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HPEX 441 Test 1

Terms

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PHYSICAL ACTIVITY
- bodily movement that is produced by the contraction of skeletal muscle and that substantially increases energy expenditure.
- any activity above resting
PHYSICAL FITNESS
- a set of attributes that people possess or achieve that relates to the ablility to perform physical activity.
- Comprised of skill-related, health-related, and physiologic components
SKILL RELATED COMPONENTS OF PHYSICALL FITNESS
- agility
- balance
- coordination
- speed
- power
- reaction time
HEALTH RELATED PHYSICAL FITNESS
- ability to perform daily activities
- possession of traits and capacities that are associated with a low risk of premature development of hypokinetic diseases (associated with physical inactivity)
- Components
- cardiovascular endurance
- muscular strength
- muscular endurance
- flexibility
- body composition
PHYSIOLOGIC FITNESS
- includes nonperformance components that relate to biological systems influenced by habitual activity
- metabolic fitness
- morphologic fitness
- bone integrity
METABOLIC FITNESS
The status of metabolic systems and variables predictive of the risk for diabetes and cardiovascular disease
MORPHOLOGIC FITNESS
The status of body compositional factors such as body circuference, body fat content, and regional body fat distribution
BONE INTEGRITY
The status of bone mineral density
PHYSICAL ACTIVITY INTENSITY
- very light
- light
- moderate
- hard
- very hard
- maximal
RELATIVE INTENSITY
- defined using a percentage of an individual's max oxygen consumption or heart rate reserve
- mL/kg
ABSOLUTE INTENSITY
- Defined using METs with values for each intensity category provided across a range of functional capacities
- L/min
1 MET
= 3.5 mL/ kg min oxygen
PHYSICAL ACTIVITY RECOMMENDATIONS
- change in focus from formal exercise prescriptions to broader public health perspective
- balance of feasibility and efficacy
- traditional exercise programming may overlook numerous health benefit associated with regular, moderate-intensity activity
- power of persuasion also found in the surgeon's general report, ACSM position stand, IOM, and IASO
BENEFITS OF PHYSICAL ACTIVITY
- Participation in regular physical activity of sufficient frequency, intensity, and duration has been shown to offer many physiological metabolic and psychological benefits
- reduction in development of CAD
- reduction in incidence of premature death
- improvement in cardiovascular and respiratory function
- decreased morbidity and mortality
- decreased anxiety and depression
- enhanced physical function and independent living in older persons
- enhanced feelings of well being
- enhanced performance of work, recreational, and sport activities
SURGEON GENERAL'S REPORT
- significant health benefits can be obtained by including a moderate amount of physical activity on most, if not all, days of the week. Through a modest increase in daily activity, most Americans can improve their health and quality of life.
- Additional health benefits can be gained through greater amounts of physical activity, People who can maintain a regular regimen of activity that is longer in duration or of more vigorous intensity are likely to derive greater benefit
2001 ACSM POSITION STAND
- overweight adults should increase their activity to approx. 45 minutes per day
2002 INSTITUTE OF MEDICINE
- recommended 60 minutes perday of moderate intensity activity to prevent weight gain
2003 IASO
- 45- 60 minutes of moderate physical activity per day to prevent weight gain and 60-90 to prevent weight regain
DOSE- RESPONSE RELATIONSHIP
- What is the minimal exercise dose for improvements in cardiovascular health or physical fitness?
- What additional dosage is required for additional benefits?
- What is the minimal dosage for prevention of disease?
