Acknowledgements Director General General Personal Family Support Services (DGPFSS), Directorate Directorate of Fitness (DFIT) (DF IT) has developed th the 4 Edition of the CF EXPRES Operations Manual. In preparing this resource resource DGPFSS DFit worked worked with a team of experienced and dedicated fitness profession professionals. als. DGPFSS
Daryl Allard Director of Physical Fitness Natacha Tremblay Physical Fitness Policy and Resources Manager (Previous) Rick McKie (Present) Marie Danais (Previo (Previous) us) National Physical Fitness Manager Daniel Bourgoin (Present) Todd Stride (Previous) National Physical Fitness Coordinat Coordinator or Christine Charron Fitness Program Coordinator PSP Training Center
Howie Woodruff Chief Instructor Canadian Forces Bases/Wings
Connie Tet Tetarenko arenko CFSU (O) Fitness Coordinator Coordinator Carolynn Derksen Carolynn CFB Shilo Regional Adapted Fitness Specialist Joanne Morgan CFB Kingston Fitness Coordinator Penny Murphy CFB Esquimalt Fitness and Sports Directo Directorr Graphic Design and Layout
Hélène Gareau Directorate Director ate of Communication, DGPFSS
TABLE OF CONTENTS Table of contents CHAPT ER 1 - INT CHAPTER INTRODUCTI RODUCTION ON ................................ ................................................................. ................................................. ................ 5 General......................................................................... ................................................. ................................................. ...................... 5 Scope ............................................. ................................................. ................................................. .................................................. .... 5 Aim ............................................. ................................................. ................................................. .................................................. .......... 6 Rationale ............................................. ................................................. ................................................. ............................................... 6 Requirement and Responsibility ................................................ .................................................. ............................................ 6 Components of the CF EXPRES Progr Program am................................................................................................................................7 ................................................................................................................................7 CHAPT ER 2 - ADM CHAPTER ADMIN INISTRATION ISTRATION ................................. ................................................................... ............................................ .......... 9 General......................................................................... ................................................. ................................................. ...................... 9 Evaluation Schedule ................................................ ................................................. ................................................. ..................... 9 Medical Consideration.......................................... .................................................. ................................................. ...................... 9 Pension Implications ................................................. ................................................. ................................................. .................... 12 Reports and Returns ................................................ ................................................. ................................................. .................... 12 Responsibilities .............................................. ................................................. ................................................. ................................. 12 Action on Posting of CF Person Personnel nel .............................................. ................................................. ............................................ 13 CHAPTER CHAPT ER 3 - EV EVALUA ALUATION TION PROC PROCEDU EDURES RES ............................... ..............................................................1 ...............................15 5
PART I - GENERAL .....................................................................................................................................................................................15 Staff Organization and Pre-Evalu Pre-Evaluation ation Instructions for Evaluator Evaluatorss.............................................. ............................. 15 Pre-Evaluation Pre-Ev aluation Instructions for CF Per Personnel sonnel ............................................... ................................................. ........................ 15 Emergency Procedur Procedures es .................................................. ................................................. ................................................. ............. 16 Equipment for CF EXPRES Evaluation ............................................... ................................................. ..................................... 16 PARTT II - PRELIMINARY ADMINISTRATION PAR ADMINISTRATION ................................................ ................................................. ..................................... 17 Service Particulars ............................................... .................................................. ................................................. .......................... 18 PARTT III – FITNESS ASSESSMENT PAR ASSESSMENT ............................................... ................................................. ................................................. ..... 22 Cardiorespirator Cardior espiratoryy Fitness (DND 279 Sections D 1, 2&3) 2&3)........................................... ........................................... ................................................. .... 22 20 MSR Prot Protocol ocol (Section D1) ............................................ ................................................. ................................................. ...... 22 Calculation of VO2 max. (DND 279, 279, Section Section D1-3) .............................................. .................................................. ......... 25 20 MSR Referen References ces .......................................... ................................................. .................................................. ......................... 26 mCAFT Prot Protocol ocol (DND 279, Section D2) .......................................... ................................................. .................................... 26 Stepping Exercise Sequence .......................................... .................................................. ................................................. ...... 30 Handgrip Prot Protocol ocol .............................................. .................................................. ................................................. ........................ 36 Muscular Endurance (DND 279 Sections F1, F2) ............................................ .................................................. ................ 37 Push-ups Prot Protocol ocol .................................................. ................................................. ................................................. ........................ 37 Sit-ups Prot Protocol ocol ............................................... ................................................. ................................................. ............................... 39 Safety............................................. ................................................. .................................................. ................................................. . 40
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TABLE OF CONTENTS PARTT IV – FITNESS SUMMARY ............................................. ................................................. ................................................. .............. 41 PAR Section G – Fitness Results ................................................ ................................................. ................................................. ....... 41 Section H – Other .............................................. ................................................. ................................................. ......................... 42 Section J – Exercise Prescriptio Prescriptionn ............................................. ................................................. ................................................ 43 Section K – Certification of Understanding ............................................... .................................................. ...................... 43 Section L – Progr Program am Approv Approval al ................................................ .................................................. ............................................... 43 DISTRIBUTION OF DND 279 CF EXPRES Form ................................................ .................................................. ............... 43 CHAPTER 4 - EXERCIS EXERCISE E PRESC PRESCRIPTION RIPTION ..... .......... .......... .......... ........... ........... ........... ............ ........... ........... ........... ........ ... 45 General......................................................................... ................................................. ................................................. ................... 45 Supervision of Exerc Exercise ise Progr Programs ams ................................................ .................................................. ......................................... 45 Exercise Prescrip Prescription tion .......................................... .................................................. ................................................. ......................... 45 Warm-up War m-up ............................................... ................................................. ................................................. ............................................ 45 Cool-down............................................................................ ................................................. .................................................. ........... 46 Aerobic Fitness Progr Programs ams ............................................ .................................................. ................................................. ............ 46 Muscular Strengt Strengthh and Endurance Endurance............................................. ............................................. ................................................. .......................................... 48 Heart Rate Monitoring .................................................. ................................................. ................................................. ........... 49 Rate of Progr Progression ession - All Fitness Progr Programs ams .......................................... ................................................. .............................. 50 Prescription Prescrip tion Materials ............................................... ................................................. ................................................. .................. 50 Sport and Recreation Activities............................................. .................................................. ................................................. . 51 Feedback to CF Person Personnel nel ................................................. ................................................. ................................................. ....... 51 CHAPT ER 5 - HEAL CHAPTER HEALTH TH RELATED FITNESS FITNE SS .............................. ............................................................ .............................. 53 General......................................................................... ................................................. ................................................. ................... 53 Lifestyle Assessment ................................................. ................................................. ................................................. .................. 53 Strengthening Strengthen ing the For Forces ces Health Promo Promotion tion Progr Program am ............................................ .................................................. ... 53 ANN EX A .............................. ................................................................ .................................................................... ............................................... ............. 55 History and Rationale Rationale............................................ ............................................ ................................................. ................................................. ................... 55 Tool 1 CF EXPRES Form (DND 279)............................................... ................................................. ................................... 56 Tool 2 Medical Referr Referral al Form (DND 582) ............................................. ................................................. ....................... 57 Tool 3 List of Medications Medications............................................ ............................................ ................................................. ................................................. ...... 58 Tool 4 Ergomet Ergometer er Steps ................................................. ................................................. ................................................. ..... 60 Tool 5 Handgrip dynamometer adjustments .......................................... ................................................. ................... 61 Tool 6 Prediction of VO2 max from the 20 MSR ............................................. ................................................. .......... 62 Tool 7 CF MPFS: UNTIL 31 MAR 2008............................................... .................................................. ............................ 63 Tool 8 Evaluation Room Set Up ............................................ ................................................. .......................................... 64 Tool 9 Aerobic prediction for 20 MSR using EXPRES Progr Program am Booklets................................................. ....... 65 Tool 10 Per Percentiles centiles for Prescriptio Prescriptionn using EXPRES Progr Program am Guides............................................ ..................... 66 Tool 11 20 MSR Per Percentiles centiles for Males: EFFECTIVE 01 APR 2009 ............................................... ........................... 67 Tool 12 20 MSR Per Percentiles centiles for Females: EFFECTIVE 01 APR 2009 ................................................ .................... 68 Tool 13 Strength and Muscular Endurance Guidelines for Prescrip Prescriptions tions.............................................. ........ 69
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TABLE OF CONTENTS Tool 14 Tool 15 Tool 16 Tool 17
Protocol Per Protocol Percentiles: centiles: EFFECTIVE 01 APR 2009.................................................................. ............................. 70 Aerobic prescription for mCAFT ........................................... .................................................. ............................... 71 Borg Scale ............................................... ................................................. ................................................. .................. 72 Acronyms Acron yms........................................... .................................................. ................................................. ......................... 73
List of Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5
20 MSR set up ........................................... ................................................. ................................................. ................... 23 Ceiling Post-Ex Post-Exercise ercise Heart Rates ............................................. ................................................. ............................. 28 mCAFT starting stage ........................................... ................................................. ................................................. ...... 29 Correct Corr ect mCAFT Stepping Cadence (footplants.min-1) ............................................ ........................................ 29 O2 Cost in (ml-kg-1.min-1) for Different Dif ferent Stages Stages of the mCAFT .......................................... ............................ 35
NOTE 1.
The term term “CF “CF Personnel” Personnel” refers refers to a member of the Canadian For Forces ces and includes Officers and and non-Commissioned Members; 2. The masculine is employed throughout the manual to refer refer to to both genders; and 3. The term term ‘’Medical Care Care Provider’’ Provider’’ represents represents a military military medical officer and/or civilian civilian physician and/or approved physician assistant (PA) who is authorized to practice with the CF.
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FOREWORD Foreword 1. The 4th Edition of this Operations Manual has been prepared to provide provide instruction and guidance for the delivery of the CF EXPRES Progr Program. am. The physical fitness evaluation is conducted to measure fitness levels of Canadian Forces personnel in comparison to the Canadian Forces Minimum Physical Fitness Standards Standar ds (MPFS). 2. This manual is being updated to streamline streamline current current testing procedures. procedures. This has been done in an attempt to free up both time and resour resources ces for fitness progr programming. amming. Upon receipt, this manual will supersede all previous CF EXPRES Ops Manual editions including the 1980/90s versions of the CF EXPRES and the 1996 protocol manual for 20 MSR, 20 MSR PERI’s Handbook-An Alternative Aerobic Ops Manual and Test , as well as the 3rd Edition of the Operations Manual in their entirety. Modifications to this manual may be made by DFIT from time to time and will be forwarded to you accordingly. accordingly. 3. It is essential that the evaluation prot protocols ocols and instructions provided in this manual be strictly adhered adhered to in order to ensure ensure valid and reliable evaluation results. results. Safety is paramount paramount when administering this evaluation. You must ensure ensure that the evaluation is conducted in the safest manner and environment environment possible.
Daryl Allard Director of Fitness Director General Personnel Personnel Family Support Services
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Chapter 1
INTRODUCTION
General 1. This manual describes the Canadian Forces Forces (CF) Program Program for physical physical fitness fitness training training and evaluation, named the CF EXPRES Program. CF EXPRES derives from the words “exercise” “exercise” and “prescription”. It provides guidance and direction on how to administer administer the CF EXPRES Program Program for CF personnel. The program program is in line with DAOD 5023-2, and shall be adhered to by all DGPFSS Staff involved in the CF EXPRES Program.
Scope 2. The Canadian For Forces ces recognizes recognizes the importance of physical fitness. In recent recent years, increased emphasis has been placed on physical education and health promotion. The CF EXPRES Program Program is the trademark program in regards to CF physical fitness. 3. To effectively deal with with the many factor factorss that influence physical physical fitness, the efforts of commanding officers, medical authorities, dieticians, health promoters, promoters, physical educators, and fitness, sports and recreation recr eation personnel at all levels must be coordinated. The fitness evaluation described in this manual must be considered an important tool in the development of an overall health and wellness strategy for CF personnel. 4. Since the CF EXPRES EXPRES Program Program is pertinent to to a number of related related areas, areas, awareness awareness of the following following orders, directives directives and publications is important to the users of this manual: • • • • • • • • • • • • • • • •
DAOD 5023-0, Universality of Service; DAOD 5023-1, Minimum Operational Standar Standards ds Related to Universality Universality of Service: DAOD 5023-2, Physical Fitness Program, CFAO 50-2 Recreation; CFAO 50-3 Sport Sports;s; Veterans Affairs Web site: http:/ http://www.vrab-tacra.gc /www.vrab-tacra.gc.ca/VRAB .ca/VRABTA TACRA_content CRA_contents.htm s.htm CF Interim Aquatics and Water Safety Policy; A-PD-050-15/PT-001/PT-002, A-PD-050-15/PT-001/PT-00 2, Physical Physical Fitness Tr Training aining in the Canadian For Forces: ces: DAOD 2007-0 and 2007-1 General Safety Program; DAOD 5021-2 Heat Stress; DAOD 5031-1 5031-100 Adventure Tr Training; aining; DAOD 7002-0 Boards Boards of Inquiry Inquiry and Summary Investigations; CFAO 24-6, Investigat Investigations ions of Injuries and Death; ADM (HR-Mil) Instruction 11/04 Medical Standar Standards ds for the Canadian For Forces; ces; CSEP Canadian Physical Activity Fitness Fitness and Lifestyle Lifestyle Approach Approach 3rd 3rd edition; and CSEP Certified Personal Personal Trainer Study Guide.
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Chapter 1 - Introduction Aim 5. The aim of the CF CF EXPRES Program Program is to assess the physical physical fitness level level of Canadian Forc Forces es personnel and to provide exercise prescriptions prescriptions in order to enhance the operational effectiveness and general health of Canadian Forces personnel.
Rationale 6. The roles and and objectives of the CF may require require personnel personnel to serve serve in a variety variety of geographic geographic locations and environmental environmental conditions in both peacetime and wartime. In peacetime, CF personnel must deal effectively ef fectively with the pressures of modern society, as they are not isolated from the many factors that influence the Canadian lifestyle. lifestyle. While Canadians enjoy a high standard standard of living, health problems problems that result from sedentary and stressful lifestyles are a major concern which, over time, can negatively impact the CF’s operational effectiveness. 7. In wartime, the CF might be engaged in highly intense conflict, where where battles could be fast moving, moving, far ranging, unrelenting, unrelenting, and conducted under a variety of environmental environmental conditions. Since the pace of this type of conflict may be sustained for extended periods of time, CF personnel must be conditioned to cope with many physical and mental stresses. Under these circumstances, the physical fitness of the individual is fundamental to the effectiveness of the CF CF..
