Results of the physical activity assessments from Boukje Groot Student: Suzanne Doolaard Studentnumber: 130599018 Teacher: Nuno Pimenta Course: Exercise Testing and Prescription Date: 02-05-2014
Table of contents Introduction...3 PAR-Q...4 Risk Assessment and Classification...6 Bodycomposition...8 Skinfold...8 Bio-impedance... 10 Cardioresperatory data... 11 Tests... 12 Push-up test... 12 Crunch test... 12 30 chair stand test... 13 Postural and Functional Screening... 14 Static screening... 14 Mobility... 14 Core stability... 15 Gait checking... 15 Conclusion... 16 Goals and Exercises... 17 Goals... 17 Exercises... 17 References... 17 2
Introduction This report is about the physical assessments of Boukje Groot, done by Suzanne Doolaard. In this report you can find the assessments that are done with Boukje as my client. The assessments are done in a logical order. This is to assess if it is save for Boukje to be physical active. After the assessments the level of physical fitness of Boukje became clear. Boukje scored good on almost all the assessments except for her VO 2 max and she should work on her balance. For this reason the training will be focused improving Boukje her VO 2 max and her balance. Knowing this there is made a goal for Boukje to work on; In the upcoming weeks I want to increase my VO 2 max with 15% by interval training and work on my balance by balance exercises. This report will describe the purpose of all the assessments and the scores of Boukje. 3
PAR-Q Before you start doing any assessments the PAR-Q should be filled in by the client. The PAR-Q questionnaire is an easy way to look if the client is able to be more physically active. 4
Boukje answered NO to all PAR-Q questions, so she can be sure to: Start becoming much more physically active begin slowly and build up gradually. This is the safest and easiest way to go. Take part in a fitness appraisal this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively. 5
Risk Assessment and Classification This form is an easy and fast way to determine if the client has any disease or signs and/or symptoms. Diagnosed diseases: 1. Cardiovascular diseases - Cardiac disease; - Peripheral vascular disease; - Cerebrovascular disease 2. Metabolic diseases - Diabetes (Type I and II); - Renal disease 3. Pulmonary diseases - Chronic obstructive pulmonary disease; - Asthma; - Interstitial lung disease; - Cystic fibrosis Signs and symptoms of disease: 1. Chest pain or discomfort (or in other areas that may result from ischemia); 2. Shortness of breath at rest or with mild exertion; 3. Dizziness or syncope; 4. Orthopnea or paroxysmal nocturnal dyspnea; 5. Bilateral ankle edema; 6. Palpitation or tachycardia; 7. Intermittent Claudication; 8. Known heart murmur; 9. Unusual fatigue or shortness of breath with usual activities. Coronary artery disease risk factors: Age Family history Cigarette smoking Sedentary lifestyle Hypertension Obesity Dyslipidemia Prediabetes NEGATIVE coronary risk factors HDL-C >60 mg/dl Men > 45 yr; Women > 55 yr MI or coronary intervention or sudden death of first degree relative before 55 years if male or before 65 years if female Current or quitted within 6 months, or passive smokers < (30 /day; 3 d/wk; 3 months; moderate intensity physical activity: >40% and <60% VO2res) SBP > 140 mmhg and/or DBP > 90 mmhg, confirmed at two separate occasions, or antihypertensive medication BMI > 30 kg/m2, or WC > 102cm (men) or 88cm (women) LDL-C > 130 mg/dl, or HDL-C < 40 mg/dl; or Lipid lowering medication; or Total-C > 200 mg/dl Impaired fasting glucose (IFG): - (100 mg/dl < Fasting Glucose < 125 mg/dl); or Impaired glucose tolerance (IGT): - (140 mg/dl < oral glucose test < 199 mg/dl). Confirmed at two separate occasions 6
Risk Stratification: Low risk Moderate risk High risk Asymptomatic; and < 2 risk factor; Asymptomatic; and > 2 risk factors; > 1 signs and symptoms; and/or > 1 cardiovascular, metabolic or pulmonary disease Low risk Asymptomatic; and < 2 risk factor; Moderate risk Asymptomatic; and > 2 risk factors; High risk > 1 signs and symptoms; and/or > 1 cardiovascular, metabolic or pulmonary disease (ACSM, 2013). Boukje has no asymptomatic and risk factors so she does not have to visit the doctor (see table below) before she will start to be more physically active. 7
Bodycomposition Before you start doing any exercises you should know some information about the body of your client. For this reason I did some assessments on Boukje. These assessements are; skinfold equations, bioimpedance and cardioresperatory data. Skinfold Skinfold equations: solutions for females Triceps: Vertical fold; on the posterior midline of the upper arm halfway between the acromion and the olecranon processes, with the arm held freely to the side of the body Suprailiac: Diagonal fold; in the line with the natural angle of the iliac crest taken in the anterior axillary line immediately superior to the iliac crest Abdominal: Vertical fold; 2 cm to the right side of the umbilicus Skinfold equations: solutions for females Skinfolds (mm) Triceps Suprailiac Abdominal 1st measure 15 mm 12 mm 10 mm Calculation of body density: 3SKF = 15 + 12 + 10 = 37 Body density (females) = 1.089733 0.0009245 ( 3SKF)x 37 + 0.0000025 x 37 2 0.0000979 x 22 Body density (females) = 1.0568 Calculation of % body fat %Body fat = [(4.95 / body density) - 4.50] x 100 %Body fat = [(4.95 / 1.0568) - 4.50] x 100 = 18,4 % Boukje has a body fat percentage of 18,4 which is good (see table). (ACSM, 2013) 8
