By Karyn Gallivan, MS, ATC, CSCS, NSCA-CPT, NASM-CPT
Contributor, Sports & Fitness Network
The Health & Fitness Assessment, Part III – Cardiovascular & Strength Testing
Last month (The Health and Fitness Assessment, Part II), I discussed the fitness evaluation process and its components. In this installment, we will look at resting heart rate, blood pressure, and body composition. This month I will discuss a little bit about submaximal cardiovascular endurance, muscular fitness testing, and flexibility.
Cardiorespiratory Endurance (submaximal exercise test)
Cardiorespiratory endurance is the ability to sustain dynamic, vigorous-intensity exercise using large muscle groups. This type of exercise depends on the ability to consume (respiratory system), transport (cardiovascular system) and use (skeletal muscle) oxygen efficiently. The greater the efficiency of these systems, the higher someone’s VO2max will be. Generally, a person with higher cardiorespiratory fitness has a reduced chance of death from all causes.
Stationary cycle ergometers and treadmills are common modes to test aerobic capacity, and many protocols exist for each. Each cardiovascular exercise machine will also have testing protocols. In addition, there are cardiovascular fitness evaluations for walking and running if that mode of evaluation is preferred. If there are no contraindications to exercise, follow these general procedures:
- Obtain RHR and RBP information in the exercise position prior to the test.
- After properly positioning your client on the equipment, begin the test with a two- to three-minute warm-up at an intensity not higher than the first stage of the exercise test.
- The exercise protocol should consist of approximately two- to three-minute stages.
- HR should be monitored at least twice during each stage, preferably at the second and third minutes. If HR difference between the second and third minute of the stage is greater than five bpm, extend the stage until steady state is reached (two HRs within five beats).
- Blood pressure (BP) should be monitored near the end of each stage.
- Member’s rating of perceived exertion level (RPE) and the “talk test,” should be monitored at the conclusion of each stage. These can then be used to prescribe exercise training intensity.
- Terminate the test when members achieve 85 percent of their maximal heart rate (MHR), or 70 percent of heart rate reserve. MHR may be estimated, in lieu of a maximal test, using the standard 220 age or a newer formula of 208 (0.7 x age).
- Cool down and Monitor HR, BP, RPE, and signs and symptoms at least five minutes post-exercise, or longer if abnormal responses were noted.
- Conclude the test when HR and BP stabilize, although not necessarily to resting levels.
Muscular fitness is an important component of physical fitness because it positively influences body composition, bone mass, self-esteem, musculotendinous integrity (related to low-back pain) and glucose tolerance (related to type 2 diabetes). Muscular fitness describes both muscular strength (the maximal force a muscle can produce) and muscular endurance (the ability of a muscle to resist fatigue). There are a few considerations to recognize before performing common tests to measure muscular fitness:
- Strength and endurance are specific to the muscle group, the speed of movement, the type of contraction and the joint angle being tested.
- Members should be familiarized with the equipment, and instructed on the proper movements of all exercises used in the test.
- Appropriate spotters should be used, and all safety measures should be reviewed with members prior to the assessments.
Dynamic muscular strength (upper and lower body) is sometimes assessed using the one-repetition maximum (1-RM), or the heaviest weight that can be lifted one time. However, performing a battery of 1-RM tests may prove to be impractical and/or increase associated risks. Tests of muscular fitness may be substituted by choosing a submaximal level of resistance, and counting the maximal number of repetitions before fatigue. The appropriate weight (and exercise) may be based on a percentage of 1-RM (estimated 6-RM or 10-RM) or body weight (e.g., 70 percent). After strength training, the same initial weight would be used to reassess muscular fitness of a particular muscle.
Flexibility is the ability to move a joint through a full range of motion. It depends, in part, on the muscles, ligaments and tendons surrounding the joint, the degree of warm-up and the type of joint in question. Flexibility is an often-neglected component of physical fitness, and those who are inflexible may be at higher risk for injury during activity, and/or lower-back pain. While flexibility assessments are not necessary, it is necessary to address this component of fitness, especially for those who have been sedentary for a while.
Next time, I will follow up with my thoughts on other assessments to consider. While not all of these are necessary, it is nice to have points of comparison for a client who often doesn’t see their progress. Being able to see improvement in these simple measures is often the motivation they need to continue.