ACSM Testing

ACSM Based Fitness ACSM Based Fitness TestingTesting

Blood PressureBlood Pressure

Resting Blood Pressure - Resting Blood Pressure - ACSMACSM

► Patient should be seated for at least 5 minutes in a Patient should be seated for at least 5 minutes in a chair with their back supported and their arms chair with their back supported and their arms bared and supported at heart level. Patients should bared and supported at heart level. Patients should refrain from smoking cigarettes or ingesting refrain from smoking cigarettes or ingesting caffeine during the 30 min. preceding the caffeine during the 30 min. preceding the measurement.measurement.

► Wrap cuff firmly around upper arm at heart level; Wrap cuff firmly around upper arm at heart level; align cuff with brachial arteryalign cuff with brachial artery

► The appropriate cuff size must be used to ensure The appropriate cuff size must be used to ensure accurate measurement. The bladder of the cuff accurate measurement. The bladder of the cuff should encircle at least 2/3 of the upper arm. Many should encircle at least 2/3 of the upper arm. Many adults require a large adult cuffadults require a large adult cuff

Resting Blood Pressure - Resting Blood Pressure - ACSMACSM

► Place stethoscope bell below the Place stethoscope bell below the antecubital space over the brachial arteryantecubital space over the brachial artery

► Quickly inflate cuff pressure to 20 mm Hg Quickly inflate cuff pressure to 20 mm Hg above estimated systolic blood pressure.above estimated systolic blood pressure.

► Slowly release pressure at a rate equal to Slowly release pressure at a rate equal to 2 to 3 mm Hg per second, noting the first 2 to 3 mm Hg per second, noting the first Korotkoff soundKorotkoff sound

► Continue releasing pressure, noting when Continue releasing pressure, noting when sound becomes muffled (4sound becomes muffled (4thth phase phase diastolic BP) and when sound disappears diastolic BP) and when sound disappears (5(5thth phase diastolic BP). For classification phase diastolic BP). For classification purposes, the latter is used.purposes, the latter is used.

Body CompositionBody Composition

Hydrostatic WeighingHydrostatic Weighing

Hydrostatic Weighing - Hydrostatic Weighing - ACSMACSM

► Based on Archimedes’principle – when a body is Based on Archimedes’principle – when a body is immersed in water, it is buoyed by a counterforce immersed in water, it is buoyed by a counterforce equal to the weight of the water displaced. This equal to the weight of the water displaced. This loss of weight in water, corrected for the density of loss of weight in water, corrected for the density of water, allows calculation of body volume.water, allows calculation of body volume.

► However, the volume of air in the lungs at the time However, the volume of air in the lungs at the time of measurement (usually residual volume must be of measurement (usually residual volume must be accounted for.accounted for.

► Bone and muscle tissue are more dense than Bone and muscle tissue are more dense than water, whereas fat tissue is less dense. Therefore, water, whereas fat tissue is less dense. Therefore, a person with more FFM for the same total body a person with more FFM for the same total body mass weighs more in water and has a higher body mass weighs more in water and has a higher body density and lower percentage of body fat.density and lower percentage of body fat.

► Although hydrostatic weighing is a standard Although hydrostatic weighing is a standard method for measuring body volume, several method for measuring body volume, several sources of error are inherent in the proceduresources of error are inherent in the procedure

Dr. Pritschet Dr. Emmett

JEBP


► Archimedes and King HieronArchimedes and King Hieron► ““Arch” knew that density = mass Arch” knew that density = mass

/ volume/ volume► Arch knew the mass of the crownArch knew the mass of the crown► Volume = mass on land minus Volume = mass on land minus

the mass in waterthe mass in water► Underwater, Arch weighed gold Underwater, Arch weighed gold

and silver each with the same and silver each with the same mass as the crownmass as the crown

► However, the volume for the gold However, the volume for the gold was different from the crown. was different from the crown.

► ““Eureka, the crown is a fraud.”Eureka, the crown is a fraud.”


► Example. A person weighs 75 Example. A person weighs 75 kg in air and 3 kg in water.kg in air and 3 kg in water.

