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Basic Information
Age: ____________ Weight: ___________ Height: ___________ Body Fat %: _______ BMI: ____________
Physiological Assessment
Resting heart rate: _________ beats per minute
To find your target heart rate in beats per minute, take your maximum heart rate (220 - age) and multiply it by your target heart
rate percentage.
Example: I am a 25 year old female. My maximum heart rate is 195 beats per minute (220 - 25). I want to improve my fitness by
exercising at a moderate intensity. So I calculate 70-80% of my maximum heart rate.
195 x 0.70 = 136.5
195 x 0.80 = 156
So I want to aim to keep my heart rate between 136 and 156 beats per minute.
Step on and off a 12 inch high box for three minutes. Alternate feet each time you step up. Try to maintain
a steady four beat cycle. It's easy to maintain if you say "up, up, down, down". Go at a steady and
consistent pace. You want to aim to complete 24 step-ups per minute.
At the end of 3 minutes, remain standing while you immediately check your heart rate. Take your pulse for
one minute.
The lower your heart rate is after the test, the fitter you are. Compare your heart rate results to the table
below. Remember, these scores are based on doing the tests as described, and may not be accurate if the
test is modified at all.
132.853 - (0.0769 x Weight) - (0.3877 x Age) - (3.2649 x Time) - (0.1565 x Heart Rate) = _______________
As calculated:
Weight is in pounds (lbs)
Time is expressed in minutes and 100ths of minutes
Heart rate is in beats/minute
Age is in years
It can also be calculated using an online calculator here.