Medical-Fitness Technician
Certification Course
Part C: Assessing Medical-Fitness
Learning Modules: 25-34
Learning Module 33-A:
Arm Muscle Fitness - Extensors
Study the Learning Module and take the Quiz.
All calisthenic type exercise tests are only for participants with a BMI < 35 and otherwise fit enough to safely perform the exercises (with modification if needed). Participants with a BMI > 35 or otherwise not fit enough to perform modified calisthenic type exercises are limited to the 10-minute Aerobic Fitness Test.
Learning Objective:
  • Know how to conduct the Push-Up Test
  • Calculate the Arm Extensor Fitness Score
The Arm Muscle Fitness Test is a 2-part test using a 1-minute Push-Up Test for the arm extensors and a 1-minute Inverted-Row Test for the arm flexors. The two test scores are combined into a single averaged Arm Muscle Fitness Score. Only the combined Arm Muscle Fitness Score is used in the formula to calculate the participant's Total Fitness Score (aka: Medical-Fitness Score).
The Push-Up Test is used to assess Arm Extensor Fitness, which is a 1-minute AMRAP (as many reps as possible) during which your client performs as many push-ups as possible (to the best of his/her ability) until the time runs out.

The push-up exercise mainly targets the Pectoralis Major and Triceps Brachii muscles.
Know how to do a Push-Up.
​(Watch the video below on Youtube.)
​Push-Up Instructions:
  • Start in the front hand-plank position.
  • Hands on the floor shoulder-width apart and directly under the shoulders.
  • Body and legs straight with only the hands and toes (males) or the knees (females) on the floor.
  • Start with the arms extended.
  • Lower the chest to where it almost touches the floor.
  • The body remains rigid.
  • The elbows move closer to the hips than the shoulders.
  • Return to the starting up position.
  • Complete at full arm extension.

Explain the testing procedure to your client:​​
  • Your Arm Extensor Strength Test is a 1-minute Push-Up AMRAP (as many reps as possible).
  • You may warm-up and then tell me when you are ready.
  • I will start the Timer when you start your first Push-Up.
  • I will count your reps aloud, and you may count silently with me.
  • You may stop and rest if needed, but if you do, the Timer keeps running.
  • I will announce the Total number of Push-Ups that you did during the 1 minute.
  • If most of your Push-Ups were not performed properly, I will assign a grade to your technique.​

Test Protocol:
  • Make sure your client has a firm, level surface with plenty of space.
  • Stand several feet away from your client so that you can observe the complete Push-Up movement.
  • Confirm that your client understands the Push-Up movement and the test procedure.
  • After your client has warmed up, ask him/her to indicate when he/she is ready to begin.
  • Start a hand-held 1-minute Timer when your client begins doing his/her first Push-Up.
  • Observe your client at all times and check his/her body movements.
  • Especially note the position of his/her body in relation to the floor.
  • Count out loud each completed Push-Up (>30 degrees at the elbows) from the straight-arm position.
  • Say "No Rep" if a Push-Up attempt is < 30 degrees, and do not count the rep.
  • Do not inform your client how much time has elapsed or remains.
  • Repeat the number of the last Push-Up when the Timer stops (alarms).
  • Record the Total number of completed Push-Ups during the 1-minute test.
  • Assign a Grade for the position-consistency of your client's Push-Ups.​
​
Grade by the degrees of elbow flexion:
  • A = 120+
  • B = 90-120
  • C = 60-90
  • D = 30-60
  • F < 30 = No Rep

Scoring the Test Result:
  • Divide the total number of Push-Ups by 30 and then multiply that number by 100.
  • Round off to the first decimal.
  • Example: Total Reps = 17 push-ups. (17 / 30) x 100 = 56.66 = 56.7 (Raw Rep Score)
  • Grade your client's ability to perform the standard (gender specific):
  • --  A = Consistently lowered and raised their straight body through the full range of motion (120+ degrees at the elbows).
  • --  B = More consistently lowered and raised their almost straight body through nearly the full range of motion.
  • --  C = More consistently lowered and raised their body with significant bends upward or downward at the waist and/or significantly limited the range of motion.
  • Males who do their push-ups from their knees start the test with a C grade.
  • --  D = More consistently lowered and raised their body with significant bends upward or downward at the waist and/or greatly limited the range of motion, or more consistently lowered and raised their nearly flaccid body by "worming" their body and then their legs up, and then letting their legs and body down all the way onto the floor.
  • Adjust your client's Raw Rep Score by his/her Grade to get their Arm Extensor Strength Score:
  • -- A: Raw Rep Score = Arm Extensor Fitness Score (no deduction)
  • -- B: Raw Rep Score x 0.90 = Arm Extensor Fitness Score (-10%)
  • -- C: Raw Rep Score x 0.75 = Arm Extensor Fitness Score (-25%)
  • -- D: Raw Rep Score x 0.50 = Arm Extensor Fitness Score (-50%)
  • Example: 56.7 Raw Rep Score with a D Grade = 56.7 x 0.50  = 28.35 = 28.4 Arm Extensor Strength Score

Arm Extensor Strength Score Interpretation:​
  • Use the Score Interpretation chart below.
  • An Arm Extensor Strength Score of 100 (or more) indicates Very High Fitness in relation to health benefit.
  • An Arm Extensor Strength 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 an Arm Extensor Fitness Score < 100 to try a Fitness Training Program for just 1 month and to return for a Follow-Up Medical-Fitness Assessment. If they follow your Exercise Rx (Learning Module 35), they will see significant improvement.