FITNESS ASSESSMENT

BY- RUCHA GADGEEL

EVALUATION
 Body composition assessment
 Muscular fitness
1. Muscular strength
2. Muscular endurance
3. Muscular Power
 Flexibility
 Cardiovascular endurance
BODY COMPOSITION

 It is the relative percentage of body mass that is fat and

fat-free tissue.

CLINICAL IMPORTANCE OF BODY COMPOSITION ASSESSMENT –

 It can be used as an indicator of various systemic
conditions occurring in concurrence with excess fat
deposition in the body.

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
BODY MASS INDEX (BMI) / QUETELET INDEX

 It is the assessment of weight relative to height.

 BMI = Body weight / Height2 ( kg/m2)

CLINICAL SIGNIFICANCE –
 Obesity related health problems increase beyond BMI of 25
kg/m2.
 Increased risk of mortality beyond BMI of 30 kg/m2.

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
CLASSIFICATION OF DISEASE RISK BASED ON BODY MASS INDEX
(WHO vs Asian Criteria)
WHO CRITERIA ASIAN CRITERIA DISEASE RISK
Underweight <18.5 <18.5
Normal 18.5-24.9 18.5-22.9
Overweight 25.0-29.9 23-24.9 Increased
Pre-Obese - 25-29.9
Obese >30 >30
Obese Type 30-40 30-40 High
1(Obese)
Obese Type 2 40.1-50 40.1-50 Very High
(Morbid Obese)
Obese Type 3 >50 >50 Extremely high
(Super Obese)

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
CIRCUMFERENCES
 Circumference / Girth measurements provide a general
representation of body composition.

 Rotational duplicate measurements with a cloth tape

measure with spring-loaded handle ( Gulick tape measure)
are recommended.

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
STANDARDIZED DESCRIPTION OF CIRCUMFERENCE SITES AND
PROCEDURES

SITES PROCEDURES

ABDOMEN Horizontal measure at the height of

the iliac crest, usually at level of
umbilicus

ARM Horizontal measure midway

between the acromion and
olecranon processes

BUTTOCKS / HIPS Horizontal measure at maximal

circumference of buttocks
CALF Horizontal measure at level of
maximum circumference between
the knee and ankle

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
SITES PROCEDURES
FOREARM Measure taken perpendicular to the
long axis at the maximal
circumference with palms facing
anteriorly
HIPS / THIGH Horizontal measure taken at
maximal circumference of the
proximal thigh just below the
gluteal fold
MID THIGH Measure taken midway between
the inguinal crease and patella with
the foot on a bench, knee flexed at
90 degrees
WAIST Horizontal measure taken at the
narrowest part of the torso(directly
above iliac crest for
standardization) with arms at the
side and abdomen relaxed

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
WAIST CIRCUMFERENCE

 It can be used as an indicator of health risks where

abdominal obesity is the primary issue.

 Measurement is done immediately above the iliac crest ,as

proposed by National Institutes of Health Guidelines.

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
RISK CRITERIA FOR WAIST CIRCUMFERENCE IN ADULTS

RISK CATEGORY WAIST WAIST

CIRCUMFERENCE CIRCUMFERENCE
(CM) IN WOMEN (CM) IN MEN

VERY LOW < 70 cm <80 cm

LOW 70-89 cm 80-99 cm
HIGH 90-110 cm 100-120 cm
VERY HIGH >110 cm >120 cm

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
WAIST-HIP RATIO (WHR)
 It is the circumference of the waist above the iliac crest
divided by the circumference of the hips.

 Health risk is considered high when WHR is -

>0.95 for young men and >0.86 for young women
>1.03 for men and >0.90 for women (aged 60-69 years)

CLINICAL SIGNIFICANCE-
 Android vs Gynoid Obesity

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
SKINFOLD MEASUREMENTS

 PRINCIPLE – The amount of subcutaneous fat is proportional to

the total amount of body fat.
 TOOL - Measurements are taken using a skinfold calliper.