Requirementt and Responsibility Requiremen 8. The Chief of Defence Staff Staff (CDS) and the Defence Defence Management Committee Committee officially adopted the the th CF EXPRES Program on the 14 of February 1983. As directed in DAOD 5023-2 (Physical Fitness Evaluation Evaluat ion Table), CF personnel of the Regular and Primary Reserve are required, unless exempt or excused from evaluation (see the Exemptions and Excusals from Physical Fitness map), map), to meet the mandatory physical fitness standard on an annual basis. The physical physical fitness training training prescribed under the CF EXPRES program program should be conducted during normal working working hours. This physical training training shall be considered as fulfilling the military requirement requirement for participation part icipation in the CF EXPRES Program even when conducted outside normal working hours. 9. Leadership is fundamental fundamental to the progr program’s am’s success and and therefore therefore the primary responsibility responsibility rests with with the chain of command to ensure that all CF personnel actively participate par ticipate in a regular exercise exercise program. DGPFSS/DFIT acts as primary advisors on all matters pertaining to Canadian Forces Forces physical fitness policy. Directorate Director ate Military Career Policy and Grievance (DMCPG) is currently the Office of Primary Interest (OPI) for fitness policy covered under DAOD 5023-2 Physical Fitness Program.
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Chapter 1 - Introduction 10. Commanding Officers (COs) (COs) are responsible for programs programs conducted conducted in accordance with CF policy and Command direction. PSP Evaluators Evaluators are responsible to their PSP Fitness Fitness and Sports Directors and PSP managers, who are responsible to their Commanding Officers for planning, organizing, conducting, instructing, and evaluating CF physical physical training programs. programs. Where necessary, CF personnel who hold appropriate appropriat e civilian fitness qualifications (CSEP-CPT/CEP) (CSEP-CPT/CEP) or military qualifications such as Basic Fitness Training Assistant (BFTA) and have been authorized through DFit may assist in the evaluation and training of personnel under this program. 11. At all levels there is a requir requirement ement for for Medical Officers (MOs) to advise the chain of command command on the medical aspects of physical training, training, including the capability of individuals to participate in each aspect of the CF EXPRES Program. In particular, Medical Officers’ input will be required for: for: a. Request for CF CF EXPRES Modified/Alternat Modified/Alternate e protocols protocols on the various various test items; b. Medica Medicall Referral Form (DND 582) NSM 7530-21-897-67 7530-21-897-6766; 66; and c. Investigations related to reporting of injuries or death arising from progr programs ams conducted under the auspices of the CF EXPRES Program Program (CF 98 – Report on Injuries or Exposure to Toxic Toxic Material).
Components of the CF EXPRES Program 12. The three components of the CF EXPRES Program are as follows: a. Health Appraisal and Physical Fitness Evaluation. All CF personnel shall complete annually annually the Health Appraisal Questionnaire (DND 279) and a physical fitness evaluation, except in the following circumstances: • met CF EXPRES Incenti Incentive ve program for the previous year; • medical excusal; • training excusal; and • release. b. Exercise Prescription. Based on the health appraisal and physical fitness evaluation results, results, all CF personnel shall be provided with an individual exercise program program that includes frequency frequency,, intensity, time, and types of activities. c. Exercise Participation. All CF personnel, when not participating regularly regularly in a recognized recognized unit physical fitness program, program, shall participate par ticipate in a directly supervised or self-supervised self-super vised exercise program progr am (Section G para 59 G2 of this manual).
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Chapter 2
ADMINISTRATION
General 1. The CF EXPRES EXPRES Program Program is the primary primary evaluation evaluation program program administer administered ed by the the Personnel Personnel Support Program Progr am (PSP) staff. For this reason, continual continual efforts are being made to reduce the administrative requirement requir ement through the integr integration ation of new evaluation methods and advances in information technology. Electronic delivery of all administrative aspects of the progr program am is envisioned.
Evaluation Schedule 2. All CF personnel must must be evaluated evaluated annually unless unless “excused” “excused” or have achieved the incentive level the previous year and are are exempt from testing testing in accordance with current current fitness policy. Evaluation schedules/booking procedures procedures will vary from Base to Base depending on local needs and procedur procedures. es.
Medical Consideration Pre-screening ing for Fitness Evaluation and Training. Prior to attempting the 3. Pre-screen the evaluation described in Chapter 3 of this manual, all CF personnel must complete the Health Appraisal Questionnaire, as well as undergo pre-evaluation heart rate and blood pressur pressure e screening. These procedur procedures es are necessary to determine determine potential issues requiring requiring a Medical Officer consultation prior to an evaluation. Refer to Sections B and C of the CF EXPRES form: DND 279 (Tool (Tool 1).
4. Referral to a Medical Officer. CF personnel must be refer referred red to a Medical Officer utilizing the Medical Referral Form, Form, DND 582 (Tool 2), prior to the CF EXPRES evaluation when any of the following conditions are met: a. Individual answers YES to one of the two Health Appraisal questions on the DND 279 (Section B); or b. Individual’s resting heart rate exceeds 100 bpm, and/or blood pressur pressure e exceeds 150/100 mmHg; or c. Individual develops any symptoms, which in the experience of the PSP Evaluator or the individual, are outside of those normally encountered; encountered; or d. If there is a concern for the individual’s well being. 5. Medical Action. The Medical Officer, based on his/her assessment, will make one one or more of the following recommendations recommendations on the DND 582: a. The individual individual is fit for the the fitness evaluation and subsequent training: I. Without limitations; or II. With limitations noted; or b. The individual is unfit for the evaluation and training: I. Permanently; or II. Temporarily.
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Chapter 2 - Administration 6. Medical Chits/Medical Referral Form (DND 582). It is important that Medical Officers (MO) or Physician Assistants (PA) (PA) include appropriate dates and timelines for each medical diagnosis/prescriptions, so that PSP Evaluators can properly plan future evaluations and programs. 7. Physiological Considerations physiological reasons, it may may be impossible for some Considerations.. For physiological CF personnel to perform one or more of the evaluation components as prescribed by the testing protocols. prot ocols. If the physiological difficulty is such that the evaluator determines determines that medical attention is required, the medical referral route must be chosen. Examples include but are not limited to: a. b. c. d. e.
an arm that cannot achiev achieve e full extension during a push-up due to scar tissue; palms that cannot cannot be placed flat on the floor due to limited range range of motion at the wrist; sway-back; large girth; and inability to turn or pivot properly during a 20 20 MSR evaluation, evaluation, etc. etc.
NOTE: Props are not to be utilized during testing protocols protocols (e.g., placing pl acing a person up on aerobic steps so that their stomach does not touch the ground on the down phase of the push-up) unless approved by the Modified Protocol Advisory Committee (Paragraph 8).
8. Application for a Modified Protocol. In rare rare or unusual circumstances, circumstances, CF personnel unable unable to perform the standardized protocol protocol of one or more components of the CF EXPRES program may request request permission to perform perform a modified protocol. CF personnel may apply to the DGPFSS/DFIT Modified Protocol Prot ocol Advisory Committee for consideration of their case. PROCEDURE PROCED URE TO FOLLOW FOLLOW TO REQUEST MODIFIED MODI FIED PROT P ROTOCOLS OCOLS
CF personnel must request the modified protocol through their c hain of command. 1. The request must include the following: a. b. c. d.
Memo from the individual; Last 3 completed DND 279 (if applicable); Last incomplete or medical DND 279; and DND 582 with doctor’s recommendation for the modified protocol. The 582 should highlight the capabilities and limitations of the t he applicant and comment as to why normal protocols are considered considered inappropriate and/or unsafe (CF 2018 also accepted).
2. The individual’s CO shall review review and may may provide comments before before the documents documents are forwarded to DGPFSS DGPFSS HQ. 3. Documentation must must be sent sent to DGPFSS/PSP DGPFSS/PSP DFit Attention National Physical Fitness Manager (NPFM) following following “Protected B” procedures. procedures.
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Chapter 2 - Administration 9. Application for Alternative Aerobic Protocol (mCAFT). In some instances, instances, due to orthopedic or physiological difficulties, it may not be possible for an individual to perform the 20 MSR, which is the standard aerobic protocol for the CF EXPRES program1. CF personnel may may apply to to their local MO and/ or Base Surgeon to perform perform the mCAFT as a permanent alternative alternative aerobic testing protocol. protocol. As such, the mCAFT will only be of fered to individuals in possession of a DND 582 or other medical documentation that includes the MO and/or Base Surgeon Surgeon’s’s comments supporting and recommending the alternative protocol. PROCEDURE TO FOLLOW TO REQUEST AN ALTERNATIVE PROTOCOL (mCAFT only)
CF Personnel must request a permanent alternative protocol through t heir MO and/or Base Surgeon. The request must include the following: a. Last completed DND 279; b. Last incomplete or medical DND 279; and c. DND 582 (CF 2018 also accepted). The Medical Care Provider, based on his/her assessment, may make comments on the DND 582 supporting and recommending recommending the alternative alternative protocol. It is important that the medical chit includes both a start and end date (if applicable). DFit approval is not not required for alternative protocol requests.
10. Medical Excusals. The CF personnel medically excused excused from from portions of the CF EXPRES program program should continue with the evaluation and complete the protocols that they are physically capable of performing. Section G of DND 279 and the individual’s Personal Personal Evaluation Report (PER) must reflect that they are “Med Excused” as opposed to “Did not meet CF MPFS”, and section H1 of the DND 279 will reflect “medically excused”. 11. To ensure that the proper procedur procedures es are are followed, followed, fitness evaluators evaluators must clearly clearly indicate indicate in the the appropriate appropriat e sections of the DND 279 that the individual cannot perform specific evaluation items (e.g., push-ups: sections F1, G3) and check, “medically excused excused for PER purposes” (Section H1). 12. It is conceivable that an individual attempting attempting the CF EXPRES progr program am fails some or all of the items items for which he/she was deemed fit to test. The inability to meet the standard standard on these items would be reflected in the specific fitness results of Section G. Howev However, er, such failure failure would not change the text text block “Medically excused for for PER purposes.” purposes.” Results of the completed components shall be used to provide provide a personalized exer exercise cise prescription prescription.. 1
See Annex A for History and Rationale about the 20 MSR and mCAFT protocols
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Chapter 2 - Administration Pension Implications 13. It is important that PSP evaluators evaluators complete complete the DND 279 279 in accordance accordance with proper procedures. procedures. The completed form provides proof of CF direction and control of the CF program by approving the individual to proceed with the assigned exercise exercise prescription. The DND 279 is often considered a key document document for determining determ ining a disability pension for injuries sustained while conducting physical fitness training. 14. It is in the CF’s best interest interest that its personnel participate participate in physical fitness activities that are are conducted in accordance accordance with this manual and other related policy and orders. orders. Due to the unique nature nature of the CF work environment, environment, it is not always possible for its personnel to participate in a physical fitness training program program during normal normal working hours. When engaged in the CF EXPRES Program Program on their own time, it is understood that CF personnel will be doing so to meet military operational requirements. requirements.
Reports and Returns 15. The CF EXPRES Program Program form (DND 279) will be the only form form used to record record individual evaluation results and exercise exercise prescription. In accordance with the Privacy Act, the DND 279 is a “Prot “Protected ected B” document and must be treated as such.
Responsibilities 16. PSP Fitness and Sports Instructors/Fitness Instructors/Fitness Coordinators Coordinators are responsible for for the completion and accuracy of each DND 279. 279. Only personnel who are Certified Personal Personal Trainer Trainer (CPT) or Certified Exercise Physiologist (CEP) qualified, as sanctioned by the Canadian Society for Exercise Physiology (CSEP), and who receive formal training and certification on the PSP Instructor course are authorized to evaluate, provide exercise prescriptions, and sign evaluation forms. NOTE: The 20 MSR of the CF EXPRES Program remains a maximal aerobic test that is administered after resting vital signs have been checked and a health questionnaire has been administered. From a risk management management perspective, perspective, fitness and sports staff will not provide the 20 MSR CD or a copy of the 20 MSR CD to anyone for use. The Unit or Squadron is always free to book a supervised practice or familiarization session with trained PSP staff. If a practice or familiarization 20 MSR is requested, the members will fill out sections A, B, and C of the DND 279. Sections D - L do not need need to be filled out.
17. Basic Fitness Training 17. Training Assistants Assistant s (BFTA) and PSP Fitness Leaders may assis assistt with the assessment process but may not complete the exercise prescription prescription portion of the evaluation (Sections G to J). Units or CF personnel located in remote remote locations where no PSP Fitness and Sports staff are available may request testing assistance from their pre-determined pre-determined support base or use pre-authorized fitness evaluators evaluators to conduct and sign off the DND 279. If a non-PSP evaluator’s evaluator’s assistance assistance is required, units must contact DGPFSS/DFIT for approv approval al prior to completing any of the evaluation procedures. procedures.
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Chapter 2 - Administration 18. PSP Fitness and Sports Directors are are ultimately responsible responsible for monitoring the quality control control of the CF EXPRES program and exercise prescription so as to have uniformity throughout their Base or Wing. 19. DGPFSS HQ in conjunction with with DMCPG on behalf of CMP is responsible responsible for the ongoing development development of the CF EXPRES policy and program.
Action on Posting of CF Personnel 20. When CF personnel are posted, their physical physical fitness records (DND 1117) 1117) held by the PSP Fitness and Sports Spor ts Director must be forwarded to the Unit Records Section/Orderly Room for onward transmission to the new unit.
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Chapter 3
EVALUA EVAL UATION TION PROCEDURES
PAR ART T I - GEN G ENERAL ERAL 1. The CF EXPRES program program is a fitness evaluation that predicts one’s one’s ability to meet the five common military tasks as described in the Universality of Service (DAOD (DAOD 5023-0). The evaluation is administered administered to all CF personnel except those subject to special Command (Land Force Command Physical Fitness Standard) Standar d) or task-specific unit evaluations (e.g., JTF2, SAR Tec Tech, h, Fire Fighter, Fighter, Divers, and CSOR). The CF EXPRES evaluation is comprised of 4 components: oxygen uptake 20 Metre Shuttle Run (MSR) or modified CAFT (mCAFT) to predict maximum oxygen (VO2 max); II. handgrip dynamomet dynamometer er to predict overall overall muscular strength; endurance; and III. push-ups to predict upper body muscular endurance endurance. IV. sit-ups to predict abdominal muscular endurance
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2. Optimally, evaluation procedures procedures are conducted conducted en masse and duration will vary depending on group size. When testing a single individual, allow approximately approximately 45 minutes for an evaluation. evaluation.
