This document provides instructions and forms for conducting a senior fitness test on a participant named Luis Gonzales on April 19, 2014. It includes instructions for the participant, a demographics questionnaire, a scorecard to record performance on various fitness tests such as the chair stand test and 2-minute step test, a personal profile form to assess ratings and percentiles for each test, and notes on Luis's performance and areas for improvement. The goal is to evaluate Luis's current fitness levels and identify strengths and weaknesses through a series of standard senior fitness assessments.

1. Texas Woman’s University
KINS 1583: Foundations of Assessment in KINS
Senior Fitness Test Packet
Senior Fitness Test: Participant Instructions Prior to Assessment
Place drive way
Date 4 / 19 / 2014
Time 6 :00 PM
Although the physical risks associated with the testing are minimal, the following
reminders are important in assuring your safety and helping your score the best you
can.
1. Avoid strenuous physical activity one or two days prior to assessment.
2. Avoid excess alcohol use for 24 hours prior to the assessment.
3. Eat a light meal one hour prior to the assessment
4. Wear clothing and shoes appropriate for participating in physical activity.
5. Bring a hat and sunglasses for walking outside, and reading glasses (if needed) for
completing forms.
6. Bring the Photo and/or Video Release Form.
7. Inform evaluator of any medical conditions or medications that could affect your
performance during the assessment.
*Note: As partof your testing, you will be asked to perform the aerobic endurancetest checked below:
6-minutewalk test around a flat course to determine the amountof distance you can cover in that time
or 2-minutestep test to see how manytimes you can step (march) in place in 2 minutes.

2. Texas Woman’s University
KINS 1583: Foundations of Assessment in KINS
Senior Fitness Test Packet
Senior Fitness Test Packet Page 2 of 5
Senior Fitness Test: Demographics
Ask questions to gain initial knowledge of participate. Questions can include but are not limited to:
Date: 4 / 19 / 2014 Name of Participant: Luis Gonzales
How do you feel today? Good
Do you have any current health conditions that may
affect your performance on this fitness assessment?
no
Do you exercise regularly? Yes No
If you do exercise, how much and how often?
Other questions (the evaluator demes important):
Q1.
A1.
Q2.
A2.
Q3.
A3.
Do the best you can within your “comfort zone” and
never push yourself to the point of overexertion, or
beyond what you think is safe for yourself. I have
been instructed to discontinue testing if at any time
you show signs of dizziness, pain, nausea, or undue
fatigue.
Read the statement to the participant . . .
Yes No
Would the participant like a copy of the final
report? If yes, how would you like it sent to you?
Yes No
Address:
Email:

3. Texas Woman’s University
KINS 1583: Foundations of Assessment in KINS
Senior Fitness Test Packet
Senior Fitness Test Packet Page 3 of 5
Senior Fitness Test: Scorecard
Date 4 / 19 / 2014 Name of Participant Luis Gonzalez
Gender M = F =
Date of Birth 2 / 27 / 1954
Body Mass Index (BMI) H = 5'7 W= 170
Assessment Instructions Trial 1 Trial 2 Best Score
Chair Stand Test Number of stands in 30 seconds 16 16
Arm Curls Test Number of repetitions in 30 seconds 24 24
6-Minute Walk Number of yards
2-minute Step Test* Number of steps in 2-minutes 98 98
Chair Sit-and-ReachTest
Nearest ½ inch (+ or -), toe is zero
Extended leg: R or L
-10 -9 -9
Back ScratchTest
Nearest ½ inch (+ or -), fingertip is zero
Hand over shoulder: R or L
0 0 0
8’ Up-and-Go Test Nearest 1/10 seconds 5 sec 4 sec 4 sec
*Omit2-minutestep test if 6-minutewalk test is given.

4. Texas Woman’s University
KINS 1583: Foundations of Assessment in KINS
Senior Fitness Test Packet
Senior Fitness Test Packet Page 4 of 5
Senior Fitness Test: Personal Profile Form
Date 4 / 19 / 2014 Name of Participant Luis Gonzalez
Gender M = F =
Date of Birth 2 / 27 / 1954
Assessment
Best
Score
Rating*
Below Normal Above
average range average
<---25th%-----------------------75th%--->
Percentile
Rank^
Comments
Chair Stand Test 18 x 65%
Arm Curls Test 24
85%
Arm curl was made with a
doorstopperthat wighted
6 lbsgreat posture,
improvisation was needed
as not having a dumb bell.
item weights 6 lbs.
6-Minute Walk N/A N/A N/A
2-minute Step Test* 98 x 45%
Chair Sit-and-ReachTest -9 5%
Luis doesn’tdo may
streching exercises

5. Texas Woman’s University
KINS 1583: Foundations of Assessment in KINS
Senior Fitness Test Packet
Senior Fitness Test Packet Page 5 of 5
Assessment
Best
Score
Rating*
Below Normal Above
average range average
<---25th%-----------------------75th%--->
Percentile
Rank^
Comments
Back ScratchTest 0 75%
his strech was zero
indicating that he's
completely flexible in his
upper extremidies needs to
work on lower limbs.
8’ Up-and-Go Test 4 70%
speed as he rosefrom the
chair, no problem sitting
back in place.
Body Mass Index (BMI)
H = 5'7
W= 170
BMI = 26.6
< 18 Underweight, may signify loss of muscle or bone
19-26 Healthy range
> 27 Overweight, may cause increased risk of disability/disease
*Rating categoriescan be determined fromtables5.3 and 5.4 and are illustrated in the SFT performance charts (see figures 5.2. and 5.3)
^Percentile ranks are determined fromtables in appendix H