this really depends on the person. Most very overweight people are not looking forward to an ‘assessment’ only to learn how bad things are.
Many of the tests that are often part of an assessment are skewed if a person is very overweight, and bony landmarks are difficult to see. I may or may not do body composition. Since I use near infrared technology, it is not as invasive as calipers, and most clients are okay with that. I always check blood pressure. Even though most clients are on medication and are aware of it, I always want to make sure.
I do a musculoskeletal assessment as well as possible and use the wall test (from the BioMechanics Method) and/or the squat test per NASM. I tend to forego any strength endurance tests but look for range of motion in the shoulder and hips. I also try very hard to find something that is praiseworthy so that I can start my summary with a positive statement.
The main thing is to be flexible and sensitive to the client. And assessment is often the first encounter with a client, and I like to keep that on a positive note. If I sense anxiety on the part of the client, I just leave it out. Every subsequent workout will double up as a test anyway.
I also agree with Karin, it really depends on the individual client.
Self-esteem and body image are a few issues that will help you determine where to start with this population. You will need to be sensitive to their needs and understand that many of the standard fitness assessments will not be practical to use with this population. It may or may not be practical to assess body composition on some obese clients. Calipers and circumference measures may be invasive or uncomfortable for this population (certainly it would help to have this baseline but again, depends on the individual).
Helping the client understand the role of any assessment you choose–and how it may relate to activities of daily life. For examples of fitness tests, a squat test may work for this population and you can help them understand the functional aspects of performing this exercise. Endurance tests may not be needed since it may be clear that it will result in an uncomfortable/poor experience for the client. If they are winded walking a block or two, this may be your baseline. Getting up and down from the floor can be difficult, so I would avoid fitness assessments on the floor. Postural and range of motion assessments may work just fine.
Build a rapport with the client first and assess their level of comfort. Exercises or assessments that are related to their activities of daily life will help them understand how exercises can improve their daily activities.
There are many people who are classified as obese who are extremely mobile and active and then there are those who are morbidly obese and are extremely immobile
My best suggestion would be to ask yourself why?
Do you HAVE to measure? It’s no secret that the person is obese and the goal is to lose weight in order to become healthy. Assessments can be very humiliating for them.
Hello Eileen Bochsler,
The client decides which tests and measurements are done. You may want to have them wear the same clothes for reassessments; measurements are thrown off when tight/loose clothes are worn…frustrating for the client and trainer when the results are poor.
Natalie aka NAPS 2 B Fit.
When it comes down to assessing a decondtioned client (I never call them obese) Do what absolutely needs to be done for you to effectively do your job to meet the clients needs. You don’t always have to go 1,2,3, with ever client.. hence why were called personal trainers. Make them feel comfortable and at ease, explain why you need to do the assessments your doing and how its going to translate into an overall POSITIVE training experience.
You need baselines.. so at the bare minimum
Before Photos (anterior, sagetial, posterior)
Girth Measurements (again depending on the client, don’t let them get warped around this numbers game)
Possibly base line walking test on the treadmill, using the Ebbeling Single-stage Treadmill Test.
Tracking clients data from session to session also helps reinforce positive experience, as they can visual see more reps/weight done pr a certain exercise.
Hope this helps.