亚洲体适能学院身体评估表格

1、更多资料，关注微信公众号：资料小超市健康和體適能評估表集Health and Fitness Assessment Kit高級私人教練專用For Advanced Personal Trainer身體狀況安全問卷調查PAR-Q FORM(為年齡介乎至人士之問卷)(A Questionnaire for People Aged 15 to 69)會員姓名Name : _ 會員號碼Membership No.: _為閣下安全，請回答以下問題（在適用處打上號）For your safety, please answer the following questions by ticking () th

2、e appropriate box ()沒有 有（或不清楚）NOYES or not sure1. 你的醫生有否告訴你，你的心臟有問題，並要求你只能在醫生建議的情況下才能進行運動？Does your doctor ever said that you have a heart condition and so that you should only do physical activity recommended by a doctor?2. 當你進行運動時，胸腔有否感到痛楚？Do you feel pain in your chest when you do physical activi

3、ty?3. 在過往一個月，你曾否試過在沒有運動情況下出現胸腔痛楚感覺？In the past month, did you have chest pain when you were not doing physical activity?4. 你有否由於頭暈而導致失去平沖，或至失去知感？Do you lose your balance because of dizziness or do you ever lose consciousness?5. 你有否因改變你的運動計畫而導致骨骼或關節問題惡化的情況？Do you have a bone or joint problem that cou

4、ld be made worse by a change in your physical activity?6. 你的醫生現時有否開藥方給你用於血壓或心臟等問題？Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?7. 你是否知道有可因素導致你不運動的原因？Do you know of any other reasons why you cannot do physical activity?我已經閱讀、明白及完成這問卷

5、。以上問題的答案均是本人所同意。I have read, understood and completed this questionnaire. All questions are answered to my full satisfaction.簽署日期SignatureDate Instruction of PAR-Q身體狀況安全問卷調查使用指引If you answered yes to one or more questions若有的答案有一個彧以上Talk with your doctor by phone or in person BEFORE you start becomin

6、g much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-O and which questions you answered YES.在你進行運動或體適能評估之前，請親身或透過電話諮詢你的醫生。告訴你的醫生有關PAR-Q的資料及那些問題專案的是有。 You may be able to do any activity you want - as long as you start slowly and build up gradually. Or,

7、you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.你或許能進行任何運動，但要在開始時將強度降低，並逐漸提高。或你可能限制只能參與對你安全的運動。諮詢你的醫生有關你希望參與的運動，並參考醫生的意見。 Find out which community programs are safe and

8、helpful for you.尋找對你合適與安全的社會康體計畫If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can:若你真實地回答所有的問題，並所有的答案是沒有。你能夠: start becoming much more physically active - begin slowly and build up gradually. This is the safest and easiest way to go.進行運動 (但要在開始時將強度降低，並逐漸提高。這

9、是最安全及最容易的方法。) take part in a fitness appraisal - this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively.進行體適能評估 (這是最好的方法測試你現在體適能狀況，因此你能更有效計畫你的健康生活。) 健康和體適能評估表個人資料Personal Information姓名Name會員號碼Membership no.住址Address男/女 Male/Female身高(米) Bod

10、y Height (m)年齡Age: 测试日期Test Date項目Items1st2nd3rd4th靜態心跳率 (每分鐘心率數目) Resting Heart Rate (b.p.m.)目標心跳率 (50%-75%) Target Training Heart Rate血壓(心縮壓和心舒壓)Blood Pressure (mmHg) Diastolic/Systolic評級Classification體重 (公斤)Body Weight (kg)體重指數BMI評級Classification體脂百分比 - 皮折測量Body Composition - % Body Fat (Skinfold

11、)男 胸部 Men Chest女 肱三頭肌Women Triceps腹部Abdomen髂脊上緣Suprailium大腿 Thigh大腿 Thigh總數 (毫米)Total (mm)估計體脂百分比Estimated Body Fat評級Classification電子測量 % Body Fat (BIA)腰臀比例 Waist-hip ratio評級Classification上身肌力及肌耐力測試Upper Body Muscular Strength & Endurance測試日期Test Date項目Items1st2nd3rd4th最多俯臥撐次數Maximum No. of push-ups

