7.4 Exercise Testing
- Specific assessment objectives: A clear purpose should be identified before the assessment. Knowing this objective will ensure the selection of the most suitable procedure.
- The “gold standard” (accurate measure): One test is considered the criterion or gold standard for each component, as it provides the most accurate measurement of a specific variable. If using the gold standard test is not feasible (due to expensive equipment or the need for trained personnel), alternative tests can be employed to estimate the variable of interest. However, this may result in some level of inaccuracy. Personal trainers should be aware of the potential measurement error when using an indirect test to estimate a fitness component.
- Equipment calibration: Devices like weight scales may produce different readings for the standard weight over time. To ensure accuracy, calibrate the device before the testing session and adjust it accordingly to produce an accurate reading.
- Standardization: Implementing uniform standards helps reduce or eliminate sources of variability.
- Interpretation issues: Currently, there are no established national or international standards for interpreting health-related physical fitness assessments. As a result, the interpretation of results may vary.
- Muscular Strength testing (including power, speed, agility, and reaction time)
- Muscular (Anaerobic) Endurance testing
- Cardiorespiratory (Aerobic or Cardiovascular) Endurance testing
- Flexibility testing
Important note: Exercise testing should be performed after a client's medical clearance if the client's health status indicates any potential risk to physical activity.
We highly recommend preparing information about testing protocols and the associated risks and benefits in the form of a brochure or other hand-outs for your clients. This information should be presented to your client before any exercise testing. In addition, it can be a part of the Informed Consent Form.
Providing more information to your clients is always helpful and ensures smooth testing protocols. The information should include instructions about what your client should be doing the day before testing and on the same day.
This information can include the following:
- Restriction of excessive physical activity the day before testing
- Ensuring enough sleep to be rested for testing day
- Wearing comfortable clothing that enables you to move without limitations
- Wearing appropriate shoes (running shoes should be reserved for running and walking and not be worn for regular fitness training)
- Provide a list of medications and supplementation the client is taking as well as the reasons why they are taking it
- Do not drink alcohol the day before testing, and of course, do not drink alcohol on testing day
- Do not smoke at least 3 hours before exercise testing
- Do not eat 2-3 hours before testing to avoid possible complications (nausea during testing, for example, or feeling sluggish after eating)
These precautions will save you time and help you present yourself most professionally to your clients. Being prepared and having all the needed information ready is crucial to being effective.
Considering the differences between conducting initial exercise testing at the beginning of your client’s fitness journey and performing regular follow-up tests with them is essential. At the beginning of the fitness journey, avoiding maximal testing protocols and opting for various sub-maximal tests instead is recommended. The rationale behind this approach is to minimize the risk of causing DOMS (Delayed Onset Muscle Soreness) in your client. Clients can still be evaluated on their baseline fitness levels while avoiding excessive muscle strain, which might discourage them from continuing their fitness journey.
As your client progresses and becomes more accustomed to physical activity, their muscles adapt, and the likelihood of experiencing DOMS decreases. According to Schoenfeld (2012): “During follow-up tests, it is less likely that DOMS will occur, but there is still a chance. Consequently, it may be more appropriate to incorporate maximal testing protocols depending on the client’s specific goals, training history, and overall progress. Nevertheless, it is crucial to closely monitor the client’s response to these tests, as overexertion can still cause DOMS.”
7.4.1 Observation
Before diving into specific testing protocols during your first session with a client, it is recommended by the PT Business Academy to begin with observational assessments. Observation during a fitness assessment performed by a personal trainer is crucial in understanding a client’s static posture and active movement patterns. In addition, this process helps trainers identify any imbalances, asymmetries, or limitations that may impact the client’s performance and safety during exercise (Clark et al., 2014). Employing a three-part assessment can provide valuable insights into the client’s physical condition, including a postural assessment, a movement analysis, and a flexibility and mobility assessment.
Visual Postural Assessment: This involves evaluating the client’s static posture while standing, sitting, or lying down. The trainer looks for deviations or misalignments in the body’s natural alignment, which could indicate muscle imbalances, joint restrictions, or other issues that may need to be addressed in their exercise program (Kritz & Cronin, 2008). In Chapter 4, Section 3, we have discussed the topic of posture, examined Common Postural Deviations, and analyzed the impact of sitting and phone usage on posture. There will be even more information shared about postural assessment.
Movement Analysis: This component of the observation process examines the client’s active movement patterns during various exercises or functional movements. The trainer assesses these movements’ quality, control, and efficiency, identifying compensations, weaknesses, or imbalances that may contribute to injury or limit performance (Cook et al., 2006). If you want to learn more about the PTBA movement analysis, ask us about our practical workshops to expand your theoretical knowledge through practical skills.
Flexibility and Mobility Visual Assessment: Lastly, the trainer evaluates the client’s flexibility and range of motion in specific joints and muscle groups. This assessment can help identify areas of tightness or restriction, which may impact the client’s overall movement and function (Norkin & White, 2016).
A comprehensive fitness assessment can include balance and core assessments and postural, movement, and flexibility assessments. Incorporating balance and core assessments into a fitness assessment allows for a more comprehensive understanding of the client’s overall functional capabilities and potential areas for improvement.
A personal trainer can gather crucial information through these observation techniques to design an effective and safe exercise program tailored to the client’s unique needs and goals. Addressing identified issues through targeted exercises, stretches, and modifications can help improve overall function and reduce the risk of injury.
Let’s look a bit deeper into these observational assessments.
Visual Postural assessment
Postural assessment involves observing and analyzing a person’s posture to identify potential issues or imbalances affecting their health, mobility, and overall posture. Personal trainers and health professionals commonly use this practice to assess and diagnose musculoskeletal imbalances, prevent injury, and develop effective exercise programs.
Posture refers to the relative arrangement of the body at any given moment, which is a composite of the positions of the body’s various joints. The position of each joint influences the position of the other joints.
Posture can generally be classified into two types: static and dynamic. It can also be further divided into correct (or neutral) and faulty (or poor) (Physio-Pedia, 2023).
