NCSF Personal Training Study Guide Chapter 7 – Resting and Active Fitness Assessment

If you have not yet signed up for the NCSF CPT certification, receive a big discount here.

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

Make sure to check out Trainer Academy for premium NCSF CPT study materials. They will reduce study time by 50% and have an exam pass guarantee. Read my full review on them here. You can save $100 on their MVP study system with the code: PTPSUB

Chapter Goals:

• Know the basics of the many assessment types throughout the chapter.
• Find the health goals for assessments such as blood lipid and glucose profile.
• Use body composition testing like girth and skinfold measures.
• Understand the steps needed for clearing a client for exercise.
• Understand testing format and order.
• Identify and implement both cardiorespiratory and muscular fitness testing.

Resting Cardiovascular Tests

It is important to conduct pre-exercise physical evaluations to see if clients are ready for fitness programs.

A resting battery of assessments usually will include these:

• RHR and resting blood pressure
• Body comp
• Height, weight, and BMI
• Evaluation of posture
• Potential referral for a blood lipid profile

Measurement Discrimination and Organization

The controllable factors that may affect the resting state of the client should all be accounted for and removed so that the assessment is efficient and effective.

The readiness and preparation of the client will help the assessment accuracy.

Accurate testing will require knowledge, precision, organization, and experience.

Resting Heart Rate

This gives insight into the heart’s performance when it is not being stressed with activity.

This measure may be taken with a monitor or physically done by the tester using the typical testing parameters and steps.

First, assessing resting heart rates requires a calm and relaxed physiological environment. Any stimulus, perceived stress, or anxiety will cause the heart rate to accelerate beyond its resting requirements.

Second, personal trainers should instruct clients to avoid stimulants, such as caffeine and tobacco products, before assessing their pulse.

Third, the client should not talk during the assessment, which can also elevate the heart rate. Have clients sit or lie down and place the arm to be assessed on a supportive structure. Have them maintain the position for two to five minutes to ease the postural shift, and talk to them to reduce the anxiety of being tested.

Fourth, identify the site for measurement. Keep the arm supported at approximately heart height and palpate the radial pulse using the index and middle fingers.

Fifth, the assessment should be for 60 seconds for resting heart rate. Exercise heart rate can use a 15-second pulse count multiplied by four. Multiple recordings of subsequent visits will help predict an average waking resting heart rate.

Last, if the value is consistently above 100 beats per minute, the client should be referred to a physician before engaging in any physical testing or activity above walking.

Exclusive PTP CPT Offers
Gold Standard Cert	Most Popular Cert	Best Study Materials
A Good Option	A Good Option	Best CPT for you?

Blood Pressure

This shows the body’s internal environment during its resting metabolism.

The categories we put people in are:

Normal blood pressure is when the systolic number is less than 120 and the diastolic is less than 80.

Elevated blood pressure is a systolic number between 120 – 19 and a diastolic of less than 80.

High blood pressure stage 1 is considered to be 130 – 139 systolic and 80 – 89 diastolic. It can be either of these or both.

High blood pressure in stage 2 is systolic at 140 or more and 90 or higher in diastolic. It can be either of these or both.

A hypertensive crisis is considered higher than 180 systolic and more than 120 diastolic. It can be either of these or both. This requires immediate consultation.

This testing can be done through the use of a machine or using more traditional testing.

For testing, follow these steps:

First, have the subject sit in a chair with feet flat on the floor and arms supported by a desk or table.

Second, place the appropriately sized cuff around the right arm so that the bottom of the cuff is two fingers from the flexion crease of the elbow.

Third, the arm used for the assessment should be at the same elevation as the heart. If using an electronic device, be sure the sensor is over the brachial artery.

Fourth, a cuff that is too small will falsely increase the reading, whereas a cuff that is too large will have the opposite effect.

Lastly, inflate the cuff to 165 mmHg for females and 185 mmHg for males or 20 mmHg above the previous systolic reading. Let the client know you will take the measurement twice to validate the initial measure.

Lipid Screening

This test can only be performed by a qualified healthcare professional.

These are relatively helpful in finding some specific diseases.

Body Composition and Anthropometrics

BMI is an easy-to-use metric for the general population, and it looks at the risk associated with body fat. It is not the most reliable for people considered to be in shape.

A value of 25 BMI is an initial risk indicator, and then 27 starts the high risk, with 30 and higher being obesity.

BMI classifications:

• Underweight = < 18.5
• Normal = 18.5 – 24.9
• Overweight = 25 – 29.9
• Obesity = 30 – 34.9
• Obesity 2 is 35 – 39.9
• Extreme obesity = > 40

Girth/Circumference Values

Waist circumference is a solid predictor for developing metabolic and cardiovascular diseases.

Other girth and circumference measures are helpful to measure frequently throughout exercise programs, and as such, they make good starting measures when starting with clients.

Skinfold Assessments

Skinfold is a relatively accurate way to find an individual’s body fat.

