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Essential Pre-Screening Procedures for Client Fitness Assessment

This guide outlines critical pre-screening procedures to ensure client safety and accurate fitness assessment. Focused on minimizing injury risk and highlighting health concerns, it covers necessary evaluations such as PAR-Q, medical history, and risk factor analysis. The initial procedures include client interaction, informed consent, and risk stratification based on ACSM guidelines. Key assessments involve physical exams, lab tests, and exercise testing. Understanding the validity, reliability, and objectivity of tests reinforces accurate interpretations of fitness results for better client communication.

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Essential Pre-Screening Procedures for Client Fitness Assessment

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  1. Pre-screening Procedures-What you need to know and do before testing your clients

  2. Before Assessing Fitness: • Reduce risk of injury or death during assessment or activity • Identify lifestyle habits and health status which may prohibit assessment • Identify lifestyle habits and health status which may be risk factors for disease (risk classifications)

  3. A Comprehensive Health Evaluation Includes: • PAR-Q • Medical History • Signs and Symptoms • CHD Risk Factor Analysis • Disease Risk Classification/Initial Stratification • Physical exam or medical clearance • Lab. Tests (blood lipids, glucose) • Resting HR, BP and EKG measurement • Graded Exercise Test (GXT)

  4. Initial Procedures: • Provide pre-test instructions (p. 39 Heyward) • Greet the client • Explain the purpose of the evaluation • What you are testing • The procedures of the test

  5. Pre-test Screening Procedures • Page 20, ACSM • Administer Par-Q, Medical History and refer to Dr. if necessary • READ Screening documents and assess disease risk • Note risk factors for CAD (p. 22) • Note signs/symptoms (p. 23-4) • Stratify based on risk (p. 27)

  6. Informed Consent • Administer immediately prior to testing/training • Must ensure that participant understands the purposes and risks associated with the test or the exercise program • Must state that client was given an opportunity to ask questions and has sufficient info. to give consent • If < 18 yoa, must have parent or guardian sign

  7. Initial Risk Stratification • Risk Stratification - likelihood of an event occurring during activity (p. 27 ACSM) • Low risk = Men < 45 and women < 55 yoa who are asymptomatic and have no more than 1 risk factor • Moderate risk = Older individuals (men > or = 45 yoa and women > or = 55 yoa) or those with 2+ risk factors • High risk = Those with 1 + signs/symptoms or with known disease

  8. Is medical clearance and supervision necessary? • See Table 2-1, page 20 ACSM • Level 3

  9. Testing order • INFORMED CONSENT • Resting BP and HR • Body Composition • Cardiorespiratory Endurance • Muscular Fitness • Flexibility

  10. Testing Environment: • Professional appearance/attitude • Privacy, safe, clean • Comfortable temperature (~ 70-74 degrees) • Functional, calibrated equipment • Use of appropriate equipment (valid, reliable, objective)

  11. Test Validity • The ability of a test to ACCURATELY measure what it is supposed to measure • Direct measurement of VO2 with metabolic equipment (gold standard) compared to indirect measurements of VO2 using equations to estimate value • Validity coefficient - relation between predicted scores and criterion scores (< or = 1.0)

  12. Test Reliability • The ability of a test to yield CONSISTENT and stable scores • Reliability coefficient: the extent to which a test can reproduce the same information each time it is given. (= or < 1.0). Most fitness tests have coefficients of 0.90 or higher.

  13. Relation between Test Reliability and Validity • It is NOT possible for a test to be valid and not reliable (if it measures what it claims, it will do it consistently) • It IS possible for a test to be highly reliable without being valid (measuring what it claims to measure) • Example: body composition using home BIA scales

  14. Test Objectivity • Objective tests yield similar scores for a given individual when the same test is performed by different technicians • Calculate the correlation between pairs of scores measured on the same individual by different technicians • Objectivity coefficient: cannot exceed 1.0. Trained technicians should have 0.90 or better

  15. Test Interpretation • Classification of fitness tests results provides a context for clients –ALWAYS CLASSIFY ALL RESULTS!! • Consider the data you are using to evaluate – criterion or norm-referenced • Interpretation for clients should be simple and positive

  16. Interpretation • Criterion referenced – no comparison to others, provide a minimum acceptable level • Norm-referenced – compared to the population from which the norms were established • Interpreting percentages • Body Comp. interpretation (pp. 66-67 ACSM vs. p.162 Heyward)

  17. Female, aged 35 years • Total Cholesterol = 220 mg/dl • BP = 120/80 mm Hg • BMI = 24 kg/m2 • Non-smoker • Active • MI in mother at age 66 years • Diabetic

  18. Male, aged 46 years • No signs/symptoms • BP, CHO, Glucose, BMI all WNL • Non-smoker • Active • No family history

  19. Male, aged 27 years • BP = 138/96 mm Hg • CHOLESTEROL = 180 mg/dl • LDL = 150 mg/dl • BMI = 30 kg/m2 • Sedentary • Smoker • No family history

  20. Female, aged 53 years • Cholesterol = 210 mg/dl • HDL = 65 mg/dl • LDL = 120 mg/dl • Non-smoker • No family history • BMI = 22 kg/m2 • BP = 132/86 mm Hg • Glucose = WNL

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