Bioelectrical Impedance Analysis – OMRON Handheld BIA
1. Have the participant wash and completely dry their hands
2. Input required information when prompted by device
3. Setting personal data – select guest
4. Set mode – select normal or athlete
5. Enter height in feet and inches
6. Enter weight in pounds
7. Enter age
8. Select gender
9. Stand with both feet slightly apart
9. 9
10. Place both hands on the monitor by holding the grip electrodes. Wrap middle finger around the
groove of the handle. Place the palm of hand on the top and bottom of electrodes. Put thumbs up,
resting on the top of the monitor. (Note: The position of the hands is important for the accuracy
of the measurement)
11. Hold the arms straight out at a 90 degree angle
12. Press the START button
13. Hold the electrodes with both hands
14. Record the results from the LCD display
Skinfold
1. Perform skinfold measurements for 8 sites
2. Calculate body density using gender specific equations
a. Seven site formula
b. Three-site formulas
3. Calculate percent body fat using population specific equations
4. Determine Fitness Category
Relative Weight
1. Measure height with shoes on
2. Measure weight in pounds
3. Elbow Measurement – place your thumb and index finger on the two prominent bones on either
side of your elbow, then measure the distance in inches between the bones with calipers.
4. Determine frame size – reference IdealWeight Chart. The chart lists elbow measurements for a
medium frame. If your elbow measurement for a particular height is less than the number of
inches listed, you are a small frame. If your elbow measurement for that particular height is more
than the number of inches listed, you are a large frame.
5. Determine the midpoint for the weight range at the corresponding participant height
6. Calculate relative weight by dividing the measured weight by the midpoint value
7. Provide interpretation – desirable (0.90 – 1.10), overweight (1.11 – 1.20), obese (> 1.20)
Ball and Swan
Procedures for women
1. Record age in years
2. Record hip circumference in cm
3. Calculate 3SF – sum the triceps, supra iliac, and thigh skinfold measurements
4. Calculate body fat percentage: %BF = -9.606 + 0.435(3SF) - 0.001429(3SF)2
+ 0.153(hip) +
0.07292(age)
Procedures for men
1. Record age in years
2. Calculate 7SF – sum the chest,Midaxillary, triceps, subscapular, abdomen, supra-iliac, and
thigh skinfold measurements
3. Calculate body fat percentage: %BF = 0.465 + 0.180(7SF) - 0.0002406(7SF)2
+ 0.06619(age)
No single assessment can truly determine exact body composition as there are discrepancies with
each test but using multiple can be useful in comparing the results. It is likely no two assessments will
10. 10
have the same result. This is because discrepancies accompany each body composition assessment
making it hard to determine a precise and accurate measurement. It is arguable which assessment is the
most accurate and even then the test results depend on numerous factors. BMI uses height and weight to
determine the recommended value for an individual. These values do not consider an individual’s
genetics, metabolism, frame size or activity level. While these values are an estimated number used as a
guideline, it is not realistic for everyone. Clients should understand that ethnicity has a huge impact on
body composition and is not taken into account in a BMI table. This relates to other body composition
tests as well. Each test has its own list of discrepancies that can affect the result. With underwater
weighing there are sources of error in the RV measurement such as when people estimate the value. It is
also difficult for a client to blow out all of their air under water. And finally there is always equation
assumption error. Skinfolds are based on the assumption that half of the body’s fatty tissue is directly
underneath the skin. There are many different equations for calculating skinfolds which can cause a range
of body fat percentages and the accuracy of the test depends on the skill and experience of the technician.
Test Result Interpretation/Classification
BMI 29.4% Overweight
Bod Pod 29.8% (population specific) Overweight
Waist Circumference 74cm Not at risk
BIA (Lab) 32% Overweight
Skinfold 7 site 30.2% Overweight
Skinfold 3 site (thigh, triceps,
suprailiac)
33.3% Overweight
Skinfold 3 site (abdomen, thigh,
suprailiac)
29% Overweight
Relative Weight 1.43 Obese
Ball and Swan 35.96% Obese
Underwater weighing 26.4% Healthy
Figure 4. This table shows the client’s body composition test results and the risk classification. All
calculations are shown in the appendices section.
After looking at the results from multiple body composition assessments,NoMo scored six
overweight classifications, two obese classifications, two healthy classifications and one not at risk.
Averaging all the tests results in a body fat percentage of 30 and classifies the client as obese. Some tests,
however, are not considered the most accurate. It was noted in the skinfold tests that her thigh was hard to
measure and could therefore affect the results proving the skinfold measurements and results less accurate
than other tests. Additionally, underwater weighing is noted to be difficult to set up and challenging for
the client to give an accurate reading. I believe the bod pod is the most accurate which I will use to
determine her final body fat percentage. Using the population specific equation she has a 29.8% body fat
resulting in an overweight classification. In contrast NoMo’s waist to hip ratio proves she is not at risk for
obesity. Furthermore, her bod pod result using the non-population specific equation classifies her as
healthy.