- There is evidence for an inverse relationship between physical activity and several health outcomes
EXERCISE RISKS
- Regular physical activity reduces incidence of atheroschlerosis
- regular physical activity acutely increases risk of sudden cardiac death and acute MI
- Exercise only affects Cardiovascular events in those individuals with non-normal CV systems
- Risk of exercise for any population depends on its CV disease prevalence
SUDDEN DEATH AMONG YOUNG INDIVIDUALS
- ages less than 35 years
- incidence of death within 1 hour of sport participation among US high school college athletes is 1 death per year for every 133,000 men and 769,000 women
- Congenital and non-atherosclerotic disease
- Most common disease is hypertrophic cardiomyopathy (much higher to men 50:1)
- The second common disorder was coronary artery anomalies
EXERCISE-RELATED CARDIAC EVENTS IN ADULTS
- Estimated at 1 death per year for every 15,000 to 18,000 individuals
- higher in individuals who do vigorous exercise compared to those who do moderate intensity exercise
- higher in those individuals who exercise infrequently
- commmon cause is acute atherosclerotic plaque ruptures
RISK OF CARDIAC EVENTS ASSOCIATED WITH EXERCISE TESTING
- risk will vary with population studied
- In a mixed population there are 6 cardiac events per 10,000 tests
RISKS OF CARDIAC EVENTS DURING CARDIAC REHABILITATION
- individuals at greaterst risk during vigorous physical activity (100 times greater risk)
- Proper monitoring and facilities manage this risk
PREVENTION OF EXERCISE RELATED CARDIAC EVENTS
- Pre-participation physicals
- Periodic health screening
- approprate evaluation prior to starting a program like health history and stress testing
PURPOSE OF HEALTH APPRAISAL
- Appraisal techniques
- Health History Appraisal
- Rationale for Fitness Assessment
- Informed consent
- Environmental and Lab Concerns
- Fitness Assessment
- Legal implications of Emergency care
- provide info relevant to the safety of fitness testing before beginning exercise training
- Identify known diseases and risk factors for CAD and other potentially preventable chronic disease
- Identify additional factoors that require special consideration when developing an appropriate exercise program
LEVEL 1: ACSM Pre-Participation Screening for Self-Guided Activity
- Risk Stratification and Medical Clearance
1. Complete ACSM/AHA Questionaire or PAR-Q
2. Determine need for medical clearance and obtain if recommended
3. Proceed to Level 2
LEVEL 1: ACSM Pre-Participation Screening for Professionally Guided Exercise Testing
- Risk Stratification and Medical Clearance
1. Identify presence of major CAD risk factors
2. Identify signs and symptoms of CV, pulmonary, and or metabolic disease through questionaire
3. Determine ACSM risk category for Level 2 and 3
4. Determine need for medical clearance prior to testing and or participation
5. Proceed to level 2 and follow recommendations based on risk category
LEVEL 2: ACSM Pre-Participation Screening for Self-Guided Activity
- Additional Pre-Participation Assessment
- initiate general physical activity recommendations as outlined by the U.S. Surgeon General
- Look for aerobic and resistance training regimens in the ACSM Fitness Book
- Individuals needing medical clearance from Level 1 would benefit from a professionally-guided pre-exercise assessment and prescription
LEVEL 2: ACSM Pre-Participation Screening for Professionally Guided Exercise Testing
(LOW RISK)
- Perform informed consent for testing and or training
- Complete appropriate assessment procedures like medical history, physical examination, laboratory tests, and body composition
LEVEL 2: ACSM Pre-Participation Screening for Professionally Guided Exercise Testing
(MODERATE RISK AND HIGH RISK)
- Perform informed consent for testing and or training
LEVEL 3: ACSM Pre-Participation Screening for Professionally Guided Exercise Testing
(LOW RISK)
- Exercise Test Considerations
- Further medical examination and exercise testing not necessary prior to initiation of exercise training
- Medical supervision for submaximal or maximal exercise testing not necessary
LEVEL 3: ACSM Pre-Participation Screening for Professionally Guided Exercise Testing
(MODERATE RISK)
- Medical examination and exercise testing recommended prior to initiation of vigorous exercise training
- Medical supervision recommended for maximal exercise testing
LEVEL 3: ACSM Pre-Participation Screening for Professionally Guided Exercise Testing
(HIGH RISK)
- Medical examination and exercise testing recommended prior to initiation of moderate or vigorous exercise training
- Medical supervision recommended for maximal or submaximal exercise testing.
CAD Risk Factors from FAMILY HISTORY
- Myocardial infarction
- coronary revascularization
Sudden death before 55 years of age in father or other male first degree relative
- Sudden death before 65 years of age in mother or other female first degree relative
CAD Risk Factors from CIGARETTE SMOKING
- Current cigarette smoker or those who quit withing the previous 6 months
CAD Risk Factors from HYPERTENSION
- Systolic blood pressure >140 mm Hg or diastolic >90 mm Hg
- confirmed by measurements on at least 2 separate occasions or on antihypertesive medication
CAD Risk Factors from DYSLIPIDEMIA
- LDL cholesterol >130 mg/dl or HDL cholesterol <40 mg/dl
- Total serum cholesterol that is greater than 200 mg/dl
CAD Risk Factors from IMPAIRED FASTING GLUCOSE
- Fasting blood glucose >100 mg/dL confirmed by measurements on at least two separate occasion
CAD Risk Factors from OBESITY
- Body Mass Index >30 kg m^2
- or Waist girth >102 cm for men and >88 cm for women
- or Waist/hip ratio is >0.95 for men and >0.86 for women
CAD Risk Factors from SEDENTARY LIFESTYLE
- Persons not participating in a regular exercise program or not meeting the minmal physical activity recommendations from the U.S. Surgeon General's Report
NON-MODIFIABLE RISK FACTORS
- Age
- Male Gender
- Family History
MODIFIABLE RISK FACTORS
- cigarette smoking
- hypertension
- poor cholesterol profile
- diabetes
- physical inactivity
OTHER RISK FACTORS FOR CAD
- Obesity
- Elevated lipoprotein (>30 mg/dl)
- Homocysteine(vitamin B6, B12, Folate (lowers homocysteine) supplements may help)
- Free Radicals (vitamin E and C supplementation may reduce oxidative stress)Free radicals are produced when energy is produced.
