Fitness Assessment Form (Ped 027) : Name: - Class Schedule
Fitness Assessment Form (Ped 027) : Name: - Class Schedule
Fitness Assessment Form (Ped 027) : Name: - Class Schedule
Name: ___________________________________
JIMWEL B. MACAWILE Class Schedule: _____________________
Anthropometry: Girth Measurement
IE 1ST RE
Chest 31 INCH
Right Upper Arm
10 INCH
Right Forearm
9 INCH
Waist
27 INCH
Hips
30 INCH
Right Thigh
13"&19"
Right Calf
13 INCH
Waist and Hip Ratio:
0.90
Goal: ____________________________________
Partial Curl Up
Repetitions
IE 33
Interpretatio ABOVE
n AVERAGE
1ST RE 35
Interpretatio ABOVE
n AVERAGE
Agility: Hexagon Test
Trial 1 Trial 2 Tr Av
ial er
3 ag
e
IE 60 60
60 SECS 60 SECS
SECS SECS
Interpretatio
n POOR
1ST RE
Interpretatio
n
Static Postural Assessment
Kinetic Movement IE 1ST RE
View Chain Observation
Checkpoints L R L R
Head Forward head* / /
Shoulder Protracted* / /
Retracted
Lateral Lumbo-pelvi Anteriorly tilted*
c-hip Posteriorly tilted
Adducted
Anterior Knees Abducted / /
Internally rotated*
Externally rotated / /
Feet Flat* / /