Static posture represents the alignment of the body’s segments or how a person holds themselves “statically” or “isometrically” in space. Maintaining proper postural positions involves multiple postural muscles, generally deeper muscles with higher concentrations of type I muscle fibers that hold static positions or low-grade isometric contractions for extended periods.
Good posture or structural integrity is the state of musculoskeletal alignment and balance that allows muscles, joints, and nerves to function efficiently.
The correct posture entails horizontal alignment of the pelvis, providing a balanced foundation for the lumbar vertebrae. The concave curve of the lumbar spine and the convex curve of the thoracic region of the spine are sinusoidal and well-balanced, such that the cervical spine has a small concave curve. The head position is aligned with the pelvis, falling within the center of gravity.
Characteristics of correct alignment include:
- Body parts balanced and symmetrical around the center of gravity
- Balanced front-to-back and right-to-left distribution, allowing the spine to maintain its normal curvature (slight inward curve at the lower back and neck and slight outward curve in the upper back)
- Even and parallel joints to the floor (shoulders, hips, knees, and ankles)
- When standing, the line of gravity should be just in front of the ankles, through the center of the knee, hip, and shoulder joints, and the external auditory canal of the ear
- Equal distribution of body weight on both legs
- Proper sitting posture is similar to standing, except thighs are parallel to the floor, and knees are bent at a 90° angle. The centerline of gravity passes through the same positions of the spine from the hip to the ear as in standing.
However, suppose a participant exhibits deviations from the good posture in their static position. In that case, this may indicate muscle-endurance issues in postural muscles and/or potential joint imbalances. The movement begins from a static postural position, so poor posture often signifies dysfunctional movement. Although movement screens provide valuable information about neuromuscular efficiency, a static postural assessment is a starting point for trainers to identify muscle imbalances and potential movement compensations associated with poor posture (Kendall, 2005).
A static posture assessment can offer valuable insights into the following:
- Muscle imbalances at a joint and the working relationships of muscles around a joint
- Muscle imbalances often contribute to dysfunctional movement
- Altered neural actions of the muscles moving and controlling the joint
For example, tight or shortened muscles are often overactive and dominate movement at the joint, potentially disrupting healthy joint mechanics.
The procedure of an assessment
Static posture should be observed from the anterior, posterior, and lateral aspects, and the observations compared to give a holistic impression of the client (Pimenta et al., 2016).
The client should remove any sweatshirts or jackets to expose as much of the body as is appropriate so the trainer can get a good visual of the body’s alignment. The client should breathe naturally while standing in a normal and relaxed position. Sometimes closing their eyes for a moment, then opening them, can help clients get into a more relaxed and normal posture.
The trainer starts with the postural assessment, working from head to foot. Next, make a profile of the front of the client’s body, back, and both sides, looking for gross deviations and taking notes on what they see.
- Head – Notice if the client’s head is rotated or tilted, forward or neutral.
- Upper back – Is it kyphotic, flat, or neutral?
- Shoulders – Are they dropped or elevated, forward or internally rotated? Look at all the profiles. Does the client have a “winged” scapula?
- Pelvis – Trainers will need to touch the client, so they ask for permission first and let the client know what they are looking for. Trainers should check if the hips are level by having the client stand with hips and shoulders touching a wall. Does the client have an anterior (lordotic) tilt or a posterior (under tuck) tilt?
- Q-Angle – When standing with feet together, are the client’s hips significantly wider than their knees?
- Knees – Are they the same height? Do they have a gross medial or lateral rotation?
- Feet – The trainer should look at the client’s bare feet. Do they have an excessive arch? Are they flatfooted? When a client walks, look if the feet internally or externally rotate. Does the client pronate or supinate when walking, or is their weight evenly distributed on their feet?
- As clients walk, look at them from the feet up and the head down to see anything you overlooked while they were standing still. What is going on with the client’s feet? Does the client rotate through the torso while walking? Is the client’s arm swing consistent from side to side?
A photographic record may be made – with the client’s express consent, or a posture observation form completed, noting observations like “a forward head position,” etc.
The side-effect of poor posture
Poor posture, such as lordosis (excessive inward curvature of the lower back), kyphosis (excessive outward curvature of the upper back), flat back (reduced lumbar curve), hyperlordotic posture (exaggerated lumbar curve), and swayback (forward-leaning posture with an accentuated curve in the lower back), can lead to a variety of side effects.
These may include:
- Muscle strain and imbalance: Poor posture can cause some muscles to become tight, overworked, or weak, leading to muscle imbalances and strain.
- Joint stress and degeneration: Abnormal spinal curvatures can increase joint stress, potentially leading to premature wear and tear, arthritis, and other degenerative conditions.
- Pain and discomfort: Discomfort and pain can result from muscle strain, joint stress, or nerve compression. Typical areas of pain include the neck, shoulders, and lower back.
- Nerve compression: Poor posture can cause spinal misalignment, which may compress nerves and result in conditions like sciatica, radiculopathy, or other nerve-related issues.
- Reduced lung capacity: Kyphosis, in particular, can cause a decrease in lung capacity due to the compression of the ribcage, leading to shortness of breath or difficulty breathing.
- Digestive issues: Poor posture can compress abdominal organs, potentially resulting in digestive problems like acid reflux, constipation, or bloating.
- Poor circulation: Improper spinal alignment can impede blood flow, which may contribute to swelling or numbness in the extremities.
- Fatigue: Muscle strain and the energy required to maintain poor posture can lead to fatigue and reduced physical performance.
- Headaches: Muscle tension and nerve compression resulting from poor posture can contribute to tension headaches.
- Aesthetic concerns: Poor posture can lead to an unbalanced appearance and negatively impact self-esteem and body image.
- In women, it can lead to an imbalance in the core muscle leading to incontinence and/or pelvic organ prolapse.