Exclusive PTP CPT Offers
Gold Standard Cert	Most Popular Cert	Best Study Materials
A Good Option	A Good Option	Best CPT for you?

This assessment style looks at skin folds in specific areas where certain populations hold their fat. These numbers are put into an equation to suit the skinfolds used, and then a calculation is made for the body fat percentage.

The biggest factors that are related to skinfold testing are test validity, the subject population, the skill of the tester, and the psychological impact the test may have on the client.

It is generally a rule of thumb that you should use skinfold assessment on lean people and girth measurements on everyone else.

The 3 sites for male clients are abdominal, chest, and thigh.

The 3 sites for female clients are the triceps, thigh, suprailiac.

Postural Assessments

These have gained a lot of popularity and provide very useful data for educated practitioners.

We have both static and dynamic postural assessments that can be done.

Static posture is taken when the body is not moving, while dynamic posture is when the body is going through some specific movement patterns.

Some common postural deviations are:

• Forward head
• Abducted scapula
• Rounded shoulders
• Thoracic kyphosis
• Hyperlordotic lumbar spine
• Lateral pelvic spine
• Knee/ankle deviations

The ability to perform good postural assessments requires understanding the proper anatomical position.

The proper anatomical position has the line of gravity passing through the axis of each joint when the joint segments align vertically.

Knowing the anterior, lateral, and posterior views involving the plumb line is important.

Exercise Participation Clearance

Upon a decision being made, professionals will have put their clients into one of these categories:

Unrestricted exercise – no evidence exists that exercise will harm the person at any intensity. Programs will reflect the exercise level determined.

Modified exercise program – the data seen from the professional puts the individual at a lower risk, but some things should be restricted to accommodate those exact concerns.

Supervised program – this person may have a significant risk, and their exercise should be guided by a small group or one-on-one training professional. Extra precautions are taken.

Medically supervised program – this person requires clearance from their medical professional for starting a program and is at a higher risk for injury or health problems from activity.

Exercise Testing

Fitness testing is fundamental for the design of a solid program and is most useful when its results are valid, appropriate for the client, and specific to their own goals.

There is not a single testing protocol that is perfect for every client.

The rationale for testing includes the following:

• Finding the baseline data for physical measures
• Assessing ability
• Finding the strengths and weaknesses
• Identifying starting points
• Determining the readiness for training activities
• Educating your clients
• Finding the goal-setting data

Test validity is the ability of a test to measure what it is designed to do accurately. This is usually compared to the gold standard.

Test reliability is the ability for tests to be consistently done and get the same result.

To increase validity:

• Make sure the protocol is valid
• Make sure the tester is skillful and experienced in the test protocols
• Make sure the client is proficient in the test action
• Use strict discrimination in measurement
• Psychologically prepare the client for the event and properly motivate them
• Make sure the environment is safe and ideal for the test
• Make sure all the equipment functions properly and is calibrated
• Make sure the client has met pretest instructions
• Ensure no variable has entered the equation, such as illness or high stress.
• Clearly defined scoring system

To increase reliability:

• Duplicate the conditions (time, environment, location, recovery)
• Strict adherence to the protocol
• Consistent pretest factors: warm-up and motivation
• Consistency with a scoring system
• Emphasize tester consistency
• Use the same assessment instrument

Testing Considerations

The testing environment, test administration, test economy, test format, health and safety considerations, and test interpretation are all important to detail.

The ideal order for exercise testing has the resting test or tests of minimal fatigue first, then the strength, power, and speed tests, followed by the anaerobic endurance testing, then the anaerobic capacity tests, and then ending with the aerobic tests.

The needs analysis is made based on the data collected from the exercise testing. This focuses on the individual’s health coming first, with function, fitness, and performance last if it were a pyramid.

Goal setting is important after the needs analysis is formed. Proper goals should consider three things:

• The client’s abilities and motivation
• The right period of time in which the goals should be attained
• The required efforts on behalf of the client

The goals will fall under objectives, short-term, and long-term goals.

Exercise Testing

Cardiorespiratory fitness is considered the most important measure of health-related fitness as it plays a role in physiological function and correlates very well with disease and lifespan.

Physical fitness evaluations should have a periodic assessment of the cardiorespiratory fitness levels.

It is a good idea to have some form of VO2 testing, with more valuable testing being the Submax testing, as this fits the less performance-focused clients and generally works well for most people.

It is important to go through these charts and tables to find the steps for testing the various popular forms of Submax VO2 testing for cardiorespiratory fitness.

Testing for Muscular Fitness

Testing for muscular fitness includes assessment of the ability of both muscular strength and endurance.

Muscular strength test presents a high level of risk for injury to the body due to the mechanical strain they put on deconditioned clients.

Using testing that implements multiple reps and estimates max weight is better.

Muscular endurance testing requires isometric contractions for long time periods.

Flexibility and mobility assessments also fall under muscular testing and are quite popular. It is a good idea to prescribe exercise in programs based on individual limitations in these areas.