NASM 6th Edition chapter 6 – Fitness Assessment

If you have not signed up for NASM CPT, sign up here to save 25% with my personal code PTP25.

Get your copy of the NASM CPT exam cheat sheet. It helps immensely in studying for the exam.

My PTP students report cutting their NASM study time and effort in half with Trainer Academy. 

Benefit from the Exam Pass Guarantee and Retake Fee Guarantee. Plus, take advantage of my current discount code PTPJULY for 35% off the MVP Program (Ends July 21st, 2025). 

Try it out for free here to see if it’s right for you, or read my detailed review for further insights.

Chapter 6 NASM study guide

Guidelines for Health and fitness professionals

What shouldn’t be done

1. Counseling clients
2. Diagnosing conditions or injuries
3. Rehab or physical therapy
4. Providing meal plans or detailed diets

What should be done

1. You should coach clients
2. You should identify your client’s limits and past injuries
3. Recommend a physician for medical advice
4. You can provide general knowledge on nutrition but should refer to a nutritional list or dietitian for more specific needs.

Objective and subjective information

Before starting a routine with any new client, you must assess their current and past health and fitness levels. For subjective information, you need to ask them questions; for objective information, you need to perform fitness assessments.

Objective information:

• Blood pressure
• Cardio assessments
• Postural assessments
• Performance assessments
• Body analysis

Subjective information:

• Clients occupation
• Hobbies, general diet, and lifestyle
• Personal information
• A brief medical history

PAR-Q (physical activity readiness questionnaire)

The PAR-Q was created to help get specific answers on the health history of a new client. This helps determine possible risks of training with a client. If a new client answers yes to any of the questions on the PAR-Q, they will need their doctor’s written permission to start training with you. You can check out the PAR-Q here.

Your client’s occupation

Asking a new clients about their occupation can help determine many postural problems they may be experiencing. Here are some of the most common ones.

• Excessive sitting can cause rounding of the upper back and tight hip flexors.
• Wearing high heels excessively can cause tightness in the muscles of the calves.
• Repetitive overhead movements experienced by construction workers, volleyball players, or electricians can cause impingement in the shoulders.
• An upper crossed syndrome can be caused by stress due to shortening the upper trapezius and scalenes.

Your clients’ lifestyle

This gives the trainer insight into the likes and dislikes of their client. Active recreational activities can be added to the client’s cardio training program.

Your client’s medical history

• Any medications a client takes may affect how intense the exercises should be.
• Chronic diseases need to be accounted for in all exercises and programs.
• Past surgeries may limit your client’s range of motion or may cause joint instability.
• Pain should be accounted for and taken into consideration for all exercises.
• Your client’s medical history will allow you to gauge the risk for any health-related issues your client experiences.

Common medications and heart rate/blood pressure

• Beta-blockers
• Calcium channel blockers
• Digitalis
• Thyroid medications
• Diuretics
• Nitrates
• Bronchodilators
• Vasodilators
• Antidepressants

Note that educating your client on using these medications is not your job. We need to know the basic functions and how they can affect our training regimen with our clients.

Blood pressure and heart rate assessments

The two most common ways of recording heart rate are using the radial pulse on the thumb side of the wrist (preferred method) or the carotid pulse on the side of the neck (use with caution).

Blood pressure can be measured using a sphygmomanometer with a pressure dial, inflatable cuff, stethoscope, and a bulb with a valve. It is highly recommended that personal trainers take a professional course for taking blood pressure.

https://exrx.net/Testing/HeartRate has all the blood pressure and heart rate assessments.

Target heart rate zones and the formula for maximum heart rate

The predicted maximum heart rate equation is 220-age. Multiply this number by the training zone (between 65% and 95%) of the predicted heart rate Max.

Training zone 1: This helps to build your client’s aerobic base and will aid in recovery.

Training zone 2: This helps to build your client’s aerobic endurance.

Training zone 3: This helps your client build high-end work capacity (primarily anaerobic).

Body composition assessments

• Underwater weighing: The most accurate way of measuring body composition. It measures the mass per unit volume of the human body.
• Bioelectrical impedance: The most convenient way to measure body composition. Also known as body fat analysis. It analyzes the strength and the speed of an electrical impulse sent through the body. With the addition of information such as gender, weight, and height, it can relatively accurately predict body fat percentage.
• Skinfold tests: The most difficult way to measure body fat. A skinfold caliper can measure the width of external body fat in millimeters. You measure different sites on the human body, and the grand total is added up to create a body composition total. Here’s a great site on how to take skinfold measurements.

Circumference measurements

Circumference measurements help to measure the circumference of different body parts. Some of the benefits of circumference measurements are: it’s easy to do, provide quick information on client progress, are affordable, and are not hard to learn the technique. Here is a good resource for circumference measurements.

Suggested circumference measurement areas:

• Upper arms
• Neck
• Calves
• Chest
• Thighs
• Hips
• Waist
• Forearms

BMI (Body mass index)

The body mass index test is extremely easy and is a good way to screen patients and it applies to both men and two women. Body mass index is difficult to apply to people with excessive muscle mass, such as bodybuilders. Here are the ranges for body mass index. Here’s a good site to calculate BMI.

Formula: Weight (kg) / Height (m2)

• <18.5 = Underweight
• 18.5 to 24.9 = Healthy
• 25 to 29.9 = Overweight
• 30 to 34.9 = Obese
• >35 = Severe obesity
• ≥ 40 = OMGG 

YMCA three-minute step test

This test calculates your client’s cardiorespiratory fitness level and efficiency. It is done in a time of only three minutes, which makes it extremely easy to do. You will need a 12-inch step to perform this test.

• Have your client step up and down the step at a pace of 96 steps per minute.
• Having a metronome to have your client follow along with as they step up and down is handy.
• After three minutes of stepping, you must immediately find the recovery pulse.
• Depending on this pulse, you will start your client in the appropriate heart rate training zone according to the text.

The Rockport walking test

This is another cardiorespiratory assessment to assess your client’s cardiovascular fitness. This test is best for obese clients.

• Jot down your clients’ wait and have them walk 1 mile on the treadmill as fast as he or they can control.
• Record the time it took for your client to go 1 mile and record their heart rate the exact second that they finish the 1 mile.
• Weight in pounds = 1 for men and 0 for women. The time is expressed in minutes and the 100th of minutes. Heart rate is in beats per minute and age is in years.
• The formula is located on page 131 in the textbook. You do not need to memorize this formula; recognize it as being the formula for the Rockport walk test.

Pronation distortion syndrome

This is characterized as having flattened feet and abducted knees. This can lead to pain in the lower back/lower extremities and injuries. It is very common for ACL injuries.

Lower crossed syndrome

An anterior pelvis or lower back tilt characterizes this postural distortion syndrome.

Upper crossed syndrome

A forward head posture and rounded shoulders characterize this.

The overhead squat assessment

MEMORIZE THE FULL THING! Especially the chart on page 144!

If you want additional study materials, check out the team over at Trainer Academy. They have incredible study materials for NASM And I have a special limited-time discount for my readers. I also suggest you check out my review on Trainer Academy here.

NASM flashcards for Chapter 6