Fitness Assessment Protocol Worksheet

Miami Dade Fire Rescue Occupational Safety and Health Bureau

FITNESS ASSESSMENT PROTOCOL WORKSHEET Name: Date:

Age: BP: Height: inches Weight: lbs Resting HR: THR: ______

AEROBIC CAPACITY WFI Treadmill

PROTOCOL:  Fit client with heart rate monitor. Heart rate (HR) will be monitored throughout evaluation and cool-down.  When HR exceeds THR, the client continues for 15 seconds in the same stage.  The evaluation is stopped if any of the following occur:  HR does not return to, or below, the THR. Time MPH %Grade  Client reaches the max stage (18 minutes).  Client feels unable to continue. 0:00 - 1:00 3.0 0  The highest stage reached is circled. 1:01 – 2:00 3.0 0  Record HR after one minute of cool-down. 2:01 – 3:00 3.0 0

Treadmill Sub-maximal VO2 Prediction Formula 3:01 - 4:00 4.5 0 Step 1: Calculate Target Heart Rate (THR) 4:01 – 5:00 4.5 2 THR Formula: [208 - (0.7 × AGE)] × .85 5:01 – 6:00 5.0 2 [208 - (0.7 × )] × .85 6:01 – 7:00 5.0 4 [208 - (_ _)] × .85 7:01 – 8:00 5.5 4 8:01 – 9:00 5.5 6 × .85 9:01 – 10:00 6.0 6 Target Heart Rate: ______10:01 - 11:00 6.0 8 Step 2: Calculate Body Mass Index (BMI) 11:01 - 12:00 6.5 8 BMI formula: 703 X Weight (lbs) 12:01 – 13:00 6.5 10 2 Height (in) 13:01 – 14:00 7.0 10 703 X lbs 14:01 – 15:00 7.0 12 2 ( in) 15:01 – 16:00 7.5 12 703 X lbs 16:01 – 17:00 7.5 14 17:01 – 18:00 8.0 14 703 X Recovery Phase Body Mass Index: ______0:00 - 1:00 3.0 0 1:01 – 2:00 3.0 0 Step 3: Determine time Test Terminated (TT) 2:01 – 3:00 3.0 0 TT: ______

OSHB Page 1 of 10 4/4/2018 Miami Dade Fire Rescue Occupational Safety and Health Bureau

VO2 Max Calculation Example: S E C O N D S T O D E C I M A L E Q U I V A L E N T Client: SECONDS DECIMAL SECONDS DECIMAL SECONDS DECIMAL Age: 48 1 0.02 21 0.35 41 0.68 Height: 72” 2 0.03 22 0.37 42 0.70 Weight: 221 lbs 3 0.05 23 0.38 43 0.72 THR: 148 bpm 4 0.07 24 0.40 44 0.73 BMI: 30 TT: 7.53 5 0.08 25 0.42 45 0.75 6 0.10 26 0.43 46 0.77 Scenario: 7 0.12 27 0.45 47 0.78 At 7 minutes and 32 seconds, the client 8 0.13 28 0.47 48 0.80 exceeds THR. The assessment continues for 9 0.15 29 0.48 49 0.82 the additional 15 second monitoring period. 10 0.17 30 0.50 50 0.83 The HR remains above client’s THR. Test is 11 0.18 31 0.52 51 0.85 terminated and time recorded at 7min 32 sec. 12 0.20 32 0.53 52 0.87 Use Table to convert 32 seconds to the 13 0.22 33 0.55 53 0.88 decimal equivalent of 0.53. 14 0.23 34 0.57 54 0.90 15 0.25 35 0.58 55 0.92 Calculation: 16 0.27 36 0.60 56 0.93 VO2 = 56.981 + (1.242 ×TT) – (0.805 × BMI) 17 0.28 37 0.62 57 0.95 VO2 = 56.981 + (1.242 × 7.53) – (0.805 × 30) 18 0.30 38 0.63 58 0.97 VO2 = 56.981 + 9.35 – 24.15 19 0.32 39 0.65 59 0.98 VO2 = 42.18 20 0.33 40 0.67 60 1.00 VO2 = 42 ml/kg/min

VO2 max = 56.981 + (1.242 × TT) – (0.805 × BMI)

VO2 max = 56.981 + (1.242 × ___) – (0.805 × ___)

VO2 max = 56.981 + _____ – _____

VO2 = ______OR VO2= ______ml/kg/min

IF CLIENT EXPERIENCES CHEST PAIN, LIGHT-HEADEDNESS, ATAXIA, CONFUSION, NAUSEA, OR CLAMMINESS AT ANY TIME DURING ANY EVALUATION, TERMINATE ASSESSMENT IMMEDIATELY!