► 72 kg of water was displaced72 kg of water was displaced► Volume = 72 kg = 72 liters or Volume = 72 kg = 72 liters or

72,000 cm72,000 cm33

► Density = mass / volumeDensity = mass / volume► Therefore the density would Therefore the density would

equal 75 kg / 72,000 cmequal 75 kg / 72,000 cm33, or , or 1.0416 g/cm1.0416 g/cm33

► So?So?


►Body fat = (495 / D) - Body fat = (495 / D) - 450450

►This is the Siri equation.This is the Siri equation.► (495 / 1.0416 g/cm(495 / 1.0416 g/cm33) – 450 ) – 450

= 25.23% body fat.= 25.23% body fat.► If all measurements are If all measurements are

correct, the entire correct, the entire procedure has a 1% procedure has a 1% margin of error for body margin of error for body fats between 4 and 30%.fats between 4 and 30%.

Air Plethysmography (Bod Air Plethysmography (Bod Pod)Pod)

Plethysmography - ACSMPlethysmography - ACSM

► Body volume can also be measured by air Body volume can also be measured by air displacement rather than water displacement displacement rather than water displacement (hydrostatic weighing).(hydrostatic weighing).

► One commercial system uses a dual-chamber One commercial system uses a dual-chamber plethysmograph that measures body volume plethysmograph that measures body volume by changes in pressure in a closed chamber.by changes in pressure in a closed chamber.

► This new technology shows great promise and This new technology shows great promise and can more easily accommodate individuals who can more easily accommodate individuals who cannot perform the procedures associated cannot perform the procedures associated with underwater weighing.with underwater weighing.

Air Plethysmography (Bod Pod)

Similar principle as UWW Air instead of water Comparison

– Error = ±2-3%– Costly– Convenient for subject– Low tech skills

Skin Fold Measurements - Skin Fold Measurements - ACSMACSM

► Abdominal – vertical Abdominal – vertical fold; 2 cm to the right fold; 2 cm to the right of the umbilicusof the umbilicus

► Triceps – Vertical fold; Triceps – Vertical fold; halfway between the halfway between the acromion and acromion and olecranon processolecranon process

► Chest – Diagonal fold; Chest – Diagonal fold; 1/2 the distance 1/2 the distance between the anterior between the anterior axillary line and the axillary line and the nipple (men) or 1/3 of nipple (men) or 1/3 of the distance for the distance for womenwomen

Skin Fold Measurements - Skin Fold Measurements - ACSMACSM

► Subscapular – Diagonal Subscapular – Diagonal fold (45fold (45°° angle); 1 to 2 angle); 1 to 2 cm below the inferior cm below the inferior angle of the scapulaangle of the scapula

► Suprailiac – Diagonal Suprailiac – Diagonal fold; in line with the fold; in line with the naturla angle of the naturla angle of the iliac crest taken in the iliac crest taken in the anterior axillary line anterior axillary line immediately superior immediately superior to the iliac crestto the iliac crest

► Thigh – Vertical fold; on Thigh – Vertical fold; on the anterior midline of the anterior midline of the thigh, ½ between the thigh, ½ between the proximal border of the proximal border of the patella and the the patella and the inguinal crease (hip)inguinal crease (hip)

EIU ATP/AFP EquationsEIU ATP/AFP Equations

► Body Density (BD) EquationsBody Density (BD) Equations► Males. BD = 1.1125025 - (0.0013125 x Males. BD = 1.1125025 - (0.0013125 x SK. FLD. SK. FLD.

SUMSUM) + (0.0000055 x ) + (0.0000055 x SK. FLD.SK. FLD. SUMSUM22) - (0.000244 x ) - (0.000244 x age)age) Males - Triceps, Subscapular, and ChestMales - Triceps, Subscapular, and Chest

► Females. BD = 1.089733 - (0.0009245 x Females. BD = 1.089733 - (0.0009245 x SK. FLD. SK. FLD. SUMSUM) + (0.0000025 x ) + (0.0000025 x SK. FLD.SK. FLD. SUMSUM22) - (0.0000979 ) - (0.0000979 x age)x age) Females – Triceps, Suprailiac, and AbdominalFemales – Triceps, Suprailiac, and Abdominal

► Percent body fat = [(4.95/BD)-4.5] x 100Percent body fat = [(4.95/BD)-4.5] x 100

Bioelectric ImpedanceBioelectric Impedance

► Measurement of Measurement of body water.body water.