11. 11
Prediction ofAerobic Capacity
VO2 is the milliliters of oxygen per body weight per minute used by the body to do activity. This
number reflects a person’s cardiovascular strength. Knowing VO2 is useful for trainers and clients to
track fitness levels and progress. With this, realistic goals can be set and improvement can be assessed.
VO2 helps with exercise prescription and choosing workouts at the right intensity to meet goals. Initial
VO2 max tests can determine the specific target heart rates that an individual should be exercising at. This
helps clients understand the importance and link between heart rate,intensity and duration of exercise in
regards to meeting their goals. VO2 is determined through maximal and submaximal exercise testing.
While these tests are beneficial, maximal tests can pose a danger for clients who are overweight and
obese. Submaximal testing poses less risk to the patient and requires less effort than maximal testing.
Max heart rate is predicted prior to starting a sub-max test. The client stays within 85% of the predicted
heart rate max during the submaximal exercise test. Once the test is finished, VO2 is calculated and then
this number is used for the client’s exercise prescription. There are a variety of submaximal exercise tests
used to predict VO2 max including a variety of equipment that can be utilized. The following submaximal
tests and procedures are described.
YMCA Cycle Test
1. Adjust seat and handlebars.
2. Set pedal speed to 50 rpm (metronome = 100 bpm) with .5 KP on the bike which is your
initial work rate.
3. You decide the next stage based on the HR response to this initial work rate. Once you
determine the work rate for the stage make sure that this exact workload is maintained.
4. Each stage is 3 minutes. You need to complete at least 2 full stages that elicit a HR of
between 120 and 170 bpm (or 85% HR max). If your HR is too low – do another stage—if
your HR is too high—STOP –REST—then start again at a lower work rate.
5. Monitor HR and work rate constantly-- Make sure that the subject stays with the metronome
and that the pendulum on the flywheel has not drifted.
6. Take heart rate every minute. Record the HR at the end of minute 2 and 3 of each stage. If
HR is not steady state at the end of 3 minutes continue another minute. ONLY report the
final Steady State HR and the work rate for each stage. STOP increasing stages if the subject
reaches a HR of 85% of HR max or when 4 total stages are completed (initial plus 3 more).
7. When the test is completed decrease the resistance and have the subject cool down by
pedaling for 3-5 more minutes.
Astrand-Rhyming Cycle Test
1. Adjust seat and handlebars.
2. Set pedal speed to 50 rpm (metronome = 100 bpm)
3. Set initial workload at about 75 W,100 W or 150 W for untrained, moderately trained or
well-trained subjects respectively. (Note 1 Watt 6 kgM.min-1
)
4. This exact workload should be maintained for 6 minutes. (Monitor HR and work rate
constantly-- Make sure that the subject stays with the metronome and that the pendulum on
the flywheel has not drifted).
12. 12
5. HR should be recorded every minute for the first 3 minutes. After 3 minutes if the HR is not
at least 125 bpm then increase the work by about 50-75 Watts. Begin timing again!
6. The heart rate must reach at least 125 bpm. If the heart rate is above 170 bpm or above 85%
of age predicted HR then stop the test and cool the subject down, rest for a while and then try
again.
7. If the HR is within 125 bpm to – about 85% of age predicted HR then continue at this SAME
workload for 3 more minutes (this is a 6 minute test).
8. Check HR every 30 seconds to make sure that HR is at steady state. The object is to have the
subject be in steady state for the last 3-4 minutes of the 6 minute test. Remember steady state
means that the HR is within 5 beats per minute of each reading.
9. When the test is completed then decrease the resistance and have the subject cool down by
pedaling for 3-5 more minutes.
Queens College Step Test
1. The athlete steps up and down on the platform at a rate of 22 steps per minute for females and
at 24 steps per minute for males. 16.25in height for step.
2. The subjects are to step using a four-step cadence,'up-up-down-down' for 3 minutes.
3. The athlete stops immediately on completion of the test, and the heart beats are counted for
15 seconds standing up. Multiply this 15 second reading by 4 will give the beats per minute
(bpm) value to be used in the equation listed in the appendices.
Canadian Aerobic Fitness Step test
1. Select the appropriate stage for your sex and age using Table 1 (see protocol sheet)
2. Then determine the stepping cadence (beats per minute to set on the metronome) for that
stage using Table 2.
