Marquette University

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8-1-1983

Physical Fitness of Physical Therapy Students

Dennis Sobush
Marquette University, dennis.sobush@marquette.edu

Richard Fehring
Marquette University, richard.fehring@marquette.edu

Published version. Physical Therapy, Vol. 63, No. 8 (August 1983): 1266-1273. DOI. © 1983
American Physical Therapy Association. Used with permission.
 Physical Fitness of Physical Therapy Students
DENNIS C. SOBUSH
and RICHARD J. FEHRING

Physical fitness norms do not exist for physical therapists or physical therapy
students. This lack, in part, reflects the complexity of physical fitness and the
scarcity of data reported on physical fitness norms of other populations. This
report describes the methods used and the results obtained for 16 physical
fitness factors of 98 female and 13 male physical therapy upperclassmen and
discusses the implications of physical fitness in the practice of physical therapy.
Means, standard deviations, ranges, and percentile ran kings are given by sex
for each of the 16 fitness factors. The purpose of this study was to begin to
establish physical fitness norms. As physical fitness norms are established, it
will be possible to determine how norms of physical therapists and physical
therapy students compare with established values.

Key Words: Physical fitness, Physical therapists.

There is more to good health than just not being maximum torque to one-half its maximal torque
sick. Proper nutrition, stress management, and phys- value is an index of muscle fatigue or endurance. This
ical fitness are essential requirements for maintaining sophisticated testing device is familiar to physical
and improving health. People are becoming increas- therapists and commonly used by them.
ingly aware of their responsibility not only for pre- The third factor, muscle strength, has been quan-
venting disease but also for improving their health tified for isometric, isotonic, and isokinetic contrac-
status by modifying their life styles and changing tions for the trunk and extremities. For example, an
their environments. isometric dominant handgrip test is commonly used
Physical fitness, one of the key requirements for to measure upper extremity strength. 5 By using the
good health, is a complex area. Speculation continues Cybex@ II dynamometer, isokinetic peak torque out-
as to what factors contribute to physical fitness. The puts can be determined easily for the muscle groups
literature supports three vital factors: cardiorespira- that extend and flex the knee. 6
tory endurance, muscular endurance, and muscular Other important physical fitness factors have also
strength.! been documented in the literature. For flexibility
The first factor, cardiorespiratory endurance, is fitness, the sit-and-reach test provides a measure of
frequently represented by maximum oxygen uptake length for the gastrocnemius-soleus, hamstring, and
(V02max).2 For arriving at good estimates of Vo2ma.. posterior trunk musculature and is more practical to
practical "field-type" tests have been designed for administer to a large number of subjects than is a
groups of healthy young men and women. Safe and complete goniometric assessment. 7 For estimating
widely used field tests include the 12-minute run and body density (percentage fat), many methods are
the 1.5-mile run for time. 3 currently available. Hydrostatic underwater weighing
The second factor, muscular endurance, can be provides reliable data for calculating the proportion
measured with a device such as the Cybex® 11* iso- of fat in the total body, but anthropometric measures
kinetic dynamometer, which records the force of mus- (skinfold, circumference, diameter) are more practical
cle contraction as a function of time. 4 The elapsed for clinical use. 2 Lung volume (vital capacity) and air
time, in seconds, for a muscle group to regress from flow (forced expiratory volume in one second) are
generally accepted measures of respiratory function
Mr. Sobush is Assistant Professor, Program in Physical Therapy, and are easily determined in the clinic.s An accurate
Marquette University, Milwaukee, WI 53233 (USA).
Dr. Fehring is Assistant Professor, College of Nursing, Marquette determination of blood pressure can be obtained with
University, Milwaukee, WI 53233. repeated measures that take into account the emo-
This article was submitted September 13,1982; was with the authors
for revision eight weeks; and was accepted for publication March 21,
tional state of the person and environmental condi-
1983. tions. Pulse rates taken immediately after a person
*Cybex Division of Lumex, Inc, 2100 Smithtown Ave, Ronkon-
has completed a maximal physical effort (eg, the 1.5-
koma, NY 11779. mile run) can be compared with published values of