Staff Organization and Pre-Evaluation Instructions for Evaluators 3. PSP Evaluators Evaluators must organize organize the evaluation evaluation site and and procedures procedures to maximize CF personnel confidentiality. Where possible, a PSP Evaluator Evaluator should be designated designated as a specific unit/section representative (PSP Unit Rep). This organization and procedures enhance the cooperation between PSP, PSP, CF personnel, and the unit. 4. A respectful respectful and profession professional al rapport rapport between CF personnel and the evaluat evaluator or is imperative. The evaluatorr must be open and sensitive to information provided evaluato provided by CF personnel including but not limited to job demands, lifestyle habits, current levels of physical activity, activity prefer preference, ence, and barriers to participating in a fitness training program. program. 5. For safety safety and consistency of results, results, the evaluation procedur procedures es have have been standar standardized. dized. Judgment must nevertheless be exer exercised cised throughout all phases of the program.
Pre-Evaluation Instructions for CF Personnel 6. A minimum of 48 48 hours prior to the CF EXPRES Program Program evaluation, evaluation, CF personnel personnel must be informed informed of the following guidelines: a. CF personnel should not: • exercise six hours prior to test; • consume alcohol for at least six hours prior prior to test; and • eat, smoke, or drink tea tea or coffee for at least two hours hours prior to test. test. b. CF personnel should wear running shoes and fitness/sports appropriat appropriate e clothing. NOTE: Posting the pre-evaluation pre-evaluation instructions in the Base Routine Orders could be an efficient ef ficient alternative.
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Chapter 3 - Evaluation procedures Emergency Procedures 7. When the CF EXPRES program is properly adminis administered, tered, there are minimal risks to the individual. Nevertheless, an appropriate emergency protocol protocol shall be developed in conjunction with the Emergency Response Team. Practice drills shall also als o be conducted semi-annually: a. Emergency procedur procedures es shall be posted in suitable locations; b. Emergency phone numbers are are to be clearly clearly posted at all telephones and and should be written written on the back of any evaluation clipboard; c. All evaluators evaluators shall be First Aid and and CPR CPR trained; trained; and d. PSP Evaluators Evaluators must brief all CF personnel on safety requirements requirements and emergency emergency procedures procedures prior to the start of the fitness evaluation.
Equipment for CF EXPRES Evaluation (20MSR, mCAFT, handgrip, push-ups and sit-ups) 8. • • • • • • • • • • • • • • • • • • • • •
List as follows: DND 279 CF EXPRES form; DND 582 - Medical Referral Referral Form; DND 1117 CF EXPRES envelope; room thermometer; emergency communications system (telephone, etc.); clipboard, data sheet and pen; chair with arm rests; aneroid sphygmomanomet sphygmomanometer er and stethoscope; beam scale, weigh scale or stadiomet stadiometer; er; measuring tape (20 m); 20-metre distance on a flat surface indoors or outdoors; outdoors; line marker or pylons at the two 20-metre 20-metre boundaries boundaries and the two 1 metre lines; CD player; compact disc (CD) titled “20-metre shuttle run”; numbered pinnies; mCAFT steps / CD titled mCAFT mCAFT;; calculator; handgrip dynamometer; mats; stop watch; and CF EXPRES progr program am booklet.
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Chapter 3 - Evaluation procedures 9. Calibration of equipment is essential to ensure ensure accuracy accuracy of results. results. Equipment should should be calibrated as follows: a. b. c. d.
measuring tape tape should be verified from from time to to time against known standards; standards; ergometer ergomet er steps will have the exact exact dimensions outlined outlined in Tool Tool 4; weigh scales scales should be calibrated calibrated weekly with the use of known weights; each month the handgrip dynamometer dynamometer should should be securely placed in a holding device such as a vice. Add known weights to the handle, (for example, example, 10 kg, 20 kg, 30 kg, etc.) and check the reading scale. If they do not correspond, correspond, one of the following procedures procedures should be done: I.
Make the appropriate appropriate adjustments as per the manufactur manufacturer’s er’s instructions by adjusting recorded recor ded readings by the amount by which the readings were off (Tool 5); or II . Send the the dynamometer dynamometer to the manufactur manufacturer er for for calibration. calibration.
PAR ART T II - PRELIM PRE LIMINAR INARY Y ADMINI ADMI NISTRA STRATION TION 10. DND 279 SECTION A - Service Particulars. All service particulars will be firmly firmly printed printed in capital letters on the CF EXPRES Program Program form form (DND 279). If a figure has fewer digits than the spaces allocated on the form, zeros are to be used, beginning at the left side (for example, DOB 7 Mar 1960 would be recorded 1960/03/07).
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Chapter 3 - Evaluation procedures Service Particul Particulars ars
11.
The following codes are to be used in the appropriat appropriate e blocks: a. Rank: abbreviation abbreviationss are to be used along with the appropriat appropriate e codes:
b. Gender and code: Male M Female F 12. DND 279 SECTION B - Health Appraisal. The Health Appraisal consists of two questions as per Tool 1. Instruct individuals to carefully carefully read and honestly answer the first two questions questions of the Health Appraisal Questionnaire. Questionnaire. Only individuals who answered NO to to all questions are cleared for evaluation. evaluation. Individuals who answer YES to one or both questions shall be referred referred to their Medical Care Provider using a DND 582-Medical Referral Form (Tool 2). PSP evaluators will complete Section C once they have verified the individual’s resting vital vital signs. Individuals will also be referred referred when their vital signs do not meet the
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Chapter 3 - Evaluation procedures pre-screening criteria of the CF EXPRES evaluation. pre-screening evaluation. Section C - Vital Signs on the DND 279 form form is to be completed prior to the transfer transfer of the file to the medical staff. The individuals referred referred to the Medical Care Provider Provider should be told that there is no cause for alarm, but that the Health Appraisal Questionnaire and resting vitals are designed to work as a simple safety precaution. precaution. NOTE: DO NOT ATTEMPT ATTEMPT to diagnose or discuss in detail why the individual had a YES response or vitals above the criteria criteria for pre-screening. pre-screening. The CF EXPRES evaluation is physically physically demanding and may be an inappropriate inappropriat e evaluation for some CF personnel.
13. List of Medications. Too Tooll 3, developed in conjunction with the Director Director General Health Services, includes medications that may impact impact an individual’s ability to to undertake an evaluation. evaluation. Should an individual answer YES to question 2 on the DND 279 Health Appraisal Questionnaire and provide information or documentation to to the kind of medication he/she is taking, a review review of Tool Tool 3 is advised. It is important to note that the tool serves as a reference list and that other medications which are not listed may also influence fitness f itness evaluation results. If in doubt, refer the individual to their Medical Care Provider. Provider. 14. For medically medically fit individuals, the instructor will proceed proceed with the evaluation evaluation after confirming that the pre-evaluation pre-ev aluation instructions (para 6 above) above) were followed. followed. Non-compliance with the instructions does not necessarily mean postponement; however, individuals must be informed that it may have a negative effect on the results. 15. DND 279 SECTION C - Vital Signs. Pre-e Pre-evaluation valuation Heart Rate (HR) and pre-ev pre-evaluation aluation Blood Pressure Pressur e (BP) are influenced by many factors. factors. Nervousness and anxiety in anticipation of the evaluation may elevate the individual’s HR and BP. BP. A few minutes of informal chatting can do much to calm apprehensive individuals. Tak Take e the time to answer questions and to explain the evaluation procedures. procedures. This may help minimize the individual’s anxiety. 16. Prior to to evaluating evaluating the vital vital signs, ensure ensure the individual individual is seated comfortably (prefer (preferably ably in a chair with arm rests) with both feet feet flat on the floor for approximately approximately five minutes. During this time, complete DND 279 Section A and B. 17. Measuring Pre-evaluation HR. The measurement of the pre-evaluation pre-evaluation HR is to to be done using a stethoscope. Position the the stethoscope in your your ears with the earpieces earpieces pointing forward. forward. The diaphragm of the stethoscope should be placed either on the sternum or over the second intercostal intercostal space on the left hand side. It may be placed over the individual’s individual’s t-shirt. Should it not be possible to utilize a stethoscope, resting resting heart rate may be measured by palpating the radial radial artery. For this procedure, procedure, the index and middle fingers should be used to gently apply pressure on the inside of the wrist just below the thumb. The resting pulse is determined determined using a 15-second count count and the first beat is counted as “zero”. The total number of beats in the 15-second count is then multiplied by 4 to give a value in “beats per minute” (bpm). 18. In the event that the pre-ev pre-evaluation aluation HR exceeds 100 beats/minute, wait an additional five minutes and repeat the procedure. procedure. Should the pre-evaluation pre-evaluation HR still exceed 100 beats/minute on the second
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Chapter 3 - Evaluation procedures reading, the individual shall be referred referred to a Medical Care Provider Provider utilizing the DND 582. The individual shall not perform per form the evaluation or receive an exercise program program until appropriate medical clearance is received. a. Effective April April 1st, 2007 member’s membe r’s whose whose resting resting blood pressur pressuree lies between PRE-EVALUATION HEART RATE 141/91 mm Hg and 150/100 150/1 00 mm Hg will be permitted to perform their CF EXPRES evaluation restrictions. Thewithout pre-evaluation HR is determined using using a 15-second count. Count the first beat as “zero”. on firstsreading, pre-evaluation exceed exceeds s 100 bpm: that Waithis fiveblood minutes anderetake the b.If, PSPtheFitness Fitnes and Sports Instructor willHRadvise the member pressure pressur is slightly reading. above the normal range and will encourage him to consult with his MO. The member should If, on second reading, pre-ev pre-evaluation 100that bpm: The individual cannot serves complete bethe verbally told that there is aluation no causeHR for exceeds alarm and consulting his physician as a the simple evaluation. Refer to Me Medical dical Care Provide Provider r using DND 582. safety precaution. c.
PSP F&S Instr will check block C of the DND279 DND279 to indicate that the member has been been advised.
19. Measuring pre-evaluation BP. When conducting pre-evaluation BP a stethoscope and sphygmomanometer shall be used. An appropriate size of blood pressure cuff should be chosen and applied to the individual’s left arm. Additional procedures are: a. The cuff should be wrapped wrapped securely around around the left arm with the lower margin two or three centimetres above the antecubital space. The arm should be comfortably comfortably supported at an angle of 10° to 45° from the trunk with the lower edge of the cuff at heart level; b. Locate and note the brachial brachial artery and the antecubital space by palpation; c. Position the stethoscope stethoscope in your ears with the earpiece earpiece pointing forward; d. Locate the radial artery; e. Close the valve valve on the air pump by turning turning the thumbscrew thumbscrew in a clockwise direction until it is tight; f. Inflate the cuff quickly until the radial artery pulse can no longer be felt. Continue to inflate the cuff to a level 20 to 30 mm Hg above the level of the radial pulse (normally not above 180 mm Hg); g. Quickly position the diaphragm of the stethoscope stethoscope over the brachial brachial artery. Apply a minimum amount of pressure on the diaphragm of the stethoscope stethoscope so as not to distort the artery. The diaphragm should be in complete contact with the skin. The stethoscope should not touch touch the cuff or its tubing; h. Release the cuff pressure pressure at a rate rate of approximately 2 mm Hg per second; i. The systolic blood pressure pressure is determined determined by the first perception of sound (Korotkoff sound). Note the exact numerical line on the scale where you hear this beat; j. The diastolic diastolic BP isis determined determined when the sounds sounds cease to to be tapping tapping in quality quality and are fully muffled; and k. The cuff is then deflated to zero zero pressure pressure and removed from the the individual’s arm. arm.
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Chapter 3 - Evaluation procedures 20. In the event event that the pre-evaluation pre-evaluation systolic blood blood pressure pressure is greater greater than 150 mm Hg and/or the pre-evaluation diastolic blood pressure is greater than 100 mm Hg, have the individual rest quietly for five minutes before before repeating the measurement. measurement. If after two readings (total) the individual’s individual’s preevaluation systolic BP and/or pre-evaluation diastolic BP are still greater, the individual is not permitted to undertake the evaluation. evaluation. Refer to the Medical Care Provider Provider utilizing the DND 582. a. Effective April 1st, 2007 an individual whose pre-evaluation blood pressure lies between 141/91 mm Hg and 150/100 150/1 00 mm Hg will be permitted to perform their CF EXPRES evaluation without restrictions. b. PSP Evaluator will will advise the individual their BP reading is slightly above the normal normal range and will encourage him/her him/her to consult with his/her Medical Care Care Provider. Provider. The individual should be verbally told that there is no cause for alarm and that consulting a Medical Care Provider serves as a simple safety precaution (see the box below for instructions)
PRE-EVALUA PRE-EVAL UATION TION BLOOD PRESS PRESSURE URE
If, on the first reading, the pre-evaluation BP exceeds 150/100 mm Hg: Wait five minutes and retake the reading. If, on the second reading, the t he pre-evaluation BP exceeds 150/100 mm Hg: The individual cannot complete the evaluation. Refer to Medical Care Provider using using DND 582. If pre-evaluation BP is between 141/91 mm Hg and 150/100 mm Hg: The individual is permitted to perform their CF EXPRES evaluation evaluation without restrictions. restrictions. BUT, the PSP Fitness and Sports Sports Instructor will check the appropriate box in Section C of the DND 279 indicating that the individual has been advised to consult with their Medical Care Provider. c. PSP Evaluator will check block C of the DND 279 to indicate that the individual has been advised.
21. Automated BP Monitors. When conducting the CF EXPRES evaluation, blood pressure pressure should be measured using a sphygmomanometer and stethoscope. stethoscope. Curr Current ent DGPFSS/DFIT policy mirrors Canadian Society for Exercise Physiology (CSEP) policy, which permits the use of automated BP monitors by hearing impaired fitness appraisers. DGPFSS/DFIT also accepts the use of automated blood pressure pressure devices if approved by the Directorate of Medical Policy. 22. PSP Evaluators Evaluators will record the numerical values values for the pre-evaluation pre-evaluation HR and select the appropriate BP box corresponding with the individual’s results on the DND 279 Section C.
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Chapter 3 - Evaluation procedures PAR ART T III – FITN ESS ASSESSMENT ASSESS MENT Cardiorespiratory Cardioresp iratory Fitness2 (DN (DND D 279 279 Section Sections s D 1, 2&3) a. 20 Metre Shuttle Run (20 MSR) b. Modified Canadian Aerobic Fitness Test (mCAFT)
20 MSR M SR Protocol P rotocol (Section D1) D1) 23 General. Effective 1 January 1999, the 20 MSR was approved as the primary aerobic evaluation for CF personnel regardless of age. In 2007, 2007, the 20 MSR became the only aerobic testing protocol permitted for CF personnel. personnel. The individuals who, for medical reasons, cannot perform perform the 20 MSR, may apply to perform the mCAFT as an alternative protocol protocol as per Chapter 2 para 9 of this document. 24. The 20 MSR is a progressive evaluation, evaluation, in which the individual cannot manipulate his/her pace to compensate for diminished physiological capacity (fatigue). Therefo Therefore, re, there is a far greater chance that the 20 MSR will be discontinued due to physical fitness than for a sudden physiological trauma. The uniqueness of the shuttle run is its gradual, gradual, controlled build-up. build-up. This is different from from a timed run on a track, such as the 1.5 mile run where, w here, for example, an individual may start too quickly and slow down at the end, resulting in a lower score than what may have been attained. 25. The 20 MSR has many positive features: features: a. b. c. d. e.
is progr progressive essive and emphasizes safety; gives a very accurat accurate e reading of aerobic fitness; provides a personal challenge for all CF personnel; permits a number of individuals to be evaluat evaluated ed at the same time; and simulates the physical demands of CF work better than the mCAFT due to its dynamic and robust nature.
