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Client Assessment

  • DD slash MM slash YYYY
  • Overhead Squat Assessment

  • Figure 4.14 Overhead Squat Assessment, Start, Anterior View
  • Figure 4.15 Overhead Squat Assessment, Start, Lateral View
  • Figure 4.16 Overhead Squat Assessment Finish, Anterior View
  • Figure 4.17 Overhead Squat Assessment Finish, Lateral View
  • Overhead Squat Assessment

    A quick and easy way to assess a client’s overall movement quality during a functional movement pattern involves the Overhead Squat Assessment. This observation assesses dynamic flexibility on both sides of the body and integrated total body strength.

    Position

    • Have the client stand with feet shoulder-width apart, and pointed straight ahead. The foot and ankle complex should be in a neutral position.
    • Have the client raise her arms overhead with elbows fully extended. The upper arms should bisect the ears (Figures 4.14, 4.15).

    Movement

    • The client should squat to chair level height and return to the start position.
    • Repeat five times from each view.

    Views

    • View the feet, ankles, and knees from the front (Figure 4.16).
    • View the lumbo-pelvic-hip complex and shoulder, and cervical complex from the side (Figure 4.17).
    • View up to five repetitions before resetting.

    Compensations

    • Foot and Ankle
      • Flatten: The arch of the foot may appear flat (Figure 4.18)
      • Turn out: The client may stand, squat, or walk with her feet externally rotated (Figure 4.19)<
      • Heel of foot rises: The client’s body weight may shift forward and heel pressure may slightly rise (Figure 4.20)
    • Knees
      • Knees move inward: The knees may have a knock-kneed appearance, where the knees converge and are not lined up over the middle of the foot (Figure 4.21)
      • Knees move outward: The knees may have a bow-legged appearance, where the knees move away and are not lined up over the middle of the foot (Figure 4.22)
    • Lumbo-Pelvic-Hip Complex
      • Excessive forward lean: The trunk may fall forward so the lower leg and trunk line are not parallel (Figure 4.23)
      • Lower back arches: The lower back may overly arch or extend (Figure 4.24)
    • Upper Body
      • Arms fall forward: The arms may fall forward in front of the ears (Figure 4.25)

    When performing the Overhead Squat Assessment, record all findings (Table 4.9). Refer to the Overhead Squat Solutions Table in the Appendix to determine which muscles to address through corrective flexibility and strengthening techniques.



  • Table 4.9 Overhead Squat Assessment Findings

  • The Rockport One-Mile Fitness Walking Test

  • For overweight and inactive women, the Rockport One-Mile Fitness Walking Test provides a reasonable estimate of cardiorespiratory fitness. The purpose of the test is for the client to walk as fast as possible for 1 mile, either on a treadmill or on a flat 1-mile course. After the client completes the mile, the Health and Fitness Professional should measure the client’s heart rate immediately. If a heart rate monitor is not available, the Health and Fitness Professional can take the pulse manually for 10 seconds, and multiply that number by 6 to get the number of beats per minute. Do not count a pulse for an entire minute because the heart will start to decrease over that minute, changing the test results. The Health and Fitness Professional should also note the exact time it took the client to complete the mile.

    Health and Fitness Professionals should use the following steps to estimate a cardiorespiratory starting point (10). They should then modify the starting point based on the ability level. Once determined, Health and Fitness Professionals should refer to the Cardiorespiratory Fitness Training chapter of this text for specific programming strategies.

    Step one: Record the client’s weight and have the client walk 1 mile, as fast as she can control, on a treadmill. Record the time it takes the client to complete the walk. Immediately record the client’s heart rate (in beats per minute) at the 1-mile mark. Then use the formula below to determine the client’s oxygen consumption (VO2) score (10).

