Health Coach Helper: Lesson 6
The next two chapters cover the different assessments you might perform with a client prior to, and throughout, an exercise program. These assessments serve a number of purposes, including determining the client’s current health status, tracking progress and motivating a client. (See Table 11-1 on page 293 for full details.) Here’s what you need to learn from these chapters: What are these different assessments telling us? Who are they appropriate for? And are there any contraindications?
Chapter 11 reviews the different body-composition and body-size assessments one can use with a client. Body composition looks at the content of an individual’s mass (fat mass vs. fat-free mass), while body size is simply an absolute measurement (height, weight, girth measurements, etc.). Both have advantages and disadvantages, so this chapter breaks down which assessment is more appropriate in various circumstances. Both body composition and fat distribution can provide important health-related information; however, when someone is very overweight or obese, skinfold measurements can be inaccurate. In these cases, girth measurements would be a more appropriate assessment. Also, keep in mind that these assessments can be uncomfortable and embarrassing for a client; therefore, an overweight or obese client doesn’t need to be reminded that his or her percent body fat is in the “obese” category. For this reason, girth measurements can also serve as a helpful tool because you’re not classifying the client in any category; you’re simply getting a starting measurement from which to track future progress. Finally, keep in mind that these assessments are always an option and never a requirement, so if the client doesn’t feel comfortable doing them, don’t! Hopefully with time he or she will be more comfortable with assessments.
Chapter 12 cover the types of physiological assessments one might want to perform with clients. Again, going back to the question of who the assessment is appropriate for, clients who are starting in Phase 1 of cardiovascular training do not need to perform a cardiovascular assessment until they reach phase 2. You can, however, gain valuable information your client’s mobility and stability by using the other assessments, regardless of whether your client is a beginner or seasoned exerciser. These assessments will help you create a workout program for your client that addresses any compensations that may become evident.
Chapter 11 Key Points: Body-composition Assessment and Evaluation
Understanding Body Composition: Body-composition models—essential fat for men and women; body composition and health risks—waist circumference and waist-to-hip ratios (WHR) and related health risks; desirable body weight and percent body fat—percent norms for men, women and female athlete triad; ideal body weight—knowing how to calculate ideal/desired body weight (see example in “Apply What You Know” on page 297).
Body-composition Assessment of Morbidly Obese Clients: Methods such as bioelectrical impedance analysis (BIA) may not give an accurate reading, so girth measurements might be the best choice. Also, keep in mind that we want to creat positive experiences for our clients, so if they aren’t comfortable these assessments, don’t do them!
Body-composition Assessment Techniques: For each of the following techniques, you will want to know who the assessment is appropriate for, the basic procedure, and any advantages/disadvantages: body mass index (BMI), circumference measures, skinfold calipers.
-BMI: know how to calculate it and the BMI Reference Chart (Table 11-5)
-Circumference Measures: Anatomical locations of different sites (Table 11-6); how to calculate waste-to-hip ratio (WHR) and the norms (Table 11-7). Note: you do NOT need to know the body density (BD) equation on page 301 for the exam.
-Skinfold measurements: Three different sites for men and women and how to interpret (NOT memorize) Table 11-9 and 11-10
-Know what and how the following might be used: bioelectrical impedance analysis (BIA), hydrostatic weighing, dual energy X-ray absorptiometry (DEXA), air displacement plethysmography (ADP), near-infrared interactance (NIR).
Chapter 12 Key Points: Physical-fitness Assessments
General assessment guidelines: Know the considerations listed on page 316-317
Baseline resting measurements: Know the basic procedure and function for each of the following measurements:
-Heart rate: resting heart rate, exercise heart
-Blood pressure: What the normal responses to exercise are and classification of blood pressures (Table 12-2)
Cardio assessments: Know who these assessments are appropriate for, any contraindications, and any advantages or disadvantages of each (e.g., with the 1-mile walk test you can assess multiple people at one time).
-Ventilatory threshold testing: VT1 (submaximal talk test)
-Treadmill test: Balke and Ware treadmill test
-Field tests: Rockport 1-mile walk test
Static posture, balance, and core function assessments: Know the objective (what information you gather) of each assessment, contraindications, and why you may or may not elect to use these assessments with a client.
-Stork-stand balance test and Sharpened Romberg Test
-McGill’s Torso Muscular Endurance Test Battery (trunk Flexor endurance, trunk lateral endurance, trunk extensor endurance)
-Mobility assessment: modified body-weight squat test and overhead reach