26. Staff Organization. The ideal individual to evaluator evaluator ratio is 5:1. This ratio should normally normally not exceed 15:1. To facilitate facilitate the evaluation procedure, procedure, BFTA qualified members and Fitness Leaders may assist the PSP Fitness and Sports Staff with conducting the 20 MSR as per evaluation protocols. protocols.
2
See Annex A for History and Rationale about the 20 MSR and mCAFT protocols
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Chapter 3 - Evaluation procedures 27.. Prior to the 20 MSR test, the following set-up (Figure 27 (Figu re 1) must be completed: a. measure out out a 20-metre 20-metre distance and place pylons/markers pylons/markers and/or tape at each end of the 20-metre distance; b. measure in a distance of 1 metre from each end of the 20-metre course and place pylons/ markers and/or tape at the 1 metre line; and c. ensure that the sound signals can be heard at both ends of the 20-metre shuttle run course. Figure 1 20 MSR set up
28. Information Briefing. An information information briefing will be given to to all individuals prior to the the commencement of the evaluation. The briefing should include: a. short description and demonstration demonstration of exercise exercise prot protocols ocols (full details details to be given given prior to to each activity); b. an outline of safety aspects (e.g., should individuals individuals wish to to leave leave the testing testing area after completing the 20 MSR, ensure that another individual accompanies them, and that their whereabouts are known); and c. requir requirement ement to stop if unusual pain or difficulty is experienced. 29. Warm-Up. Prior to the evaluation, evaluation, all individuals will be given an instructed general warm-up warm-up session. Due to the nature of the evaluation, the general warm-up should be thorough and concentrated on the lower extremities. extremities. Individuals will be provided a few minutes minutes to conduct their own specific warm-up, warm-up, stretching, stretchin g, or pre-ev pre-evaluation aluation routine.
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Chapter 3 - Evaluation procedures 30. Conducting 20 MSR. Individuals should perform the 20 MSR component in a group group setting. Groups of individuals will perform the test together, together, shuttling (running) back and forth across the course. The evaluation starts at a walk-jog pace of 8.5 km/hr and increases 0.5 km/hr for each one-minute one-minute stage. The maximum length of the test is 20 minutes. On average, most male individuals will complete 8-10 minutes of shuttling while most female individuals will complete 6-8 minutes of shuttling. 31. The following following steps should be followed in conducting the 20 MSR: a. have the individuals line up on one of the 20-metr 20-metre e lines. Ensure that that there there is adequate adequate distance between individuals; b. provide each member with a numbered pinnie; c. recor record d the individual’s number beside their name on the data sheet; d. explain and demonstrat demonstrate e the testing prot protocol ocol to the individuals being evaluated. Emphasize that turns are executed using a pivot motion and that wide turns are not acceptable; e. advise individuals not to leave leave the gym or evaluation evaluation area area after completing the 20 MSR without permission of a staff member (e.g., water, washroom, etc.); f. Start the 20 MSR CD ensuring that the volume is adequate; g. At the “The test starts in 30 seconds” warning, advise all individuals that the evaluation will begin in 30 seconds; h. Ensure at every sound signal that all individuals have reached one of the 20-metre lines; i. If at any point the individual does not reach the 19-metr 19-metre e line, have that individual stop the evaluation immediately immediately and recor record d the last completed stage on the data sheet; j. Individuals reach reaching ing the 19-metr 19-metre e line but failing to reach the 20-metr 20-metre e line will receive a “warning”. The evaluator evaluator or their appointed assistant will call out “WARNING” “ WARNING” followed followed by the pinnie number of the individual, in a voice clear enough for the individual and the evaluator at the other 20-metre line to hear. Two warnings in a row will result in terminatio terminationn of the test e.g., (one warning, then on the next warning the test is terminated). Have that individual stop the evaluation immediately and record the last completed stage on the data sheet; k. Individua Individualsls can accumulate a number of warnings provided that they do not receive two in a row. If it becomes evident that the individual is clearly trying to “play the system” by not attempting to reach the 20-metre line, the evaluator has grounds to terminate the test for the individual; l. Explain that an individual receiving a “WARNING”, having reached the 19-metre line but not the 20-metre 20-metr e line, must turn on the beep and shuttle back in the other direction. It is not necessary to touch that 20 metre line; however, he/she must touch the 20 metre line at the other end of the course. Failure to to do so will result in termination termination of the test; test; and m. PSP or BFTA BFTA qualified personnel will accompany accompany the group through through the first few few stages of the 20 MSR so that proper pace and coordination can be established. THE EVALUATOR
The evaluator will not give verbal encouragement during the performance of the 20 MSR. Encouragement may result in individuals straining beyond their limits.
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Chapter 3 - Evaluation procedures 32. Discontinuation of the 20 MSR. The PSP Evaluator shall discontinue the test if: a. b. c. d.
an individual stops; an individual individual fails to reach reach the the 19-metre 19-metre line; line; an individual individual fails to reach reach the the 20-metre 20-metre line twice in a row; row; an individual demonstrat demonstrates es signs and symptoms of discomfort (for example, staggering), complains of dizziness, extreme leg pain, nausea, chest pain, shows facial pallor, or mental confusion; e. at any time, the evaluat evaluator or becomes concerned with the safety of an individual.
33. Cool-Down. A supervised walk within the testing area area should take place place allowing the individuals’ individuals’ HR to slow down. If request requested ed by the individuals, time and guidance should be provided to perform perform stretching stretchin g concentrating on lower extremities musculature. musculature. The cool-down should concentrate on the lower extremities.
Calculation of VO2 max (DND (DN D 279, 279, Section D1 and 3) 34. Upon completion of the 20 MSR: MSR: a. insert last stage completed in Section D1 of DND 279; 279; b. determine VO2 max prediction using Tool 6 and insert result in Section D1 of DND 279; and c. insert MPFS for VO2 max in Section D3, using Tool 7.
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Chapter 3 - Evaluation procedures 20 MSR References Astrand, P.O. P.O. & Rhyming, I. (1954). A Nomogram for calculation of aerobic aerobic capacity (physical fitness) from pulse rate during submaximal submaxim al work. Journal of Applied Physiology. 7, 7, 218-221. Cooper, K.H. (1968). A means of assessing maximal oxygen intake. intake. Journal Journal of the American Medical Association. 203, 135-137. Fitness and Amateur Sport (1987). (1987). Canadian Standardized Standardized Test of Fitness (CSTF) (CSTF) Operations Manual. Third Edition. Gadoury, C. & Léger, L. (1984). (1984). Unpublished Data. Léger, L. & Gadoury, C. (1989). Validity of the 20 m shuttle run test with 1 min stages to predict predict VO2 max in adults. Canadian Journal Journal of Sport Sciences. 14, 14, 21-26. Leone, M. & Léger, L. (1983). Unpublished data. Paliczka, V.J., Nichols, A.K. and Boreham, C.A.G. (198 Paliczka, ( 1987). 7). A multi-stage shuttle run as a predictor of running performance and maximal oxygen uptak uptake e in adults. British Journal Journal of Sports Medicine. 21, 163-165. 163-165. Stevenson, J.M., Andrew. Stevenson, Andrew. G.M., Bryant, J.T., Thompson, J.M. Lee, S.W. & Swan, R.D. (1988). Development of Minimum Physical Fitness Standards Standards for the Canadian Armed Forces: Phase II. School of Physical and Health Education, Department of Mechanical Engineering, Queen’s University, University, Kingston, ON.
mCAFT Protocol (DND 279, Section D2) 35. General. The Modified Canadian Aerobic Fitness Fitness Test (mCAFT) will only be used as an alternative protocol prot ocol for individuals with medical restrictions that prevent prevent them from from performing the 20 MSR. As per Chapter 2 para 8, CF personnel may apply to their chain of command, through the local Medical Care Provider and/or Base Surgeon, to be evaluated evaluated using this alternative protocol. protocol. This modification would normally be granted for orthopedic reasons. 36. Evaluation Site. The mCAFT should take place in a room measuring at least 3.60 m x 6.10 m that is separate from the main gymnasium gymnasium This room should be fairly private, private, quiet, and have adequate adequate ventilation and a constant temperature temperature around 20 degrees Celsius. See Tool 8 for evaluation room room set-up. Shower and change room room facilities should should be located in close proximity. proximity. If the main gymnasium gymnasium area has to be utilized, every effort should be made to screen off of f a corner to ensure some degree of privacy. In either case, a separate or private area area must be available for debriefing the individual at the conclusion of the evaluation.
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Chapter 3 - Evaluation procedures Measurement. t. Prefer 37. Weight Measuremen Preferably, ably, weight is to be measured with a beam scale, but a weight scale or stadiometer can also be used. All weight measurements are recorded recorded to the nearest nearest 0.1 kg in block D2. Ensure the scale is on a flat surface. surface. If it is placed on a rug, use a half-inch half-inch board under under the scale. The individual must be weighed without footwear footwear and in light clothing. Ensure the the individual stands stands erect and has both feet entirely on the scale.
38. mCAFT. The mCAFT is a double step test where the individual completes one or more sessions of three minutes minutes of stepping at predetermined predetermined speeds based on their age and gender. Everyone begins the stepping sequence on the double 20.3 cm step. Fitter (and younger) individuals may may complete their appraisal with a single step sequence using the single 40.6 cm step by crossing to the other side of the stepping apparatus (Tool 5). 39. The mCAFT is structured so that in most cases the individual’s first three-minute three-minute stage is at an intensity of 65 to 70 percent of the average average aerobic power expected expected of a person ten years older. Instructions and time signals are given on the CD as to when to start and stop exercising and for the counting of the ten-second measurement measurement of the post-exercise heart rate. rate. Depending on the exercise exercise heart rate response, the individual will either proceed to the next stepping stepping stage or have the test terminated. terminated. The second stage of three minutes of stepping is at 65 to 70 percent of the average aerobic power expected expected for their own age group. If they do not attain or exceed the ceiling heart rate, rate, a further three minutes of stepping is performed per formed at an intensity equivalent to 65 to 70 percent of the aver average age aerobic power for a person ten years younger. younger. The individual completes as many of these progressivel progressivelyy more demanding three-minute three-minut e bouts of exercise as necessary to equal equal or exceed the ceiling post-exercise post-exercise heart rate. The ceiling is set at 85 percent of the predicted maximum heart rate for for their age group. To determine determine the ceiling post-exercise heart rate, refer refer to Figure 2. Having the individual exercise to this level of intensity helps in deter determining mining an accurate aerobic capacity.
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Chapter 3 - Evaluation procedures Figure 2 Ceiling Post-Exercise Post-Exercise Heart Rates
40. Use of HR monitor. It is recommended that you use a valid and reliable heart rate monitor monitor to determine determ ine heart rates during the mCAFT. mCAFT. Befor Before e beginning the mCAFT, the heart rate monitor monitor should be fitted according to the manufacturer’ manufacturer’s recommendations. Ensure that the heart rate monitor monitor is working properly. y. If a heart rate monitor is unavailable, heart rate determination determination using a stethoscope stethoscope is permitted. The reading of the heart rate monitor is made immediately immediately upon completion of the stepping stage and not after the ten-second count, as is the case when using the radial palpation or auscultation. 41. Starting Stage. Determ Determine ine the starting stage of stepping exercise exercise based on age and gender, using Figure 3.
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Chapter 3 - Evaluation procedures Figure 3 mCAFT starting stage
42. Information Briefing. The evaluator must inform individuals; a. b. c. d.
that all stepping stages stages are are three three minutes minutes in duration; to stop stepping and maintain a motionless position as soon as the music stops; that a HR check check is done at the end of each stepping stage; that they will proceed through the evaluation (continue to the next stepping stage) until their HR reaches the post exercise HR ceiling; and e. of the reasons why the test shall be discontinued (see para 52).
43. mCAFT - Conduct of the Stepping Sequence. Demonstrat Demonstrate e and have the individual practice the stepping sequence, first without the music, and then with, but not more than twice each time. Ensure that they place both feet completely completely on the top step and that the legs are fully extended and the back is upright during this phase of the movement. movement. Running or hopping is not permitted, permitted, individuals must step step up and down while maintaining proper cadence. Count and/or step a few steps with an individual who is experiencing difficulty. See Figur Figure e 4 for proper stepping cadence.
Figure 4
Correct mCAFT Stepping Cadence (footplants.min-1) NOTE: Stages 1-6 for men and stages 1-7 for women are done using a two-step pattern pattern on the double 20.3 cm steps. Stages 7 and 8 for men and stage 8 for women use a single-step pattern on a step 40.6 cm in height. (Use the back or side of the top step for this.)
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Chapter 3 - Evaluation procedures Stepping Exercise Sequence A. Two-Steps Start: Individuals can start with either foot. If they start with the right foot the stepping is as follows:
Stand in front of the first step, feet together.
(1) “STEP”. Place your right foot up on the first step.
(2) “STEP”. Place your left foot up on the second step.
(3) “UP”. Place your right foot up on the second step, so feet are together.
(4) “STEP”. Start down with your left foot to the first step.
(5) “STEP”. Place your right foot on ground level.
(6) “DOWN”. Place your left foot on ground level, feet are together.
Cadence STEP-STEP-UP!, STEP-STEP-DOWN!; and UP - 2-3!, DOWN - 2-3!, UP - 2-3!, DOWN - 2-3!.
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Chapter 3 - Evaluation procedures B. One-Step Start:
Stand at the back or side of the top step with feet together.
(1) “STEP”. Place your right foot up on the first step.
(3) “STEP”. Place your right foot on ground level.
(4) “DOWN”. Place your left foot down on ground level, so feet are together.
Cadence STEP UP! STEP DOWN! UP-2 DOWN-2! UP-2 DOWN-2!
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(2) “UP”. Place your left foot up on the step, so feet are together.
Chapter 3 - Evaluation procedures Post-exercise ercise Heart Rate. Start the CD player and have the individual perform 44. Post-ex per form the first stage of the test. When the music stops have have the individual remain standing standing and motionless. motionless. Deter Determine mine the postexercise exer cise heart rate with the stethoscope, heart rate monitor monitor or radial artery. Do not use the carotid artery.
