Testing strength and cardiovascular fitness for clients with chronic pain will require some creativity and adjustments on a case-by-case basis. Since traditional strength implements like free weights, cables, and sometimes even tubing can be too strenuous on joints for clients with chronic pain, bodyweight exercises may be more appropriate as they can help us assess relative strength and muscular endurance. Although push-ups and squats are not absolute strength tests, establishing a benchmark to measure progress in muscular endurance is often a more reasonable and relevant assessment to clients with chronic pain than maxing out. It’s very unlikely that your chronic pain clients will want to improve their 1 RM, but they will most likely need to increase the endurance of typically fatigued muscles.
For testing cardiorespiratory or cardiovascular fitness, assessments like the mile-run and even step test are too rigorous for chronic pain patients. Still, evaluating cardiovascular fitness is important for all clients as this fitness component provides a good gauge for overall fitness. We can establish a benchmark for clients with chronic pain through a modification of the conventional step test.
Before starting the step test, be sure to measure the client’s resting heart rate. Depending on the severity of a client’s symptoms, try the step test for anywhere from 10 seconds to a minute; be sure the selected time-frame will be challenging, but not exhausting. Immediately after completing the step test, measure the client’s pulse, and after the client has rested for one minute, measure the pulse again to see how much they have recovered. In a traditional step test, you would wait a minute before estimating a client’s heart rate and plug that number into an equation to determine cardiovascular efficiency. By measuring their heart rate right after the step test, you can get a good idea of how intensely they may be working with respect to their max heart rate. You can also observe how quickly (or efficiently) their cardiovascular system may be in returning close to their resting heart rate through comparing their pulse right after the step test to their heart rate after a minute of rest. This will be especially helpful in cardio programming for a very deconditioned client that may be drained after walking for a minute (or even less!). You will be able to use results from their step test to determine appropriate work:rest ratios to improve cardiovascular fitness and endurance over the course of their training.
NEXT: Agility/Coordination Assessments
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