NSCA CPT Chapter 11 – Fitness Testing Protocols and Norms

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Chapter Objectives:

• Know the protocols for selected fitness testing.
• Administer the selected fitness tests correctly.
• Find valid and reliable measurements for clients’ fitness levels and choose appropriate tests for individual clients.
• Discuss clients’ results and their relationship with normative data.

Vital Signs

Heart rate and blood pressure are two ways to measure vital signs common in training. These both prove effective for determining the proper exercise intensity. 

Heart Rate

Most adults have an average heart rate of 60 – 80 beats per minute, with females having 7 – 10 more beats than males.

Heart rates lower than 60 bpm classify people as having bradycardia. 

Heart rates over 100 bpm classify people with tachycardia.

Equipment used:

• Stopwatch
• Stethoscope
• Heart rate monitor

Palpation procedure

Use the index finger and middle fingertips to palpate the pulse. Please avoid using the thumb, as it has its own inherent pulse. Use one of the areas mentioned after step 3.

Next, if using a stopwatch, you start with the first beat as zero and go to either 6, 10, 15, 30, or 60 seconds.

The last step is to make the measure you have equal to what it would be at 60 seconds. So, multiply by the appropriate number. 

Sites for palpation:

• Brachial artery: the anterior-medial aspect of the arm just distal to the belly of the biceps brachii muscle, 1 inch superior to the antecubital fossa.
• Carotid artery: on the anterior surface of the neck, just lateral to the larynx. Avoid applying too much pressure to this location when palpating for HR. 
• Radial artery: on the anterior-lateral surface of the wrist, in line with the base of the thumb. 
• Temporal artery: the lateral side of the cranium on the anterior portion of the temporal fossa, usually along the hairline at the level of the eyes. 

Blood pressure

This is the force of blood acting on the vessel walls.

The sounds that are emitted are vibrations called Korotkoff sounds.

Equipment used:

• Mercury or Sphygmomanometer
• Air bladder 
• Stethoscope

Procedure

The client should not ingest caffeine within 30 minutes of testing.

The client will sit upright in a chair with back support with left arm exposed, supinated, and at heart level.

Use the appropriate cuff size for the client’s arm.

Begin measuring BP after 5 minutes of rest in the position of step 2.

Put the cuff on the arm with the bladder over the brachial artery.

The client’s palm is face-up, and the stethoscope is put firmly over the antecubital space.

The sphygmomanometer dial is at eye level.

When all are in place, inflate the air bladder to 160 mmHg above the anticipated BP. When at max, decrease 2 – 3 per second.

Record the diastolic and systolic to the nearest 2 mmHg found when hearing the first Korotkoff sound and the cessation of the sounds.

Wait and observe for 10 – 20 more mmHg to confirm the loss of sounds.

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After 2 minutes, do the process again. If the difference is over 5 mmHg, then take a third.

Once the BP is determined, classify the client.

Body Composition

Body comp measurement is of great interest to trainers and clients. There are advantages and disadvantages to all of them.

Anthropometry

This is the science of measurement of the human body. We typically include height, weight, and body girth measurements.

Body Mass Index

This is used to examine someone’s body mass related to their stature. It is an accurate indicator in some ways for the amount of body fat based on height and weight. However, it does not consider muscle and is more used for the general population or people who don’t train regularly.

BMI = body weight in kg divided by height in square meters.

Height 

Basic measurement, which is also known as stature

Equipment needed

• Standard platform scale
• Flat, rigid, right-angled device

Procedure

Ask the client to take off footwear.

Get the client to stand erect and face the wall or stadiometer.

Tell the client to align the lowest orbit of the eye with their ear opening.

The client will take a deep breath and hold it until the measure ends.

Read the measure.

Mark the wall or stabilize the device and record the measurement to the closest centimeter.

Compare the values to the charts in the book.

Weight

The mass of an object under normal acceleration from gravity.

Equipment

• Calibrated and certified scale

Skinfolds

This measures the subcutaneous fat tissue. They are highly correlated with body density measurements from underwater weighing.

Equipment needed: 

• Skinfold caliper
• Nonelastic tape measure
• Pen or other marking devices

Skinfold Sites

Chest: Take a diagonal fold half the distance between the anterior axillary line and the nipple for and 1/3 of the distance from the anterior axillary line to the nipple for women. 

Midaxilla: Take a vertical fold on the midaxillary line at the xiphoid process level. 

Triceps: Take a vertical fold on the posterior midline of the upper, halfway between the acromion and olecranon processes; the elbow should be extended and relaxed.

Subscapular: Take a fold on a diagonal line coming from the vertebral border to 1 to 2 cm from the inferior angle of the scapula.

Abdomen: Take a vertical fold at a lateral distance of approximately 2 cm from the umbilicus. 

Suprailium: Take a diagonal fold above the crest of the ilium at the spot where an imaginary line would come down from the anterior axillary.

Thigh: Take a vertical fold on the anterior aspect of the thigh midway between the hip and knee joints. 

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Medial calf: The client places the right leg on a bench with the knee flexed at 90 degrees. On the medial border, mark the level of the greatest calf girth. Raise a vertical skinfold on the medial side of the right calf 1 inch above the mark and measure the fold at the max girth.

Bioelectrical impedance is a way to measure body comp using electrical impedance through the body between two electrodes. This measures the body’s cells and the response to electricity, as muscle and fat respond differently.

Waist to hip girth ratio

Not a true body comp, but it is a valuable tool for assessing the relative fat distribution and disease risk.