MAJOR SIGNS OR SYMPTOMS SUGGESTIVE OF CARDIOVASCULAR< PULMONARY OR METABOLIC DISEASE
- Pain or discomfort in the chest, jaw, neck arms, or other areas suggestive of ischemia
- Shortness of breath at rest or with mild exertion
- Dizziness or syncope (loss of consciousness)
- Orthopnea (labored breathing at certain positions) or parozysmal nocturnal dyspnea (fluid collects in alveoli when lying down)
- Ankle edema from poor circulation which is a sign for congestive heart failure
- Palpitations or tachycardia
- intermittent claudication (reduction of blood flow to periperal muscles)
- known heart murmur
- unusual fatigue or shortness of breath with usual activities
COMPENSATED CONGESTIVE HEART FAILURE
- Have congestive heart failure
- Have the ability to maintain 5 L/min for cardiac output
- Something else is able to maintain profusion
DECOMPENSATED CONGESTIVE HEART FAILURE
- Have CHF
- Not able to maintain cardiac output
- Heart gets huge
- Kidneys retain fluid to get more blood flow
PAR-Q: PHYSICAL ACTIVITY READINESS QUESTIONAIRE
- self administered
- easy to use and cost effective
- limitations
CUSTOMIZED QUESTIONAIRES/ASSESSMENT
- personal health history
- health behaviors
- risk behaviors
LOW RISK STRATIFICATION CATEGORY
- Men <45 years of age
- Women <55 years of age
- with asymptomatic and meet no more than one risk factor threshold
MODERATE RISK STRATIFICATION CATEGORY
- Men >45 years
- Women >55 years
- Those who meet threshold for 2 or more risk factors
HIGH RISK STRATIFICAION CATEGORY
- individuals with one or more signs and symptoms suggestive of cardiovascular, pulmonary, or metabolic disease
- Known cardiovascular, pulmonary, or metabolic disease
AACVPR Risk Stratification Criteria (LOWEST RISK)
- All characteristics must be present
- absence of complex ventricular dysrhythmias during exercise tsting and recovery
- absence of angina or other significant syptoms
- presence of normal hemodynamics (HR, blood pressure) during exercise testing and recovery
- Functional capacity >7 METs
- Resting ejection fraction >50%
- Uncomplicated myocardial infarction or revascularization procedure
- Absence of complicated ventricular dysrhythmias at rest
- absence of congestive heart failure
- absence of signs or symptoms of postevent/postprocedure ischemia
- Absence of clinical depression
AACVPR Risk Stratification Criteria (MODERATE RISK)
- Any one or combination of these findings
- Presence of angina or other significant symptoms occuring at high levels of exertion
- Mild to moderate level of silent ischemia during exercise testing or recovery(ST segment depression <2 mm from baseline)
- Functional capacity <5 METs
- Rest ejection fraction = 40%-49%
AACVPR Risk Stratification Criteria (HIGH RISK)
- Any one or combination of these findings
- Presence of complex ventricular dysrhythmias during exercise testing or recovery
- presence of angina or other significant symptoms occuring during low levels of exertion
- High level of silent ischemia (ST segment depression >2mm from baseline) during exercise testing or recovery
- Presence of abnormal hemodynamics with exercise testing or recovery
- Rest ejection fraction <40%
- History of cardiac arrest or sudden death
- Complex dysrhythmias at rest
- Complicated myocardial infarction or revsacularization procedure
- Presence of congestive heart failure
- Presence of signs or symptoms of postevent/ postprocedure ischemia
- Presence of clinical depression
EJECTION FRACTION
= End diastolic volume - blood left in left ventricle
= stroke volume/end diastolic volume
stroke volume = diastolic - systolic
RATIONALE FOR THE FITNESS ASSESSMENT
- Establish a baseline
- Aid in program design
- Establish realistic and prudent goals
- Evaluate changes and appropriateness of program
- provide feedback and motivation
EXERCISE TESTING
