ACE Group Fitness Instructor Manual
Chapter
 Health
5
Screening
1
Typical forms



Legal

Informed consent

Liability waiver
Health screen

Health-risk appraisal/health history

PAR-Q

Medical/physician’s release
Psychological

Lifestyle information

Exercise history and attitude questionnaire

Exercise confidence survey
2
Reasons for health screening

Referral


Safety


Identify those in need of referral
to a healthcare provider for more
extensive medical evaluation.
Ensure the safety of exercise
testing and participation.
Testing and/or fitness
program development

Determine the appropriate type
of exercise test or program.
3
Health history

Demographic information

Past and present exercise
history

Coronary artery disease (CAD)
risk factors

Medications

Recent or current illness and
injuries

Surgery and injury history

Family medical history
4
CAD risk factor assessment
(available on Moodle)
5
ACSM intensity guidelines

Moderate-intensity exercise

3 to 6 METs

40 to 60% VO2max

40 to 60% heart-rate reserve (HRR)


12 to 13 rating of perceived exertion
(RPE)
Vigorous-intensity exercise

Greater than 6 METs

Greater than 60% VO2max

Greater than 60% HRR

Greater than 13 RPE
6
CLASSIFICATION OF EXERCISE INTENSITY FOR
CARDIORESPIRATORY ENDURANCE
%HRR or
VO2R
%HRmax
RPE
(6-20)
<40
<64
<12
3-4
Moderate
40-60
64-77
12-13
5-6
Vigorous/
Hard
60-85
77-94
14-16
7-8
Very Hard
>85
>94
17-20
>9
Intensity
Light
RPE
(1-10 )
Talk Test
Comfortable
speech is
possible
Speech
possible with
some
difficulty
Speech
limited to
short phrases
METS
< 3.0
3-6
> 6.0
Speech is
very difficult
Sources:
Swain, D.P. & Leuthoholtz, B.C. (2007). Exercise Prescription: A case study approach to the ACSM Guidelines -2nd edition (2007), p38
ACSM’s Resources for the Personal Trainer (2nd ed), 2007. Lippincott, Williams & Wilkins Publishers, pg 414.
Webster, AL, Aznar-Lain, S. (2008). Intensity of physical activity and the “Talk Test”: A brief review and practical application. ACSM’s
Health & Fitness Journal, 12:3 p 13-17.
Haskell, WL, et al. Physical Activity and Public Health: Updated Recommendation for Adults from the American College of Sports
Medicine and the American Heart Association. Med. Sci. Sports Exerc., Vol. 39, No. 8, pp. 1423–1434, 2007. http://www.acsm-msse.org
Medication


Health-history forms should
include information regarding
medications the participant is
taking (prescription and overthe-counter).
A fitness professional must be
aware of the effects of
medications on heart rate and
blood pressure, both at rest
and during exertion.
8
Musculoskeletal conditions



Both chronic and acute injuries
must be addressed in the
health-screening process.
Serious injuries and past
surgeries, along with their
dates of occurrence, should be
recorded.
Any recent traumatic injury or
injury causing immediate pain
requires a physician’s
clearance prior to beginning an
exercise program.
9
ACE Group Fitness Instructor Manual
Chapter
 Fitness
6
Assessments
10
Fitness assessment: body mass index (BMI)


BMI is a relative measure of height to body
weight for determining the degree of obesity.
BMI should not be used solely in determining
body composition for an athletic or muscular
person because it does not distinguish
between fat mass and fat-free mass.
11
Table for determining BMI
12
BMI weight classifications
13
Fitness assessment: circumference measurements



Circumference measurements
can be used to assess body
composition as well as bodyfat distribution.
Measurements are taken with
a cloth measuring tape and
must be taken at specific
anatomical sites for accuracy.
More practical than other
methods of body-composition
assessment for obese
participants
14
Submaximal aerobic fitness test



A cardiorespiratory fitness test designed so
that the intensity does not exceed 85%
heart-rate reserve (HRR).
Provides an estimation of the VO2max
without the risks associated with maximal
exercise testing
Examples

YMCA submaximal step test

McArdle step test

Rockport fitness walking test (1-mile walk)

BYU jog test
15
Fitness assessment: muscular endurance


Muscular endurance assessments
measure a muscle or muscle group’s
ability to exert a submaximal force
either repeatedly or statically over
time.
Common muscular endurance tests:

Push-up test

Half sit-up (curl-up) test

Plank (timed)-not in ACE text
16
Fitness assessment: flexibility


Measures the range of motion
(ROM) at specific joints

Trunk flexion (sit-and-reach)

Shoulder flexibility
As with any test or exercise,
the participant’s health and
injury history should be
considered.
17
Reassessment



Measurable changes usually
take about 4 to 6 weeks.
The first follow-up
assessments should be
administered 4 to 12 weeks
after the onset of training.
The information gained
during the follow-up
assessments can be useful in
participant motivation as well
as in future exercise
programming.
18