2 weeks ago, I spoke on laying a foundation by planning to succeed. This project management for fitness is known as Periodization. Now that big picture has been laid down, I'm looking to go back to the beginning and focus on what should occur to enhance the effectiveness of any plan, the initial evaluation.
Purpose of Evaluation
A fitness evaluation is a combination of forms and fitness related tests used to determine your current state of health. The information collected is critical for determining what type of exercise plan is appropriate for the individual. These baseline or initial measurements will allow for monitoring progression throughout the program. To forgo an evaluation can create a variety of hurdles toward accomplishing goals. It is recommended not to get in hurry. Haste can create waste (as in time, money, and injury).
Breakdown of an Evaluation
Physical Activity Readiness Questionnaire (PAR-Q)
A PAR-Q is a self-screening tool that can be used by anyone who is planning to start an exercise program. For legal and procedural reasons, it is standard to fill this form out prior to any exercise program.
A sample of the PAQ-Q is listed directly below.
1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
2. Do you feel pain in your chest when you do physical activity?
3. In the past month, have you had chest pain when you are not doing physical activity?
4. Do you lose your balance because of dizziness or do you ever lose consciousness?
5. Do you have a bone or joint problem (for example, back, neck, knee, or hip) that could be made worse by a change in your physical activity?
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
7. Do you know any other reason why you should not do physical activity?
Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.
• You may be able to do any activity you want—as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.
• Find out which community programs are safe and helpful to you.
NO to all questions - If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can:
• start becoming much more physically active – begin slowly and build up gradually. This is the safest and easiest way to go.
• take part in a fitness appraisal – this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively. It is also highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.
DELAY BECOMING MUCH MORE ACTIVE:
• If you are not feeling well because of a temporary illness such as a cold or a fever – wait unit you feel better; or
• If you are or may be pregnant – talk to your doctor before you start becoming more active.
PLEASE NOTE: If your health changes so that you then answer YES to any of the above questions, tell you fitness or health professional. Ask whether you should change your physical activity plan.
PROTOCOLS INVOLVING PAR-Q
If you have examined the content above, you will see that it is protocol to seek parameters from a medical professional prior to starting a program IF you checked yes to any question. One should not get upset or let that detour him/her from wanting to pursue a exercise plan.
A medical release with parameters from the doctor can remedy this step. More times than not, the fitness professional may have a medical release form that can be emailed, faxed to the individual's primary physician. Once the parameters have been set by the medical professional, the individual and the fitness professional can proceed further.
An intake form(s) is/are a series of questions that can inquire about Family Health History, Personal Medical History, Current Physical Activity, Lifestyle and Nutritional Habits. This additional information is confidential in addition to vital for creating the appropriate plan for the individual.
NOTE: In history and lifestyle, there may be answers that create a need for medical clearance as well. According to the American College of Sports Medicine (ACSM), these are known as risk factors (see above).
If an individual has 2 or more risk factors and has the signs of Cardiovascular Disease (CVD) or possibly a metabolic issue, such as diabetes, a medical clearance will be needed. For a simple guideline, download this PDF from the ACSM.
Evaluation Consent Form
Prior to any evaluation, an individual can be presented with an authorization form to do so. Known as a consent form, it is a simple written statement (most of the time for fitness/wellness) 🙂 that grants permission to allow the tests specified in the statement to occur. It should also say that the information is confidential between practitioner and the individual.
Types of tests for the an evaluation can include the following,
The question(s) address what goal(s) does the individual wish to accomplish (weight/fat loss, improve health, increase strength, etc.)
Resting Heart Rate
Blood Sugar Level
Body Circumference Measurements
Pending on the facility and/or practitioner, low to moderate impact physical fitness testing and measurement may occur. These may include
Sit and Reach Test
Push Up Test
There are definitely MANY more tests that can be added to this list. This is a sample.
My Personal Physical Assessment Choice
If an individual is beginning from scratch or after a substantial amount of time off, I am not looking to make the individual/potential client physically move too much until I have a better understanding of his/her range of motion abilities. This is more than a sit and reach test...which to me doesn't make too much sense, especially if the individual is already addressing back pain issues. On a personal note, along with vitals and health history, I look at 2 criteria points to assist in formulating an exercise plan,
- Body Structure (bone length, circumference)
- Joint Mobility (range of motion)
An individual's structure, range, and current health status dictates not only what is appropriate, but HOW the exercise should be done. It can vary slightly or a lot pending on the individual. Case in point, let's say it is "leg day" and there are 2 people training. Someone with a small waistline, stable range of motion, long leg bones (femur, tibia, fibula), is going to have a different form compared to someone with 40 extra pounds, diabetic, high blood pressure, shorter leg bones, and heavily restricted range of motion. The exercises can be the same but the form would be catered to the individual.
3-Day Nutrition Journal
This could potentially be the longest of all the initial evaluations, the 3-day food journal gives the practitioner an idea of what kind of foods and how many times a day an individual eats. This is helpful in pinpointing potential habits and/or choices that can potentially need altering. Non-Dietitians, Nutritionists have a scope of practice they can assist in. Anything too detailed, especially with metabolic issues, is to be referred to the appropriate professional - a Registered/Licensed Dietitian or Nutritionist.
Working Agreement / Contract
After the evaluation has occurred, the individual is usually presented with a choice to either continue on his/her own or work with a qualified professional. If the individual opts to work with a professional, he/she is presented with a working agreement / contract. In it, the terms of the agreement are listed in writing. This usually involves the listings of policies and procedures, including cancellation and payments. If the terms are agreeable by both parties, signatures are applied to the document. Both parties receive a copy for records. Now that all the procedural is out of the way, concentration on the fitness goals is what remains.
Online Training Considerations
After reading all of this, you may wonder about how this can all of this be done in an online format? To be quick, ALL of it cannot. Some of the "vitals" requiring bloodwork cannot be done online. More times than not, this will occur in a corporate wellness or wellness center. The other alternative is to set up a physical with your primary care physician.
Physical fitness tests may not be able to be conducted as well. That isn't necessarily a deal breaker. The online trainer will be wise in progressing a plan SLOWLY with the client should the practitioner work with online clients. Intake and working agreement will still be VITAL for safety of both the individual and the trainer alike.
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