When observing active movement, we assess dynamic posture- the body or its segments are moving—walking, running, jumping, throwing, and lifting. Observing active movement determines muscle imbalances effectively, and poor posture contributes to neural control. It also helps identify movement compensations (Whiting & Rugg, 2012). When compensations occur during movement, it usually indicates some form of altered neural action, commonly called “faulty neural control,” which normally manifests due to muscle tightness or an imbalance between muscles acting at the joint.
Movement analysis
Movement analysis based on visual observation is an essential tool for personal trainers. It allows them to assess their client’s ability to perform daily activities effectively and safely. By breaking down movement into five primary categories (Cook et al., 2006), trainers can better understand and evaluate their clients’ movement patterns:
- Bending/raising and lifting/lowering movements (e.g., squatting)
- Single-leg movements
- Pushing movements (in vertical/horizontal planes) and resultant movement
- Pulling movements (in vertical/horizontal planes) and resultant movement
- Rotational movements
Movement screens help trainers observe the efficiency and capability with which a client performs various activities of daily living. These observations can reveal imbalances, asymmetries, and compensatory movements that may have developed due to repeated, forced body positions throughout the day. For instance, a production worker might be exposed to frequent body positions that significantly impact their ability to move correctly.
By identifying these movement errors through basic visual observations, trainers can work to minimize their impact on the client’s movement patterns. This ultimately leads to improved performance, reduced risk of injury, and enhanced overall well-being for the client.
The procedure of an assessment
At the PTBA, we believe it’s essential to first assess your client’s natural motor skills without any adjustments. This approach allows you to observe their daily movement patterns without interventions, helping you evaluate any potential negative impacts on their posture and overall movement. As a personal trainer, we recommend you begin the assessment by asking the client to perform each exercise as they typically would, without any external load, to minimize the risk of injury or other unwanted outcomes.
During the client’s execution of the exercise, observe closely and provide only basic directions that enable you to assess their movement better (e.g., “go slower” or “go slightly faster”). Pay close attention to all details, and promptly document any significant observations. These cues may prove to be crucial later in the assessment process.
It’s important to acknowledge that every client you work with will likely have developed habits and compensatory movement patterns that significantly influence many of the issues they seek to address.
After observing their natural movement closely, it’s time to demonstrate proper form to the client. Once they have seen your demonstration, ask the client to perform the movements as you have shown them. During each movement, take note of the client’s ability to maintain proper joint alignment and form without pain. Finally, ask the client how their body feels while performing each movement and document their feedback (Bushman, 2017).
Here are some provided guidelines for observational movement analysis:
• Squats – The client should stand with feet hip to shoulder-width apart, chest lifted, abs engaged, and arms reaching forward. They should slowly lower into a squat position and repeat 5 to 10 times. Observe internal rotation of the hip (knees knocking), external rotation of the hip (knees bowing), leaning to one side or the other, and heels lifting up (Rippetoe & Kilgore, 2007).
- Lunges – The client should stand with feet hip to shoulder-width apart, right foot forward, and left foot back with the heel lifted. Weight should be in the heel of the front foot and on the ball of the back foot. The client should slowly lower the back knee toward the floor and return to standing. Repeat about five times on each leg. Look for hip, knee, and ankle alignment, internal/external rotation of the hip, the front knee sliding forward beyond the toes, the front heel lifting up, and/or balance issues. Notice if there is a difference on each side (Clark et al., 2014).
- Pull – Have clients perform a row, seated if necessary. The client should stand with feet hip to shoulder-width apart, chest lifted, abs engaged, and knees slightly bent. Using a tube or cable machine, the client should perform a row by pulling elbows toward the ribs, then return to the starting position. Have clients repeat 5 to 10 times. Observe whether clients can keep their shoulders down and retract their shoulder blades. Watch for activation of muscles (lats/rhomboids/mid traps), control through concentric and eccentric phases of contraction, and symmetry on both sides of the body (Schoenfeld & Contreras, 2016).
- Push – The client should perform a knee-based push-up with hands wider than shoulder-width apart. They should lower the push-up to 90 degrees at the elbow and press back up to the starting position, repeating 5 to 10 times. Look for back swaying, scapular stability/scapular winging, and symmetry during eccentric and concentric phases (Zatsiorsky & Kraemer, 2006).
- Core – The client should lie on their back with their knees bent and feet on the floor with the trainer’s hand under their low back. Instruct them to maintain pressure on the trainer’s hand. As the client maintains abdominal contraction, have them bring one leg up to 90 degrees at the knee and hip, then lower without arching through the spine. Repeat with the opposite leg. If the client does not have a problem with that, have them lift one leg to 90 degrees and hold, then bring the opposite leg to 90 degrees without arching through the spine. If the client has no problem with that, place the trainer’s hand under the client’s lumbar spine, and have the client lower both heels to the floor while maintaining a 90-degree angle at the knees. Ideally, the client should maintain the same pressure on the trainer’s hands until their feet touch the floor (Akuthota & Nadler, 2004).
Flexibility and mobility visual assessment
Using flexibility tests, assessing participants’ range of motion (ROM) effectively identifies body areas that may require focused stretching. Stiff, inflexible muscles and joints can increase the risk of injury and negatively impact the performance of even the simplest tasks. Therefore, during initial assessments of posture and movement, a trainer may choose to assess the flexibility of specific muscle groups suspected to have tightness or limited movement (Kisner & Colby, 2017).
After conducting the following flexibility assessments, note whether the ROM is “good” or “needs improvement” on the client’s chart. Instead of recording exact ROM measurements, address these areas by strengthening opposing muscle groups and lengthening tight muscles.
Piriformis/Medial glute – The client should sit upright on a bench, placing one ankle on the opposite knee. If the client’s shin is somewhat parallel to the floor, they have good ROM; if the knee points slightly upward at an angle, ROM is limited. Observe any differences between the right and left sides and note the symmetry of the client’s ROM.
Hamstring: passive straight leg raise – The client should lie supine on the floor (if the client experiences back pain when lying like this with both legs extended, have them bend one leg with their foot on the floor). The client should contract their abs, fully extend the leg, dorsiflex the foot, and lift the straight leg as high as possible. Observe how high the leg goes before it starts to bend at the knee or the spine begins pressing into the floor. Ideally, they should lift their legs close to 80 degrees. Again, note the symmetry of their ROM.