LIMITATIONS
 Poor technique / inexperienced evaluator
 Extremely obese/ lean patient
 Improperly calibrated calliper

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
STANDARDIZED DESCRIPTION OF SKINFOLD SITES AND
PROCEDURES

SKINFOLD SITE PROCEDURE

ABDOMINAL Vertical fold,2 cm to the right

side of the umbilicus

TRICEPS Vertical fold , on posterior

midline of upper arm,
halfway between the
acromion and olecranon
processes
BICEPS Vertical fold ,on the anterior
aspect of the arm over the
biceps belly
Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
SKINFOLD SITES PROCEDURES
SUBSCAPULAR Diagonal fold at 45 deg angle ,1-
2 cm below the inferior angle of
the scapula
THIGH Vertical fold, on the anterior
midline of the thigh, midway
between the proximal border of
patella and the inguinal crease.
MEDIAL CALF Vertical fold, at the maximum
circumference of the calf on
midline of its medial border
CHEST / PECTORAL Diagonal fold , one-half the
distance between ant. Axillary
line and nipple for men and one
third distance between the same
for women.
Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
BIOELECTRICAL IMPEDANCE ANALYSIS
 Broadly used tool for body composition assessment
 Based on the electrical properties of biological tissues
 The human body is divided into 5 segments – 2 for upper
limb , 2 for lower limb, 1 for trunk
 Various techniques of measurement – single/multiple
frequency , whole body /body segment analysis ,
spectroscopy, vector analysis

Reference : Sami F. Khalil , Mas S Mokhtar. The Theory and Fundamentals of Bio impedance Analysis in Clinical Status Monitoring and
Diagnosis of Diseases. Sensors 2014,14,10895-10928;doi : 10.3390/s140610895
Whole body bio-impedance measurement
techniques
 Hand to foot method
 Foot to foot method
 Hand to hand method

Reference : Sami F. Khalil , Mas S Mokhtar. The Theory and Fundamentals of Bio impedance Analysis in Clinical Status Monitoring and Diagnosis of Diseases. Sensors
2014,14,10895-10928;doi : 10.3390/s140610895
ADVANTAGES-
 Estimates fat mass , fat free mass and total body water
 It is a more precise measurement for determining lean/fat
mass as compared to other measurement techniques

Reference : Sami F. Khalil , Mas S Mokhtar. The Theory and Fundamentals of Bio impedance Analysis in Clinical Status Monitoring and Diagnosis of
Diseases. Sensors 2014,14,10895-10928;doi : 10.3390/s140610895
OTHER TECHNIQUES
 Dual-Energy X-Ray Absorptiometry (DXA)
 Total Body Electrical Conductivity (TOBEC)
 Near Infrared Interactance
 Computed Tomography (CT)
 Magnetic Resonance Imaging (MRI)
 Densitometry
1. Hydrodensitometry
2. Plethysmography

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
MUSCULAR STRENGTH

 It is the muscle’s ability to exert a force

 Methods of evaluating muscular strength –

1. Static testing
2. Dynamic testing

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
MUSCULAR ENDURANCE
 It is the muscle’s ability to perform successive exertions /
repetitions

 Assessment is done for various regions of the body using

specialized field tests
Upper extremity endurance – Push ups / Modified pull ups
Trunk endurance – Abdominal Curls
Lower extremity endurance – Mini squats

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
PUSH UP
TEST

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
ABDOMINA
L CURL UP

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
YMCA BENCH
PRESS TEST

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
FLEXIBILTY
 It is the ability to move a joint through its complete range
of motion

 It is assessed using various tools and field tests

 Commonly used tests –

1. YMCA sit and reach test
2. Back saver test
3. Back scratch test
Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
YMCA SIT AND
REACH TEST

Reference : ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition
BACK SCRATCH TEST
BACK SAVER TEST
THANK YOU !