- maintaining a high degree of safety depends on
- knowing when not to perform tests
- knowing when to terminate
- being prepared for emergencies that might arise
ABSOLUTE CONTRAINDICATIONS TO EXERCISE TESTING
- Recent significant change in resting ECG
- Unstable angina
- suspected or known dissecting aneurysm
RELATIVE CONTRAINDICATIONS TO EXERCISE TESTING
- Left main coronary stenosis
- uncontrolled metabolic disease
- ventricular aneurysm
INSTRUMENT AND STANDARDIZATION FOR WEIGHT
- instrument is a balance such as a beam scale
- Standardization:
- nude or hospitalization
- facility developed standards
INSTRUMENT AND STANDARDIZATION FOR HEIGHT
- Instrument used is a stadiometer
- No shoes
- Heels together
- Take after a deep inhalation
- look at measurements at head level
BODY MASS INDEX
- BW(kg)/Ht(m^2)
- Underweight: <18.5 kg/m^2
- Normal: 18.5- 24.9
- Overweight: 25- 29.9
- Obesity I: 30-34.9
- Obesity II: 35- 39.9
- Obesity III: >40
CIRCUMFERENCES
- Determines pattern of body fat distribution
- Abdomen
- Arm
- Buttocks/hips
- calf
- forearm
- Hips/Thigh
- Mid-thigh
- Waist
- all measurements should be made with a flexible inelastic tape measure
- The tape should be placed on the skin surface without compressing the subcutaneous adipose tissue
- If Gulick spring loaded handle is used, the handle should be extended to the same marking with each trial
- Take duplicate measures at each site and retest if duplicate measurements are not within 5 mm
- rotate through measurement sites or allow time for skin to regain normal texture
Android obesity
– abdominal fat
- Associated more with CHD, hypertension, and Type II diabetes
Gynoid obesity
- hip and thigh fat
ABDOMEN CIRCUMFERENCE
(primary)
- subject is standing upright and relaxed
- horizontal measure taken at the greatest anterior extension of the abdomen, usually at level of umbilicus
ARM CIRCUMFERENCE
- Subject is standing erect with arms hanging freely at the sides with hands facing the thigh
- horizontal measure is midway between the acromion and olecranon processes
BUTTOCKS/HIPS CIRCUMFERENCE
(primary)
- With subject standing erect and feet together
- horizontal measure is taken at the maximal circumference of buttocks
CALF CIRCUMFERENCE
- subject standing erect and feet 20 cm apart
- horizontal measure taken at the level of max circumference between the knee and ankle, perpendicular to the long axis
FOREARM CIRCUMFERENCE
- Subject standing, arms hanging downward but away from trunk and palms facing anteriorly
- a measure perpendicular to the long axis at the maximal circumference
HIPS/THIGH CIRCUMFERENCE
- subject standing, legs slightly apart
- horizontal measure is taken at the maximal circuference of the hip/proximal thigh just below the gluteal fold
MID-THIGH CIRCUMFERENCE
- subject standing and one foor on a bench so the knee is flexed
- a measure is taken midway between the inguinal crease and the proximal border of the patella perpendicular to the long axis
WAIST CIRCUMFERENCE
(primary)
- subject standing, arms at the sides, feet together, and abdomen relaxed
- a horizontal measure taken at the narrowest part of the torso directly above the iliac crest
SKINFOLD MEASURES
- Regression equations determined from hydrostatic weighing
- Amount of subcutaneous fat is proportional to the total amount of body fat
- Accuracy depends on skill and experience of technician
- All measurements should be made on the right side of the body with the subject standing upright
- Caliper should be placed directly on the skin surface, 1 cm away from the thumb and finger, perpendicular to the skinfold, and halfway between the crest and the bsae of the fold.
- Don't let go of pinch
- Wait 1 to 2 seconds before reading caliper
- Take duplicate measures at each site and retest if duplicate meaurements are not within 1 to 2 mm.
