Medical-Fitness Technician
Certification Course
Part C: Assessing Medical-Fitness
Learning Modules: 25-34
Learning Module 33-B:
Arm Muscle Fitness - Flexors
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 Inverted-Row Test
  • Calculate the Arm Flexor Fitness Score
  • Calculate the combined Arm Muscle 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).
NOTE: The Arm Flexor Strength Test (1-min Inverted-Rows) can be omitted if rings or a bar is not available. Your client's Total Fitness Score will still be valid, but your client's Exercise Rx should also omit the Inverted-Rows until this test can be administered and the results factored into your calculations.
The Inverted-Row Test is used to assess Arm Flexor Fitness, which is a 1-minute AMRAP (as many reps as possible) during which your client performs as many inverted rows as possible (to the best of their ability) until the time runs out.

The inverted-row exercise mainly targets the Latissimus Dorsi and Biceps Brachii muscles.
Know how to do an Inverted Row.
​(Watch the video below on Youtube.)
​Inverted-Row Instructions:
  • Set rings or bar about waist level.
  • Position yourself underneath the bar or rings facing up.
  • Grip the bar or rings shoulder width apart.
  • Start with arms extended.
  • The position of the arms should be nearly vertical.
  • The bar or rings should be directly above the upper chest.
  • Pull the body up until the bar or rings touch the chest. 
  • Pivot on the heels of your feet.
  • Alternatively, bend the knees to 90 degrees with feet flat on the floor and pivot at the knees.
  • Body remains straight and rigid - no sagging at the waist.
  • Lower the body by extending the arms in a controlled manner.
  • Return to the starting down position.
  • Complete at full arm extension

Explain the testing procedure to your client:​​
  • Your Arm Flexor Strength Test is a 1-minute Inverted-Row 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 Inverted-Row.
  • 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 Inverted-Rows that you did during the 1 minute.
  • If most of your Inverted-Rows 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 Inverted-Row movement.
  • Confirm that your client understands the Inverted-Row 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 Inverted-Row.
  • Observe your client at all times and check his/her body movements.
  • Especially note the position of his/her body in relation to the bar or rings.
  • Count out loud each completed Inverted-Row (>45 degrees at the elbows) from the straight-arm position.
  • Say "No Rep" if an Inverted-Row attempt is < 45 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 Inverted-Row when the Timer stops (alarms).
  • Record the Total number of completed Inverted-Rows during the 1-minute test.
  • Assign a Grade for the position-consistency of your client's Inverted-Rows.
​
Grade by the degrees of elbow flexion:
  • A = 120+ (chest touches the bar/rings)
  • B = 90-120
  • C = 60-90
  • D = 45-60
  • F < 45 = No Rep

Scoring the Test Result:
  • Divide the total number of Rows by 30 and then multiply that number by 100.
  • Round off to the first decimal.
  • Example: Total Reps = 23 inverted-rows. (23 / 30) x 100 = 76.66 = 76.7 (Raw Rep Score)
  • Grade your client's ability to perform the standard inverted-row:
  • --  A = Consistently raised their straight body and touched their chest to the bar or rings.
  • --  B = More consistently raised their almost straight body to almost touch their chest to the bar or rings.
  • --  C = More consistently raised their body with significant sagging at the waist to get their chest half way or more to the bar or rings.
  • --  D = More consistently raised their body with significant sagging at the waist to get their chest less than half way to the bar or rings.
  • Adjust your client's Raw Rep Score by his/her Grade to get their Arm Flexor Strength Score:
  • -- A: Raw Rep Score = Arm Flexor Fitness Score (no deduction)
  • -- B: Raw Rep Score x 0.90 = Arm Flexor Fitness Score (-10%)
  • -- C: Raw Rep Score x 0.75 = Arm Flexor Fitness Score (-25%)
  • -- D: Raw Rep Score x 0.50 = Arm Flexor Fitness Score (-50%)
  • Example: 76.7 Raw Rep Score with a C Grade = 76.7 x 0.75  = 57.53 = 57.5 Arm Flexor Strength Score

Arm Flexor Strength Score Interpretation:​​
  • Use the Score Interpretation chart below.
  • An Arm Flexor Strength Score of 100 (or more) indicates Very High Fitness in relation to health benefit.
  • An Arm Flexor 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 Flexor Strength 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.
Calculating the combined Arm Fitness Score
Add the Arm Extensor Strength Score and the Arm Flexor Strength Score.
​Then divide  the sum by 2 and round-off to the first decimal.
Example:  28.4 + 57.5 = 85.9
85.9 / 2 = 42.95 = 43.0
NOTE: If a bar or rings are not available for testing your client's Arm-Flexor Strength, you may omit the Inverted-Row Test and only use your client's Arm-Extensor Strength Score (Push-Ups result) to calculate your client's Total Fitness Score while maintaining a high level of validity.