CHAPTER 7: Health and fitness assessment: Collecting and Analyzing Information
The PT Business Academy (PTBA) Personal Training Success System (PTSS) encompasses all aspects of a personal trainer’s work, guiding you toward service excellence. As an aspiring personal trainer, you’ve now acquired the foundational knowledge needed to conduct the assessment process and analyze the collected data effectively. This is a vital part of the 8th stage of the PTSS – Professionalism & Business.
Professionalism begins with completing essential tasks that contribute to outstanding work and exceptional service. Understanding your client’s current status, potential limitations, and specific needs is crucial in the personal training process. In chapters 1 and 2, we provided valuable insights into your role as a personal trainer and psychological tools to build rapport, gain trust, and create a motivating and supportive environment for your clients. After delving into a deeper understanding of the human body in chapters 3, 4, 5, and 6, we will now explore methods and techniques for collecting physical data from our clients.
The second stage of the PTSS consists of two main components:
1) Health-related assessment and
2) Fitness-related assessment.
A health assessment evaluates an individual’s current health status, encompassing physical and mental well-being. This concept stems from the World Health Organization’s definition of “health,” which refers to “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (WHO, 1948). As discussed later in this chapter, a health assessment typically involves gathering information on the client’s medical history (HHQ – Health History Questionnaire), lifestyle habits (Lifestyle Questionnaire), and exploring the possible acute limitations of physical activity (PARQ – Physical Activity Readiness Questionnaire). It is important to note that health assessments conducted by personal trainers are not equivalent to those performed by healthcare providers.
The primary goal of a preliminary health assessment conducted by a personal trainer is to identify individuals who may have medical conditions that place them at a higher risk of adverse events during physical activity or exercise. Performing a health assessment before any exercise-related assessments is crucial for obtaining valuable knowledge about the client’s health status and their exercise-related risk of health complications (Pimenta et al., 2016).
On the other hand, fitness testing involves a series of exercises designed to evaluate a client’s overall health and physical condition. Some fitness tests serve medical purposes, while others determine an individual’s eligibility to participate in specific activities, such as the Army Combat Fitness Test (U.S. Army, 2020). These tests are considered the starting point for creating a suitable exercise program for general health and fitness purposes. In addition, they help to minimize the risk of injury and provide the trainer with the necessary insights to establish clear and effective fitness goals (Quinn, 2022a).
Health and fitness assessments are essential because people engage in physical activity for various reasons, such as losing weight and enhancing their appearance. While exercise positively impacts reducing a person’s risk of developing certain diseases, cancer, anxiety, depression, and more, the benefits far outweigh the risks; however, exercise also carries inherent risks (Warburton, Nicol, & Bredin, 2006). Most people can regularly participate in moderate to vigorous fitness activities without adverse health consequences, but this is not universally true. In all types of physical activity, including fitness testing, there is potential that physical exertion could exacerbate unforeseen, underlying pathologies, such as high blood pressure, abnormal heartbeats (arrhythmia), fainting, heart attack, stroke, or even death. Therefore, trainers should always be mindful of safety guidelines and take appropriate action when necessary. As a best practice, trainers should ensure that individuals seeking to participate in a regular exercise program are ready to do so and have a clean bill of health (ASCM,2018).
In this chapter, we will delve deeper into the process of health and fitness assessments, exploring various methods for collecting data, interpreting the results, and thus establishing a solid foundation for designing tailored exercise plans for your clients (discussed in Chapter 9). We will also discuss the importance of monitoring progress, adjusting training programs as needed, and celebrating your clients’ achievements. By the end of this chapter, you will have the tools and knowledge necessary to conduct comprehensive assessments that will provide the foundation for your program development and design.
That is why the purpose of health and fitness assessment is (ASCM, 2017):
1) identifying the client’s current exercise participation or fitness level (physically inactive individuals are at greater total risk for acute cardiac events than their physically active counterparts)
2) identifying the presence of signs or symptoms and/or known cardiovascular, metabolic, or renal disease
3) identifying clients with medical contraindications (health conditions and risk factors) who should be excluded from physical activity until those conditions have been corrected or are under control
4) detecting at-risk individuals who should first undergo medical evaluation and clinical exercise testing before initiating an exercise program
5) identifying those clients with medical conditions who should participate in medically supervised programs
6) desired exercise intensity.
The current ACSM exercise preparticipation health screening recommendations are primarily designed to minimize the likelihood of “at-risk” individuals experiencing severe exercise-related cardiovascular events, such as sudden cardiac death or acute myocardial infarction.
As you now understand the importance of fitness testing and health assessments, we want to emphasize the importance of following a specific order when performing assessments and tests with clients. This particular order is designed to ensure the accuracy of testing results and your client’s safety.
To better understand the sequence of assessments and tests, we will divide them into three phases:
1) Preliminary Health Assessment,
2) Collecting Resting Fitness Data, and
3) Exercise Testing.
Let’s briefly explore these three phases:
- Preliminary Health Assessment includes standard assessment forms and questionnaires given to clients. The most crucial questionnaire is the Health History Questionnaire (HHQ), which gathers health data indicating potential contraindications or points of caution for physical activity. The Physical Activity Readiness Questionnaire (PARQ) focuses on the acute state and current limitations to physical activity, while the HHQ collects information regarding past events or limitations. Additionally, the Lifestyle Questionnaire (LQ) provides valuable insights into behaviors that might negatively impact our clients’ health in the future, which we can aim to correct.
- Resting Fitness Data consists of various measurements taken while the client is at rest, such as resting heart rate, blood pressure, DNA testing, lab testing, and anthropometric data (height, weight, circumference measurements, caliper measurements, etc.).
- Exercise testing encompasses several tests to estimate clients’ current fitness levels and assess their abilities across various fitness components (excluding body composition, which is covered in the resting data). These tests will help you gain a comprehensive understanding of your client’s fitness capabilities and inform the development of tailored training programs.