45. When determining determining the heart rate manually, start counting the pulse at the termination of the command word “COUNT” “COUNT” and continue counting until the first sound of the command word “STOP”. The first beat is counted as one. Do not count a heartbeat that occurs during the command word “COUNT”. “COUNT”. In such cases, the next next heartbeat is counted as one. If you are using a heart rate rate monitor, monitor, get the heart rate reading immediately immediately upon completion of the stage. 46. DO NOT stop stop the CD during the test. test. A 10 sec HR check is included on the CD track. track. Each stepping stepping stage post exercise HR is used to determine if the individual can continue to the next stepping stage. HR reading and decision must be accomplished during the timed interval BETWEEN the musical stepping tempos. Count the first beat as “one”.
If the heart rate is equal to or exceeds the ceiling Post Exercise Exercise Heart Rates: stop the test.
47. Deter 47. Determining mining an accurate post-exercise post-exercise heart rate is critical for deciding if the individual should continue to another stage to predict maximum oxygen consumption (VO2 max). At the end of each stepping stage, quickly position yourself and the individual to take a 10 sec s ec post exercise HR check to determine determine if the individual can continue. If the heart rate is equal to or exceeds the ceiling post-exercise post-exercise heart rate (10 second count) stop the test (Figure (Figure 2). If not, advise the individual to get ready for the following following stage. 48. Completion of Subsequent Stages. If the individual’s heart rate is below the ceiling post-exercise heart rat rate e shown in Figure 2 and there are no contraindications, have the individual complete another stepping stage. Repeat the same stepping, timing, and counting procedure procedure as for stage one until the individual’s HR reaches the ceiling post-exer post-exercise cise heart rate shown in Figure 2. 49. Discontinuation of the mCAFT. The PSP Fitness and Sports evaluato evaluatorr shall discontinue the step test if: a. an individual stops; b. an individual’ individual’ss post-exercise post-exercise HR is equal to to or exceeds exceeds the ceiling limit as indicated in Figure. 2. c. an individual individual cannot maintain the proper proper cadence after the first minute minute of stepping (for physiological reasons or not); d. an individual demonstrat demonstrates es signs and symptoms of pain or discomfort (for example, staggering), complains of dizziness, extreme leg pain, nausea, chest pain, shows facial pallor or mental confusion; e. at any time, the evaluat evaluator or becomes concerned with the safety of an individual.
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Chapter 3 - Evaluation procedures 50. If it becomes obvious that the individual is unable to maintain the proper cadence after the first minute of stepping; step with the individual. If the difficulty in stepping is related to some physiological function, discontinue the test and refer the individual to the Medical Care Provider. 51. Cardiorespir Cardiorespiratory atory Test Recovery and Cool-Down. After the individual completes their last stepping stage, keep the individual in sight and have him or her walk slowly for two minutes before before sitting down. During this time, record values values in section D2 of DND 279. It is important that the individual does not leave the testing area after completing the mCAFT. mCAFT. Should the individual wish to leave the testing area, area, ensure that they are accompanied, and that their whereabouts whereabouts are known. After two minutes, ask the individual to sit down to measure their post exercise HR and BP. NOTE: If the individual appears fatigued or light-headed, elevate their legs on the ergometer steps. If light-headedness persists, have them lie down and rest their legs (elevated) on the steps.
52. Measure and record record the post-exercise systolic systolic and diastolic BP reading: a. Between 2:00 and 2:30 minutes; and b. Between 3:30 and 4:00 minutes. Measure and record post-exercise HR: a. Between 4:00 and 4:30 minutes.
53. The post-exercise post-exercise measures are taken after the last stepping stage is completed to ensure that HR and BP drop below the resting ceilings levels before individuals continue with the fitness evaluation. Thus, HR must be less than 100 1 00 bpm, systolic BP less than 150 mm Hg, and diastolic BP less than 100 mm Hg. Record values on DND 279 Section D2. NOTES:
I. Individual HR and/or BP must be below the criteria befor before e you can continue continue the evaluation; and II. If HR/BP values are above the pre-exercise criteria wait approximately five minutes and take take readings again. If the values are still above above the criteria, criteria, the test is discontinued discontinued and the individual must be sent to the Medical Care Provider with a DND 582 explaining the situation.
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Chapter 3 - Evaluation procedures 54. mCAFT VO2 max Calculation. The calculation of VO2 max for the mCAFT must be done prior to providing feedback. The calculation of VO2 max shall be done as follows: a. confirm the final stepping stage then deter determine mine the O2 cost for this level of exertion using Figure 5 below;
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Chapter 3 - Evaluation procedures Figure 5 O2 Cost in (ml-kg-1.min-1) for Different Stages of the mCAFT
b. confirm the individual’s body mass (weight) in kg and age in years as recor recorded ded in block D2 and A respectively; c. insert these three variables (O2 cost, body mass, and age) into the VO2 max formula in block D2; d. record the VO2 max score. may be rounded off to the nearest nearest decimal at the end of the entire calculation: calculation: NOTE: Final value may ex. 34.34 = 34.3 34.3 ex. 34.57 = 34.6 ex. 34.98 = 35.0 ex. 35.05 = 35.1 e. insert MPFS for VO2 max in Section D3, using Tool 7.
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Chapter 3 - Evaluation procedures Handgrip Protocol 55. Once the aerobic component has been completed completed and the individual is cleared to continue, the muscular strength test is carried out. The handgrip measurement is an indicator of overall muscular strength. The following following procedure procedure will be used: a. Have the the individual grasp the the dynamometer dynamometer in the appropriat appropriate e hand. The grip is taken taken between the fingers and the the palm, at the base of the thumb. Adjust the grip of the dynamometer so that the second joint of the fingers fit snuggly under the handle and take the weight of the instrument. b. Lock the grip in place; c. The dynamometer dynamometer is held in line with the forear forearm m at thigh level, away away from from the body (at no more than a 45 degree angle), and then squeezed vigorously so as to exert maximum force. Have the individual exhale while squeezing (to avoid build up of intrathoracic pressure); pressure); d. As the individual squeezes the dynamometer dynamometer,, their arm must remain motionless. As such, neither the hand nor the dynamometer should be allowed to touch the body or any other object. Measure both hands alternately allowing two trials per hand. Record scores for each hand to the nearest kilogram. Add the best score for each hand and record it as a single score, to the nearest “0.1 kg” under “total”. The MPFS for this protocol are available in Tool 7. 7. Record the MPFS score in Section Sectio n E, DND 279.
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Chapter 3 - Evaluation procedures Muscular Endurance (DND (DN D 279 Sections F1, F1, F2) Push-ups Protocol 56. The following procedures procedures will be used for push-ups: a. Start Position Position.. In the start position the individual lies flat on their stomach with their legs and feet together together.. Hands pointing forward are positioned underneath the shoulders. To establish an acceptable hand position the evaluator may stand directly over the individual being tested. If the evaluator can see the entire hand(s) (including fingers and thumb), then the position of the hands is too wide. Conversely, if the hands are are under the chest chest and the evaluator cannot see any portion of the hand(s) then the position is too narrow. narrow. Elbows are comfortably comfortably back along the sides;
b. Movement/Extension Movement/Extension Phase. Using the toes as the pivot point, the individual pushes up from the floor/mat (if using a mat use only a very thin or a very firm mat so as not to affect the integrity of the push-up) by straightening straightening the arms to full extension. extension. During this extension movement the elbows may flare out to the side as long as the hands remain in position pointing forward (it is not required that the individual maintains his or her elbows close to the sides during the movement movement phase, thus performing performing more of a triceps push-up). The body must be kept in a straight line including the head. The head should not normally be cocked cocked to look forward—such forwar d—such action is contraindicat contraindicated. ed. The individual descends to the down position;
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Chapter 3 - Evaluation procedures c. Down Position. The down position differs from the start position in that the individual does not return to lying on their stomach. return stomach. During the execution execution of their push-ups the individual must keep their body suspended off the floor/mat throughout throughout the evaluation. The proper down position position has the back of the upper arms (triceps area) parallel to the floor/mat. The chin, chest area, stomach, thighs, or knees should not touch touch the floor/mat in the down position. Incidental contact contact of any body part should not be used as a reason to terminate the test, or not count push-ups, unless the individual through through such contact contact gains a clear advantage. advantage. Once the individual has attained the down phase they continue with the next push-up (extension phase);
requires es assistance in determ determining ining the correct down position, the evaluat evaluator or may NOTE: If the individual requir hold an object (such as a ruler) in the air under the individual’s shoulder at the proper height of the down position. Each time the individual descends to to the down position he should touch touch the object. Using the hand in these instances is not recommended. d. Counting. Push-ups are to be performed continuously and without a time limit. Push-ups that do not confor conform m to the described prot protocol ocol will not be counted. The test shall be discontinued as soon as the individual is seen to strain forcibly to complete complete a push-up or is unable to maintain proper push-up technique. In many cases, lack of compliance with protocol prot ocol (e.g., arching back on a push-up, not going down far enough, moving hands farther apart) can be corrected corrected verbally and simply results in push-ups that do not count. Such situations should not result in termination of the test unless it is evident that advantage is being gained. Count the initial movement up up as one and then count each subsequent repetition to full extension and record in Section F1, DND 279. e. Discontinuation of the test. The evaluator shall discontinue the test: I. If the individual voluntarily terminates the test. II. If the individual is seen to strain forcibly to complete a push-up. III. If the individual demonstrates demonstrates alarming physiological physiological signs and symptoms that that could impede on his safety or health. The MPFS for this protocol are available in Tool 7. 7. Record the MPFS score in Section F1, DND 279.
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Chapter 3 - Evaluation procedures Sit-ups Protocol3 57.. The following procedure will be used for sit-ups 57 sit-ups:: Position.. The individual lies in a supine position, knees bent at a right angle (90 degrees), a. Start Position and feet about 30 cm apart. apart. Hold, or have someone else hold, the individual’s individual’s ankles and ensure that their heels are are in constant contact contact with the mat. The hands must be placed on the side of the head and remain in contact with the head at all times. Tou Touching ching or cupping the ears is acceptable, while pulling on the ears is not. The elbows must remain pointed pointed towards towards the knees throughout the duration of the test so as to prevent the flapping of the elbows; Movement/Sit-up Phase. When ready, give the command to begin. The individual b. Movement/Sit-up individual is required required to sit up, initially keeping the lower back flat against the ground and “curling” up to touch the top of the knees (patella) with the elbows (olecranon process), and then lower themselves back to the start position. The key to determining that the individual has returned to the start position is when the shoulder blades (inferior angle of the scapula) come in contact with the mat between each repetition;
c. Counting. The initial touch of the elbows (olecranon (olecranon process) to the top of the knees (patella) counts as one. Each subsequent touch of the knees, when the sit-up has been performed properly, properl y, counts as another repetition. The individual will perform as many repetitions as possible within one minute. minute. The individual may may pause whenever whenever necessary. Improperl Improperlyy performed sit-ups (for example, did not return return to starting position, lif ted buttocks to gain momentum), will not be counted but are not reasons to discontinue the test. The evaluator can make verbal corrections. corrections. Count the number of sit-ups completed in one minute, or the number completed when the test was discontinued, and record in Section F1, DND 279. d. Discontinuation of the test. The evaluator shall discontinue the test: I. II. III. IV.. IV
If the individual voluntar voluntaryy terminat terminates es the test At the end of the minute allocated for the test; If the individual is seen to strain for forcibly cibly to complete a sit-up If the individual demonstrat demonstrates es alarming physiological signs and symptoms that could impede on his/her safety or health.
The MPFS for this protocol are available in Tool 7. 7. Record the MPFS score in Section Sectio n F2, DND 279. A member’s size and/or excessive excessive hip flexor strength may result in the PSP Fitness and Sports Instructor being physically unable to anchor anchor an individual’s individual’s feet to the mat. If the instructor cannot consistently secure secure and stabilize an individual’s individual’s lower limbs for the duration of the test, the anchoring of the feet t hrough the use of a foot brace or wall bar may be permitted. 3
See Annex A for History and Rationale
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Chapter 3 - Evaluation procedures
Safety 58. The individual is to exhale exhale when pushing or sitting up so as to minimize minimize Valsalva Maneuvers (a forced expiration expiration against a closed glottis, for example, performing a strain while breath holding). For standardization and safety, the PSP Evaluator will not give verbal encouragement during the performance of the above muscular exercises. exercises. The encouragement may may result in an individual straining to to try to get an extra extra repetition. If an individual shows signs and symptoms of serious discomfort (evaluator (evaluator judgment prevails), prevails), the evaluator evaluator will have the individual lie down down and check heart rate rate and blood pressure pressur e if appropriate. If the individual does not seem to recuperate recuperate after a few minutes, request assistance from a Medical Care Provider. The evaluator will not give verbal encouragement during the performance of the muscular exercises. exercis es. The encouragement may result result in an individual straining beyond their limits.
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Chapter 3 - Evaluation procedures PAR ART T IV – FITNESS FITN ESS SUM S UMMAR MARY Y Section G – Fitness Results 59. Results are determined determined as follows: a. Aerobic Fitness. A yes is indicated if the individual met the MPFS standar standard d for cardiorespiratory cardiorespiratory fitness. A no is indicated if the individual did not meet the standar standard, d, as indicated at section D3 of the DND 279 form. b. Handgrip (HG). A yes is indicated if the individual met the MPFS standard for muscular strength (handgrip). A no is indicated if the individual did not meet the standard, as indicated in section E of the DND 279 form. c. Push-ups (P-U). A yes is indicated if the individual met the MPFS standard for muscular endurance (push-ups). A no is indicated if the individual did not meet the standard, as indicated in section F1 of the DND 279 form. d. Sit-ups (S-U). A yes is indicated if the individual met the MPFS standard for muscular endurance (sit-ups). A no is indicated if the individual did not meet the standard, as indicated in section F2 F2 of the DND 279 form. e. Met MPFS (yes/no). A yes is indicated if the individual attained a score equal to or greater than the MPFS in all physical fitness components: section D (VO2 max – 20 MSR or mCAFT), section E (muscular strength - hand grip), and section F (muscular endurance – both push-ups and sit-ups). A no is indicated if one or more scores in Section D, E, and F are below the MPFS. f.
