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Questions Yes No
Has your doctor ever said that you have a heart condition and that
you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when do physical activity?
In the past month, have you had chest pain when you were not
doing physical activity?
Do you lose your balance because of dizziness or have you ever lost
consciousness?
Do you have a bone or joint problem (for example, back, knee, hip)
that could be made worse by a change in your physical activity
Is your doctor currently prescribing drugs for your heart condition?
Do you know of any other reason why you should not do physical
activity?
Moderate (40 – 55%) : 220 – age = ___PMHR
MHR x 0.4 = ___bpm
MHR x 0.55 = ___bpm
Vigorous (60 – 85%):
MHR x 0.6 = ___bpm
MHR x 0.85 = ___bpm
Name:
Age: Sex:
THR:______(Moderate Activity) THR:_______ (Vigorous Activity)
Weight: Height:
Physical Fitness Score Remarks (AB-Above
Components and Tests Target/BT- Below
Target)
Standing Long Jump
Curl Ups
Chair Push-Ups
50 m Sprint
Shuttle Run
Sit and Reach
3-minute step test
Performance Target for
Boys
AGE Standing Curl Chair 50 m. Shuttle Sit and 3min. Step Test
Long ups Push- sprint run Reach(cm)
Jump Ups (sec) (sec.)
(cm)
15 205 38 21 7.5 10.9 55 107
16 215 42 22 7.3 10.8 56 105
17 222 45 23 7.0 10.7 64 102
18 230 47 24 6.8 10.4 69 99
Performance Target for
Girls
AGE Standing Curl Chair 50 m. Shuttle Sit and 3min. Step Test
Long ups Push- sprint run Reach(cm)
Jump Ups (sec) (sec.)
Sprains
- Is a stretch or tear of a ligament
Strain
- Is a twist, pull or tear of a muscle or tendon
Knee Injuries
Fractures
- is a break in the continuity of a bone
Dislocations
- when the two bones that come together to form a joint become
separated
Sprains- Is a twist, pull or tear of a
muscle or tendon
Strain - Is a stretch or tear of a
ligament
Knee Injury
Fracture - is a break in the
continuity of a bone
Dislocations when the two bones
that come together to form a joint
become separated