    132.853 - (0.0769 × weight in pounds) - (0.3877 × age in years) + (6.315 × gender, which is a 0 for women) - (3.2649 × time in minutes) - (0.1565 × heart rate in beats per minute) = VO2 score

    The following shows how to calculate the VO2 score for a 57-year-old female client who weighs 123 lb and walks 1 mile in 18 minutes, with at a heart rate of 112 beats per minute at the end of the 1 mile walk.
    132.853 - (0.0769 x 123) - (0.3877 x 57) + (6.315 x 0) – (3.2649 x 18) – (0.1565 x 112) = 24.9
    This client has a VO2 max score of 24.9

    Step two: Locate the client’s VO2 score using the Rockport Walk Test Norms Chart (Table 4.6).

    Step three: Determine the appropriate starting program using the appropriate category.

    • Poor: Zone one (65 - 75% of HRmax)
    • Fair: Zone one (65 - 75% of HRmax)
    • Average: Zone two (76 - 85%of HRmax)
    • Good: Zone two (76 - 85% of HRmax)
    • Very good: Zone three (86–95% of HRmax)

    Step four: Determine the client’s maximal heart rate by subtracting the client’s age from the number 220 (220 – age). Then, take the maximal heart rate and multiply it by the following percentages (in decimal form) to determine the appropriate starting heart rate ranges for each zone.

    • Zone one: (Maximal heart rate × 0.65) to (Maximal heart rate × 0.75)
    • Zone two: (Maximal heart rate × 0.76) to (Maximal heart rate × 0.85)
    • Zone three: (Maximal heart rate × 0.86) to (Maximal heart rate × 0.95)
    Refer to the Cardiorespiratory Fitness Training chapter for proper use of these zones through specific stage training programs. Health and Fitness Professionals can use the Karvonen formula, or HRR formula, may be used instead of the straight percentage method (220-age) to determine the appropriate exercise intensity once they establish the client’s baseline cardiorespiratory fitness level.


    Rockport One-Mile Fitness Walking Test Calculator


  • ⦁ Zone one: (Maximal heart rate × 0.65) to (Maximal heart rate × 0.75) ⦁ Zone two: (Maximal heart rate × 0.76) to (Maximal heart rate × 0.85) ⦁ Zone three: (Maximal heart rate × 0.86) to (Maximal heart rate × 0.95)
  • Partial Curl-up (Crunch) Test Procedures for Women

    • Place a mat on the floor and have the client lay on her back, with her knees bent at about a 90 degree angle, feet firmly planted with shoes on, arms at her sides, and palms facing the mat. Ask the client to straighten her fingers and place a piece of masking tape so her longest finger touches the edge of the tape. Place another piece of tape at a distance of 10 cm from the first piece. Make sure both pieces of tape are set up parallel to each other.
    • Set a metronome to 50 beats per minute. A Health and Fitness Professional can purchase a metronome at a musical instrument retailer or download an application onto most mobile phones with advanced connectivity and computing ability.
    • Next, ask the client to perform a curl-up by lifting her shoulder blades off the mat so her trunk makes a 30 degree angle with the floor and her longest finger touches the second piece of tape. The client should tuck her chin in and not flex the neck forward during the movement portion of the test. Have the client return to the starting position before repeating another curl-up. The client should perform each curl-up should in time with the metronome.
    • The client should perform as many curl-ups as possible for the duration of one minute up to a maximum of 25 curl-ups. The client should perform each curl-up in a controlled manner, with the upper back touching the mat while at the starting position and with no pause between each repetition.
  • Table 4.7 Partial Curl-up (Crunch) Test
  • Push-up Test Procedures for Women

    • Place a mat on the floor and have the client assume a modified knee push-up position by kneeling on the mat’s surface with the legs together and the hands placed shoulder width apart. The lower legs should be in contact with the mat and the ankles plantar flexed. Instruct the client to lower her body towards the mat until the elbows form a 90 degree angle, or the upper arms are parallel to the ground. The client’s abdomen should not touch the mat. This is the starting position.
    • Begin the test by having the client push her body off the mat while keeping her back straight. The client should use her knees as a pivotal point throughout the movement. Instruct the client to push up until her arms are extended but not locked. Have the client return to the starting position.
    • Instruct the client to perform as many push-ups as possible without pausing and with control of the movements. Stop the test when the client is unable to complete a full push-up or she is unable to maintain proper technique for two consecutive repetitions.
  • Other Tests

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