FITNESS ASSESSMENT FORM

Name: Suratos, Kayne Ghie M. Class Schedule: T (7:30-9:30AM)

Anthropometry: Girth Measurement
IE 1st RE
Chest
Right Upper Arm
Right Forearm
Waist
Hips
Right Thigh
Right Calf
Waist and Hip Ratio:
Goal: Allows cross-sectional analysis of the relationship between obesity and risk
of disease.
Static Postural Assessment
Kinetic Chain Movement IE 1st RE
View Checkpoints Observation
L R L R
Head Forward head*
Shoulder Protracted*
Retracted
Lateral Lumbo-pelvic-hip Anteriorly tilted*
Posteriorly tilted
Adducted
Anterior Knees Abducted
Internally rotated*
Externally rotated
Feet Flat*
Cardiorespiratory Endurance: Step Test
60-sec HR
IE 115
Interpreta BELOW AVERAGE
tion
1st RE 105
Interpreta AVERAGE
tion

Dynamic Postural Assessment: Overhead Squat

View Kinetic Chain Movement Observation IE 1st RE
Checkpoints L R L R
Feet Turns out
Anterior Moves inward
Knees
Moves outward
Lumbo-pelvic-hip Excessive forward lean
Lateral Low back arches ✓
Low back rounds
Shoulder Arms fall forward
Feet Heel of foot rises
Foot flattens
Posterior Lumbo-pelvic-hip Assym. Weight shift
Shoulder Shoulder elevated
Anaerobic:300-Yard (274m) Shuttle
Trial 1 Trial 2 Average
IE 54 secs 53.2 secs 53.6 secs
Interpreta BELOW AVERAGE
tion
1st RE 52.3 secs 52 secs 52.15 secs
Interpreta AVERAGE
tion
Agility: Hexagon Test
Trial 1 Trial 2 Trial 3 Average
IE 12.3 secs 12 secs 12 secs 12.1 secs
Interpreta EXCELLENT
tion
1st RE 12.1 secs 11.6 secs 11.5 secs 11.7 secs
Interpreta EXCELLENT
tion

Flexibility: Sit-and-Reach Test

Trial 1 Trial 2 Trial 3 Best (cm)***
IE 14cm 16cm 16cm 39cm
Interpretation EXCELLENT
1st RE 15cm 16cm 16.5cm 40.91cm
Interpretation EXCELLENT

Speed: 40-Yard (37m) Sprint

Trial 1 Trial 2 Average
IE 5.45 secs 5.38 secs 5.42 secs
Interpretation VERY GOOD
st
1 RE 5.37 secs 5.35 secs 5.36 secs
Interpretation VEY GOOD
Aerobic: 12-Minute Run
Laps Distance Result (m)
IE 11 200m 2200m
Interpretation ABOVE AVERAGE
1st RE 11 200m 2200m
Interpretation ABOVE AVERAGE

Partial Curl Up
Repetitions
IE 26
Interpretation BELOW AVERAGE

1st RE 28
Interpretation BELOW AVERAGE

Strength
1 RM= 14

Criterion Scores and Normative Values

Duration of Exercise (sec) x 100/ Recovery

pulse x 5.6
=CV Efficiency

Zone One MHR x 0.65

MHR x 0.76
Zone Two MHR x 0.76
MHR x 0.85
Zone Three MHR x 0.86
MHR x 0.90

Very Poor Zone One

Poor
Below Average Zone One
Average Zone Two
Above Average Zone Two
Good
Excellent Zone Three
 Aerobic: 12 Minute- Run (Male)
Age 13-14 15-18 17-20 20-29 30-39 40-49 >50
Excellent >2000 >2800 >3000m >2800m >2700m >2500m >2400m
Above 2400- 2500- 2700- 2400-2800m 2300- 2100- 2000-
Average 2700 2800 3000m 2700m 2500m 2400m
Average 2200- 2300- 2500- 2200-2399m 1900- 1700- 1600-
2399 2499 2699m 2299m 2099m 1999m
Below 2100- 2200- 2300- 1600-2199m 1500- 1400- 1300-
Average 2199 2299 2499m 1999m 1699m 1599m
Poor <2100 <2200 <2300m <1600m <1500m <1400m <1300m
Speed: 40-Yard (37m) Sprint
Rating Men Women
Very <4.80 <5.30
good
Good 4.80- 5.30-5.59
5.29
Average 5.10- 5.60-5.89
5.29
Fair 5.30- 5.90-6.20
5.60
Poor >5.60 >6.20

Anaerobic: 300-Yard (274m) Shuttle

Excellent Above Average Below Poor
Average Average
<50 50-52 52-53 53-55 >55
secs secs secs secs secs

Aerobic: 12 Minute-Run (Female)

Age 13-14 15-18 17-20 20-29 30-39 40-49 >50
Excellent >2000 >2100 >2300m >2700 >2500m >2300 >2200m
m m
Above 1900- 2000- 2100- 2200- 2000- 1900- 1700-
Average 2000 2100 2300m 2700m 2500m 2300m 2200m
Average 1600- 1700- 1800- 1800- 1700- 1500- 1400-
1899 1999 2099m 2199m 1999m 1899m 1699m
Below 1500- 1600- 1700- 1500- 1400- 1200- 1100-
Average 1599 1699 1799m 1799m 1699m 1499m 1399m
Poor <1500 <1600 <1700m <1500 <1400m <1200 <1100m
m m

Partial Curl Up
Age 18-25 26-35 36-45 46-55 56-65 65+
Excellent >43 >39 >33 >27 >24 >23
Good 37-43 33-39 27-33 22-27 18-24 17-23
Above 33-36 29-32 23-26 18-21 13-17 14-16
Average
Average 29-32 25-28 19-22 14-17 10-12 11-13
Below 25-28 21-24 15-18 10-13 7-9 5-10
Average
 Poor 18-24 13-20 7-14 5-9 3-6 2-4
Very Poor <18 <13 <7 <5 <3 <2

Waist-to-Hip Ratio
Formula: Waist measurement/Hip
Measurement=Waist to Hip Ratio
Men Women
Prone to >0.95 >0.80
Chronic
Diseases
FLEXIBILITY: Sit and Reach
Men Women
Superior >42 >45
Excellent 32cm-41 cm 36-44 cm
Good 21cm-29cm 26cm-35cm
Average 15cm-20cm 16cm-25cm
Fair 8cm-15cm 7cm-15cm
Poor 1cm-2cm 5cm-6cm
Very poor <1cm <5cm

Agility: Hexagon Test

Gender Excellent Above Average Average Below Average Poor
Male <11.2 secs 11.2-13.3 secs 13.4-15.5 secs 15.6-17.8 secs >17.8 secs
Female <12.2 secs 12.2-15.3 secs 15.4-18.5 secs 18.6-21.8 secs >21.8 secs