- Rotate through measurement sites or allow time for skin to regain normal texture and thickness
ABDOMINAL SKIN FOLD
- vertical fold
- 2 cm to the right side of the umbilicus
BICEPS SKIN FOLD
- vertical fold
- on the anterior aspect of the arm over the belly of the biceps muscle- 1 cm above the level used to mark the triceps site
TRICEPS SKIN FOLD
- vertical fold
- on the posterior midline of the upper arm
- halfway between the acromion and olecranon processes
- arm is held freely to the side of the body
CHEST/PECTORAL SKIN FOLD
- Diagonal fold
- MEN- 1/2 the distance between the anterior axillary line and the nipple
- WOMEN- 1/3 the distance between the anterior axillary line and the nipple
MEDIAL CALF SKIN FOLD
- vertical fold
- maximum circumference of the calf on the midline of its medial border
MIDAXILLARY SKIN FOLD
- Vertical fold
- On the midaxillary line at the level of the xiphoid process of the sternum
- horizontal fold taken at the level of the xiphoid/sternal border in the midaxillary line
SUPRAILIAC SKIN FOLD
- diagonal fold
- in line with the natural angle of the iliac crest
- taken in the anterior axillary line immediately superior to the iliac crest
SUBSCAPULAR SKIN FOLD
- Diagonal fold
- 1 to 2 cm below the inferior angle of the scapula
THIGH SKIN FOLD
- vertical fold
- on the anterior midline of the thigh
- midway between the proximal border of the patella and the inguinal crease
DENSITOMETRY
- Hydrostatic weighing
- Plethysmograph

%fat = (457/body density) - 414.2

%fat = (495/body density)- 450
BIOELECTRICAL IMPEDANCE
- Weak current passed between electrodes
- Mass of fat-free tissues is proportional to the electrical conductivity of the body
- Fat is a poor conductor of electrical current
- More Fat, More impedance
DEXA
- 3 compartment model (fat mass, mineral-free lean mass, and mineral stores)
- Low-level radiation
- Expensive, not readily accessable
ADVANTAGES/ DISADVANTGES FOR SKINFOLD
- highly regarded technique
- prone to many sources of error
- not more accurate than hydrodensitometry
- SEE = +/- 3.5%
ADVANTAGES/ DISADVANTAGES FOR BIOELECTRICAL IMPEDANCE
- less technician training required compared to skinfolds
- Numerous pretest control conditions have to be followed by client
- SEE = +/- 4.6% to 5%
% BODY FAT STANDARDS FOR WOMEN
- Essential fat = 8-12%
- Athletic = 12-22%
- Obese (<34 years)= >36%
- Obese (35-55 years) = >39%
- Obese (>56 years) = >39%
% BODY FAT STANDARDS FOR MEN
- Essential fat = 3-5%
- Athletic = 5-13%
- Obese (<34 years)= >22%
- Obese (35-55 years) = >26%
- Obese (>56 years) = >26%
EQUATION FOR LBS. OF FAT AND LEAN TISSUE
Lbs. of fat = body weight X %fat
Fat free weight (lean tissue) = Body weight - lbs. of fat
EQUATION FOR IDEAL BODY WEIGHT
Women= Fat Free Weight/ (1-.2)

Men = Fat Free Weight/ (1-.15)
CM to INCHES
1 inch = 2.54 centimeters
LBS. to KG
1 kg = 2.2 lbs
ADVANTAGES FOR STEP TESTS
- simple
- portable
- indestructible
- permanent calibration
DISADVANTAGES FOR STEP TESTS
- awkward
- not accurate when looking at VO2
- difficult to pace
ADVANTAGES FOR CYCLE ERGOMETER
- ease of obtaining many measures
- fairly inexpensive
- minimal upper body movement
DISADVANTAGES FOR CYCLE ERGOMETER
- local fatigue
- not accustomed to cycling
- equipment must be maintained and calibrated
SETTING APPROPRIATE RESISTANCE ON SUBMAXIMAL CYCLE ERGOMETER TESTS
- Astrand Rhyming: initial resistance is 1.0kp (300kgm/min) for females and 2.0kp (600kgm/min) for males. If resistance doesn't obtain a heart rate between 120 bpm and 170 bpm then increase resistance by 0.5 kp
- YMCA: initial resistance is 0.5kp (150 kgm) and increases with heart rate
- Measure kp on side of bike by either adding weight or turning the knob clockwise