Hip flexor: Thomas test – While in a supine position, the client should bring one knee to the chest with the opposite leg extended. If the hip flexors are tight, the extended leg will bend at the knee, and/or the client’s head will lift off the floor. Observe differences on the right and left sides of the body (Kendall et al., 2005).
Pectoralis/lats – The client should remain supine with tight abs, spine neutral, and arms down to the side. The client should extend both arms up over their head until they are resting on or towards the floor. Observe whether the client can touch their hands, wrists, and elbows to the floor without arching the spine. If the client cannot reach the floor, they may have tight pecs and/or lats. Note the symmetry of the ROM.
Subscapularis/Teres major: shoulder mobility – The client should remain supine on the floor with abs tight, spine neutral, and elbows directly lateral to the shoulder. Keeping elbows in position, the client should externally rotate their forearms towards the ground. Observe whether the client can touch their hands and wrists to the ground without arching their spine. If they cannot, they have tight and weak internal rotators. Note the symmetry of the ROM (Page et al., 2010).
Quadriceps – The client should lie prone on the floor with arms crossed and head resting on the arms and legs extended. The client should bring one foot to their glute. The client should be able to bend more than 90 degrees at the knee. Note the symmetry of the ROM. Remember that clients with a lot of body fat or muscle may be restricted by the mass of the back of their leg, not necessarily by the tightness of the quadriceps (Norkin & White, 2016).
Numerous standardized tests are available for personal trainers to assess flexibility and range of motion (ROM). By following the test protocols and comparing the collected data to normative values, you can evaluate your client’s performance relative to established standards.
Some of the widely-used standardized flexibility or ROM tests include (taken from the book Assessments for Sport and Athletic Performance by David H. Fukuda, 2018) :
Sit and Reach Test: This test measures the flexibility of the lower back and hamstring muscles. The client sits on the floor with their legs extended straight in front of them and reaches forward, attempting to touch or surpass their toes. The distance reached is then recorded and compared to normative values.
Testing protocol:
- Have the client remove their shoes and sit on the floor with their legs fully extended and feet approximately hip-width apart.
- Place a measuring tape or sit-and-reach box on the floor between the client’s legs, with the zero end aligned with their feet.
- The client should place one hand on top of the other, then slowly reach forward as far as possible, sliding their hands along the measuring tape or box.
- Ensure the client maintains straight legs and does not bounce during the reach.
- Record the furthest point reached by the client’s fingertips. Repeat the test 2-3 times and use the best score for comparison.
The following table presents the normative values for the Sit and Reach Test based on age and gender. These values are derived from general population data. They can be used as a reference for interpreting an individual’s test results.
Back Scratch Test:
This test assesses the flexibility of the shoulder joint. The client reaches one arm overhead and down their back while the other arm reaches up from the lower back. The aim is to touch or overlap the fingers of both hands. The distance between the fingertips (or the overlap) is recorded and compared to normative values.
Testing Protocol:
- Instruct the client to stand up straight with their feet shoulder-width apart.
- Have the client reach one arm overhead, bending at the elbow to touch the upper back, palm facing the body.
- The client should then reach the other arm behind their back and up, attempting to touch or overlap the fingertips of both hands.
- Measure the distance between the fingertips or the overlap, if applicable.
- Repeat the test with the other arm overhead and compare the results to normative values.
The following table presents the normative values for the Back Scratch Test based on age and gender. These values are derived from general population data. They can be used as a reference for interpreting an individual’s test results.
Balance and Core
Given the importance of balance and the condition of the core musculature to fitness and overall quality of life, these baseline assessments should be collected to evaluate the need for comprehensive balance training and core conditioning during the early stages of a conditioning program. While dynamic balance correlates more closely with people’s daily activities, these tests are generally movement-specific and quite complex. Consequently, a trainer should aim first to evaluate the basic level of static balance that a participant exhibits by using the sharpened Romberg test or the stork-stand test.
Sharpened Romberg Test
(Sources: Black et al., 1982; Newton, 1989)
The Sharpened Romberg Test, also known as the Tandem Stance Test, is a simple yet effective assessment of an individual’s static balance and proprioception. It is primarily used to evaluate the integrity of the vestibular system and neurological function related to balance. The test is an adaptation of the traditional Romberg Test, which assesses balance with the feet together in a narrow stance.
In the Sharpened Romberg Test, the individual stands with one foot directly in front of the other, heel touching toe, and arms crossed over their chest. After the person is instructed to maintain that position with opened eyes for 30 seconds, the person is instructed to close their eyes and maintain this position for a specified duration, usually 30 or 60 seconds. The test administrator observes the person’s ability to maintain balance throughout the duration of the test.
The test is considered successful if the individual can maintain their balance without moving their feet, swaying excessively, or requiring external support. If the person is unable to maintain balance, the test can be repeated with the other foot in front to determine if there is a difference in balance between the two positions.
The Sharpened Romberg Test is a quick and straightforward way to assess an individual’s static balance. Still, it is important to note that it may not be suitable for individuals with severe balance issues or those who may be at risk of falling. In these cases, alternative balance assessments or professional supervision should be considered.
Objective:
To assess static balance by standing with a reduced base of support while removing visual sensory information
Equipment:
- Flat, non-slip surface
- Stopwatch
Instructions:
1)Explain the purpose of the test.
2) Instruct the participant to remove his or her shoes and stand with one foot directly in front of the other (tandem or heel-to-toe position), with the eyes open.
3) Ask the participant to fold his or her arms across the chest, touching each hand to the opposite shoulder.
4) Allow sufficient practice trials. Once the participant feels stable, instruct him or her to close his or her eyes. Start the stopwatch to begin the test.
5) Always stand in close proximity as a precaution to prevent falling.
6) Continue the test for 60 seconds or until the participant exhibits any test-termination cue. Allow up to two trials per leg position and record the best performance on each side.
