Physical activity is an integral part of childhood, adulthood and general health. Defined as any movement of the body that requires energy expenditure, physical activity is extensively used as a marker for health in both children and adults. As noted by Nelson et al., participation in aerobic and muscle-strengthening activities recommended by the ACSM/AHA provides improvement in personal fitness, reduced risk for premature chronic health conditions and mortality related to physical inactivity. Continuing, reinforcing healthy habits and giving children a baseline of fitness allows students to experience and understand the components of how health-related fitness is essential for promoting a healthy lifestyle. Thus, the value of physical activity and its effect upon lifelong health denotes the need for a program that accesses and reinforces physical fitness in schools.
Specifically, the FITNESSGRAM – a health related physical fitness assessment – compares students to health fitness standards carefully established for each age and gender that indicates good health. Testing cardio respiratory (cardiovascular) endurance, muscular strength & endurance and flexibility, the FITNESSGRAM indicates areas where an individual might need to improve upon and reports individualized feedback on an individual’s personal level of health-related fitness. Accessing both the physical fitness of students at San Diego State University (SDSU) and the reliability & validity of the FITNESSGRAM, results denote a relationship between participation in physical activity, muscle strengthening, active stretching and Body Mass Index (BMI) and muscle & flexibility tests (90-degree push-up and trunk test).
In 1977 Charles Sterling discovered the FITNESSGRAM as a type of “report card” for physical fitness that provided schools a template to accurately and effectively measure their students fitness levels (Plowman et. al, 2006). In order to fully understand the purpose of the FITNESSGRAM testing system, one must consider its origins and motivation for its use. As the Director of Health and Physical Education in Richardson, Texas, Sterling realized the overwhelming number of students who do not exercise in their schools, so his idea gave parents and administration a check up on student’s fitness. Up until Sterling, physicians were the primary authority on one’s health, and they relied almost solely on “anthropometric measurements” (Pate et al., 2012). Sterling joined Dr. Kenneth Cooper, the “father of aerobics”, at the Cooper Institution for Aerobics Research in 1981 to collaborate and develop each student’s physical fitness, where they would formulate how to base one’s health on something more than just their waistline and limb proportions.
The test, coined FITNESSGRAM by Nancy Voith, is a play off the concept of a telegram and suited the intended purpose of the report: “to communicate important fitness information to children and parents” (Plowman et. al, 2006). In 1982, the Campbell Soup Company’s Institute for Health and Fitness became the test’s first national sponsor and Dr. Marilu Meredith was hired as the National Project Director, a position she held until 2012. Since its founding, the FITNESSGRAM has gained massive popularity, as it represents over one-hundred years of research and effort into determining the most ideal fitness standards for the country and how to measure them. For over 35 years, the FITNESSGRAM has been the “most trusted and widely used fitness assessment, education, and reporting tool in the world” (Cooper et al., 2014).
Many tests have been conducted to conclude whether the FITNESSGRAM test is reliable or not. In the article, Reliability and Validity of the FITNESSGRAM, Morrow Jr. tested the FITNESSGRAM to determine if the reliabilities and validities of the test were associated with confounding variables or not. Different scenarios were organized to determine the quality of data collected in this large-scale fitness test with “individual students (N=1,010) on two occasions” (Morrow et al 2013). The criterion-referenced reliabilities were “very good to generally acceptable for all FITNESSGRAM test items” (Morrow et al. 2013). It was found that the reliability and validity were unrelated to any confounding variables, so schools and parents should feel safe having their children perform the FG test. Because it was based on such strong scientific evidence, the FITNESSGRAM was widely adopted by many individual school districts who were just as concerned with improving their students health and fitness.
Because the FITNESSGRAM is a criterion-referenced test (CRT), the 14 possible events established cut off points that can be applied to the general population. The advantage for the criterion-referenced standards is established from good health levels of fitness, meaning gender and age need to be taken into consideration when performing the tests. All the tests analyze either cardiovascular endurance, muscular strength, flexibility, or body composition. According to the Cooper Institution, there are two primary zones that students can fall into, the “Healthy Fitness Zone and the Needs Improvement Zone” (Cooper, 2014).
The Healthy Fitness Zone (HFZ) is what students are urged to achieve. If a student successfully completes an event and is scored within this zone, they are considered to have an optimal fitness level, and as a result, have good health. A unique attribute of the FITNESSGRAM is that it promotes the understanding of health benefits that come along with being active and physically fit, and compares one’s results to a criterion-based standard, rather than against other students. The alternative to the HFZ, is the Needs Improvement Zone, which defines a child’s level of fitness as an indication of the potential health risks they may face, whether it be in the present or the future.
In relation to aerobic capacity, the criterion-referenced standard was designed to “represent the lowest levels of aerobic capacity consistent with minimizing disease risk and ensuring adequate functional capacity for daily living” (Cureton & Warren, 1990). The Cooper Institute began perfecting the boundaries of how aerobic capacity should be set. Soon after, they linked VO2max with disease risk in adults. In recent years, studies found that there has been a correlation between aerobic capacity tests (one-mile walk/run, PACER) and existing disease risks for children, proving that the implementation of the FITNESSGRAM standard was, and still is, a useful indicator of detecting health risk and is also a marker of one’s potential longevity.