► Impedance or Impedance or (resistance) (resistance) decreases with decreases with body water.body water.

► Assumption that Assumption that body water is at a body water is at a constant value.constant value.

► 3-4% error3-4% error

Bioelectric ImpedanceBioelectric Impedance

Bioelectical Impedance Bioelectical Impedance Analysis (BIA) - ACSMAnalysis (BIA) - ACSM

► Abstain from eating or drinking with 4 Abstain from eating or drinking with 4 hours of the assessmenthours of the assessment

► Avoid moderate or vigorous physical Avoid moderate or vigorous physical activity within 12 hours of the activity within 12 hours of the assessmentassessment

► Void completely before the assessmentVoid completely before the assessment► Abstain from alcohol consumption Abstain from alcohol consumption

within 48 hours of the assessmentwithin 48 hours of the assessment► Ingest no diuretic agents, including Ingest no diuretic agents, including

caffeine, prior to the assessment unless caffeine, prior to the assessment unless prescribe by a physicianprescribe by a physician

Dual Energy X-Ray Dual Energy X-Ray Absorptiometry - ACSMAbsorptiometry - ACSM

►Can be used to assess total bone Can be used to assess total bone mineral as well as regional estimates of mineral as well as regional estimates of bone, fat, and lean tissue.bone, fat, and lean tissue.

► It uses a three component model to It uses a three component model to predict body fatness and offers predict body fatness and offers advantages over densitometry advantages over densitometry techniques.techniques.

►DEXA is typically found in clinical DEXA is typically found in clinical setting and can be used to measure setting and can be used to measure body composition across the life spanbody composition across the life span

Duel-Energy X-Ray Absorptiometry (DEXA)

New gold standard? Comparison

– Error = ±1-5% (software)– Very costly– Very high tech– Quick– Subject friendly

Infrared Interactance - Infrared Interactance - ACSMACSM

► Based on the principle of light Based on the principle of light absorption and reflection absorption and reflection using near-infrared using near-infrared spectroscopy to provide spectroscopy to provide information about the information about the chemical composition of the chemical composition of the bodybody

► Further research is needed to Further research is needed to develop and cross-validate develop and cross-validate gender-specific equations for gender-specific equations for infrared interactance and to infrared interactance and to determine whether this is an determine whether this is an accurate method for accurate method for assessing body compositionassessing body composition

MenMen

WomenWomen

Body Mass IndexBody Mass Index

BMI = BMI = wt (kg) / ht (m)wt (kg) / ht (m)22

BMI = BMI = (704.4 x wt (lb) / ht (in) (704.4 x wt (lb) / ht (in) 22. .

Body Mass IndexBody Mass Index

Waist-to-Hip RatioWaist-to-Hip Ratio

Waist-to-Hip Ratio - ACSMWaist-to-Hip Ratio - ACSM

► Individuals with more fat on the trunk, Individuals with more fat on the trunk, especially abdominal fat are at increase risk especially abdominal fat are at increase risk for various diseases.for various diseases.

► The waist to hip ratio has been used as a The waist to hip ratio has been used as a simple method for determining body fat simple method for determining body fat patternspatterns

► Waist to hip ratio = circumference of waist Waist to hip ratio = circumference of waist divided by the circumference of the hipsdivided by the circumference of the hips

Waist-to-Hip Ratio - ACSMWaist-to-Hip Ratio - ACSM

MenMen WomenWomen

Very High Very High Health RiskHealth Risk

> 0.94> 0.94 > 0.82> 0.82

Ages 60-69Ages 60-69 > 1.03 > 1.03 > 0.90> 0.90

Waist Circumference - ACSMWaist Circumference - ACSM

►The waist The waist circumference can circumference can be used alone as be used alone as an indicator of an indicator of health risk health risk because because abdominal obesity abdominal obesity is the issue.is the issue.