Remedial Physical Fitness Training for MPFS. A yes is indicated in Section G6 if the individual has not met MPFS and must be registered for for remedial physical physical fitness training. A no is indicated if the individual met the MPFS.
g. Supervision for Remedial Physical Fitness Training. The guidelines for for the assignment assignment of an individual to a training program which involves direct supervision or self-super vision are as follows (Section G7, DND 279): I.
af ter DIRECT if the individual fails to meet the Direct Supervision. Place a check mark after standard for any of the fitness evaluation items (V02 Max, HG, P-U, S-U). The frequency of remedial physical fitness training shall be no less than three times per week, for a minimum of twelve weeks. Howev However, er, the Fitness and Sports Spor ts Director or his delegated representative representative can make exceptions to this guideline when it is clear that the individual is ready to pass their evaluation. Direct supervision implies direct monitoring/reporting monitoring/reporting of an individual’s exercise exer cise program program by a certified PSP Fitness and Sports staff. Often this will occur through through group or individual individual physical fitness sessions. At Bases or locations where where this is not possible, Commanding Officers should seek direct supervision through local civilian professional resources resour ces or through military personnel with prov proven en fitness credentials, (e.g., Kinesiology Physical Education degree holder, Certified Personal Trainer-CPT, Advanced Fitness Training Assistant-AFTA, etc). Re-test procedures must follow all DAOD 5023-2 directives and guidelines set out in this manual.
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Chapter 3 - Evaluation procedures II. Self-supervision. A check mark shall be placed after SELF if the individual meets or exceeds all standar standards. ds. In this case, the individual is responsible for their own fitness in accordance with the programs issued on the DND 279 form or provided during his or her unit military fitness program.
III. Medically Excused. CF personnel who have a valid medical excusal from some components of the MPFS are still subject to completing the other components of the evaluation. The evaluatorr must select Section G and Section H1-Comments: “Medically excused for PER evaluato purposes.” IV. Next evaluation. The evaluator will indicate indicate in Section H1, DND 279 the appropriate date date for the individual’s next annual evaluation. Examples: I.
CF personnel has achieved MPFS FY 08/09 on September 1st, 2008. Next evaluation September 1st, 2009.
II. CF personnel achieved incentive program FY 08/09 on September 1 st, 2009. Next evaluation September 1st, 2010. III. CF personnel did not meet CF MPFS. Remedial training for for a minimum of 3 months. Indicate suggested re-evaluation date. NOTE: The CF EXPRES is valid for 365 days (730 if the individual has achieved achieved incentive exempt exempt status) st from the date the test has been completed. completed. However However,, the reporting period is April 1 to March 31st.
I.
CF personnel personnel failing to achieve achieve CF MPFS will be advised by the chain chain of command if administrative procedures procedures will apply in accordance with DAOD 5023-2.
Section H – Other 60. Section H1. The PSP Fitness and Sport Spor t Instructor must record recommendations regarding regarding the CF personnel to the Commanding Officer.
COMME COM MENTS NTS TO BE INS I NSERTED ERTED IN SECTION SE CTION H1, H1, DND 279: 279: • • • • • •
met CF MPFS FY___/___ met incentive program FY ___/___, exempted exempted FY ___/___ did not meet CF MPFS FY ___/___, next evaluation month ____ ____ medically excused for PER purposes FY ___/___ ___/___ UNTIL 31 Mar 2009 ONLY no MPFS for CF personnel 56-60 years of age next evaluation date/month/year ___/___ / ____
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Chapter 3 - Evaluation procedures 61. Section H2. PSP Evaluator Evaluator signature is required required in section H2. PSP Fitness and Sports Directors Directors or PSP Fitness Coordinators are not required to sign the DND 279 unless they conducted the evaluation.
Section J – Exercise Prescription 62. See Chapter 4 for exercise prescription.
Section K – Certification of Understanding 63. The individual signs and acknowledges the prescription and recommendation to maintain a CF EXPRES record record book. In cases of refusal to sign, the evaluator may may note in section K “member refused to sign” then distributes the required required copies.
Section L – Program Approval 64. Copy 2 must be sent to individual’s unit and signed by the Commanding Officer.
DISTRIBUTI DISTRI BUTION ON OF DND 279 279 CF EXPRES Form Form 65. Completed DND 279 forms forms will be distributed in accordance with the following procedures: procedures: a. Copy 1 to the Base Surgeon; b. Copy 2 to the individual’s Orderly Room or Unit EXPRES Coordinat Coordinator or (for CO’s signature and filing in individual’s Unit pers file-UPR); c. Copy 3 to PSP Fitness Fitness Section (Physical Fitness Envelope - DND 1117); and d. Copy 4 to the CF member. NOTES:
I.
Copy 2 must be approv approved ed and signed by the CO. It is not necessary for Copy 1, 3, and 4 to be signed by the CO. II. Dependent on local procedures procedures completed completed DND 279 279 and overall overall fitness records records contained contained in the Physical Physi cal Fitness Envelope (DND 1117) may be kept at the Gymnasium/Fitness Center Center in place of the UPR if acknowledged / registered as a satellite site of the UPR on any given base in accordance with the Privacy Act.
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Chapter 4
EXERCISE PRESCRIPTION
General 1. The goal of the exer exercise cise program program is to promot promote e and enhance physical physical fitness. fitness. The underlying underlying concept of performance related fitness is that increased status in each of the constituent fitness components is associated with better performance performance or optimal work performance. The CF EXPRES exercise exercise prescription information provides provides the building blocks of performanc per formance-related e-related fitness and overall health and wellness.
Supervision of Exercise Programs 2. The guidelines for the prescription prescription of an individual individual training progr program am are listed listed in Chapter Chapter 3, Part Part IV of this manual. CF personnel who fail any any of the test items will be subject to to direct supervision. CF personnel who meet or exceed the Minimum Physical Physical Fitness Standard will be self-supervised.
Exercise Prescription 3. The exercise exercise prescription information shall contain contain the following: a. a warm-up and cool-down that includes a flexibility/stre flexibility/stretching tching progr program; am; b. an aerobic progr program am to include recommended quantity and quality of activity; and c. a muscular strength and endurance progr program am to include recommended quantity and quality of activity.
Warm-up 4. A series of warm-up exer exercises cises are appropriat appropriate e prior to to commencing physical fitness training. training. A proper proper warm-up will move all major muscle groups, increase body temperature, temperature, raise heart hear t rate and respiration rates, and generally generally prepare the body for the physical fitness activities that are to follow. The warm-up should be gradual and be approximately approximately 10 minutes in duration. To increase increase blood flow, the individual should begin with easy jogging, brisk walking or other other activities conducted in an easy manner. manner. A series of dynamic and static flexibility fl exibility exercises exercises should then be performed. 5. CF personnel pursuing a flexibility/stre flexibility/stretching tching routine routine should be encouraged encouraged to: a. b. c. d. e. f. g.
stretch slowly and smoothly without bouncing; stretch use gentle stretch stretch-and-hold -and-hold or continuous movement, whichever is right for the exer exercise; cise; avoid stretchi stretching ng injured muscles; avoid pain and holding their breath during the the stretch; stretch; hold each stretc stretching hing exercise exercise repetition repetition for for a minimum of 15 seconds; strive for a relaxed feeling; and keep warm while stretching.
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Chapter 4 - Exercise prescription 6. Specific warm-up warm-up exercises exercises and stretches stretches that may may be prescribed prescribed are outlined outlined below: a. Arm circles: Full, slow sweeping sweeping circles using both arms. arms. Fro Frontwards ntwards and then backwards; backwards; b. Side stretch: Reach one arm arm overhead and the other down by the side of the leg. Repeat, alternating altern ating from side to side; c. Cat-back: On all fours, arch, tuck chin chin to chest and exhale. Return to to flat-back position. Don’t sag; d. Pelvic tilt: On your back, knees bent, feet feet flat on floor. floor. Tight Tighten en abdominal and buttocks buttocks and press your lower back firmly against the floor; e. Sit-and-reach: One leg straight, the other bent with with sole of the foot near knee of straight straight leg. Reach out along the straight leg; f.
knees bent, feet flat on the floor. floor. Roll legs to one side Knee crossovers: Seated, legs in front, knees toward the floor. Look over the other shoulder;
g. Thigh stretch: Bend one knee, grasp grasp ankle behind, and pull pull foot gently gently toward toward seat. Repeat alternately with other other leg. Don’t arch arch your back; h. Lunge: Shift weight forward and down over bent front front leg, with your rear leg as straight straight as possible and its heel off the floor; and i.
Calf stretch: One foot in front front of the other and feet feet pointing straight ahead, bend both both legs (squatting) to stretch stretch the soleus muscle in the the rear leg. Repeat with legs further apart and back leg straight to stretch the calf muscle in the rear leg.
Cool-down 7. Upon completion of physical fitness training, cool-downs assist the various body systems to return to their homeostatic states in a safe, gradual fashion. Following exercise, exercise, body temperature should be permitted to gradually return return to normal. This process can be assisted by conductin conducting g an active recovery recovery period followed by stretching exercises. 8. The active recovery recovery period period will prevent prevent blood pooling; and stretching stretching exercises exercises will not only improve improve flexibility, but also assist in reducing the degree of muscle soreness after exercise. exercise. Approx Approximately imately 10 minutes of cool-down activities are important impor tant at the end of the workout.
Aerobic Fitness Programs 9. An aerobic aerobic fitness program program will be given to each each individual. The aerobic aerobic fitness program program shall include the recommended quantity and quality of activity to improv improve e and/or maintain aerobic fitness. 10. The following following general general guidelines for the the prescription prescription of aerobic aerobic exercise exercise shall be utilized utilized based on the FITT Principle: a. Frequency: 3-5 times per week. The frequency prescribed prescribed will depend on the individual’s current current level of activity as well as his/her performance on the CF EXPRES Test;
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Chapter 4 - Exercise prescription b. Intensity: Ta Target rget heart rate zone (THRZ) for exercise exercise prescription should be between 60-90% of predicted predict ed heart rate max (HRM). (See formula below). The exercise exercise intensity prescribed prescribed will depend upon the individual’s performance on the 20 MSR, which has been correlated to maximal aerobic capacity;
CALCULATING TARGET HEART RATE: SECTION I, DND 279: From 220, subtract the individual’s age (Heart Rate Maximum = 220 – age). Then multiply the From HRM by the desired intensity. Example—a 38 year old individual, trying for a workou workoutt intensity of 60%-90%. HRM = 220 – 38 HRM = 182 Multiply HRM x Desired Intensity (60%) 182 X 60% = 109 Multiply HRM x Desired Intensity (90%) 182 X 90% = 164 c. Time: Normally 20 – 60 minutes minutes of continuous continuous activity. The time of exercise exercise sessions will be based on the individual’s current level of activity and performance on the 20 MSR; and d. Type: Activities that use large muscles muscles groups and can be done done in a continual and rhythmic rhythmic manner.. The type of aerobic activity prescribed manner prescribed should be based upon the activity preferen preference ce of the individual. 11. It should be emphasized that these are general guidelines. It is the responsibility of the evaluat evaluator or to determine determine the starting exercise intensity, intensity, frequency, time, and type of exercise. exercise. Relying on their professional qualifications and experience, evaluators evaluators shall prescribe exercise exercise based on the following criteria: a. their inter interaction action with the member: b. the curr current ent physical activity/training level of the individual; and c. any additional information that is gathered during the evaluation. 12. In concurrence concurrence with these guidelines, the following CF EXPRES (English) Program Program Guides (series A-PD-050-062/PT-) may also be utilized: a. b. c. d. e. f. g.
Personal Tr Training aining Record – 007; CF EXPRES Info Booklet; Walking – 012; Swimming – 014; Stationaryy Cycle – 016; Stationar Rope Skipping – 018; Cycling – 020;
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Chapter 4 - Exercise prescription h. i. j. k.
Jogging – 022; Cross-country Skiing – 024; Skating – 026; and Snowshoeing – 028.
13. CF EXPRES Program Guides. The CF EXPRES Program Program Guides are are comprised of 3 levels of 13 13 weeks in duration. Following the completion completion of the CF EXPRES evaluation, an individual’s results results will be calculated and percentiles will be assigned to each performance in accordance accordance with the charts found in Tool 1016 of this manual. When prescribing the CF EXPRES Program Program Guides, the assigned percentile will then determine determ ine the level of exercise and the starting week at which the individual should start his exercise training. This would only require require adjustment under special circumstances circumstances (e.g., individual’s prescriptions should be adjusted to start at a less advanced level if they are at the beginner level in a requisite skill such as snowshoeing or swimming). 14. Additional Aerobic Activities. The CF EXPRES Program Program Guides include include activities originally approved approved as part par t of the CF EXPRES training program; program; they are recognized as justifiable exer exercises cises for the purposes of ensuring safe and reliable training programs. programs. This is not to suggest that physical training be necessarily limited to these activities. Evaluators may may prescribe alternate alternate fitness activities such as rowing machines, machines, step machines, elliptical etc., but must exercise due diligence with respect to the safety of the selected activities.
Muscular Strength and Endurance 15. A muscular strength strength and endurance program program shall be provided provided to each each individual. The program program will be tailored to improve or maintain muscular strength and endurance, and be based on the FITT principle. 16. In addition to developing a personalized muscular strength strength and endurance program program for CF personnel, the following CF EXPRES (English) Progr Program am Guides (Series A-PD-050-062/PT A -PD-050-062/PT-)-) may be utilized: a. Muscular Strength and Endurance Endurance – 010; and b. Nautilus – 030. 17. Numerous variations in weight training equipment 17. equipme nt have occurred occurred since the publication publicatio n of the CF EXPRES Program Progr am Guides. PSP Evaluators Evaluators should aid individuals with the application of the Guide and current information to the equipment available.
AND/OR
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Chapter 4 - Exercise prescription CF EXPRES Online Exercise Prescription 18. Direct the CF individual to the CF EXPRES Online Exercise Exercise Prescription tool tool via the provided flyers to, to, www.CFEXPRES.ca. As phase two of WebEXPRES, the CF Online Exercise Prescription is a powerful and interactive interac tive tool that provides fitness recommendations to individual that have recently completed the CF EXPRES evaluation. The online prescription tool provides a comprehensive physical physical fitness training program progr am for all military personnel regardless regardless of location. Based on your EXPRES test results, the Online Exercise Prescription Prescription will: • Calculate and analyze your EXPRES test results. • Report on your Aerobic Fitness, Muscular Strength and Endurance Endurance Fitness Fitness results. • Display a table that that shows your target target heart rate rate zone. • Creat Create e a printable 12-week exercise exercise prescription prescription based on your age, gender, gender, and EXPRES test results. • Prov Provide ide illustrated illustrated instructions on how to perform perform specific exerc exercises. ises.