VO2 Max:

Fitness can be measured by the volume of oxygen you consume while exercising at your maximum capacity. VO2 max is the maximum amount of oxygen in milliliters one can use in one minute per kilogram of body weight. Those who are fit have higher VO2 max values and can exercise more intensely than those who are not as well conditioned. Numerous studies show that you can increase your VO2 max by working out at an intensity that raises your heart rate to between 65 and 85% of its maximum for at least 20 minutes three to five times a week.

NORMATIVE DATA FOR VO2 MAX

Male (values in ml/kg/min):

Age Very Poor Poor Fair Good Excellent Superior 13-19 <35.0 35.0 - 38.3 38.4 - 45.1 45.2 - 50.9 51.0 - 55.9 >55.9 20-29 <33.0 33.0 - 36.4 36.5 - 42.4 42.5 - 46.4 46.5 - 52.4 >52.4 30-39 <31.5 31.5 - 35.4 35.5 - 40.9 41.0 - 44.9 45.0 - 49.4 >49.4 40-49 <30.2 30.2 - 33.5 33.6 - 38.9 39.0 - 43.7 43.8 - 48.0 >48.0 50-59 <26.1 26.1 - 30.9 31.0 - 35.7 35.8 - 40.9 41.0 - 45.3 >45.3 60+ <20.5 20.5 - 26.0 26.1 - 32.2 32.3 - 36.4 36.5 - 44.2 >44.2

Female (values in ml/kg/min):

Age Very Poor Poor Fair Good Excellent Superior 13-19 <25.0 25.0 - 30.9 31.0 - 34.9 35.0 - 38.9 39.0 - 41.9 >41.9 20-29 <23.6 23.6 - 28.9 29.0 - 32.9 33.0 - 36.9 37.0 - 41.0 >41.0 30-39 <22.8 22.8 - 26.9 27.0 - 31.4 31.5 - 35.6 35.7 - 40.0 >40.0 40-49 <21.0 21.0 - 24.4 24.5 - 28.9 29.0 - 32.8 32.9 - 36.9 >36.9 50-59 <20.2 20.2 - 22.7 22.8 - 26.9 27.0 - 31.4 31.5 - 35.7 >35.7 60+ <17.5 17.5 - 20.1 20.2 - 24.4 24.5 - 30.2 30.3 - 31.4 >31.4

Table Reference: The Physical Fitness Specialist Certification Manual, The Cooper Institute for Aerobics Research, Dallas TX, revised 1997 printed in Advance Fitness Assessment & Exercise Prescription, 3rd Edition, Vivian H. Heyward, 1998.p48

MUSCULAR STRENGTH Grip-Strength

PROTOCOL  Explain assessment to client.  The hand grip strength evaluation uses the Jamar Hydraulic Hand Dynamometer and is a series of six (6) measurements – three (3) for each hand.  The isometric contraction (squeezing) required during this evaluation must be eased into and then released slowly, without swinging the arm, pumping the arm, or jerking the hand.  Make sure the client’s hands are dry, and place the dynamometer in the hand to be evaluated.  Adjust the dynamometer, ensuring that the bottom of the handle clip is adjusted to fit snug in the first proximal interphalangeal joint.  Rotate the red peak-hold needle counterclockwise to the “0” position.  Instruct the client to bend slightly forward with the elbow bent at a 90-degree angle, shoulder adducted and neutrally rotated, forearm and wrist in a neutral position.  Instruct the client to squeeze with maximum strength for two (2) to three (3) seconds while exhaling then slowly release grip. The peak-hold needle will automatically record the highest force exerted.  Record the reading to the nearest kilogram. Measure both hands alternatively allowing three (3) evaluations per hand, resetting the peak-hold needle to “0” each time.  Record the highest score.

Dominant Hand: LEFT RIGHT

Trial I kg kg

Trial II kg kg Trial III kg kg

Highest: kg

MUSCULAR STRENGTH Vertical Jump

LEG POWER TEST The Vertical Jump assessment is an optional test to the static leg strength evaluation. Some individuals shy away from the static leg dynamometer, despite the emphasis on comprehensive prescreening, instruction, supervision, and proper execution. This test was chosen to be offered as an alternative, but is not directly comparable to the results of Static Leg Dynamometer. The static leg assessment measures muscular strength which is only one component of power. This evaluation measures leg power using a formula to calculate the rate of force produced to propel body weight vertically in the air.