Important body indexes for body composition and health assessment: Body Mass Index = 60,6 / 1,753 2 = 19,72 Cutoff values: 19,72 BMI > 25 (overweight) and > 30 (obese) Body Adiposity Index = hip circumference (cm) / height (m) 1,5-18 Body Adiposity Index = 96 / 1,753 1,5 18 = 23,4 Cutoff values: not yet defined Waist-to-hip ratio (WHR) = waist circumference (cm) / hip circumference(cm) WHR = 74 / 96 = 0,77 Cutoff values for high WHR WHR > 0,80 Waist-to-height ratio (WHtR) = waist circumference (cm) / height (cm) Cutoff values for high WHtR WHtR > 0,5 On all above assessments Boukje scored good. 9
Bio-impedance Weight: 60,6 kg Height: 175,3 cm BMI: 19,7 kg/m2 Fat: 21,2% RM: 1377 kcal The fat percentage of Boukje by bio-impedance is different than by skinfold. This is because, for example, the amount of water in your body can already make a big difference at the time of the measurement. For this reason the fat percentage from the skinfold is more reliable. As you can see in table below the fat percentage of Boukje is between fair. But because we will use the skinfold measurement, were her fat percentage was 18,4, she scored good. (ACSM, 2013) As for her BMI, which is 19,7 kg/m 2, the reference is BMI > 25 (overweight) and > 30 (obese). So this means that Boukje her BMI is good (ACSM 2013). 10
Cardioresperatory data HRmax: 188 bpm VO2max: 42 ml/kg/min Boukje her VO 2 max was assessed by the Tredmill test. During this test Boukje had to run on a tredmill with an 5% incline. The first three minutes she run at 8km/h, the following three minutes she run at 9km/h and the last three minutes she run at 10 km/h. During this test her heart rate was measured. With this information her VO 2 max could be calculated. As you can see in table below Boukje her VO 2 max is average. This means that her VO 2 max needs some improvement. (ACSM,2013) 11
Tests Push-up test The push-up test is a simple test to evaluate the endurance of the abdominal muscle groups and upper body muscles. Within this test you should to the maximum number of push-ups you can execute (ACSM 2013). Boukje did 17 repetitions in this test. As you can see in the table below this means that she scored good. (ACSM,2013) Crunch test The crunch (curl-up) test is a simple test to evaluate the endurance of the abdominal muscle groups and upper body muscles. Within this test you should to the maximum number of crunches you can execute (ACSM 2013). Boukje did 27 repetitions in this test. As you can see in the table below this means that she scored average. 12
30 chair stand test The 30 second chair stand test is a good test to evaluate the strenght of your lower body muscles. Although this test is mostly used for older adults this could also be done with Boukje. For Boukje we will do two measurements with a few weeks in between. Through this way you can measure if Boukje made any progression. 13
Postural and Functional Screening Static screening Frontal plane Looking at Boukje in frontal plane there were no abnormalities. Sagital plane Looking at Boukje in sagital plane, you see that she has is a little kyphotic in her nek. Mobility Hip Boukje has an 90 degree angle on both Her legs. This means that her mobility of her hip is good. She did this without feeling any pain. Spine Boukje has a good mobility in her spine. This is because she can touch the floor with her hands while bending over. She also has a good mobility when her spine is held backward. She did this without feeling any pain. Shoulder Boukje her mobility in her shoulders is good. This Is because she can touch her hands on her back on both sides. She did this without feeling any pain. 14
Core stability Within this test Boukje should keep her legs as high As possible without moving her spine. She is able to do this with her legs in an 85 degree angle. This is a good score. She did this without feeling any pain. Gait checking Boukje has some trouble with this exercise. On both of her legs she is shaking with her knee. This means that she need some imporvment on this. 15
Conclusion Looking at all the assessment that are done Boukje scored really well. On almost all the assessments she scored a good. Only her VO 2 max and her balance need some improvement. Besides that she also scored good on the PAR-Q test and the Risk Assessment and Classification form which means that it is save for Boukje to become more physically active. Knowing this, goals can be set up for Boukje to work on. With these goals she can improve her Vo 2 max and her balance. 16
Goals and Exercises Goals In the upcoming weeks I want to increase my VO 2 max with 15% by interval training and work on my balance by balance exercises. Exercises With these exercises Boukje can work on her balance. Stand on one leg on a balance board or pillow. You can do this with both legs. Stand with one leg on a platform. Bend trough your knee and then come slowly up.you can do this with both legs. Start with some help from the wall and eventually try to do it without any help. This exercise can be done in four different movements. Stand on one leg while jumping forward, jumping backward, jumping to the left and jumping to the right. This exercise can be done on both legs. 17
References ACSM(2013). ACSM s Guidelines for Exercise Testing and Prescription. Baltimore, Lippincot Williams & Wilkins. Ashwell, M., P. Gunn and S. Gibson (2012). Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analyses. Obes Rev 13(3): 275-286. Bergman, R. N., D. Stefanovski, T. A. Buchanan, A. E. Sumner, J. C. Reynolds, N. G. Sebring, A. H. Xiang and R. M. Watanabe (2011). A better index of body adiposity. Obesity (Silver Spring) 19(5): 1083-1089 Nesheim, M. C. (1990). Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans 1990. Hyattsville, Maryland, US Department of Agriculture and US Department of Health and Human Services. Weltman, A., R.L. Seip, and Z.V. Tran, Practical assessment of body composition ub adult obese males. Hum Biol, 1987. 59(3): p. 523-55. Weltman, A., et al., Accurate assessment of body composition in obese females. Am J Clin Nutr, 1988. 48(5): p. 1179-83. 18