3. Note that the stepping pattern is a 6-step sequence. You can use stairs anywhere to do this
test as long as you have a metronome and the steps are about 8 inches high.
4. You perform each stage at the appropriate cadence for 3 minutes.
5. Immediately after stopping, check HR for 10 seconds. If the # beats in 10 seconds is above or
equal to the number for your age group then you are done. If your 10 second HR is lower,
you go on to the next stage.
6. Repeat the process at the next stage. Check the HR table again for your age group.
7. Determine if you need to do one final stage or if you need to stop. NOTE: You should
ALWAYS stop the test if the HR is above 85% of predicted HR max.
8. If your 10 second HR is equal to or higher than the recommended value you are to stop. If it
is lower you go on to do one final stage.
9. If your pulse is still under the value then you are to perform a final 3-minute stage.
10. If at any time you cannot keep up the stepping sequence or stepping cadence you must stop
the test.
11. In your VO2 equation, you are to use the corresponding VO2 value for the last stage
completed. The last stage is only considered final if ALL 3 minutes were completed and only
if HR is below 85% of predicted HR max.
Ebbling Treadmill Walking
13. 13
INITIAL STAGE:
1. Pick a walking pace that is “brisk” but comfortable for the subject between 2 - 4.5 mph
2. Monitor HR constantly—Record HR each minute for 4 minutes
3. Must elicit HR between 50-79% of age predicted max
STAGE 2:
4. Once HR is steady state and between 50-79% of age predicted max – keep the speed the same
and bring grade up to 5% for 4 minutes
5. Again monitor HR constantly—Record HR each minute for 4 minutes
6. Record the final steady state HR for this stage and put into formula
Cooper 12-minute Run Test
1. The Cooper is a 12-minute RUN as fast as you can. This is not to be done if you are in the
moderate or high-risk category because it is nearly maximal exertion.
2. Try to maintain a steady pace.
3. Run on a measured track using the following modified procedures:
4. Instead of going exactly 12 minutes, run on a track with a known exact distance (i.e., 400
meters) per lap.
5. Run between 12 and 15 minutes and record how many complete laps you finish and the exact
time it took.
6. Calculate the distance covered in meters (i.e., # laps x 400 m/lap).
7. Then estimate velocity by calculating the distance covered / time in minutes and tenths of
minutes.
Rockport One-Mile Walk Test
1. The Rockport Test is a one-mile walk as fast as you can without jogging. If you are not
walking fast,it won’t be accurate.
2. Make sure you know exactly how far (number of laps) one mile is.
3. You will need to record your time and record your HR immediately after you finish.
4. Remember to convert time to a decimal.
5. Put your data into the equation below.
Test VO2 (ml/kg/min) Mets Interpretation
YMCA Cycle Test 36.52 10.4 Good
Astrand Cycle Test 42.45 12.13 Good
YMCA Step Test 34 9.71 Good
Canadian Fitness Step Test 30 8.5 Average
Ebbling Treadmill Test 34.38 9.8 Average
Coopers Run Test 37 10.57 Good
Rockport Walking Test 45 12.85 High
14. 14
Figure 5a. This table shows each submaximal test, its result shown in VO2 and mets, and their
corresponding classification.
From each cardiovascular assessment,NoMo’s average predicted VO2 is 37.05ml/kg/min which is
classified as good.
Figure 5b. This graph shows each submaximal test and its VO2 result. The red vertical line represents the
average VO2.
After analyzing the results from the submaximal tests, it is noted that the Rockport and the
Astrand cycle test are the highest VO2 values and are both 12 mets. Similarly, the YMCA cycle test,
YMCA step test, Ebbling test, and Coopers run test are all within 1 met of each other ranging from 9.71
to 10.57 mets. There are a couple of factors that affect these results. The Rockport test is generally for the
older population as it is a walking test. It is not uncommon for a younger or fit client to score a high VO2
on that test. Furthermore, the Astrand could have been performed at the beginning of the day and
therefore scoring a higher VO2. In terms of the tests within a close met range, the closer the mets are for
these tests show validity among the results. This lessons the risk of discrepancies and increases the
reliability of the submaximal tests. On the contrary, the YMCA cycle test uses a graph and plots to predict
VO2 max. Likewise, the Astrand uses the nomogram to predict VO2 max. These two methods can
produce error as it is slightly subjective to the physician. The Coopers test, however, simply has the client
run for 12 minutes and uses heart rate and number of laps completed to calculate VO2. I feelthis test is
the best indication of a client’s VO2 which is 37 ml/kg/min. The average VO2 will be used to for NoMo
which is 37.05 ml/kg/min.
