Medical-Fitness Technician
Certification Course
Part C: Assessing Medical-Fitness
Learning Modules: 25-34
Learning Module 34:
The Total Fitness Score
Study the Learning Module and take the Quiz.
Learning Objectives
  • Know how to calculate a Total Medical-Fitness Score.
  • Know how to interpret Total Medical-Fitness Scores in context.
Calculations
In the previous 5 Learning Modules, you learned how to conduct a set of fitness tests that include the 4 main areas of functional capacity related to health and quality of life.
  • Aerobic Fitness = 4-minute Treadmill or Shuttle Test x 2
  • Leg Muscle Fitness = 3-minute Squat Test
  • Core Muscle Fitness = 2-minute Leg-Raise Test
  • Arm Muscle Fitness = (1-minute Push-Up Test) + (1-minute Inverted-Row Test) / 2

The raw scores from each of these tests are converted to a percentile score using a standardized threshold corresponding to a "high-fit" level of functional capacity.
  • The Aerobic Fitness Score is given double weight in calculating the Total Fitness Score.
  • The Muscle Strength Scores are adjusted by grading the participant's movement technique based on full-range consistency.
  • The Arm Fitness Scores (Extensors & Flexors) are combined into one Arm Fitness Score (or only the Extensor Score is used).
  • The Total Fitness Score reflects the participant's functional capacity or medical-fitness.
Having a standardized Fitness Score for each of the 4 major areas of functional capacity allows us to combine these 4 separate scores into a Total Fitness Score by simply adding them together, and then dividing that sum by 5. (Not by 4, because the Aerobic Fitness Score is used twice in the formula.) The weighted average of the Scores for each of the 4 areas of functional capacity is the participant's Total Medical-Fitness Score (aka: Med-Fit Score).
As an example, let's say you conducted a Medical-Fitness Assessment for your client. Your calculations of the fitness test results produces the following values:
  • ​Aerobic Fitness (Shuttle*) Test: 725 meters / 800 threshold = 90.6 % x grade (N/A) = 90.6% Aerobic Fitness Score
  • Leg Muscle Fitness Test: 114 squats / 120 threshold = 95.0 % x grade 0.90 (B) = 85.5% Leg Muscle Fitness Score
  • Core Muscle Fitness Test: 64 leg-raises / 60 threshold = 106.7 % x grade 1.00 (A) = 106.7% Core Muscle Fitness Score
  • Arm Extensor Fitness Test: 23 push-ups / 30 threshold = 76.7 % x grade 0.75 (C) = 57.5% Arm Extensor Fitness Score
  • Arm Flexor Fitness Test: 21 inverted-rows / 30 threshold = 70.0 % x grade 0.90 (B) = 63.0% Arm Flexor Fitness Score
  • Arm Muscle Fitness Tests: Extensor Score 57.5 + Flexor Score 63.0 = 120.5 / 2 = 60.3% Arm Muscle Fitness Score
  • TOTAL FITNESS SCORE: (90.6 + 90.6) + 85.5 + 106.7 + 60.3 = 433.7 / 5 = 86.7%
             * Participants only do 1 of the 2 Aerobic Tests. The Shuttle Test result was used for this example.
Note: Since the Aerobic Fitness Score is given double weight (because of its higher impact on health, disease prevention, and longevity), the sum of the Scores is divided by 5 to produce the weighted average.
Interpretation
The Total Fitness Score is interpreted on the same scale as the 4 separate Fitness Scores are interpreted. The scale below shows that this example Medical-Fitness Assessment resulted in a Total Med-Fit Score in the "High Fitness Level" (80-99). But remember, this scale is in relation to the "average" person, which is sadly unhealthy and unfit due to a lifestyle that leads to premature disease, disability, despair, and death. So, an appropriate fitness Goal for most people would be 100+.
A single, standardized Total Med-Fit Score for each individual is helpful because it makes their journey to optimal health easier to visualize, track, and even compare with their peers -- for motivational purposes.
A minimum goal of 100 for the Total Med-Fit Score and for EACH of the 5 separate Fitness Scores is appropriate and very doable for most individuals -- no matter how de-conditioned and unhealthy they might be. However, it is important to consider the individual's context when interpreting the fitness scores for personal application.
Personal Context
Looking at our example's Total Med-Fit Score we can see that there may be some room for improvement. A closer look reveals that their Arm Muscle Fitness Scores are significantly lower than their other Fitness Scores. But, is the answer to that apparent "problem area" to simply prescribe twice as many push-ups and inverted-rows as the other exercises for a while until their Arm Muscle Fitness catches up to the others?
To answer this question, you will need to consider the individual's Personal Context, including:
  • Previous Medical-Fitness Scores (if any)
  • Recent Injury
  • Long-term Impairment or Disability
  • Fatigue (at the end of the tests)
  • Poor Push-Up and/or Inverted-Row Technique
  • Age
  • Gender
  • Weight (Distribution and  Composition)
  • Exercise Pattern & Routine
  • Health & Fitness Goals
While keeping these types of variables in mind (depending on your client's scores), you will usually discover the reason for their particular scores by simply having a casual, but inquisitive, conversation with them. Your objective is to determine how your client understands his/her own scores and what he/she wants to do about them.
Coming up with a sophisticated training program to "solve the problem" is not needed and is seldom appreciated. The question you want your client to answer for themselves is what is he/she WANTING and WILLING to do next? A simple, short-term recommendation is usually the best in order to keep the person engaged and motivated in their therapeutic lifestyle change (exercise/fitness) program.
Inviting your client to attend a therapeutic fitness training (which is explained in the next section) to develop a short personal training program, or to modify their current one, with a follow-up Medical-Fitness Assessment after 1-3 months may be the best recommendation for now.

Getting accurate results for a single set of Fitness Tests is a great start, but each of the scores, and even the Total Score, are not of much value without one or more Follow-Up Med-Fit Assessments to reveal the amount of CHANGE in fitness level that your client is able to achieve within a given timeframe.