CLIENT

ASSESSMENT
MATRIX
Issues and
Challenges

Name: Carl
yes

Adult/Asthma

If yes, please
describe the
issues/challeng
es.

Which
cohort(s) do
you belong to?
Example:
adult, older
adult, diabetic,
COPD, etc.

Dr. consent,
continued use
of inhaler
What
precautions or
modifications
will you take
based on your
issues/challeng
es?

For the
cohort(s) that
you belong to,
what general
precautions
would you
need to take?
Exercise in
warm moist
climates,
swimming for
cardio or
treadmill or
bike

If no
issues/challeng
es please put
N/A.

Describe the
testing
protocol that
you chose for
each
component of
fitness.

How did you

score?

What was your

rating?

Provide a
specific goal
for each
component.

Cardiovascular
fitness test

12 minute run
test

1.75 miles
VO2 Max
51.66

Good

Muscular
strength and
endurance test
Flexibility test

Bench press
test

15 reps

Fair

Sit & Reach

15 inches

Average

Increase
speed to
reach 2 miles
in 60 days
Increase to
15-20 reps in
60 days
Extend reach

Do you have
any issues or
challenges that
will require
modifications
to the usual
fitness testing
or exercise
prescription?

Per Par Q,
Chest pains
with PA

FITNESS
TESTING

BMI

Height &
weight

25.1

overweight

Adult type 2
diabetes
Which
cohort(s) do
you belong to?
Example:
adult, older
adult, diabetic,
COPD, etc.

Dr. Consent

For the
cohort(s) that
you belong to,
what general
precautions
would you
need to take?
medications

If no
issues/challeng
es please put
N/A.

Optional: Body
composition
testing (Bod
pod, skinfold
calipers,
underwater
weighing, etc),
girth
measurements,
waist to hip
ratio
CLIENT
ASSESSMENT
MATRIX
Issues and
Challenges

Name: Sally
Yes
If yes, please
describe the
issues/challeng
es.

Do you have
any issues or
challenges that
will require
modifications
to the usual
fitness testing
or exercise

Obesity and at
risk for high
blood pressure

What
precautions or
modifications
will you take
based on your
issues/challeng
es?

Self- monitor
BP & HR,
moderate
intensity,
shorter
durations

from 15-20
inches in
next 60 days
Lose 10lbs in
60 days to
reach normal
weight
category

prescription?
FITNESS
TESTING
Describe the
testing
protocol that
you chose for
each
component of
fitness.

How did you

score?

What was your

rating?

Provide a
specific goal
for each
component.

Cardiovascular
fitness test

1 mile rock
port walk test

21.30

Below average

Muscular
strength and
endurance test

Chair stand
Arm curl

9 reps
13 reps

Below average
Average

Flexibility test

Chair sit and

reach

1 inch

average

BMI

Height &
weight

33.1

obese

Increase
speed to
have time
read 19.30 in
45 days
Increase
chair stand to
15 reps in 60
days and
increases
arm curl 19
reps in 60
days
Extend reach
2 inches in
30 days
Lose 55lbs in
6 months to
meet normal
weight range

Optional: Body
composition
testing (Bod
pod, skinfold
calipers,
underwater
weighing, etc),
girth
measurements,
waist to hip
ratio

CLIENT
ASSESSMENT

Name: Jennifer

MATRIX
Issues and
Challenges

Do you have
any issues or
challenges that
will require
modifications
to the usual
fitness testing
or exercise
prescription?

Yes/medication
s
If yes, please
describe the
issues/challeng
es.

Adult High BP

Dr. Consent

Which
cohort(s) do
you belong to?
Example:
adult, older
adult, diabetic,
COPD, etc.

What
precautions or
modifications
will you take
based on your
issues/challeng
es?

For the
cohort(s) that
you belong to,
what general
precautions
would you
need to take?

If no
issues/challeng
es please put
N/A.

Start out
slowly and
build gradually

Monitor BP
avoid Valsalva
Maneuvers

FITNESS
TESTING
Describe the
testing
protocol that
you chose for
each
component of
fitness.

How did you

score?

What was your

rating?

Provide a
specific goal
for each
component.

Cardiovascular
fitness test

12 minute run
test

1.2 miles
VO2 max
25ml/kg/min

borderline

Muscular
strength and
endurance test

Curl up
35lb bench
press

20 reps
16 reps

Marginal
Average

Increase
sped with
increase
score of 1.5
miles within
90 days
Increase curl
up rep to 25
within 60
days
Increase:

Flexibility test

Sit & reach

14 inches

good

BMI

Height &
weight

28.2

overweight

Optional: Body
composition
testing (Bod
pod, skinfold
calipers,
underwater
weighing, etc),
girth
measurements,
waist to hip
ratio

CLIENT
ASSESSMENT
MATRIX
Issues and
Challenges

Name: Justin
no

Obese youth

If yes, please
describe the
issues/challeng
es.

Which
cohort(s) do
you belong to?
Example:
adult, older
adult, diabetic,
COPD, etc.

What
precautions or
modifications
will you take
based on your
issues/challeng
es?

For the
cohort(s) that
you belong to,
what general
precautions
would you

If no
issues/challeng
es please put
N/A.

Increase
bench press
to 21 reps in
60 days
Increase
reach by 2
inches within
30 days
Lose 5 lbs
per month to
reach approx.
weight of 154
to meet
normal
catergory

need to take?
Adjust
equipment
watch
environment,
in very hot or
very cold
climates

Do you have
any issues or
challenges that
will require
modifications
to the usual
fitness testing
or exercise
prescription?
FITNESS
TESTING
Describe the
testing
protocol that
you chose for
each
component of
fitness.

How did you

score?

What was your

rating?

Provide a
specific goal
for each
component.

Cardiovascular
fitness test

1 mile run

12:39 below
50 percentile

Below 50
percentile

Muscular
strength and
endurance test

Push ups
Pull ups

9 reps
0 reps

Below 50
percentile

Flexibility test

Sit & reach

14cm

Below 50
percentile

BMI

Height &
weight

30

Obese

Increase
speed within
30 days to
11:00 min in
30 days
Increase to
18 reps in
30days
Increase to
10 reps in 30
days
Extend reach
to 3 inches in
60 days
Lose 10lbs
per 30 days,
goal 50lbs
lost in 6
months to be
at 81st
percentile
with
estimated
weight of
130lbs

Optional: Body
composition
testing (Bod

pod, skinfold
calipers,
underwater
weighing, etc),
girth
measurements,
waist to hip
ratio