Muscular FitnessMuscular Fitness

Muscular StrengthMuscular Strength

Muscular Strength – 1 RMMuscular Strength – 1 RM

► The subject performs a light warm-up of 5-10 The subject performs a light warm-up of 5-10 reps at 40 to 60% of perceived maximum.reps at 40 to 60% of perceived maximum.

► Following a 1-minute rest with light stretching, Following a 1-minute rest with light stretching, the subject does 3 to 5 repetitions at 60 to the subject does 3 to 5 repetitions at 60 to 80% of perceived maximum.80% of perceived maximum.

► The subject should be close to a perceived 1-The subject should be close to a perceived 1-RM in step 2.RM in step 2.

► A small amount of weight is added, and a 1-RM A small amount of weight is added, and a 1-RM lift is attempted.lift is attempted.


► If the lift is successful, a rest period of 3 to 5 If the lift is successful, a rest period of 3 to 5 minutes is provided.minutes is provided.

► The goal is to find the 1-RM within 3 to 5 The goal is to find the 1-RM within 3 to 5 maximal efforts.maximal efforts.

► The process of titrating the increase in The process of titrating the increase in weight up to a true 1-RM can be improved weight up to a true 1-RM can be improved by prior familiarization sessions that allow by prior familiarization sessions that allow approximation of the 1-RM.approximation of the 1-RM.


►Clear communication with the subject Clear communication with the subject is needed to facilitate determination of is needed to facilitate determination of the 1-RM.the 1-RM.

►The process continues until a failed The process continues until a failed attempt occurs.attempt occurs.

►The 1-RM is reported as the weight of The 1-RM is reported as the weight of the last successfully completed lift.the last successfully completed lift.

Muscular EnduranceMuscular Endurance

FlexibilityFlexibility

Flexibility - ACSMFlexibility - ACSM

► The ability to move a joint through its The ability to move a joint through its complete range of motion (ROM)complete range of motion (ROM)

► Importance in athletics and the ability to Importance in athletics and the ability to carry out activities of daily livingcarry out activities of daily living

► Maintaining flexibility facilitates movementMaintaining flexibility facilitates movement► Movement beyond a joint’s shortened Movement beyond a joint’s shortened

range of motion can cause tissue damage.range of motion can cause tissue damage.► Factors that determine flexibility:Factors that determine flexibility:

Joint capsuleJoint capsule Body (joint) temperatureBody (joint) temperature Ligaments and tendonsLigaments and tendons

FlexibilityFlexibility► DevicesDevices

A.A. GoniometerGoniometerB.B. ElectogoniometerElectogoniometerC.C. FlexometerFlexometerD.D. InclinometersInclinometersE.E. Tape measuresTape measures

► Joint specificJoint specific► There is not one good test for over-all There is not one good test for over-all

flexibilityflexibility

A.

B.

C. D.

YMCA Sit and Reach TestYMCA Sit and Reach Test

► Place a yard stick on the floorPlace a yard stick on the floor► At a right angle, place a piece of tape at the At a right angle, place a piece of tape at the

15 inch mark15 inch mark► Have participant sit with the yard stick Have participant sit with the yard stick

between their legsbetween their legs► Heals of the feet should touch the edge of Heals of the feet should touch the edge of

the taped line and be 10 to 12 inches apartthe taped line and be 10 to 12 inches apart

Sit and Reach BoxSit and Reach Box► If a standard sit-and-reach box is available, If a standard sit-and-reach box is available,

heels should be place against the edge of the heels should be place against the edge of the boxbox

► The participant slowly reaches forward with both The participant slowly reaches forward with both hands as far as possible, holding this position hands as far as possible, holding this position momentarilymomentarily

► Knees remain extendedKnees remain extended► Participant should not hold their breathParticipant should not hold their breath► This norms are based on a sit-and-reach box in This norms are based on a sit-and-reach box in

which the “zero” point is set at 26 cm. When which the “zero” point is set at 26 cm. When using a box in which the “zero” point is set at 23 using a box in which the “zero” point is set at 23 cm, subtract 3 cm from each value in the tablescm, subtract 3 cm from each value in the tables

ACSM Testing

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