Observations:
Continue to time the participant’s performance until one of the following occurs:
- The participant loses postural control and balance.
- The participant’s feet move on the floor.
- The participant’s eyes open.
- The participant’s arms move from the folded position.
- The participant exceeds 60 seconds with good postural control.
General interpretations:
- The participant needs to maintain his or her balance with good postural control (without excessive swaying) and not exhibit any of the test-termination criteria for 30 or more seconds.
- The inability to reach 30 seconds is indicative of inadequate static balance and postural control.
7.4.2 Muscular Strength Testing
Muscular strength refers to the capacity to generate maximal force during a single contraction, such as lifting a weight that can only be lifted once before necessitating a brief rest. The one-repetition maximum (1RM) test is frequently regarded as the “gold standard” for evaluating an individual’s strength capacity in non-laboratory settings (Grgic, 2020). The 1RM test is defined as the maximum weight a person can lift for a single repetition using the proper technique. This type of testing should be reserved for individuals with prior experience in the resistance exercise being utilized for maximal testing, as untrained clients may need more skills and muscular balance to minimize the risks associated with such exertion. It is recommended that they undergo at least eight familiarization sessions with the 1RM test to obtain a reliable measurement (Grgic, 2020).
The reliability of the 1RM test varies across different studies, with inconsistent findings making it challenging to determine the true reliability of the test and the extent to which it is influenced by measurement-related factors, such as exercise selection, the number of familiarization trials, and resistance training experience (Grgic, 2020).
Muscular strength tests assess an individual’s strength for specific muscular actions. Maximal strength is the highest amount of weight a person can lift for a given exercise. Elevated muscular strength levels can improve performance in various sport-specific tasks and reduce the risk of athlete injuries (Stone, 1993). Adequate muscular strength is also required for numerous daily life activities.
In older adults, for instance, increased strength enhances physical functioning and quality of life while reducing the risk of falls (Katula, 2008). Furthermore, higher muscular strength has been linked to a reduced risk of premature mortality (Edwards, 2018).
General Guidelines for Maximal Strength Testing
The general testing procedure for any maximal strength testing is as follows:
- Choose an exercise to test a specific muscle group. Choose an exercise that the participant is familiar with and that is related to movements relevant to the individual’s personal fitness goals.
- Allow the client to warm up by practicing the exercise with light weights. The trainer should ensure that the exerciseer is using the proper technique, range of motion, and breathing pattern.
- The spotter should be in position at all times during the lift.
- If using free weights, the spotter should assist the exerciser with the lift-off.
- As many trials are allowed as it takes to achieve a true maximal effort; however, more than 3 to 5 trials often result in an inaccurate maximal effort.
- Each trial requires a maximal effort. The exerciser should rest a minimum of 1 to 3 minutes between trials to ensure the best likelihood that the trials are maximal efforts.
1RM Bilateral back squat (Earle and Beachle 2008)
Back squat protocol can be performed in a standard squat rack, a Smith-type machine or a squat press machine.
1. Equipment:
standard squat rack
olympic barbell
olympic plates
2.Technique and Procedure
The subject grasps the barbell with a closed, pronated grip slightly wider than shoulder width.
The barbell should be placed above the posterior deltoids (high bar position). The feet should be slightly wider than shoulder width and pointing slightly outward when the subject begins the descent. The subject reaches the lowest point in the descent when the top of the thighs are parallel to the ground and the barbell should rise in a continuous motion without assistance. For safety, at least two spotters should stand on either side of the barbell and follow the bar during the descent and ascent.
- The subject should warm-up by performing repetitions with a load that allows 5 to 10 repetitions.
- One minute rest.
- Estimate a warm-up load that allows the subject to complete 3-5 repetitions by adding 14-18kg (30-40 pounds) or 10-20% to the load used in step 1.
- Two-minute rest.
- Estimate a near-maximal load that will allow the subject to complete 2-3 repetitions by adding 14-18kg (30-40 pounds) or 10-20% to the load used in step 3.
- Two to four-minute rest.
- The subject performs a 1RM attempt by increasing the load used in step 5 by 14-18kg (30-40 pounds) or 10-20%.
- Two- to four-minute rest.
- If the subject fails the 1RM attempt, decrease the load by removing 7-9kg (15-20 pounds) or 5-10% and have the subject perform one repetition.
- Two- to four-minute rest.
- Continue increasing or decreasing the load until the subject can complete one repetition with the appropriate technique. The subject 1RM should be achieved within five attempts.
3.Score Interpretation: These values should be used for evaluating progress only and should not be considered an indication of the individual’s overall fitness or health.
1 RM Machine Leg Press (Phillips 2004)
Leg press is often used as a measure of maximal lower-body muscular strength test. It is especially recommended for older adults for safety reasons (Hoffman 2006).
1.Equipment:
Various types of machines that are plate-loaded.
2.Technique and Procedure
The subject sits in the leg press chair with both feet on the foot plates and an internal angle of 90 at the knee. The subject should not produce excessive lordosis of the lumbar spine during the movement.
- The subject performs a five-minute general warm-up on a stationary recumbent cycle.
- The subject performs several lifts at low or zero resistance to reestablish familiarity with the movement.
- Select an initial resistance slightly above that of the familiarization resistance (at 2,25 -6,75 kg).
- The subject performs one lift with good technique.
- The subject rates perceived exertion on a rating of perceived exertion scale (RPE) of 6 to 20.
- The subject rests for one minute if the RPE is below 12 and 12 minutes if the RPE is above 12.
- Add 2,25 to 4,5 kg depending on the RPE and have the subject repeat step 4.
- Have the subject repeat the process to momentary muscular fatigue or volitation fatigue (the subject does not wish to continue).
- Record the maximum load lifted.
3.Score Interpretation: These values should be used for evaluating progress only and should not be considered an indication of the individual’s overall fitness or health.
1 RM Bench Press (free weights) (Earle and Beachle 2008)
Bench press is often used as a measure of maximal upper body strength.