12、評級Classification20秒卷腹次數 No. of crunch completed in 20 sec評級Classification身體柔韌度Body Flexibility坐式前彎Trunk Forward Flexion (inch)評級Classification腓腸肌 (標準: 15-20)Gastrocnemius (Standard 15-20)膕繩肌 (標準: 0-10)Hamstring (Standard 0-10)髂腰肌 (標準: 低於水平面)Iliopsoas (Standard below horizontal level)背闊肌 (標準: 165)Lat

13、issimus Dorsi (Standard 165)亚洲运动及体适能专业学院 专业体适能教练Asian Academy for Sports & Fitness Professionals Professional Fitness Trainer估计脂肪百分比(男性)Percent Fat Estimations For Men皮折量度数值总和年龄Age(years)Sum of three skinfolds18-2223-2728-3233-3738-4243-4748-5253-57=588-121.82.63.44.24.95.76.57.38.113-173.64.45.26.0

14、6.87.68.49.19.918-225.46.27.07.88.69.310.110.911.723-277.17.98.79.510.311.111.912.613.428-328.89.610.411.212.012.813.514.315.133-3710.411.212.012.813.614.415.215.916.738-4212.012.813.614.415.215.916.717.518.343-4713.514.315.115.916.717.518.319.019.848-5215.015.816.617.418.118.919.720.521.353-5716.41

15、7.218.018.819.620.321.121.922.758-6217.818.519.320.120.921.722.523.324.163-6719.119.920.621.422.223.023.824.625.468-7220.321.121.922.723.524.325.125.826.673-7721.522.323.123.924.725.526.327.027.878-8222.723.524.325.025.826.627.428.229.083-8723.824.625.326.126.927.728.529.330.188-9224.825.626.427.228

16、.028.829.630.331.193-9725.826.627.428.229.029.830.531.332.198-10226.727.528.329.129.930.731.532.333.1103-10727.628.429.230.030.831.632.433.233.9108-11228.529.330.130.831.632.433.234.034.8113-11729.330.030.831.632.433.234.034.835.6118-12230.030.831.632.433.133.934.735.536.3123-12730.731.532.233.033.8

17、34.635.436.237.0128-13231.332.132.933.734.435.236.036.837.6133-13731.932.733.434.235.035.836.637.438.2138-14232.433.234.034.835.536.337.137.938.7143-14732.933.634.435.236.036.837.638.439.2148-15233.334.134.835.636.437.238.038.839.6153-15733.634.435.236.036.837.638.439.239.9158-16233.934.735.536.337.

18、137.938.739.540.3163-16734.235.035.836.637.438.138.939.740.5168-17234.435.236.036.837.638.439.139.940.7173-17734.635.336.136.937.738.539.340.140.9178-18234.735.436.237.037.838.639.440.241.0Source: Jackson and Pollack, 1985. Reprinted from the May 1985 issue of The Physician and Sportsmedicine by spe

19、cial permission from McGraw-Hill, Inc. Copyright 1990 by McGraw-Hill, Inc估計脂肪百分比(女性)Percent Fat Estimations For Women皮折量度數值總和年齡Age(years)Sum of three skinfolds18-2223-2728-3233-3738-4243-4748-5253-57=588-128.89.09.29.49.59.79.910.110.313-1710.810.911.111.311.511.711.812.012.218-2212.612.813.013.213.

