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1. |
Current musculo-skeletal condition
How would you rate the current
condition of your musculo-skeletal system? |
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Poor |
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Good |
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Ex |
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0 |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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2.
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Body composition
How
close are you to your ideal weight? Estimated kilograms
over your ideal weight or percent
body fat.
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Weight
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Obese |
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Slim |
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Kg |
>35 |
<35 |
<30 |
<25 |
<20 |
<15 |
<10 |
<6 |
<4 |
<2 |
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%BF/M |
>40 |
<40 |
<35 |
<30 |
<28 |
<26 |
<24 |
<22 |
<20 |
<18 |
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%BF/F |
>50 |
<50 |
<45 |
<40 |
<38 |
<36 |
<34 |
<32 |
<30 |
<28 |
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0 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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3.
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Abdominal strength
- feet held
How many situps can you do until exhaustion with your feet
held. Lie down on
your back with feet flat, knees bent at 90 degrees, arms
crossed and fingers holding your shoulders. Sit up so
your elbows tough your knees. Don’t count those situps where
your elbows don't touch your knees.
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Number to exhaustion. |
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Poor |
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Good |
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<5 |
5 |
7 |
9 |
11 |
14 |
17 |
20 |
23 |
25 |
30 |
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0 |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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4.
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Upper body strength
How many pressups can you do until exhaustion; women on the knees
and men on the toes. For women make sure your knees, bottom and
shoulders are in a straight line; ie your backside shouldn’t be
sticking up in the air. Don’t count those pressups where the
body flops onto the floor.
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Number to exhaustion. |
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Poor |
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Good |
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<5 |
5 |
7 |
9 |
11 |
14 |
17 |
20 |
23 |
25 |
30 |
x |
x |
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0 |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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5.
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Squat
From a standing position, how many times
can you squat down, with backside at least half way
between your knees and the floor
as they will go, and stand up straight,
until exhaustion. You may use a heel raise (as illustrated
if you need to.)
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Number to exhaustion. |
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Poor |
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Good |
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<5 |
5 |
7 |
9 |
11 |
14 |
17 |
20 |
23 |
25 |
30 |
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0 |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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6.
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Sit
and reach -
hamstring flexibility
In a sitting position, with legs outstretched in front of you,
see how far down past your toes you can reach with your fingers.
Keep legs straight and backs of knees on the floor. Score 4 if you can get your fingers to
your toes (T), 5 for the first knuckle, 6 for the second and 7
if you can get to the palms (P). Score 10 if you can get your
wrists past your toes (W).
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Poor |
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Good |
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Can't touch toes |
F |
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P |
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W |
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x |
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0 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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7.
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Ability to sit up straight - buttock
flexibility
With legs crossed and hands clasped behind the back, see if
you can sit up straight without falling over.
Your score is based on the worst of the scores for each side.
Falling over backwards on
either side scores 0.
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Fall over when hands clasped behind back |
Just |
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Good |
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0 |
7 |
8 |
9 |
10+ |
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8.
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Shoulder function - wall test - a subjective
assessment
Stand with your back to the wall. Place your hands in the surrender position
with elbows, forearms, wrists and fingers flat back on the wall. Score 10 if
you can do this with ease. Score low if you have difficulty getting into
this position or lower still if your elbows and wrists are a long way from
the wall. |
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Forearm, wrists and fingers
not flat |
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Just |
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Easy |
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0 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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9. |
Strength training behaviour
Do you have a regular and systematic strength
training program? No. of sessions per week |
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0 |
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1 |
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2 |
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3 |
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0 |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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10. |
Flexibility training behaviour
Do you have a regular and systematic flexibility
training program? No. of sessions per week |
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0 |
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1 |
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2 |
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3 |
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0 |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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Total |
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