1266 PHYSICAL THERAPY

 RESEARCH
predicted maximal heart rates according to age and 6. The Cybex® Isokinetic #7104 Dual Channel Sys-
sex. 9 Finally, resting pulse rates have been reported temtt to determine peak torque values of the
but must be loosely interpreted10; pulse rates fluctuate knee extensor and flexor muscles and endurance
because of existing internal and external factors af- time of knee extensor muscles.
fecting the person. 7. A standard anaeroid inflatable blood pressure
After reviewing the literature on physical fitness cuff and a stethoscope for determining blood
testing, we developed a test battery of 16 physical pressure readings from the left arm.
fitness factors. This test battery resembles, in part, the 8. A banked indoor track for the 1.5-mile run for
one used by Zuti and Corbin on college freshmen l l time (21.75 laps).
and can be replicated with resources common to most
physical therapy programs. Procedure
To date, no norms for the physical fitness of phys-
ical therapists or physical therapy students have been Physical fitness testing was performed at two loca-
reported. Few published reports exist that contain tions. The 1.5-mile run for time was conducted on the
sufficient information about the methods to permit indoor track at the gymnasium of the subjects' uni-
adequate replication, and, therefore, comparison of versity. All other tests were conducted at the physical
physical fitness studies is difficult. Established norms therapy department of the local Veterans Administra-
and standard testing procedures would allow physical tion medical center.
therapists and students to be assessed as physically fit Equal-sized groups were tested on two consecutive
or unfit. The purpose of this study was to begin mornings (8 AM to 12:30 PM) during the first two
establishing physical fitness norms for physical ther- weeks of a semester. Students received one week
apy students. It is hoped that this study will serve as advance notice that fitness testing would be per-
a model for further physical fitness testing of dermed formed. They were advised on how to run on the
samples of this population. banked indoor track and of the precautions to take to
avoid undue trauma when a maximum effort would
METHOD be required. Students practiced self-monitoring of
resting and exercise pulse rates from both the carotid
Subjects and the radial arteries. Instructions were given to
count their pulse rate for 10 seconds, beginning with
The subjects in this report were III volunteers (13 0, and to multiply this value by six to determine a
men and 98 women; mean age, 20.92 years) enrolled minute pulse rate.
as upperclassmen in a sectarian midwestern univer- Immediately before fitness testing, all students de-
sity's program in physical therapy. All subjects signed termined and recorded their minute pulse rate after
an informed consent form and were screened by sitting quietly for five minutes. Resting blood pres-
medical history questionnaire for coronary heart dis- sures (sitting) were then taken from the left arm by
ease risk. one of two physical therapists. A physical therapist
demonstrated the fitness tests to be performed at
Instrumentation specific stations according to a written handout given
each student.
Physical fitness data for all subjects in this study Five physical therapists conducted the physical
were obtained by using the following equipment: fitness testing. For each testing station, the same
1. The Vitalographt spirometer for measuring vol- physical therapist(s) supervised the data collection on
umetric capacity and ventilatory function. all subjects tested. The l.5-mile run for time was
2. A standard physician's office scale with weight supervised by two physical therapists.
balance for height and weight measurements. Height was measured to the nearest half-inch
3. A bend-and-reach frame, constructed according (shoes removed) and weight to the nearest quarter-
to specifications described by Wells and Dillon, pound. (Lab attire was worn: shorts for men, shorts
for flexibility determinations. 7 and halter tops or T-shirts for women.) Percentage
4. A Lange Skinfold Calipeq for skinfold measure- body fat determinations were made by skinfold cali-
ments. per. Sites selected were chest, abdomen, and anterior
5. A Jamar Adjustable Hand Dynamometer** for thigh for men, and triceps brachii muscle, suprailiac,
grip strength measurements. and anterior thigh for women. Skinfold readings were
taken on the right side according to the technique
tVitalograph Ltd, 8347 Quivira Rd, Lenexa, KS 66215.
*Cambridge Scientific Industries, PO Box 265, Cambridge, MD described by Pollock and Schmidt.2 Averages for
21613.
**Asimow Engineering Co, 1414 S Beverly Glen Blvd, Los An- ttCybex Division of Lumex, Inc, 2100 Smithtown Ave, Ronkon-
geles, CA 90024. koma, NY 11779.