EQUIPMENT:  The “Just Jump” mat made by Probotics - a timing mat used to estimate vertical distance traveled.

Hang Time Vertical Jump Height Trial I “ Trial II “ Trial III “

Highest: “

PROTOCOL The purpose of this assessment is to measure power of the lower body.

 Place the jumping mat on a level surface. Connect the cord attached to the jumping mat to the handheld computer port.  With the individual off the mat, turn the computer on. The display should read, "Step on Mat".  Have the individual step on to mat, squat to a position where the knees are at a 90° angle and the hands by the sides (momentary pause @ 90°).  Instruct the individual to jump straight up as high as he/she can, reaching toward the ceiling or an object, without tucking the legs, and land with both feet on the mat.  When the individual has completed the jump, the display will read hang time and vertical jump in inches. This vertical jump mode resets automatically.  Have the individual perform a series of three jumps and record the highest distance. This distance will be put into a formula to calculate leg power. The individual can be rated on vertical height in cm or leg power.

ANY DEVIATION FROM DESCRIBED TECHNIQUE WILL NOT BE COUNTED, AND TRIAL MUST BE REPEATED. The following are examples of situations that require a re-evaluation:  The individual fails to land with both feet on the mat.  The individual tucks the legs instead of extending them while reaching up.

TO CALCULATE POWER USE THE FOLLOWING CONVERSIONS:

Jump height conversion: inches to centimeters (______” × 2.54 = ______cm)

Body weight conversion: pounds to kilograms (______lbs ÷ 2.2 = ______kg)

Leg Power=[(60.7×jump height (cm))+(45.3×weight (kg))]–2055 Leg Power (W) = [(60.7×______cm)+(45.3×______kg)]–2055 Leg Power (Watts) = ______+ ______– 2055 Leg Power (Watts) = ______Jump Height: ______cm

Vertical Jump Age 20-29 Age 30-39 Age 40-49 Age 50-59 Height (cm) Power (W) Height (cm) Power (W) Height (cm) Power (W) Height (cm) Power (W) Excellent ≥ 58 ≥ 5094 ≥ 52 ≥ 4860 ≥ 43 ≥ 4320 ≥ 41 ≥ 4019 Very Good 54-57 4640-5093 46-51 4389-4859 36-42 3700-4319 34-40 3567-4018 Good 48-53 4297-4639 40-45 3967-4388 32-35 3242-3699 28-33 2937-3566 Fair 42-47 3775-4296 31-39 3485-3966 26-31 2708-3241 18-27 2512-2936 Needs Improvement ≤ 41 ≤ 3774 ≤ 30 ≤ 3483 ≤ 25 ≤ 2707 ≤ 17 ≤ 2511 Average of CFD 54.4 5224.07 53.6 5169.5 46.6 4924.96 43.07 4744.07

Performance Comparison Vertical Jump Results (Watts) Classification & Age Average Age Average Score Rating Firefighter 20's 26 5129.14 Excellent Firefighter 30's 33 5249.87 Excellent Firefighter 40's 44 4924.96 Excellent Fire Fighter 50's 56 4744.07 Excellent Officer 40's 44 4933.35 Excellent Officer 50's 53 4744.07 Excellent Total/Average 42.67 4954.24 Excellent

MUSCULAR ENDURANCE Push-Ups

EQUIPMENT:  Metronome  Push-up Handles

PROTOCOL . Explain assessment to client. . The individual being tested is to first get into a position on their hands and knees and place their hands onto the push-up stands. . Position the push-up stands so that they are slightly wider than shoulder width. . The Styrofoam cube is placed in a position so that, in the lowering phase of the push-up, the client’s chin contacts the cube. . The person being tested then extends the arms, straightens the legs & body into a plank position. His/her feet should be touching and remain together throughout the test. . Once in a start position the metronome is started at a rate of 80 beats per minute. . The tester should give the subject about 5-reps to get the tempo when first starting off. . The subject should use a full-range of motion; lowering themselves until the chin touches the cube. . The subject then extends at the elbow until their arms are fully straight. Care should be taken NOT to hyperextend the elbows. . Body alignment should remain straight in a plank position with the scapula stabilized and the ankles together.

ANY DEVIATION FROM DESCRIBED TECHNIQUE WILL NOT BE COUNTED. The following are examples of situations that require assessment to conclude: . Body alignment not maintained. . If the client loses tempo for more than three repetitions, the test is concluded.