ASTRAND RHYMING CYCLE ERGOMETER EQUIPMENT
- cycle ergometer
- timing clock
- calibration weight
- metronome
ASTRAND RHYMING CYCLE ERGOMETER PROCEDURE
1. Subject should be dressed appropriately
2. Calibrate cycle ergometer using standard procedures
3. Record the weight of the subject without shoes
4. Record age in years
5. Properly adjust seat height and ensure that the resistance is set to zero.
6. Have subject begin pedaling and then increase resistance to initial workload (females = 300 kgm/min, males = 600 kgm/min)
- Each subject will ride for a total of 6 minutes
8. Record the heart rate during the last 10 seconds of each minute
9. The goal is to obtain two heart rates during the 5th and 6th minutes that are within 5 beats of one another
11. Use the table provided to determine predicted VO2max
ASTRAND RHYMING CYCLE ERGOMETER CALCULATIONS
1. Average the 5th and 6th minute heart beats
2. Find the heart rate and resistance on table to find the estimated VO2 max
YMCA SUBMAXIMAL CYCLE ERGOMETER PRE-TEST PROCEDURE
1. Greet subject and explin testing procedures
2. Subject fills out PAR-Q form. If subject answers yes to any question inform them that they will need to see a physician before testing can be continued
3. Ask the subject if he or she has any questions prior to starting the test
4. Obtain subject's weight without shoes
5. Complete top portion of recording form and data sheet
6. Calculate age-predicted max heart rate
7. Obtain and record resting heart rate and blood pressure while subject is seated
YMCA SUBMAXIMAL CYCLE ERGOMETER TEST PROCEDURE
1. Adjust cycle seat to appropriate height
2. Have subject sit on cycle ergometer
3. Set metronome to appropriate bpm (100 bpm)
4. Explain pedal cadence
5. Explain RPE chart
6. Ask if the subject has any questions
7. Allow subject to warm up on the cycle ergometer for 2-3 minutes at 50 rpm at first workload
8. Subject will begin the first 3 minute stage at 150 kgm/min. Obtain and record all measurement on data sheet
9. Sequence of measurements
- Minute 2:00- heart rate
- Minute 2:15- RPE
- Minute 2:30- blood pressure
- Minute 3:00- heart rate
10. Adjust workload for the next stage based on figure
11. Continue to obtain and record data from each stage at appropriate time intervals
12. When test is complete, decrease intensity to allow for cool down
13. Use grid and record data to estimate max oxygen consumption
YMCA SUBMAXIMAL CYCLE ERGOMETER TEST CALCULATIONS
1. Plot 2 points for the 2 heart beats greater than 120bpm with their resistance level
2. Draw a line through the max heart rate
3. Draw a line through the 2 points to the max heart rate line
4. Draw a perpendicular line down from the point where the 2 point line and the max heart rate line meet. This is the predicted max workload and O2 uptake
YMCA 3-MINUTE STEP TEST PROCEDURE
1. Demonstrate stepping technique for subject
- four counts- right foot up onto bench 1, left foot up on bench 2, right foot down to the floor 3, and left foot down to the floor 4
- Allow subject practice time
2. Set timing clock to 5 minutes
3. Start metronome and timing clock when subject begins stepping
4. Offer verbal instructions if stepping pattern or rate is inaccurate
5. Subject will step for 3 minutes
6. Following the 3 minutes have the subject immediately sit down
7. Begin taking heart rate with the stehoscope within 5 seconds
8. Subject can also palpate pulse, providing a double check on the count
9. Count the pulse for one full minute
10. The one minute pulse count is the score for the test and should be recorded.
YMCA 3-MINUTE STEP TEST CALCULATIONS
1. Find the heart rate score under the appropriate gender and age
2. This will tell you the category the person is in
QUEENS COLLEGE STEP TEST PROCEDURE
1. Demonstrate stepping technique for the subject
- four counts- right foot up onto bench 1, left foot up on bench 2, right foot down to the floor 3, and left foot down to the floor 4
2. Allow subject practice time
3. Set timing clock to 5 minutes
4. Start metronome and timing clock when subject begins stepping
5. Offer verbal instructions if stepping pattern or rate is inaccurate
6. Subject will step for 3 mintues
7. Following the 3 minutes have the subject stop and remain standing
8. Wait 5 seconds, and begin taking heart rate for 15 seconds
QUEENS COLLEGE STEP TEST CALCULATIONS
Use equations to predict VO2max (ml/kg/min)
Males:
Predicted VO2max = 111.33 - (0.42 X heart rate)

Females:
Predicted VO2max = 65.81- (0.1847 X heart rate)

SEE is 16%
PRINCIPLES SUPPORTING THE USE OF SUBMAXIMAL TESTS TO ESTIMATE MAX OXYGEN CONSUMPTION
- heart rates
- age
- gender

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