Heart Rate Monitoring 19. CF personnel should be encouraged to monitor monitor their heart rate prior to, during, and after their physical fitness training training sessions. Monitoring heart rate rate prior to the exercise exercise session will provide the individual with a pre-exercise pre-exercise heart rate value, value, which may be used as a baseline for measuring progress. progress. CF personnel should also monitor their heart hear t rate during exercise sessions to ensure that they are working within their target heart rate zone, while post-exercise heart rates should be taken to ensure that appropriate recovery has occurred. 20. Heart rate may be monitored monitored by by a number of methods: a. Heart rate monitor monitor;; or b. Palpation (Radial or carotid artery) 21. CF personnel must be informed that their target target heart rate zone is based on average heart rates rates for persons of similar age, and that their own heart hear t rate max could be below or above the average. average. Therefore, Therefo re, they may have to adjust their level of activity so that they are comfortable. 22. The “Borg Scale” (Tool (Tool 17) is another another method of monitoring monitoring exercise exercise intensity. The scale uses a numbering system with descriptions descriptions of perceived effort to assess exercise exercise intensity. All PSP Evaluators should be familiar with the Borg Scale and its application. 23. The “Talk “Talk Test”, although although not as scientific as heart rate monitoring monitoring or the Borg Borg Scale, is useful. The principle of the “Talk Test” is that an individual should be able to carry on a conversation in short sentences during exercise, exercise, and if they cannot, then the intensity is too high.
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Chapter 4 - Exercise prescription Rate of Progression - All Fitness Programs 24. Progr Progression ession rates will depend on the individual’s initial functional capacity, health status, status, age, and needs or goals. CF personnel who are in poor fitness condition may experience relatively relatively quick improvements improv ements (in 6 to 12 weeks) for some fitness paramet parameters ers but as their physical condition improves, the increment or size of improvement improvement will become smaller. smaller. The PSP Evaluator Evaluator must therefore therefore impress impress upon the individual to think in terms terms of a long-term concept. Wor Words ds of encouragement are always always useful as are methods of self-discovery and self-monitoring (e.g., Resting HR will decrease over time, weight may decrease or be redistributed, muscles will tone up, individual should feel better better,, etc.).
Prescription Materials 25. All CF EXPRES materials materials are available as resource resource materials. materials. In addition, the Canadian Canadian Physical Physical Activity, Fitness and Lifestyle Approach (CPAFLA) resource materials may also be utilized. 26. The tools found in the CPAFLA CPAFLA manual may be effective in the development of an action plan for CF personnel with lower levels of physical fitness. a. b. c. d. e. f. g. h. i. j. k. l. m.
Healthy Physical Activity Participation Questionnaire; Stages of Change; Activity Inventory; Inventory Invent ory of Lifestyle Needs and Activity Prefer Preferences; ences; Choosing Altern Alternatives atives for Action; Decision Balance Sheet; Motivation List; Motivation First-step Planner; Self-Contract; Goal-Setting Workshee Worksheet;t; Relapse Planner Planner;; Fantastic Lifestyle Checklist; and Health Promotion Resources.
27. Tools 10-16 of this manual provide the VO2 max and 20 MSR percentile ranks adjusted for age and 27. gender that can be used in the calculation of the Exercise Prescription Prescription Level information. information.
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Chapter 4 - Exercise prescription Sport and Recreation Activities 28. While certain sports like soccer and squash have have a beneficial impact on conditioning one’s one’s body, they are not to be prescribed under the CF EXPRES Program. The reason is that monitoring one’s intensity as well as quantifying frequency, frequency, duration, and progression is difficult. Nonetheless, CF personnel should be encouraged to to participate in sports activities. The CF Sports Order (CFAO (CFAO 50-3) and the Recreation Recreation Order (CFAO (CFAO 50-2) pertain per tain to these activities.
Feedback Feedba ck to CF Personnel 29. Evaluator Evaluatorss must meet briefly with all individuals after an evaluation to go over test results results and applicable prescription information. information. CF personnel unable to attain the MPFS or those with specific fitness needs/injuries beyond the norm should be allocated additional time or be re-booked with a Fitness and Sports Instructor or a Physical Exercise Exercise Specialist as applicable. Feedback will generally generally include: a. an overview of the CF EXPRES evaluation results; b. a personalized exercise exercise prescription prescription based on his/her CF EXPRES evaluation evaluation results results and preferr preferred ed type of activities; c. an explanation explanation on the use of CF EXPRES Program Program Guides (if requir required); ed); d. a calculation of the targ target et heart rate zone (THRZ); e. a description description of proper proper warm-ups warm-ups and cool-downs.
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Chapter 5
HEALTH RELATED FITNESS
General 1. Health related related fitness includes includes components components of fitness that exhibit a relationship relationship with health status. status. Positive Positiv e health is associated with a capacity to enjoy life, to withstand challenges, and the absence of disease. The underlying concept concept of health-related health-related fitness is that better status status in each of the constituent components is associated with lower risk for development of disease and/or functional disability. 2. Heart attack, stroke, stroke, and cancer are are the major major causes of death and disability among Canadian adults. Physical inactivity, cigarette cigarette smoking, improper dietary dietary habits, and inappropriat inappropriate e responses to stress all contribute to the problem.
Lifestyle Assessment 3. The Canadian Society Society for Exercise Exercise Physiology Physiology has developed developed a FANT FANTASTIC ASTIC Lifestyle Lifestyle Checklist that covers a broad range of issues that have a powerful influence on health. This FANTASTIC FANTASTIC Lifestyle Checklist is a tool that will permit CF personnel personnel to reflect reflect on their various habits and attitudes. This tool is an available resource resource if required. CF personnel may wish to discuss this questionnair questionnaire e with their evaluator.
Strengthening the Forces Health Health Promotion Program 4. Strengthen Strengthening ing the Forces Forces is the CF Health Promotion Promotion program program that that promotes promotes health as a fundamental fundamental value while ensuring that the workplace supports healthy lifestyle choices. Strengt Strengthening hening the Forces provides information and programming in the following core components: a. Active Living and Injury Pre Prevention. vention. b. Addictions – alcohol and other drugs, smoking prevention prevention and cessation, problem problem gambling. c. Social W Wellness ellness – stress management, suicide intervention, family wellness, and anger management. management. d. Nutritional Nutritio nal Wellness – Weight Wellness, Top Top Fuel for Top Performance, “It’s your Choice”- nutritional awareness awaren ess campaign for messes. 5. The most current brochures and materials related to the above programs can be accessed through local health promotion professionals professionals and/or by ordering through the Canadian Forces supply system. For more information on these programs, go to: http://www.forces.gc.ca/health-sante/ps/hpp-pps http://www.fo rces.gc.ca/health-sante/ps/hpp-pps/default-eng.asp /default-eng.asp
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Annex A
Annex A
History and Rationale Cardiorespiratory Fitness protocols
Effective 1 January 1999, the 20 MSR was approved approved as the primary aerobic evaluation evaluation for CF personnel regardless of age. In 2007, 2007, the 20 MSR became the only aerobic testing protocol permitted for CF personnel with the mCAFT used as an alternative protocol. protocol. The 20 MSR is significantly more valid and reliable than the step test when compared compared to a directly measured measured maximal treadmill test. The 20 MSR has a validity correlation correlation coefficient of 0.97 when compared compared to the “gold standard” of direct measurement on a treadmill (Gadoury and Léger, Léger, 1984). The reliability of the 20 MSR has been quoted as 0.95 (Leone and Léger, 1983). Léger and Gadoury (1989) found the 20 MSR to be a significantly more accurate predictor of VO2 max than the CAFT and when compared to the treadmill VO2 max direct measure, is generally a more valid measure of VO2 max than other other popular running running tests. In comparison to the step-test, the 20 MSR can process up to 15 times more subjects per unit of time, and may be more specific to military field tasks due to its robust robust and dynamic nature. It is important to note that the Léger 20 MSR protocol has undergone some minor modifications to adapt to the requirements of the Canadian Forces. Forc es. The original protocol protocol mentions that the test is terminated terminated when an individual does not reach the 20-metre line within a few few steps. In order to provide provide a specific guideline on the distance to be covered covered by the individual a warning line, referred referred to as the 19-metr 19-metre e line, has been added to the original protocol. Curl-up protocol used to evaluate CF personnel
The CF utilizes the full sit-up as part par t of its evaluation protocols protocols because it was the full sit-up that was utilized to determine determine the predictive standard standard of the MPFS when it was established. The Canadian Society of Exercise Physiology’s Physiology’s preference preference to utilize partial curl-ups will not be used for CF evaluations unless future validation studies for MPFS occur utilizing the partial par tial curl-up protocol. Nevertheless, Nevertheless, the utilization of the partial curl-up is highly recommended as a safe and ef fective training training tool to prepare individuals for their full sit-up testing.
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Annex A Tool 1 CF EXPR EXPRES ES Form Form (DN (DND D 27 279) 9)
PROTECTED B (When B (When completed) PROTÉGÉ B (Une B (Une fois rempli)
CF EXPRES Program ─ Programme Programme EXPRES FC
Serviceparticulars ─ Détails Détails du service A. Surname ─ Nom Nom Rank ─ G G r ad ad e
Init.
SN ─ NM NM
M il it ar ar y oc oc cu cu pa pa titi on on ─ Groupe Groupe profession sionnel nel militaire t aire MOS ID ─ ID ID SGPM
Unit ─ Unité Unité
UIC ─ CIU CIU
Tel. ─ Tél. Tél.
DOB ─ DDN DDN (yyaa/mm/dj)
Age ─ Âge Âge
Sex Sexe
M
F
Health appraisal ─ Évaluation Évaluation de la santé B. Questionnaire This questionnaire is a screening device to identify personnel for whom fitness evaluation and physical activity might be inappropriate at this time. 1. To the best of your knowledge do you have a medical condition or Medical Employment Limitation (MEL) which restricts you from participating in a maximal fitness evaluation or a progressive training program? reason you would need to talk to a physician prior to 2. Is there any other reason you your fitness evaluation or training program?
C. Vital signs Pre-evaluation heart rate Signes vitaux Fréquence cardiaque avant l'évaluation
Yes Oui
Le présent questionnaire est un outil visant à identifier les personnes pour lesquelles une évaluation de la condition physique et l'exercice sont actuellement contre-indiqués. 1. Au meilleur de votre connaissance souffrez-vous d'un trouble médical ou avez-vous des restrictions médicales d'emploi qui vous empêchent de participer à une évaluation maximale de la condition physique ou à un programme de conditionnement physique progressif? raisons pour lesquelles vous devriez consulter un médecin avant de 2. Y a-t-il d' autres raisons pour participer à l'évaluation de la condition physique ou d'entreprendre un programme de conditionnement physique?
No Non
Pre-evaluation blood pressure: Tension artérielle avant l'évaluation :
Greater than 150/100 150/100 mm mm Hg Au-delà de 150/100 150/100 mm mm Hg
Less and equal than 150/100 150/100 mm mm Hg Moins et égal à 150/100 150/100 mm mm Hg
Your pre-evaluation blood pressure lies between 141/91 mm Hg and 150/100 mm Hg and is considered to be slightly above the normal range. It is recommended that you consult your MO. Votre tension artérielle avant l'évaluation se situe entre 141/91 mm Hg et 150/100 mm Hg. Cette valeur étant légèrement supérieure à la normale, il est recommandé de consulter votre médecin.
Date
Signature of CF member Signature du membre des FC ►
(yyaa/mm/dj)
Fitness assessment ─ Évaluation Évaluation de la condition physique D. Cardiorespiratory fitness ─ Capacité Capacité cardiorespiratoire 1. 20 MSR ─ CN CN 20 M
3. VO2 max
Last stage completed ─ Dernier Dernier palier exécuté
MPFS - NMCP
Predicted VO2 max ─ Prédiction Prédiction de la VO2 max (ml/kg/min)
2. mCAFT (Alternative protocol) ─ PACm PACm (Protocole de remplacement)
Post exercise values ─ Mesures Mesures post-exercice
Last stage completed ─ Dernier Dernier palier exécuté
BP ─ TA: TA: 2:00-2:30 SBP ─ TAS
DBP ─ TAD
mm Hg
O2 cost ─ Coût Coût en O2
BP ─ TA: TA: 3:30-4:00 SBP ─ TAS
DBP ─ TAD
mm Hg
Weight ─ Poids Poids
kg
Age ─ Âge Âge
years ─ années années
HR ─ FC: 4:00-4:30
BPM
Predicted VO2 max ─ Prédiction Prédiction de la VO2 max 17.2 + (1.29 x O2 cost) ─ (0.09 (0.09 x Wt in kg) ─ (0.18 (0.18 x Age in years) 17,2 + (1,29 x coût en O 2) ─ (0,09 (0,09 x poids en kg) ─ (0,18 (0,18 x âge en années) 17.2 + (1.29 x
) ─ (0.09 x
17.2 + (
) ─ ( (
kg) ─ (0.18 x
years)
) ─ ( (
)
Predicted VO 2 max ─ Prédiction Prédiction de la VO 2 max =
ml/kg/min
E. Muscular strength ─ Force Force musculaire Right hand Main droite Left hand Main gauche
F. Muscular endurance ─ Endurance Endurance musculaire 1. Push-ups Extensions des bras
Score ─ Ré Résultat
Total
Score ─ Ré Résultat
MPFS ─ NMCP NMCP
MPFS ─ NMCP NMCP
2. Sit-ups Redressements assis
MPFS ─ NMCP NMCP
Fitness summary ─ Résultats Résultats de la condition physique G. Fitness results ─ Résultats Résultats de la condition physique Yes Oui
J. Exercise prescription ─ Prescription Prescription d'exercices
No Medically excused Non Exemption médicale
Yes Oui
1. Aerobic fitness Condition aérobique
No Non
6. Fitness development for MPFS Programme de développement de la condition physique - NMCP
2. Hand grip Préhension de la main 3. Push-ups Extensions des bras
Warm up as per EXPRES guides or WebEXPRES Échauffement selon les guides du programme EXPRES ou WebEXPRES EXPRES programme guides ─ Guides Guides du programme EXPRES Activity ─ Ac A ctivité
Start level Niveau de départ 1
7. Supervision: Self ─ Autonomie Autonomie
Stationary cycling ─ Ergomètre
5. Met MPFS Satisfait aux NMCP
Direct ─ Directe Directe
Cycling ─ Bicyclette Bicyclette Skating ─ Patinage
H. Other - Autres
Snowshoeing ─ Raquette Raquette
1. Comments - Commentaires
Swimming ─ Natation Natation
Met CF MPFS FY Satisfait aux NMCP FC AF
Rope skipping ─ Saut Saut à la corde
Met incentive program FY Satisfait au programme d'encouragement AF
Cross-countryskiing ─ Ski Ski de fond Muscular strength and endurance Force et endurance musculaires
exempted FY exempté AF
Did not meet CF MPFS FY N'a pas satisfait aux NMCP FC AF
Next evaluation month Prochaine évaluation au mois de
Next evaluation before Prochaineévaluationavant
Y-A
Training objectives Objectifs d'entraînement M
2.