Just requires nonelastic tape measure.

Cardiovascular Endurance 

Submax endurance tests are used to attain reasonably accurate VO2 max predictions. These are used due to the high cost of equipment for VO2 testing.

Cycle Ergometer test

Similar to the YMCA cycle ergometer test but with a cycle and different movements, obviously. So, we will describe the YMCA test procedure.

YMCA Cycle Ergometer Test

This test will get the client to about 85% of max HR with 3 minute stages of increasing effort.

Equipment needed

• Mechanical or electrical braked cycle ergometer
• Metronome
• Stopwatch
• Heart Rate and BP equipment
• Ratings of Perceived Exertion scale

Procedure

Get the client to perform at 50 rpm and maintain for the whole test.

Put the work rate for the first stage at 150 kg/m/min

Measure heart rate in the final 15 – 30 seconds of the second and third minute of stage 1.

Use these based on the heart rate of the client:

• <80 beats/min, set the work rate for the 2nd stage at 750 kg/m/min(2.5 kg at 50 rpm)       
• 80-89 beats/min, set the work rate for the 2nd stage at 600 kg/m/min(2.0 kg at 50 rpm) 
• 90-100 beats/min, set the work rate for the 2nd stage at 450 kg/m/min(1.5 kg at 50 rpm) 
• >100 beats/min, set the work rate for the 2nd stage at 300 kg/m/min(1.0 kg at 50 rpm) 

Measure heart rate again at the last 15 – 30 seconds of the second and third minute; if within 6 beats of each other, continue for another minute.

Use the step 4 chart to set the next 2 stages and repeat the process.

Finish the test when the client reaches 85% of their age-predicted max HR.

Estimate VO2 as they do in the textbook on page 235.

Astrand Rhyming Cycle Ergometer Test

This is a 6-minute cycle test that uses a metronome, stopwatch, and cycle. 

YMCA step Test

This basic and inexpensive test can be done on one person or in large groups. It classifies fitness levels but does not provide an estimate of VO2 max. Essentially you step up and down at a certain cadence for 3 minutes and then take your heart rate after.

Equipment

• 12 inch step bench or box
• Metronome
• Stopwatch

Distance run and walk test considerations

These test measure distance traveled over time or the time taken to travel a distance. We use this information in an equation to pretty accurately estimate someone’s VO2 max. Each test is used for different populations and should be chosen accordingly. They all require about the same stuff: a track or road, a stopwatch, and maybe another measurement device. These can often be done in groups.

Muscular Strength

This is an important component of physical fitness. We need a small amount of strength to do daily tasks; as we age, it is important to retain our strength. We discuss two 1 rep max tests in this section.

The 1 rep max bench press

This measure upper body strength. Here we use free weights, which requires skill for the client being tested. 

It requires a barbell and weight plates that allow adjustments of 5 to 90 pounds. The procedure is similar to other 1 rep max tests where you warm up the exercise light and move up in increments until you find the client’s max.

The 1 rep max leg press

This is used to measure lower body strength in clients. 

This exercise uses the universal leg press machine, thus is not free weight like most 1 RM tests. 

The procedure is similar to other 1RM protocols.

Estimating 1 RM

Some people may prefer not to find a true 1 RM due to danger, so estimating a 1 RM using Submax resistance is possible. You essentially do as many reps as you can with a Submax resistance and then use the formula to find it because the number of reps you can do with one weight-related is high to your max.

Muscular Endurance

This is the ability of a muscle or group of muscles to exert Submax force for a longer time. This is as important as muscular strength due to everyday life needing it and the importance as we age.

YMCA bench Press Test

This is used to measure upper body endurance.

The equipment needed is an adjustable barbell and weight plates, and a metronome.

Procedure is:

• Spot the client close.
• Set resistance to 80 pounds for males and 35 for females.
• Look for the bench press technique.
• Set the metronome for 60 bpm to equal 30 reps per minute.
• The client begins with arms extended and shoulder width; they lower to the chest, then without pause, they raise the bar to full arm length. It follows with the metronome,

The test ends when the client can’t lift the barbell in the metronome’s cadence.

Compare the score with the classifications.

Partial Curl Up test

This measures the abdominal muscles’ endurance.

Equipment:

• Metronome
• Ruler
• Masking tape
• Mat

The same as the bench press endurance, but with a curl up to the marked tape. Essentially you are doing crunches to a cadence this time.

Prone Double Straight Leg Raise Test

This examines low back muscular endurance.

It only requires a training or massage table.

Procedure

The client starts prone; legs extended, hands under the forehead, and forearms perpendicular to the body.

The client raises the legs where the knees leave the table.

Monitor the test by sliding the hands under the thighs.

Record the duration in seconds.

End the test when their knees touch the table.

Compare the score and classify the client.

Flexibility

This is the range of motion around a joint or series of joints that a client has. 

Sit and Reach

This measures hip and low back flexibility.

Requires a yardstick or a sit and reach box, adhesive tape, and measuring tape.

The client warms up and stretches lightly so they don’t hurt themselves. They do the test without shoes and with slow movements.

The client has a yardstick on the floor and taps across the stick at a right angle of 15 cm. The heels touch the taped line and are 10 – 12 inches apart. Heels are against the box if it is used.

The client slowly moves forward with both hands while in contact with the yardstick. 

The most distant part reached is recorded and two trials are done. The knees must stay extended.

Compare the test results.

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