Physical Fitness Form

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DE LA SALLE LIPA

College of Education, Arts and Sciences


Physical Education Area
PATHFI1
Formative Assessment 2

Name: Birthday:

Section: Age:

Gender:

PART 1. HEALTH-RELATED FITNESS TEST

A. BODY COMPOSITION: Body Mass Index (BMI)

HEIGHT (meters) WEIGHT (kilograms) BMI Classification

Formula: WEIGHT [in Kilograms]


HEIGHT [in Meters] ²

B. WAIST CIRCUMFERENCE

C. FLEXIBILITY

Sit and Reach


st nd
1 Try 2 Try 3rd Try Average INDICATOR
Shoulder Flexibility Testing (Zipper Test)
Right RESULT Left INDICATOR

D. PUSH UP

Push-ups (1min) Upper


body Strength INDICATOR

PART 2. SKILL-RELATED FITNESS TEST

BALANCE

Stork Balance Stand Test

Right Supporting Foot INDICATOR Left Supporting Foot INDICATOR


(seconds) (seconds)

Physical Fitness Test Standard Norm


Pathfi1
PART 1 HEALTH RELATED FITNESS TEST

A. BMI
BMI Classification
Below 18.5 Underweight
18.5 -24.9 Normal
25.0- 29.9 Overweight
30.0 Above Obese

B. WAIST CIRCUMFERENCE - Predictor of Visceral Fat; Internal and External Fats


INDICATOR Men Women
Risk Centimeter Inches Centimeter Inches
Very High >120 >47 >110 >43.5
High 100-120 39.5-47 90-109 35.5-43
Normal 102 40 88 34.6
Low <80-99 31.5-39 70-89 28.5-35
Very Low <80 <31.5 <70 <28.5

C. FLEXIBILITY Sit and Reach


INDICAT OR MEN WOMEN
cm inches cm inches
super > > > >
+27 +10.5 +30 +11.5
excellent +17 to +6.5 to +21 to +8.0 to
+27 +10.5 +30 +11.5
good +6 to +2.5 to +11 to +4.5 to
+16 +6.0 +20 +7.5
Average 0 to 0 to +1 to +0.5 to
+5 +2.0 +10 +4.0
fair -8 to - -3.0 to - -7 to -2.5 to
1 0.5 0 0
Poor -20 to -7.5 to - -15 to - 6.0 to -
-9 3.5 8 3.0
Very poo r < - < - < - < -
20 7.5 15 6.0

D. ZIPPER TEST

INDICATOR Score in cm
Excellent Fingers overlapped by 6cm and above
Very Fingers overlapped by 4 to 5.9cm
Good
Good Fingers overlapped by 2 t0 3.9
Fair Fingers overlapped 0.1 to 1.9cm
Needs just touch fingertips
Improvement
Poor did not touch fingertips
E. PUSH UP

INDICATOR MEN Women


1719 17-19
Excellent > 56 >35
Good 47 28
56 35
Above a verage 35- 21-
46 27
Average 19- 11-
34 20
Below A verage 11- 6-
18 10
Poor 4- 2-
10 5
Very Poor <4 0-
1

PART 2 SKILL RELATED COMPONENTS

Stork Balance Stand Test

INDICAT OR Score (seconds)


Excellent >50
Good 40 50
Average 25 39
Fair 10 24
Poor <
10

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