1.Equipment:
Standard flat bench with barbell stands
Olympic barbell
Olympic plates
2.Technique and Procedure
The subject lies supine on the bench with the head, shoulders, and buttocks in contact with the bench and both feet in contact with the floor (five-point contact). The bar is grasped with a closed, pronated grip slightly wider than shoulder width. The spotter assists the subject in removing the bar to the beginning position, where the bar is held with the elbows extended. For safety, a spotter should stand close to the subject’s head holding the bar with a closed, alternated grip, and follow the bar during the descent and the ascent without touching it. Each repetition begins from this position. The bar is lowered to touch the chest at around the level of the nipple and is then raised in a continuous movement until the elbows are fully extended. During the movement, the subject should maintain the five contact points and not bounce the bar from the chest at the lowest part of the movement.
- The subject warms up by performing repetitions with a load that allows 5-10 repetitions.
- One minute rest.
- Estimate a warm-up load that allows the subject to complete 3-5 repetitions by adding 4,5-9 kg(10-20 pounds) or 5-10%, to the load used in step 1.
- Two-minute rest.
- Estimate a near-maximal load that will allow the subject to complete 2-3 repetitions by adding 4,5-9kg (10-20 pounds) or 5-10% to the load used in step 3.
- Two- to four-minute rest.
- Instruct the subject to perform a 1RM attempt by increasing the load used in step 5 by 4,5-9 kg (10-20 pounds) or 5-10%.
- Two- to four-minute rest.
- If the subject fails the 1RM attempt, decrease the load by removing 2,3-4,5 kg (5-10 pounds) or 2,5-5% and have the subject perform one repetition.
- Two-to four- minute rest.
- Continue increasing or decreasing the load until the subject can complete one repetition with the appropriate technique. The subject’s 1RM should be achieved within five attempts.
3.Score Interpretation: These values should be used for evaluating progress only and should not be considered an indication of the individual’s overall fitness or health.
The 1RM test appears to be a valid and reliable measure of performance in a large variety of populations. However, it is true that laboratory tests that require the use of equipment to test maximal muscular strength, usually a force platform or a force transducer, provide a more objective assessment than field tests do (Gavin 2012).
1 RM Dead lift test
Deadlift test is used for measuring lower body maximum strength.
1.Equipment:
various free weights and a deadlift “hex-bar” bar
2.Technique and Procedure
After an adequate warm up, the subject stands inside the open space of the bar, with feet shoulder-width apart. The knees should be in line with the toes. Bend at the hips to lower the body and grasp the bar. Ensure the head and neck are in a neutral position with eyes facing forward (avoid rounding of the spine). To perform the deadlift, pull the bar straight up by extending the knees and hips in a slow, smooth and continuous movement, until the legs are straight and the body upright.
During the lifting motion, the subject must not allow the knees to collapse inward, and the shoulders must remain above the hips at all times. The heels must also maintain contact with the ground throughout the lift.
Start with a ‘check’ 3-rep test with the weight of 20 kg or less, to check for correct technique. Then one repetition is performed for each weight in sequence. For beginners, use the table below and the kg according to the client’s weight. Less than 1 minute rest is allowed between reps. If a weight is failed, another attempt may be made.
3.Score Interpretation:
The maximum weight lifted is recorded. For standardizing the scores, calculate a score proportional to the person’s body weight (see table below).
Pull up test
The pull-up test is a common measure of upper body strength.
1.Equipment:
Horizontal overhead bar, at an adequate height so that the participants can hang from it with arms fully extended and feet not touching the floor
2.Technique and Procedure
The pull-ups are performed starting from a dead hang (arms fully extended and locked), body motionless, feet off the floor. The grip can be either with both palms facing forward or to the rear, though with both facing in the same direction. From this starting position, a pull-up is performed without excessive body motion, and the body is lifted until the chin has cleared the top of the bar. The body is then lowered until his arms are fully extended or locked out. One complete pull-up is counted when the Marine’s arms are locked out. This procedure is repeated until the Marine has reached the maximum 20 complete pull-ups, or can no longer complete a pull-up.
3.Score Interpretation:
The maximum number of correctly performed pull ups is recorded. For standardizing the scores, calculate a score proportional to the person’s body weight (see table below).
7.4.3 Muscular Endurance Testing
Muscular endurance is the ability to voluntarily produce force or torque repeatedly against submaximal external resistances, or to sustain a required level of submaximal force in a specific posture for as long as possible (Gavin 2012).
Muscular endurance tests are designed to determine the number of times a muscle group (or groups) can contract prior to fatigue.Although muscular endurance tests are specific to the given exercise and muscle groups being tested, these exercises are generally lumped into tests for the trunk, upper body, and lower body. The tests are divided into two testing methods that are often used to test muscular endurance. The first method requires the subject to perform as many repetitions as possible against a submaximal load until volitional failure using both eccentric and concentric contractions (e.g.push-ups to failure). The second method requires the subject to maintain a prespecified posture for as long as possible and therefore involves predominantly isometric contractions (e.g. flexed arm hang). The resistance used during muscular endurance tests should not require maximal effort. By not requiring a maximal effort, the risk of injury due to muscular imbalances is greatly reduced. Muscular endurance tests are not often administered to athletic populations but are usually used as minimum standards (they are administered to children, the military, firefighters etc.). They are generally easy to administer and interpret (Gavin 2012).
A relationship exists between maximal muscular strength and muscular endurance: stronger people can perform a greater number of repetitions and therefore a greater amount of work (Stone 2006).
Muscular endurance tests for the core
Curl-up and Crunch Tests
Muscular endurance tests for the trunk are usually based upon a variation of a timed curl-up or the maximal number of crunches. Maximal sit-up tests and maximal numbers of sit-ups performed in one minute are also common for testing the muscular endurance of the abdominal muscles. The protocol for the sit-up test is listed below. The standard values for the curl-up and crunch tests are not as common as they are for sit-up tests. We prefer, however, to use the curl-up and crunch tests because of the reduced risk of injury to the back.