D -J
220 ─ Age Age = Maximum heart rate (MHR) 220 ─ Âge Âge = Fréquence cardiaque maximale (FCM)
Evaluator Signature de l'évaluateur
X X
Target heart rate zone Fréquence cardiaque cible intensity % intensité intensity % intensité
Maintain Maintenir
Improve Améliorer
Aerobic fitness ─ Capacité aérobique
I. Target heart rate calculation ─ Calcul Calcul de la fréquence cardiaque cible
MAXIMUM
Nautilus
WebEXPRES program ─ Programme Programme WebEXPRES
Medically excused for PER purposes FY Exemption médicale aux fins du RAP AF
MINIMUM
Week Semaine
3
Jogging ─ Course Course à pied
4. Sit-ups Redressements assis
MHR FCM MHR FCM
2
Walking ─ Marche
=
Minimum
=
Maximum
Muscular strength and endurance Force et endurance musculaires
Training program Programme d'entraînement Aerobic ─ A A ér érobie
Muscular st strengt hand endurance Force et endurance musculaires
K. Certification of understanding ─ Attestation Attestation
♥I acknowledge the above fitness prescription and the requirement to maintain an up to date training record for aerobics and muscular strength and endurance. . ♥J'atteste comprendre la prescription donnée ci-dessus ainsi que la nécessité de tenir à jour un carnet d'entraînement pour les exercices d'aérobie, de force et d'endurance musculaires
Date (yyaa/mm/dj)
Signature of CF member Signature du membre des FC ►
L. Program approval ─ Approbation Approbation du programme
♥ The above fitness assessment and prescription have been reviewed and are approved. ♥ L'évaluation et la prescription d'exercices ont été examinées et approuvées.
Unit Unité DND 279 (09-2009) 7530-21-912-7242
Commandingofficer ► Commandant
Date (yyaa/mm/dj)
PROTECTED B (When B (When completed) PROTÉGÉ B (Une B (Une fois rempli)
COPY 1 ─ B B SURG COPIE 1 ─ MÉD MÉD C
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Design: Forms Management 613-993-4050 Conception : Gestion des formulaires 613-993-4062
Annex A Tool 2 Medical Referral Form (DN (DND D 582)
National Defence
Défense nationale
FILE / DOSSIER
PROTECTED B (When completed) PROTÉGÉ B (Une fois rempli)
DATE
MEDICAL EXAMINATION / EXAMEN MÉDICAL B SURG SURG /MÉD C MEDICAL REFERRAL --- CF EXPRES PROGRAM / DEMANDE D’EXAMEN MÉDICAL --- PROGRAMME EXPRES FC
1.
SERVICE PARTICULARS / DÉTAILS DU SERVICE SERVICE NO. / NO M ATRICULE R ANK / GRADE
N AME / N OM
INIT
2. The A/M member hasbeen screened screened for evaluationand participation on in subjectprogram subjectprogram(s)andis (s)andis referredforthe referredforthe reasonsnotedon reasonsnotedon attached attached DND279. Your assessment assessment of the member’s member’s condition condition with respect respect to participation participation in the evaluation and program is requested. ENCLO ENCLOSU SURE RE / PIÈCE È CE JOIN JOINTE TE
UN IT / UN ITÉ
2. Le milita militaire ire mentionn mentionnéé ci-dessusa -dessusa étéexaminé étéexaminé pourfins pourfins d’évalua d’évaluationet tionet de participation au(x) programme(s) en titre et vous est référé pour la (les) raison(s) mentionnée(s) mentionnée(s) sur le formulaire D DND ND 279 ci-joint. Votre évaluation évaluation de la condition du militaire est requise pour sa participation à l’évaluation et au programme.
F & S DIR DIR / DIR DIR CP ET S SIGNAT G NATUR URE E
HEALTH APPRAISAL QUESTIONNAIRE --- QUESTIONNAIRE D’ÉVALUATION DE LA SANTÉ HEART RATE FRÉQUENCE CARDIAQUE
BLOOD PRESSURE TENSION ARTÉRIELLE
OTHERS AUTRES
REPLY / RÉPONSE RÉPONSE MINUTE F & S DIR / DIR CP ET S
1.
TheA/Mmem TheA/Mmemberisfo berisfoundtobefi undtobefitforeval t forevaluat u ationand/o i onand/ortrai rtraini n ingasfollow n gasfollows: s:
1. Lemilitai t aireestjugéapteà r eestjugéapteà subirl’é subirl’éval valuatio u ationet net àsuivrele àsuivrele progra programm mmede ede conditionnement conditionnement physique selon les conditions suivante :
EXERCISE /EXERCICE WITHOUT LIMITATIONS SANS RESTRICTIONS
WITH LIMITATIONS (SEE BELOW) AVEC RESTRICTIONS (VOIR CI-DESSOUS)
LIMITATIONS / RESTRICTIONS ASSESS ASSESSMEN MENT T / ÉVALUATION TION
AEROB AEROBIC IC TRAININ TRAINING/ G/ EXERCI EXERCICES CES D’AÉRO D’AÉROBIE
MUSCUL MUSCULO O SKELET SKELETAL TRAININ TRAINING/ G/ EXERCIC EXERCICES ES MUSCUL MUSCULOSQ OSQUE UELETT LETTIQU IQUES ES
NO PUSH-UPS PAS D’EXTENSION DES BRAS
NO RUNNING OR JOGGING PAS DE COURSE NI DE JOGGING
NO NECK EXERCISES PAS D’EXERCICES POUR LE COU
NO SIT-UPS PAS DE REDRESSEMENTS ASSIS NO STEP TEST PAS D’ÉPREUVE DE LA MONTÉE DES MARCHES
NO BICYCLE EXERCISE PAS DE BICYCLETTE NO STEP TRAINING PAS D’ENTRAÎNEMENT SUR ESCALIERS
NO LOW BACK EXERCISES PAS D’EXERCICES POUR LE BAS DU DOS NO HIP EXERCISES PAS D’EXERCICES POUR LES HANCHES
NO HAND GRIP PAS DE PRÉHENSION DE LA MAIN
NO SWIMMING PAS DE NATATION
NO KNEE EXERCISES PAS D’EXERCICES POUR LES GENOUX
NO 20-METRE SHUTTLE RUN PAS DE COURSE NAVETTE SUR 20 MÈTRES
NO CROSS COUNTRY SKIING PAS DE SKI DE FOND OTHER AUTRES
NO SHOULDER EXERCISES PAS D’EXERCICES POUR LES ÉPAULES OTHER AUTRES
NO LAND FORCE COMMAND PHYSICAL FITNESS STANDARDS PAS DE NORMES DE LA CONDITION PHYSIQUE DU COMMANDEMENT DE LA FORCE TERRESTRE OTHERS AUTRES
2. The subje subject ct member member was found found to be unfit for physica physicall fitness fitness assessment assessment and training as follows: PERMANENTLY UNFIT INAPTITUDE PERMANENTE
MEDICAL CATEGORY CATÉGORIE MÉDICALE
2. Le militaire taire examiné examiné n’est est pas apte à subir l’évaluation ’évaluation de la condition physiqueni àsuivre leprogrammede conditionnementphysiquepour conditionnementphysiquepour l’unedes raisons suivantes : TEMPORARY UNFIT INAPTITUDE TEMPORAIRE
LENGTH OF TIME DURÉE DURÉE ______ _________ ______ ______ ______ ______ ______ ___
MEDICAL OFFICER’S COMMENTS / COMMENTAIRE DU MÉDECIN
D ATE
DND 582 (03-2006) 7530-21-912-7209
B SUR GE ON / M ÉDEC IN -C HEF DE LA BASE
PROTECTED B (When completed) PROTÉGÉ B (Une fois rempli)
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Design: Forms Management 613-993-4050 Conception : Gestion des formulaires 613-993-4062
Annex A Tool 3 List of Medicat Medications ions CF personnel reporting for evaluation with either the mCAFT/Step-test or the 20 MSR could be on a wide variety of medications. To complicate complicate matters many medications are known by several several different “Brand” names. The following list includes medications that are known to to significantly hinder heart rate response to exercise exercise and therefore make the interpretation interpretation of fitness testing results more difficult. diffi cult. The “Brand names” are in bold and listed in alphabetical order for ease of reference. reference. The non-proprietary non-proprietary names are shown in brackets brackets ( ) after each brand name. Anyone on these medications should be referred referred to his or her medical staff prior to any fitness assessment or exercise prescription. prescription. Apo-Acebutolol (Acebutolol hydrochloride) Apo-Atenolol (Atenolol) Apo-Metoprolol (Metoprolol tartate) Apo-Metoprolol - Type L (Metoprolol tartate) Apo-Nadol (Nadolol) Apo-Pindol (Pindolol) Apo-Propranolol (Propranolol hydrochloride) Apo-Timol (Timolol maleate) Apo-Tomop (Timolol maleate) Betaloc (Metoprolol tartate) Betaloc Durules (Metoprolol tartate) Betapace (Sotalol hydrochloride) Beta-Tim (Timelol maleate) Blocadren (Timelol maleate) Corgard (Nadolol) Corzide (Nadolol-Bendroflume (Nadolol-Bendroflumethiazide) thiazide) Dentosol (Propranolol hydrochloride) Gen-Atenolol (Atenolol) Gen-Pindolol (Pindolol) Gen-Tomolol (Timolol maleate) Indéral (Propranolol hydrochloride) Indéral-LA (Propranolol hydrochloride) Indéride (Propranolol hydrochloride/hydrochlorothiazide) Lopresor (Metoprolol tartate) Monitan (Acebutolol hydrochloride) Novo-Atenolol (Atenolol) Novo-Metoprol (Metoprolol tartate) Novo-Nadolol (Nadolol) Novo-Pindol (Pindolol) Novo-Pranol (Propranolol hydrochloride) Novo-Timol (Timolol maleate) Nu-Atenolol (Atenolol) Nu-Metop (Metoprolol tartate)
58
Annex A Nu-Pindol (Pindolol) Nu-Propranolol (Propranolol hydrochloride) Nu-Timolol (Timolol maleate) PMS-Metoprolol-B (Metoprolol tartate) PMS-Propranolol (Propanolol hydrochloride) Rhotral (Acebutolol hydrochloride) hydrochloride) Sectral (Acebutolol hydrochloride) Slow-Trasicor (Oxprenolol hydrochloride) hydrochloride) Sotacor (Sotalol hydrochloride) Syn-Nadolol (Nadolol) Syn-Pindolol (Pindolol) Taro-Atenolol (Atenolol) Tenoretic (Atenolol/hlorthalidone) Tenormin (Atenolol) Tim-Ak (Timolol maleate) Timolide (Timolol maleate/hydrochlorothiazide) hydrochloride) hloride) Trasicor (Oxprenolol hydroc Viskazide (Pindolol/hydr (Pindolol/hydrochloro ochlorothiazide) thiazide) Visken (Pindolol) Nu-Propranolol (Propranolol hydrochloride) Nu-Timolol (Timolol maleate) PMS-Metoprolol-B (Metoprolol tartate) PMS-Propranolol (Propanolol hydrochloride) Rhotral (Acebutolol hydrochloride) hydrochloride) Sectral (Acebutolol hydrochloride) Slow-Trasicor (Oxprenolol hydroc hydrochloride) hloride) Sotacor (Sotalol hydrochloride) Syn-Nadolol (Nadolol) Syn-Pindolol (Pindolol) Taro-Atenolol (Atenolol) Tenoretic (Atenolol/hlorthalidone) Tenormin (Atenolol) Tim-Ak (Timolol maleate) Timolide (Timolol maleate/hydrochlorothiazide) hydrochloride) hloride) Trasicor (Oxprenolol hydroc Viskazide (Pindolol/hydr (Pindolol/hydrochloro ochlorothiazide) thiazide) Visken (Pindolol)
59
Annex A Tool 4 Ergometer Steps Construction Plan for mCAFT steps.
It is advised that steps be constructed in 1.2 metre (4 foot) lengths in order to store store and transport easily. Details: • Double 20.3 cm steps, cut to desired length. • Use 1.9 cm (3/4) inch plywood. • Supporting panels (F) every every 0.9 to 1.2 m • Step Dimensions: A – 18.4 cm B – 25 cm C – 20.3 cm D – 45 cm E – 38.7 cm F – 70 cm
by 1.2 m
• Hand rail Dimensions G – Approx. 100 cm H – App Approx. rox. 137 137.5 .5 cm
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Annex A Tool 5 Handgrip dynamometer adjustments
1. 2. 3. 4.
Hang a free weight to the finger portion of the handle; Read and recor record d the result; Compare with the chart to confirm the calibration calibration of the handgrip handgrip dynamometer dynamometer;; Reading of the handgrip dynamometer must be within +/- 1 kg from from the chart corresponding corresponding measure; 5. If the handgrip dynamometer measurement does not correlate to the appropriate chart measure, the instrument cannot be used and must be calibrat calibrated ed (according to the manufactur manufacturer’s er’s instruction). Example: If you use a 30 kg weight for the calibration procedure, procedure, the handgrip dynamometer should read 28 kg.
61
Annex A Tool 6 Predictio Prediction n of VO2 max from the 20 MSR
62
Annex A Tool 7 CF MP MPFS: FS: UN UNTI TIL L 31 MAR 2008 2008
63
Annex A Tool 8 Evaluati Evaluation on Room Set Up
A. B. C. D. E.
Reception/Blood Pressur Pressure e Heart Rate Rate area Grip strength/Pushstrength/Push-up/Sit-up up/Sit-up area Step Test Station Rest Station Beam Scale, weigh scale or stadiometer stadiometer,, Wall Wall tape/Set tape/Set Square Square
64
Annex A Tool 9 Aerobic prediction for 20 MS MSR R using using EXPRES EXPR ES Program Booklets
hear t rate target target zones at which persons of NOTE: These percentages of max heart rate describe the heart different fitness levels could be expected to to conduct much of their training. It does not preclude aspects of their programs occurring anywhere within the 60-90% range.
65
Annex A Tool 10 Percentiles for Prescript Prescription ion using EXPRES Program Guides
66
Annex A Tool 11 20 MS MSR R Percentiles for Males: EFFECTIVE EFFE CTIVE 01 01 APR 2009
67
Annex A Tool 12 20 MS MSR R Percentiles for Females: EFFECTIVE EFFE CTIVE 01 01 APR 2009
68
Annex A Tool 13 Strength and Muscula Muscularr Endurance Guideline Guidelines s for Prescriptions
69
Annex A Tool 14 Protocol Percentiles: EF EFFECT FECTIVE IVE 01 01 APR 2009
70
Annex A Tool 15 Aerobic prescripti prescription on for mCAF mCAFT T
* NOTE: These percentages of max heart rate describe the heart hear t rate target target zones that persons at different fitness levels could be expected to to conduct much of their training at. It does not preclude aspects of their programs occurring occurring anywhere within the 60-90% range.
71
Annex A Tool 16 Borg Scal Scale e
72
Annex A Tool 17
Acronyms Acrony ms
73