20、413.513.713.914.123-2714.514.614.815.015.215.415.615.715.928-3216.216.416.616.817.017.117.317.517.733-3717.918.118.318.518.718.919.019.219.438-4219.619.820.020.220.320.520.720.921.143-4721.221.421.621.821.922.122.322.522.748-5222.822.923.123.323.523.723.824.024.253-5724.224.424.624.825.025.225.325.5

21、25.758-6225.725.926.026.226.426.626.827.027.163-6727.127.227.427.627.828.028.228.328.568-7228.428.628.728.929.129.329.529.729.873-7729.629.830.030.230.430.630.730.931.178-8230.931.031.231.431.631.831.932.132.383-8732.032.232.432.632.732.933.133.333.588-9233.133.333.533.733.834.034.234.434.693-9734.1

22、34.334.534.734.935.135.235.435.698-10235.135.335.535.735.936.036.236.436.6103-10736.136.236.436.636.837.037.237.337.5108-11236.937.137.337.537.737.938.038.238.4113-11737.837.938.138.339.239.439.639.839.5118-12238.538.738.939.139.439.639.840.040.0123-12739.239.439.639.840.040.140.340.540.7128-13239.9

23、40.140.240.440.640.841.041.241.3133-13740.540.740.841.041.241.441.641.741.9138-14241.041.241.441.641.741.942.142.342.5143-14741.541.741.942.042.242.442.642.843.0148-15241.942.142.342.842.642.843.043.243.4153-15742.342.542.652.843.043.243.443.643.7158-16242.642.842.043.143.343.543.743.944.1163-16742.

24、943.043.243.443.643.844.044.144.3168-17243.143.243.443.643.844.044.244.344.5173-17743.243.443.643.843.944.144.344.544.7178-18243.343.543.743.844.044.244.444.644.8Source: Jackson and Pollack, 1985. Reprinted from the May 1985 issue of The Physician and Sportsmedicine by special permission from McGraw

25、-Hill, Inc. Copyright 1990 by McGraw-Hill, Inc臺階測試 /Chester Step Test 12 (30cm) Step / 12吋(30釐米)臺階Name Age MaxHR 80% MaxHR姓名：_ 年齡：_ 最大心率：_bpm 最大心率的80%：_bpmHeart Rate心率 (beats/minute) 220210 200190 180170 160150 140130 120110 100 90 80 70 60 I II III IV V15 20 25 30 35 ml/kg/min 11 14 17 20 23 26 29

26、32 35 38 41 44 47 50 53 56 59 62 65 68 72 76Step Level階段Steps per min. 每分鐘臺階次數 Results Tables 測試結果Step Level階段IIIIIIIVVDate of Test測試日期Heart Rate心率Aerobic Capacity最大攝氧量 (ml/kg/min)Exertion Level自覺運動強度Fitness Rating評級Norms for Aerobic Capacity最大攝氧量的標準表格(ml/kg/min)Excellent 极好Good 好Average 水平Below Ave

27、rage 水平以下Poor 差 Males Age Group男性年齡組別 Females Age Group女性年齡組別15-1920-2930-3940-4950-5960-6515-1920-2930-3940-4950-5960-6560+55+50+46+44+40+55+50+46+43+41+39+48-5944-5440-4937-4535-4333-3944-5440-4936-4534-4233-4031-3839-4735-4334-3932-3629-3425-3236-4332-3930-3528-3326-4024-3030-3828-3526-3325-3123-

28、2820-2429-3527-3125-2922-2721-2519-23302826252320292725222119亚洲运动及体适能专业学院 专业体适能教练Asian Academy for Sports & Fitness Professionals Professional Fitness Trainer Certification 臺階測試 / Chester Step Test 10 (25cm) Step / 10吋(25釐米)臺階Name Age MaxHR 80% MaxHR姓名：_ 年齡：_ 最大心率：_bpm 最大心率的80%：_bpmHeart Rate心率 (beats/minute) 220210 200190 180170 160150 140130 120110 100 90 80 70 60 I II III IV V15 20 25 30 35 ml/kg/min 14 19 24 29 34 39 44 49 54 59 64Step Level階段Steps per min. 每分鐘臺階次數 Results Tables 測試結果Step Level階段IIIIIIIVVDate of Test測試日期Heart Rate心率Aerobic