Volume 63 / Number 8, August, 1983 1267

 Fig. 2. Respiratory function testing (VC, FEV" and FEV, /
FVC) using the Vitalograph.

position for three seconds. You will be checked for

cervical, thoracic, and lumbar spinal restriction. Rec-
ord results on test form in scores to the nearest half-
inch. Repeat three trials for flexibility" (Fig. 3).
Station 3 (grip strength). "Standing, arm alongside
the body with elbow extended and metacarpal-pha-
langeal joints in neutral position, perform three trials
of grip strength with the right (right grip) and then
the left hand (left grip). Record results of each trial
and calculate the average scores for both the right
and left sides" (Fig. 4).
Fig. 1. Abdominal skinfold assessment for percentage Station 4 (lower extremity strength and endur-
body fat determination. ance). The instructions given to each subject during
learning and testing trials on the Cybex® II isokinetic
three trials were determined, and a sum for the three apparatus were to "extend and flex your knee as fast
averages was calculated. Predictions for percentage as you can three times, pushing on the way up and
body fat were made according to data by Pollock and pulling on the way down. You will then rest for 30
Schmidt (Fig. 1).2 seconds, and when I say 'Go,' extend and flex your
Subjects were assigned a random order of complet- knee as fast as you can until told to stop (right knee
ing the four specific testing stations. The following extension peak torque and right knee flexion peak
instructions were given to the subjects at the stations. torque)."
Station 1 (spirometry). "Standing, with nostrils Each learning trial consisted of three cycles of
pinched, fill your lungs with as much air as possible, extension-flexion at 300 /sec, a 30-second rest period,
seal your lips tightly around mouthpiece, slowly ex- and four extension-flexion cycles at 180 0 /sec. Verbal
hale as long as you can to squeeze all the air out of encouragement was given to all groups during the
your lungs. Repeat three trials for vital capacity testing trials. The waiting time between trial and
(VC)." As above, "Exhale as hard and as fast as you testing sessions was uniform (approximately 53 min-
can; don't stop until you are told to stop." (Test utes). Endurance tests were terminated when the
terminated when flow curve reached a plateau.) Re- torque values for knee extension were half the peak
peat three trials for forced vital capacity (FVC) and values attained during the first several contractions at
forced expiratory volume in one second (FEV 1) (Fig. 1800 /sec (right knee extension endurance to half peak
2). torque). Subjects were secured to the Cybex® II ap-
Station 1 (flexibility). "Perform three squats. Place paratus according to standard procedures described
your feet on the footprints on the frame end, keeping for knee extension and knee flexion testing (Fig. 5).4
your knees fully extended, slowly slide your fmgertips The test battery was completed with the 1.5-mile
to push the block away from you without jerking. run for time at maximum effort, in a counterclockwise
When you can't move the block any more, hold this direction (Fig. 6). No more than 15 subjects ran at a

1268 PHYSICAL THERAPY

 RESEARCH

Fig. 3. Sit-and-reach test for flexibility of the gastroc-

nemius-soleus, hamstring, and posterior trunk muscles.

