Medical-Fitness Technician
Certification Course
Part C: Assessing Medical-Fitness
Learning Modules: 25-34
Learning Module 29:
Aerobic Fitness - Treadmill
Study the Learning Module and take the Quiz.
Learning Objective:
  • Know how to conduct an Aerobic Fitness Test using a treadmill.
  • Calculate & Interpret the Aerobic Fitness Score.
For Participants with BMI < 35
A standardized Aerobic Fitness Test for individuals with a BMI < 35 and otherwise fit enough to participate in calisthenic type exercises is a 4-minute Treadmill Test during which the participant tries to cover as much distance as possible by walking/jogging on a treadmill at 0 elevation at personally adjusted speeds until time runs out.

Treadmill Requirements:
  • Most commercial grade treadmills are adequate for testing Aerobic Fitness.
  • The speed of the treadmill needs to be manually variable from 0.5 mph to at least 10 mph.
  • The treadmill needs to be adjusted to 0 elevation.
  • The distance indicator on the treadmill needs to be accurate to 0.01 miles (16 meters or 17.6 yards).
  • The treadmill must have an emergency shut-off safety strap.
  • The treadmill must be in an area with adequate space and ventilation.​
  • The treadmill must be in good condition and operating properly.

Test Requirements:
  • Cover the timer on the treadmill dashboard so that the participant can not see the elapsed time. This is to make the test conditions consistent with the Shuttle and Track versions in which elapsed time is unknown to the client during the test.
  • Inform your client in advance to wear appropriate clothes and shoes for the test.

Explain the testing procedure to your client:
  • Your Aerobic Fitness Test involves walking/jogging for 4 minutes.
  • You will slowly warm-up to a comfortable speed.
  • You will tell me when you are ready for me to start the Timer.
  • I will announce your starting Distance and start the Timer. 
  • You may adjust the speed -- up or down -- any time using these buttons.
  • Try to cover as much Distance as you comfortably can during the 4 minutes.
  • Give it your best effort, but pace yourself to not over-do it.
  • I will announce the Distance at the end of 4 minutes.
  • I will instruct you to press the "Cool-Down" button.
  • You will continue walking as the speed decreases.
  • Do you understand how the test works?
  • Do you have any questions?

Test Protocol:
  • Explain the test and confirm your client's understanding.
  • Start the test when your client indicates he/she is ready.
  • Announce the distance displayed when you start the Timer.
  • Observe your client at all times.
  • Periodically, check the speed, distance, and time.
  • Watch for signs of distress.
  • Do not allow your client to become over-exerted and out-of-breath.
  • Do not inform your client how much time has elapsed or remains.
  • When the Timer stops (alarms), announce the distance displayed.
  • Watch the distance indicator as your client takes 5 more steps.
  • If the distance turns within those 3 steps, use the new distance as your client's finish distance.
  • Subtract the "Start" distance from the "Finish" distance to determine the "Total Distance."
  • Record the Total Distance in miles to 2 decimal numbers.

Calculation of Total Distance (example):
  • Start Distance: 0.15 (after warm-up)
  • Stop Distance: 0.63 (after 4 minutes)
  • Finish Distance: 0.64 (after 3 more steps)
  • Total Distance: 0.64 - 0.15 = 0.49

Calculation of Aerobic Fitness Score:
  • Divide the Total Distance by 0.55 and then multiply that number by 100.
  • Round off to the first decimal point.
  • Example: (Total Distance 0.49 / 0.55) x 100 = 89.09 = 89.1
  • The distance of 0.55 miles (0.88 km) in 4 minutes is the standard for a Med-Fit Aerobic Score of 100%.
  • A Score of 100% indicates an average speed of 8.25 mph (13.2 km/h).

Aerobic Fitness Score Interpretation:
  • Use the Score Interpretation chart below.
  • A score of 100 (or more) indicates a Very High Fitness Level in relation to health benefit.
  • A score below 100 indicates "room for improvement."
An “average” fitness level for an unfit and unhealthy population, which is at increased risk for sedentary-related chronic disease resulting in premature disability and death, is not satisfactory. A score of 100+ is an appropriate goal for most individuals, no matter how de-conditioned and unhealthy he/she might be.

Encourage all your clients with a score < 100 to try an Aerobic Fitness Training Program for 1-3 months and to return for a Follow-Up Medical-Fitness Assessment. If they follow your Exercise Rx (Learning Module 35), even with only 50% adherence, they will see significant improvement.
Note: The standardized, healthy level for aerobic fitness is being able to jog 0.55 miles (or more) in 4 minutes. This result is an average pace of 8.25 mph. The Treadmill Test is 0.05 miles (80 meters or 88 yards) longer than the shuttle aerobic test. The extra distance on the continuous Treadmill Test is to compensate for the more demanding stop-and-go format of the Shuttle Test (next Learning Module). This makes the Fitness Scores between the two formats more comparable.
​For Participants with BMI 35+
The Aerobic Fitness Test for individuals with a BMI of 35+ or otherwise not fit enough to participate in calisthenic type exercises is a 10-minute Walking Treadmill Test during which the participant tries to cover as much distance as possible by walking (no jogging) on a treadmill at 0 elevation at personally adjusted speeds until time runs out.
Why are Obese (Class 2 & 3) participants tested differently?
  • Medical-Fitness Training that includes jogging and calisthenic type exercises is inappropriate for individuals with a BMI > 35 due to an increased risk of injury and the lower efficiency of calisthenic exercises to burn calories compared to walking.
  • Testing muscle strength is not critical and may even be contraindicated when the BMI is 35 or greater.
  • Medical-Fitness Training is limited to Aerobic Fitness in order to: a) Condition the cardio-pulmonary-vascular system (heart, lungs, and blood vessels), b) Condition the joints, c) Avoid injury, and d) Maximize/accelerate weight-loss.
  • As body weight decreases and the heart and joints are conditioned, walking/jogging speeds can be increased as tolerated.
  • When the BMI is < 35, muscle strength can be assessed and calisthenic type exercises can be added to the fitness training program when appropriate.

The difference in the Fitness Test parameters for obese clients is because the Medical-Fitness objective for individuals with a BMI > 35 is cardiovascular fitness and weight loss, not muscle development.
The Test Instructions and Test Protocol for participants with a BMI of 35+ are the SAME as those above for participants with a BMI < 35, EXCEPT;
  • The Timer is set to 10 minutes (instead of 4 minutes)
  • The client is instructed to WALK at a slow, moderate, or brisk pace as tolerated, but to NOT jog.
  • This is for heart and joint safety, aerobic fitness training, and weight-loss purposes.​​
Calculation of Total Distance (example):
  • Start Distance: 0.08 (after warm-up)
  • Stop Distance: 0.73 (after 10 minutes)
  • Finish Distance: 0.73 (after 3 more steps)
  • Total Distance = 0.73 - 0.08 = 0.65 miles (1.04 km)

Calculation of Aerobic Fitness Score:
  • Multiply the Total Distance by 100
  • Example: Total Distance 0.65 x 100 = 65.0%
  • Note: Multiplying Total Distance by 6 = mph
  • Example: 0.65 x 6 = 3.90 mph (6 km/hr)

Aerobic Fitness Score Interpretation:
  • The initial Aerobic Fitness Goal for obese clients is to jog 1 mile in 10 minutes (6 mph) for a Score of 100.
  • Your client's Aerobic Fitness Score (65.0) can be compared directly to the initial Goal of 100.
  • When your obese client achieves a Score of 100 (and/or a BMI < 35), he/she can be transitioned to the regular Aerobic Fitness Test (if otherwise appropriate) as part of a full Medical-Fitness Assessment.