Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

FITNESS ASSESSMENT FORM (PED 027)

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: ____________________________________

Dynamic Postural Assessment: Overhead Squat


View Kinetic Chain Movement IE 1 RE
Checkpoints Observation L R L R
Feet Turns out / /
Anterior Moves inward
Knees
Moves outward /
/
Lumbo-pelvic- Excessive forward
Lateral hip lean
Low back arches
Low back rounds
Shoulder Arms fall forward

Feet Heel of foot rises / /


Foot flattens
Posterior Lumbo-pelvic- Asymmetrical
hip Weight shift
Shoulder Shoulder elevated / /

Cardiorespiratory Endurance: Step Test


60-sec HR CV THR
Efficiency
IE 156 BPM 215 115
Interpretation VERY POOR
1ST RE
206 489 115
Interpretation
VERY POOR

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* / /

You might also like