time. Each subject was paired with a nonrunning

partner who was responsible for keeping count of the
number of laps run, assisting the partner at the fmish
line, recording the fmishing time, and monitoring the
1-, 3-, and 5-minute recovery pulse rates. The runs
were preceded by a 5-minute warm-up period for Fig. 4. Right hand grip strength testing.
stretching and calisthenics. During each run, subjects
were instructed to pace themselves. If they needed to with those previously reported by other investigators
stop running, they were instructed to walk briskly for other populations using similar methods.
along the outside perimeter of the track until they According to Pollock and associates,1O the 50th
could begin running again. At the fmish, subjects percentile values of resting heart rate and systolic and
were held upright by their partners and escorted to a diastolic blood pressure for college-age women were
physical therapist who determined their maximum 65 beats per minute (bpm), 112 mm Hg, 75 mm Hg
pulse rate at the carotid artery within the first 15 and for college-age men were 63 bpm, 121 mm Hg,
seconds immediately after the run (Fig. 7). and 80 mm Hg. The 50th percentile values for women
and men of this study were 76 bpm, 106 mm Hg, 66
RESULTS mm Hg and 72 bpm, 122 mm Hg, and 70 mm Hg,
respectively.
Table 1 describes the subjects in terms of 16 phys- Zuti and Corbin reported height and weight values
ical fitness factors. The data are organized according for the 50th percentile on 1,533 college freshman
to percentile scores. Lowest and highest scores for women. ll Their 164.6 cm and 58.0 kg values were
each of the 16 factors are reported in place of the 0 close to the 164.4 cm and 59.2 kg values for women
and 100 percentiles, respectively. In addition, means, subjects of this report. For 1,717 male freshmen, 50th
standard deviations, and ranges were calculated and percentile scores of 177.5 cm and 71.7 kg are, likewise,
are presented in Table 2. similar to the 177.2 cm and 69.6 kg values found for
the men in this report. Zuti and Corbin also reported
DISCUSSION percentage body weight, that is, fat estimates, for men
and women. ll Their 23.2 percent fat estimate for the
This study generated normative physical fitness 50th percentile is 3.6 percent less than the 26.8 percent
data for upperclass students in the physical therapy value at the 50th percentile for women of this report.
program at a sectarian midwestern university. It is A 3 percent standard error has been reported, how-
based on the premise that, to defme an abnormality, ever, when using skinfold measurements for percent-
one must first defme what is considered to be age fat estimates.2 Zuti and Corbin ll reported a 10.8
"normal" for a given population. No information had percent fat estimate at the 50th percentile that com-
been previously reported for junior and senior college pares well with the 11.7 percent for men in this report.
students. The fitness factors in Table 1 were compared Using the mean heights and an average age of 20

Volume 63 / Number 8, August, 1983 1269

Fig. 5. (left) Cybe~ II dynamometer being used for isokinetic strength and endurance testing for knee flexor and
extensor muscles. Fig. 6. (center) A 1.5-mile run for cardiorespiratory endurance testing. Fig. 7. (right) Carotid
pulse rate determination immediately after run.