Graded exercise tests (GXTs) refer to tests that modify the workload (e.g., speed, incline, or resistance). The maximal oxygen uptake (VO2max) test is the gold standard for an aerobic fitness assessment. However, since this test can be costly and time-consuming, numerous alternative tests have been developed to predict VO2max scores. These alternatives predict VO2max based on maximal effort or extrapolated estimations derived from submaximal exercise tests and estimated maximal heart rate (Topendsports, 2023).
While submaximal testing may be less accurate than maximal testing, it remains suitable for general fitness settings. In addition, submaximal and basic field tests are relatively safe for personal trainers to administer. Maximal exercise testing should be performed only by specially trained exercise physiologists (with degrees and certifications) and under the supervision of a physician.
Sub-maximal Graded Exercise Test
Sub-maximal graded exercise tests can be either performed on a cycle, treadmill or a step (step tests). The subject’s heart rate and rate of perceived exertion (RPE) are monitored. Submaximal exercise tests are well-tested in the clinical setting but are sometimes difficult to perform in the general fitness setting. These tests often require specialized and calibrated bicycle ergometers or treadmills that can achieve a percent grade higher than that found in most fitness centers. For those testers without the proper equipment, it is possible to estimate relative aerobic endurance through variations of the treadmill and bicycle ergometer tests or through the use of step tests or field tests.
YMCA submaximal bike test
Based on the participant’s heart rate response to several submaximal workloads, we can predict what workload, and therefore VO2max, they would have reached if they had continued until their maximum heart rate (Beekley 2004). There are many other cycling tests and aerobic fitness tests.
1.Equipment:
Cycle ergometer
clock or stopwatch
heart rate monitor
metronome (for pedal cadence)
Before testing, adjust the cycle ergometer seat height and handlebar height and obtain resting heart rate and blood pressure measurements.
2.Procedure
The subject pedals on the cycle ergometer for 3 minutes at a resistance of 0 kg and a cadence of 50 (this is the warm-up). The subject then pedals for 3 minutes at 150 kgm/min (0.5 kg, 50 cadence). Record the heart rate at 2 minutes and 3 minutes. If these heart rate values are not within 5 bpm, continue for another minute and record the heart rate at 4 minutes. Based on the steady-state heart rate (HR) reached, increase the workload for the second stage based on the details listed in the table below. (note: 6 kgm/min = 1 Watt)
For workloads beyond 4th stage, increase the intensity by 25 watts (0.5 Kp) until termination heart rate is reached (85% of age-predicted max). Cool down after the last stage has been completed.
3.Score Interpretation: The aim is to achieve two consecutive workloads where the HR is between 110 bpm and 85% of the age‐predicted HRmax (220-age).
4.Advantages: this is a simple test to administer, reasonably accurate, and appropriate for ECG monitoring during exercise.
5.Disadvantages: the test score can be influenced by the variability in maximum heart rate in individuals.
Chester Treadmill Test
The Chester Treadmill Walk Fitness Test is a progressive treadmill test of aerobic capacity developed by Professor Kevin Sykes from the University of Chester (Sykes 2009).
1.Equipment:
treadmill with ability to change gradient
stopwatch
heart rate monitor
RPE chart
Before testing, calibrate the treadmill speed and gradient.
2.Procedure
The treadmill should be set at 6.2 km/hr (3.9 mph) for all of the tests. The gradient starts at 0% for the first two minutes, then increases by 3% every two minutes unless the participant reaches 80% of their maximum heart rate or an RPE of 14. The test ends after 12 minutes, at which the gradient is returned to 0% and the speed reduced to enable the subject to cool down.
3.Considerations: this test could be a maximal test for some individuals, and therefore care should be taken to ensure the test is stopped if the subject is unable to keep up with the work rate and becomes overly distressed.
Harvard Step test
The Harvard Step test is a test of aerobic fitness, developed by Brouha et al. (1943) in the Harvard Fatigue Laboratories during WWII. There are also many other variations of this step tests.
1.Equipment:
step or platform 50.8 cm (20 inches) high for men, 40 cm (16 inches) for women
stopwatch
metronome or cadence tape
2.Procedure:
The subjects steps up and down on the platform at a rate of 30 steps per minute (every two seconds) for 5 minutes or until exhaustion. Exhaustion is defined as when the subject cannot maintain the stepping rate for 15 seconds. The subject immediately sits down on completion of the test, and the total number of heart beats are counted between 1 to 1.5 minutes after finishing. This is the only measure required if using the short form of the test.
3.Scoring
The Fitness Index score is determined by the following equation:
Fitness Index = (100 x test duration in seconds) divided by (5.5 x pulse count between 1 and 1.5 minutes).
4.Advantages: This test requires minimal equipment and costs and can be self-administered.
5.Disadvantages: Biomechanical characteristics vary between individuals. For example, considering that the step height is standard, taller people are at an advantage as it will take less energy to step up onto the step. Body weight has also been shown to be a factor.
Submaximal field tests
Field tests are practical, often less time-consuming ways to perform testing for large groups of individuals. The most appropriate field test should be chosen upon the consideration of the age, level of fitness, and possible physical limitations (e.g., overweight, obese, etc) of the subject. The score and relative fitness is based upon the time (or distance in the 12-minute run) and the heart rate. Subjects must maintain a heart rate below 180 bmp for the test to qualify as submaximal (George 1993).
One-mile Walk Test
1.Equipment:
None needed.
2.Procedure:
The subject (after warming up) walks one mile as fast as possible. At the end of the mile, the subject takes his pulse for 15 seconds and multiplies by four to get a heart rate in beats per minute. The immediate score is the heart rate and the time.
3.Score:
To estimate VO2max from this score, use the following equation:
VO2max estimation using the one-mile walk test
V02max (L/min) = 6.952 + (0.0091 x body weight in pounds) – (0.0257 x age) + (0.5955 x sex) – (0.2240 x mile walk time in minutes) – (0.0115 x ending heart rate)
For sex use 1 for males and 0 for females
7.4.5 Power
Power is the ability to overcome resistance in the shortest period of time, leading to the ability to produce higher velocities against a given load. Muscle strength and power are often confused as synonyms; however, these attributes are, in fact, distinct because high force production may occur in the absence of movement (e.g. isometric muscle action), whereas power cannot. The tests for evaluating power and explosiveness can be easily integrated into a sports conditioning or personal training program as a measure of power is specific to the context in which, if executed, it should not be used interchangeably with other tests (Peterson, 2012).