Completed Push-Ups:

MUSCULAR ENDURANCE Prone Static Bridge

EQUIPMENT:  Stopwatch  Exercise Mat

PROTOCOL  Conduct the pre-evaluation procedures.  Place a mat on the floor and have the subject set up lying face down in a push-up position.  Next the subject should place their forearms on the mat and use the forearms for the base of support. The elbows should be lined up directly underneath the shoulders and the forearms should be pointed straight ahead. As an option the subject may clasp their hands together while resting on the forearms as long as the elbows remain directly under the shoulder.  The subject should then position their feet so that their toes are on the floor and their feet are together. The ankles should maintain an angle of 90 degrees throughout the test.  Once the feet are in position, the subject then extends the knees to lift himself/herself up off of the floor and support their body from the forearms and toes.  They should be instructed to tighten their abdominals to support their back and their back should remain flat like a plank.  You should be able to draw an imaginary line straight through their ear, center of the shoulder, hip socket, and ankle when they are in the correct position.  As soon as they are in position a stopwatch is started and the time that they can maintain proper positioning for is recorded.  Body alignment should remain like a plank, the scapula should remain stabilized, and the ankles positioned at 90 degrees.

ANY DEVIATION FROM DESCRIBED TECHNIQUE WILL NOT BE COUNTED. The following are examples of situations that require assessment to conclude: MIN SEC . Body alignment not maintained. 3 180 . Knees touch the ground 4 240 5 300 Front Bridge Statistics 6 360 Male Male Male Male 20’s 30’s 40’s 50’s Female Average 7 420 Highest 150 365 277 150 182 224 8 480 Average 121 117 120 83 92 114.83 9 540 Lowest 90 47 53 37 27 51.33 10 600 11 660 12 720 Time: Seconds 13 780 14 840

FLEXIBILITY Sit & Reach

PROTOCOL:  Prepare equipment.  Provide client with instructions.  This flexibility evaluation uses the Novel Acuflex I or equivalent trunk flexibility tester.  Advise the client that this evaluation is a series of three (3) measurements that will evaluate the flexibility of the lower back, hamstring muscles, and shoulders.  Instruct the client that the flexion required during this evaluation must be smooth and slow, as the individual advances the slide on the box to the most distal position possible.  Instruct client to sit on the floor ensuring the head, upper back, and lower back are in contact with the wall. Place the client’s legs together, fully extended. The sit & reach box is placed flat against the feet.  While maintaining head and upper/lower back contact with the wall, the client is instructed to extend arms fully in front of the body with the right hand overlaying the left hand, with middle finger of each hand directly over each other. The rule is set at 0.0” at the tips of the middle fingers.  Instruct the client to exhale slowly while stretching slowly forward, bending at the waist, and pushing the measuring device with the middle fingers.  During the stretch, legs are to remain together and fully extended, and hands are to remain overlaid. The stretches are held momentarily and the distance obtained.  If the client bounces, flexes the knees, or uses momentum to increase distance, the trial is disqualified.  Instruct the client to relax for thirty (30) seconds. Record the distance to the nearest ¼ inch.  Conduct a total of three (3) trials, recording the furthest distance on the “B” Scale.

Trial I ” Trial II ” Trial III ”

Furthest Distance: ”

SKINFOLD MEASUREMENT 7-Site Caliper

PROTOCOL  All measurements are taken on the right side of the body.  Take duplicate (2) measurements at each site and retest if duplicate measurements are not within one- to-two (1-2) mm. Three (3) measurements are always preferable to ensure accuracy.  Rotate through measurement sites or allow time for skin to regain normal texture and thickness.  Remove thumb from caliper handle.  Hold calipers on fold for two (2) seconds.  Remind clients that skinfold-caliper measurement has a margin of errors of +/- 5-10 percent.

LOCATIONS  Vertical Fold Abdominal  2cm to the right side of the umbilicus  Vertical Fold Triceps  On the posterior midline of the upper arm halfway between the acromion and the olecranon processes  Diagonal Fold Pectoral  One-half the distance between the anterior axillary line and the nipple  Diagonal Fold Suprailiac  In line with the natural angle of the iliac crest taken in the anterior axillary line immediately superior to the iliac crest  Vertical Fold Thigh  On the anterior midline of the thigh midway between the proximal border of the patella and the greater trochanter of the femur OR at the inguinal crease of the hip

Males: Chest: Abdominal: Thigh:

Females: Tricep: Suprailiac: Thigh: Fat % Sum of Weight: Calculations: Body Skinfolds: Lean Fat: Weight:

To calculate goal weight:

Lean Weight / (100 – Goal %) = Goal Weight 100

REMARKS:

Signature: Date:

Fitness Trainer (please print):

Fitness Trainer Signature:

OSHB Page 11 of 10 4/4/2018