years for men and women in this report, VC, FEV b The literature is scarce in reporting normative iso-
and FEV t/FVC values were calculated from nomo- kinetic values for peak knee flexion, peak knee exten-
grams at BTPS (body temperature at 37°C, baromet- sion, and endurance times to one-half peak torque for
ric pressure saturated with water vapor) on normal subjects comparable with those in this report (ie,
college subjects.8 For women in this report, mean VC similar body type, height, weight, and overall physical
was 3.90 L and mean FEV I and FEVt/FVC were condition). A literature review by Nosse of strength
3.65 Land 90.9 percent, respectively. For men in this relationships of the knee musculature revealed isoki-
report, mean VC was 5.68 L, mean FEV I was 4.97 L, netic studies in which the knee flexor muscle strength
and mean FEVt/FVC was 87.5 percent. These respi- was between 43 and 90 percent of the knee extensor
ratory function values are essentially normal for both muscles. 6 In those isokinetic studies that have been
sexes. This assessment information is useful before reported, variations in speed of contraction, test po-
performing cardiorespiratory endurance testing (eg, sitions, joint angles, degree of stabilization of subjects,
1.5-mile run for time) because abnormal respiratory and isokinetic resistance devices used have made
function would limit subject performance on this strength and endurance comparisons impractical. 6
fitness test. 12
Zuti and Corbin reported 50th percentile values for Equating Cooper's "fair" category for the 1.5-mile
trunk flexibility as 46.5 cm and 45.2 cm for women run for time to be approximately the 50th percentile,
and men, respectively.l1 In comparison, women and women under 30 years of age can be expected to run
men of this report revealed greater flexibility, meas- 1.5 miles in 15 minutes 55 seconds to 18 minutes 30
seconds. 13 Men of the same age are expected to run
uring 47.5 em and 47.0 cm, respectively.
1.5 miles in 12 minutes 1 second to 14 minutes. 13 The
Upper extremity grip strength measures reported
for this study are considerably less than those reported 50th percentile run times in this report were 14 min-
by Zuti and Corbin for each sex in both the dom- utes 22 seconds for women and 10 minutes 20 seconds
inant and nondominant hands, using a rectangular- for men. Both sexes demonstrated a better than "fair"
type manometer. l1 Strength comparisons for women level of cardiorespiratory endurance.
were 26.5 kg versus 22.8 kg for the right grip and 24.0 Sheffield and colleagues, as reported by the Amer-
versus 21.3 kg for the left grip. Comparisons for men ican Heart Association,14 gave a predicted maximal
were 49.6 kg versus 40.0 kg for the right grip and 45.6 heart rate at age 20 to be 197 bpm for untrained
kg versus 35.8 kg for the left grip. A study that used subjects. This value compared with the 202 bpm and
the Jamar dynamometer for grip strength testing re- 199 bpm mean values recorded for women and men
ported 31.7 kg (dominant hand) and 29.0 kg (non- in this study. Maximal pulse rates as high as 258 for
dominant hand) in 80 "normal" women (age range, women and 222 for men were noted. According to
18-52 years), and 51.4 kg (dominant hand) and 49.3 Astrand and Rodahl, the maximal heart rate may be
kg (nondominant hand) in 1,128 "normal" men (age below 175 bpm or above 215 bpm for 25-year-old
range, 18-62 years).5 women or men. 15

1270 PHYSICAL THERAPY

~
[
Q)
0>
(.)
'-
~ TABLE 1
:3 Physical Fitness Results for FEMALE (n = 98) and MALE (n = 13) Physical Therapy Upperclassmen
0-
Q)
Percentiles
"'
.0>
). Factors Lowest 25 50 75 Highest
~
~
...... F M F M F M F M F M

- Height (em) 151 .1 165.1 160.5 169.5 164.4 177.2 169.5 180.8 181.6 184.2
~ Weight (kg) 42.6 61.5 54.3 65.7 59.2 69.6 70.0 81 .1 100.3 98.0
(.) Percent fat 13.8 8.3 23.4 10.5 26.8 11.7 30.2 14.6 40.0 22.5
Flexibility (em) 25.4 39.4 16.9 16.4 48.0 45.2 20.9 19.7 67.8 57 .9
Right grip (kg) 14.0 30.0 19.6 32.2 22.8 40.0 26.2 44.0 34.7 50.6
Left grip (kg) 10.3 24.5 17.5 31 .5 21.3 35.8 24.2 40.6 32.0 46.3
Right knee extension
peak torque (ft-Ibs) 49.0 126.0 82.6 134.5 90.5 147.3 105.2 172.1 156.7 190.0
Right knee flexion peak
torque (ft-Ibs) 34.0 56.3 47 .8 69.1 52.9 83.3 61.1 104.4 78.8 127.3
Knee flexor/extensor
strength ratio (%) 43.3 38.7 51 .9 46.0 58.5 55.1 64.9 63.4 81.7 75.2
Knee extensor endurance
time to half peak torque
(sec) 19.2 28.8 30.8 29.8 36.2 34.0 40.1 39.3 68.2 42.8
Resting pulse rate (BPM) 54 60 68 62 76 72 81 84 108 90
Heart rate maximum
(BPM) 150 186 193 194 202 199 211 208 258 222
5-minute recovery heart
rate (BPM) 60 60 94 105 115 116 123 122 156 138
1 .5-mile run (min:sec) 10:42 9:34 12:58 9:59 14:22 10:29 15:51 11 :00 19:50 14:17
Resting diastolic blood
pressure (mm Hg) 50 58 59 64 66 70 72 77 100 80
Resting systolic blood
pressure (mm Hg) 88 102 98 119 106 122 112 128 156 136