Vertical Jump (Leg Power)
The vertical jump is designed to test lower body power. It is one of the most frequently used tests of power and explosiveness in strength and conditioning. The vertical jump test is easy to administer, and the results directly apply to most sports requiring jumping and others in which lower body power outputs are paramount (Peterson, 2012).
1.Equipment:
Ideally, this test is done with commercially available Vertec apparatus. Since a Personal trainer usually doesn’t have one of those, you can use a smooth, tall wall. The described procedure for this test is for using a wall and chalk. You also need a scale (to determine weight).
2.Procedure:
The subject’s weight is taken and height is measured and recorded. Then the subject should warm up – we recommend 5 minutes of moderate-intensity aerobic exercise (eg, incline walking or jogging), followed by several dynamic range of motion exercises for the hip flexors and extensors, hamstrings, quadriceps, calves, and shoulders. The subjects are then allowed several trials to familiarize themselves with the jump procedure.
The subject then rubs the middle finger of the dominant hand with chalk. Then he or she stands with the dominant shoulder adjacent to the wall and reaches as high as possible, and makes a chalk mark on the wall. Using a countermovement, the subject then jumps as high as possible and makes a second chalk mark on the wall to designate the height of maximal jump. The best of three trials is recorded.
3.Score Interpretation: This test will allow power to be calculated by using the following formula (Sayers 1999):
Peak power (W) = {60,7 x (jump height (cm) + 45,3 x body mass (kg) – 2,055}
Other equations are also in use.
Standing long jump
Standing long jump test is another frequently used test of lower body explosive performance. This test may be used in conjunction with the vertical jump test because it provides information about vertical and horizontal displacement (Peterson 2012).
1.Equipment
Flat jumping surface, at least 6 m long (eg, gym floors, rubber tracks..)
Tape measure
Roll of masking tape
Several commercially available standing long jump mats
2.Procedure
Design a starting line with a piece of masking tape. The subject should warm-up with approximately five minutes of moderate-intensity aerobic exercise (jogging or running), followed by several dynamic and rapid range of motion exercises for the hip flexors and extensors, hamstrings, quadriceps, calves, and shoulders. The subject is then allowed several trials to fully acclimate to the test.
The subject stands with the toes behind the starting line. Then he or she uses a rapid countermovement and then jumps forward as far as possible. The best of three trials is recorded.
3.Considerations
This test has an increased risk of injury, therefore, it should be reserved for well-trained people with no existing injuries or musculoskeletal discomfort.
Upper body tests
The majority of tests and training protocols emphasize lower extremity muscular power. However, upper extremity power production and performance are also exceedingly important for most sports and activities.
One of the frequently used tests to measure power of the upper body is the seated medicine ball put (Peterson 2012).
Medicine ball put
1.Equipment
45° incline bench
Medicine ball (6 kg for females and 9 kg for males)
Gymnastics chalk (or magnesium)
Measuring tape
Room with at least 8m of clearance
2.Procedure
The measuring tape is placed on the floor with the end positioned under the front frame of the bench to anchor it. The tip of the tape should be positioned, so it is aligned with the outside of the medicine ball while it rests on the subject’s chest. The tape should be extended outward from the bench for at least 8 meters.
The subject should warm up with 5 minutes of moderate-intensity aerobic exercise, followed by several dynamic range of motion exercises for the shoulder and elbow joints. The subject is then allowed several submaximal trials.
For the test, the subject should be seated comfortably on the incline bench with feet flat on the floor and the medicine ball against the chest. The subject grasps the medicine ball with both hands, one on each side, and then, without any additional bodily movement, attempts to propel the medicine ball at an optimal trajectory of 45° for maximal horizontal distance.
Every attempt should be made to propel the ball in a straight line.
Three to five attempts are permitted, with a minimum of two minutes of rest between attempts.
3.Score
The distance from where the ball lands is recorded, the best result is used.
There are a lot of modalities of a medicine ball test: also frequently used are standing medicine ball throw, kneeling overhead power ball throw, and underhand medicine ball throw (Topendsports 2023).
7.4.6 Testing Agility, Speed, Coordination, Balance and Reaction time
As a personal trainer, assessing an individual’s fitness level is crucial. However, testing various components of fitness, such as agility, speed, coordination, balance, and reaction time, focuses more on sports athletes and less on average clients.
Speed and agility are essential aspects of sports performance.
Testing agility involves evaluating an individual’s ability to change direction quickly and accurately. One common test used to assess agility is the T-test, which requires the participant to run forward, backward, and laterally around cones arranged in a T-shape.
Testing speed involves measuring how fast an individual can run a set distance, such as 40 yards. This test is commonly referred to as the 40-yard dash.
Speed and agility tests should be short, usually less than 20 seconds; longer tests may target the wrong energy systems, and fatigue may affect the results. On the other hand, if an agility test course is simple enough, subjects can build up speed between turns.
Testing coordination involves assessing the individual’s ability to synchronize their movements effectively. Coordination tests are not commonly used in a fitness test battery for athletes, even less for “ordinary” clients. However, coordination plays a big part in the performance of agility tests and many other fitness tests, such as the vertical jump and throwing power tests. One example of a coordination test is the hand-eye coordination test, where the participant catches a ball while standing at a specific distance.
Testing balance involves evaluating the individual’s ability to maintain equilibrium. One such test is the stork stand, where the participant stands on one leg for a set amount of time.
Testing reaction time involves assessing the individual’s ability to react quickly to a stimulus. A common test for reaction time is the ruler drop test, where the participant catches a ruler as it falls from a height.
By evaluating these components of fitness, a personal trainer can identify areas where the individual needs to improve and develop sports performance.