In addition to aerobic capacity, body composition is another focus that is also reliant on a criterion-referenced standard. This standard was created to “indicate the level of percent body fat and body mass index associated with increased risk of metabolic syndrome in youth” (Laursen et al., 2011). The application of these standards serves as an attempt to reduce heart disease, hypertension, diabetes, and obesity as they are all strongly correlated with a high body fat percentage. The use of the BMI test focuses on identifying those risks and allowing the person to reduce them through diet and exercise.
Finally, the last standards of fitness that are dependent upon a criterion-referenced standard are muscular strength, endurance, and flexibility. As stated by the Journal of Physical Activity and Health, “strength, muscular endurance, and flexibility are important components of healthy back function.” In contrast to the previous fitness segments, the criterion health condition to which both general and specific measures of hamstring flexibility (the Back Saver Sit and Reach), low back flexibility (no separate field test available), abdominal strength and endurance (the curl-up), and truck extension for flexibility and strength (trunk lift) were originally linked with low back pain (Plowman, 1993). The anatomical application remains strong; however, the theoretical support exceeds this biological limitation as it explains that the research evidence between low back function (in terms of measurable muscle strength, endurance, and flexibility) and low back pain onset, or recurrence, is not as substantial. This then leads to more percentile-based musculoskeletal tests rather than criterion-referenced based values (Castro-Piñero, et al., 2009).
Twelve student volunteers from San Diego State University were asked to participate in two (2) different FITNESSGRAM tests. Six males and six females were asked for basic information, which included their height (cm), weight (kg), age, gender, red ID, and their BMI. The male’s average age was 24.3 years old and their average BMI was 24.2. The female’s average age was 22.2 years old and their average BMI was 24.9. The participants were also asked three questions about their physical activity level before the tests were conducted. The first question asked how many out of the past seven days did they participate in physical activity for 60 minutes or more in the span of one day. For this question, the average answer for the male was 4.5 days in the past week. For the females, the average was 4.2 days in the past week.
The second question asked how many out of the past 7 days did they participate in exercises to strengthen and tone their muscles. The average answer for the males was 4.3 days out of the past 7 days. For the females, the average was 3.2 days. The third question asked how many out of the past 7 days did the participant do stretching exercises to relax as well as loosen up their muscles. The average male answer to this question was 3.7 days. For the female group, the average answer was 3.8 days. The numbers that were collected were analyzed to see whether they met the criterion-established HFZ. These questions are important because they give a general idea on the fitness and activity levels of each group compared to the HFZ.
After the general data was collected, the participants performed two different muscular strength tests using the FITNESSGRAM. The two tests performed were the 90-degree cadence push-up and the trunk lift. A 90-degree cadence push-up test is when a participant gets into a plank position with their arms fully extended and shoulder width apart. The shoulders, knees, hips, and feet are aligned, and the body is in a plank position with no arch in the back. The subjects were then instructed to perform a push-up by lowering their bodies until their elbows are at a 90-degree angle and then pushing back up to the original position. The subjects followed the FITNESSGRAM push-up test cadence, which means that each participant performed their push-ups at a rate of one every three seconds.
According to PubMed, “The standard cadence minimized influence of varying velocities of contraction on muscle performance” (Cogley). The participants were instructed to maintain both proper form and cadence so that tests are accurate and consistent. When looking at the HFZ for the push-up test, females in the 17+ age range should be able to do 7-15 push-ups in one set according to FITNESSGRAMS criterion referenced standards. The average number of push-ups for our group of females was 10.8. According to the data, only 2 out of the 6 met or exceeded the HFZ outlined by FITNESSGRAM. The criterion-referenced standards for males in the 17+ age range should be able to perform 18-35 push-ups in one set. All 6 male volunteers met or exceeded the HFZ. The average number of push-ups for the male group was 33.3. According to the data, all 6 of the participants met or exceeded the criterion reference standards.
The second muscular strength test that was performed was the trunk lift. Trunk lift tests are a great way to assess flexibility, endurance, and trunk extension strength since the person lifts their upper body as high as they can. According to the Journal of Physical Activity and Health, “strength, muscular endurance, and flexibility are important components of healthy back function” (Hannibal). The trunk lift test can give a good indication on whether or not the participants have healthy back functions. For the trunk lift, the participants were instructed to lay flat on their stomach and lift their trunk, or torso, off of the floor as high as they can. The participants then held the position until someone measured the distance from the floor to their chin with a measuring tape. According the guidelines outlined by the HFZ, males and females ages 17+ should be able to be 9-12 inches off the ground during the trunk lift test. The average male trunk lift height was 24.8 inches. The average female trunk lift was measured at 32.8 inches. Both of the groups easily exceeded the parameters of trunk lift standard outlined by the HFZ.
The following tables include participant body composition information, data obtained by the fitness questionnaire, results of the two FITNESSGRAM muscular tests, and whether or not participants met the HFZ criterion-standards for each. Table 1 provides the basic participant information regarding body composition, as well as the number of physical activity, strength, and flexibility days each participant self-reported per week. Table 2 includes the results of the 90 degree push-up and trunk lift muscular tests along with the outcome of pass or fail for each test according to the FITNESSGRAM HFZ criterion-standards. Also included are the pass/fail outcomes for meeting physical activity, strength, and flexibility days per week criterion-standards and BMI criterion-standards. Table 3 displays the Pearson Correlation for strength days and the push-up test and the Pearson Correlation for BMI and physical activity days. Table 4 depicts the results from the CRTs: Pearson Chi-Square, Phi, and Kappa. Lastly, Table 5 includes the independent t-test outcomes. All tests were performed are under the assumption of equal variances.