:a
IT!
(I)
IT!
...... l>
I\) :a
0
'" :x
 TABLE 2
Physical Fitness Results for Female (Male) Physical Therapy Upperclassmen
Descriptive Statistics

Fitness Variable n X s Range

F M F M F M F M
Height (cm) 97 13 165.33 176.52 6.42 6.49 151.1-181.6 165.1-184.2
Weight (kg) 97 13 60.20 75.19 10.22 11.18 43.0-100.2 61.5-98.0
Percent Fat 97 12 27.15 13.32 4.87 3.88 13.8-40.0 9.0-22.5
Flexibility (in) 96 13 18.70 13.46 3.19 2.34 10.0-26.7 15.5-22.8
Right grip (kg) 96 12 23.12 39.50 4.43 6.88 14.0-34.7 30.0-50.6
Left grip (kg) 96 13 21.05 36.74 4.37 6.47 10.3-32.0 24.5-46.3
Right knee extension 95 12 93.78 156.35 18.45 21.63 49.0-156.7 1 26.0-190.0
peak torque (ft-Ibs)
Right knee flexion 95 12 53.92 88.58 11.23 22.22 34.0-78.8 56.3-127.3
peak torque (ft-Ibs)
Knee flexor/extensor 95 12 0.59 0.57 0.914 0.108 0.433-.817 0.39-0.75
strength ratio (%)
Knee extensor endur- 92 12 36.26 35.92 8.11 4.91 19.2-68.2 28.8-42.8
ance time to half
peak torque (sec)
Resting pulse rate 88 12 77.2 74.50 11.4 11.8 54.0-108.0 60.0-90.0
(BPM)
Pulse rate maximum 92 13 204.59 204.46 17.2 11.6 150.0-258.0 186.0-222.0
(BPM)
5-minute recovery 92 13 111.98 114.46 21.5 21.3 60.0-156.0 60.0-138.0
pulse rate (BPM)
1.5-mile run (min:sec) 92 13 14:40 11 :01 2:18 1:24 10:42-26:21 9:34-14:17
Resting systolic blood 88 12 107.39 123.17 11.8 8.67 88.0-156.0 102.0-136.0
pressure (mm Hg)
Resting diastolic 88 12 67.11 71.33 9.91 7.79 50.0-100.0 58.0-80.0
blood pressure (mm
Hg)

In summary, the women in this study had greater therapists should examine the efficacy of their atti-
values for resting and maximum pulse rates, percent- tudes, appearances, and actions in eliciting desirable
age body fat estimates, and flexibility, but lesser outcomes. Physical fitness and appearance of the
values for resting diastolic and systolic blood pressure, physical therapist may have far-reaching implications
grip strength, and 1.5-mile run for time than results in the therapist-patient relationship. It may be wise
previously recorded. The men demonstrated greater to keep in mind the proverb "actions speak louder
values for resting and maximum pulse rates, resting than words" and to guard against a "do as I say, not
systolic blood pressure, percentage body fat estimates, as I do" approach. Once physical fitness norms are
and flexibility but lesser values for resting diastolic established, physical therapists will have a means of
blood pressure, body weight, grip strength, and 1.5- determining whether they are physically fit or unfit.
mile run for time than results previously reported. When combined with quantifiable information per-
Normative values for comparison on five-minute re- taining to fitness requirements for the occupation,
covery pulse rates were not identified in the literature. this interpretation can specify personal qualifications
Respiratory function (eg, ve, FEV 10 and FEV r/FVC) for being physically fit or unfit to practice. It is in the
was normal for both sexes. patients' best interest that physical therapists achieve
optimal levels of physical fitness to serve as good role
Implications for Practice models. This report is a first attempt to establish
norms and methods to determine physical fitness in
The occupational demands of physical therapy physical therapy.
practice have not yet been quantified. Longitudinal
investigations extending into the first year(s) of CONCLUSION
professional work experience may be warranted to
ascertain the degree of physical fitness compatible The results of the physical fitness factors for a
with a therapist's work-related responsibilities. narrowly dermed population of physical therapy stu-
In view of the occupational obligation to aid pa- dents were presented. The results of this study serve
tients in achieving optimal levels of function, physical as a first attempt to establish physical fitness norms