0
5
10
15
20
25
30
35
40
45
50
YMCA CYCLE ASTRAND YMCA STEP CAFT EBBLING COOPERS ROCKPORT
VO2 (ml/kg/min)
15. 15
Maximal GRX Interpretation
NoMo made it to stage 4 in the graded maximal exercise test. Her VO2 peak is 3542.5 ml/min, or
43.04 ml/kg/min. This value is NoMo’s VO2 max. The possible criteria for VO2 max include failure of
heart rate to increase with increased workload, respiratory exchange ratio greater than 1.12, a plateau in
VO2 determined by the failure to increase VO2 by 150ml with increased workload, rate of perceived
exertion is greater than 17, heart rate reaches greater than age predicted heart rate max, and lactate values
of 8mm, (Lippincott, Williams, & Wilkins p 387). The criteria for NoMo’s VO2 includes oxygen plateau
from stages 2 to 3 and 3 to 4, RPE greater than 17 in stage 4, and RER greater than 1.12 in stages 3-4.
NoMo’s average predicted VO2 max from her submaximal exercise tests is a lower value than her actual
VO2. NoMo’s average predicted VO2 is 37.08ml/kg/min where as her VO2 max is 43.04ml/kg/min. The
closest submaximal predicted VO2 was the Astrand test which predicted a VO2 of 42.45ml/kg/min.
Therefore the Astrand test was within one met of the graded maximal exercise test concluding that the
Astrand was the most accurate in predicting VO2. These discrepancies exist between submaximal
predictions and actualVO2 max because of factors that affect heart rate. Air temperature,body position,
body size and weight, environment, stress,stimulants and diet can all affect heart rate at any time which
allows room for discrepancies among different tests. Another factor that can play a role in variation
among VO2 assessments is specificity. This is explicit training to achieve a specific outcome. Training
for the Astrand cycle test can improve VO2 for that test, but may fail to achieve a similar value for say the
Coopers test. This is because the body becomes accustomed to what it is trained for and will lack where it
is not trained.
16. 16
Conclusion
After assessing the values from the blood chemistry, body composition, muscular and flexibility
fitness, and cardiorespiratory fitness, client NoMo Phat is a healthy individual. She is at low risk for
disease with no signs or symptoms. She has healthy resting values for heart rate and blood pressure. She
has good muscular strength for both upper and lower body. She also has good flexibility. Lastly, she has
good cardiorespiratory fitness from both her submaximal and maximal exercise tests. This means that
NoMo has healthy cardiorespiratory, circulatory and musculoskeletal systems. My only concern is her
body composition as it is 30% classified as obese. Her weight is also higher than recommended for her
height, which is most likely due to her high body fat percentage. An ideal body composition for NoMo is
24.9%. In conclusion, NoMo is a healthy individual with low risk of disease but a high body fat
percentage. She is able to do exercise prescription without concerns for her muscular and
cardiorespiratory health.
Test Result Interpretation
Health Risk Low risk Not at risk for disease
Resting HR 68.1 bpm Normal
Resting BP 118/74 mmHg Normal
Body Composition 30% Obese
Muscular Strength (bench press) 122lbs. Excellent
Muscular Strength (leg press) 228lbs. Average
Flexibility 35cm Good
Cardiorespiratory Fitness (max) 43.04ml/kg/min Good
17. 17
References
American College of Sports Medicine. (2013). ACSM's health-related physical fitness assessment
manual. Kaminsky, L. A. (Eds.). Baltimore, MD: Lippincott Williams & Wilkins.
Swan, D.(2015). Blood Pressure, Heart Rate, EKG [powerpoint presentation]. Retrieved from Lecture
Notes Online Web site:
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apps%2Fblackboard%2Fexecute%2Flauncher%3Ftype%3DCourse%26id%3D_298756_1
Swan, D.(2015). Body Composition [powerpoint presentation]. Retrieved from Lecture Notes Online
Web site:
https://myasucourses.asu.edu/webapps/portal/frameset.jsp?tab_tab_group_id=_2_1&url=%2Fweb
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Swan, D.(2015). Sub-maximal testing [powerpoint presentation]. Retrieved from Lecture Notes Online
Web site:
https://myasucourses.asu.edu/webapps/portal/frameset.jsp?tab_tab_group_id=_2_1&url=%2Fweb
apps%2Fblackboard%2Fexecute%2Flauncher%3Ftype%3DCourse%26id%3D_298756_1
Thompson, P. D.,& Buchner, D., et. Al. (2003). Exercise and Physical Activity in the Prevention
and Treatment of Atherosclerotic Cardiovascular Disease. AHA Scientific Statement.
doi: 10.1161/01.CIR.0000075572.40158.77. Retrieved
from http://circ.ahajournals.org/content/107/24/3109.