1272 PHYSICAL THERAPY

 RESEARCH
in physical therapy students and other select popula- apy match fitness levels of physical therapists, assess-
tions. The need for standardized methods for meas- ing curricular stress on student wellness, determining
uring physical fitness was accentuated by fitness dif- whether knowledge of one's physical fitness is an
ferences between subjects of the same sex in this and effective self-motivational strategy for fitness en-
previous reports. hancement, and establishing physical fitness norms
This report describes select physical fitness testing for physical therapists. In addition, these methods can
methods to permit replication for future research. be applied toward preventive screening for work,
Areas of future research could include determining recreation, or sport in a safe, affordable, and repro-
whether the occupational demands of physical ther- ducible manner.

REFERENCES
1. Kendall F: A criticism of current tests and exercises for 9. Proceedings of the National Workshop on exercise in the
physical fitness. Phys Ther 45:187-197,1965 Prevention, In the Evaluation, and in the Treatment of Heart
2. Pollock ML, Schmidt DH: Measurement of cardia-respiratory Disease (Myrtle Beach, SC, 1969). J SC Med Assoc 65
fitness and body composition in the clinical setting. Compr (Supp 1 to No 12):1-105, 1969
Ther 6(9): 12-27, 1980 10. Pollock ML, Wilmore. JH, Fox SM: Health and Fitness
3. Myers CR: The Official YMCA Physical Fitness Handbook. Through Physical Activity. New York, NY, John Wiley & Sons
New York, NY, Popular Library, 1977, pp 107-109 Inc, 1978, pp 266-286
4. Isolated Joint Testing and Exercise: A Handbook for Using 11. Zutl WB, Corbin CB: PhYSical fitness norms for college fresh-
CylHlx® II and the UBXT"'. Bay Shore, NY, Cybex Division of men. Res Q 48:499-503, 1977
Lumex Inc, 1980, pp 20-22, 67-70 12. Shephard RJ: Exercise in chronic obstructive lung disease.
5. Schmidt RT, Toews JV: Grip strength as measured by the Exerc Sports Sci Rev 4:263-296, 1976
Jamar dynamometer. Arch Phys Med Rehabll 51 :321-327, 13. Cooper KH: The Aerobics Way. New York, NY, M Evans &
1970 Co, Inc, 1977, p 89
6. Nosse W: Assessment of selected reports on the strength 14. Proceedings of the national workshop on exercise In the
relationship of the knee musculature. Journal of Orthopedic prevention, In the evaluation, and in the treatment of heart
Sports Physical Therapy 4(2):78-85, 1982 disease (Myrtle Beach, So. Carolina, 1969). J So Carol Med
7. Wells KF, Dillon EK: The sit and reach: A test of back and Assoc 65 (SuppI12):1-105, 1969
leg flexibility. Res Q 23:115-118,1952 15. Astrand PO, Rodahl K: Textbook of Work Physiology. New
8. Vitalograph Ltd: Lung Function Tables and Nomogrammes, York, NY, McGraw-Hili Inc, 1970, p 166
ed 4. Lenexa, KS, Vitalograph Ltd, 1977

Volume 63 / Number 8, August, 1983 1273