Protocol - Integrated Fitness - Adult

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Fitness tests used to assess a person’s muscle strength, endurance, and flexibility. Adult tests include half sit-ups (abdominal muscle strength), standard or modified push-ups (upper body muscle strength), and the "sit and reach" (flexibility). It is recommended that these fitness tests are performed with a partner.

Specific Instructions

The technician should alert the study participant that the push-up test may aggravate shoulder, elbow, or wrist pain or temporarily cause muscle soreness. Similarly, the technician should alert the study participant that the sit and reach test may aggravate low-back pain. Note: the aerobic fitness test from the President’s Challenge is a separate protocol. See the Aerobic Capacity measure.




The Half Sit-Up Test*

One of the most frequently measured muscle groups is the abdominal (stomach) muscles. Several tests (for example, sit-up and curl-up tests) have been developed to measure mainly abdominal muscular strength and endurance. We are going to use an abdominal muscular strength and endurance test called the "YMCA Half Sit-Up" test, which is a curl-up test since you lift your trunk only partially off the floor.

Equipment/Test Setting:

  • Mat or rug,
  • Stopwatch or watch with a second hand,
  • Four strips of tape to place 3.5 inches apart on mat or rug to provide start and end position for the curl-up.

Prepare the mat or rug with the tape strips as shown in the picture. You need to be able to feel the tape as your fingers move across the mat or rug from the starting and ending positions. We recommend that you do the test with a partner.


1. Lie face-up on mat or rug with knees at a right angle (that is, 90°) and feet flat on the ground. The feet are not held down.

2. Place hands with palms facing down on the mat or rug with the fingers touching the first piece of tape.

3. Flatten your lower back to the mat or rug, and half sit-up so that your fingers move from the first piece of tape to the second. Then return your shoulders to the mat or rug and repeat the movement as described. Your head does not have to touch the surface. Keep your lower back flat on the mat or rug during the movements - if you arch your back, it can cause injury.

4. Your partner will count the number of half sit-ups performed in one minute. Pace yourself so you can do half sit-ups for one minute.

5. Record your results.

*Used with permission from Fitness Testing and Assessment Manual, 4th ed. © 2000 by YMCA of the USA, Chicago. All rights reserved.

Standard and Modified Push-Up*

Alert! If you have shoulder, elbow, or wrist pain, doing this test may aggravate your condition.

The muscles of the upper body and shoulders are another frequently measured muscle group. Several tests (for example, pull-up and push-up) are used to measure the strength and endurance of these muscle groups. Less muscular strength and endurance of the upper body and shoulder group may increase the chances that a person may have shoulder pain in middle or older adulthood.

In the standard push-up test, you push your body up and down using muscles in your arms, shoulders and chest, while keeping your body straight with your feet serving as the pivot point. Your body weight is your workload. Females can reduce the load by having their knees touching the floor and acting as the pivot point. In this test, only the upper body is the load. We are going to use standard push-ups and modified push-ups as our tests for upper body and shoulder muscular strength and endurance.


1. Males start in the standard push-up position (elevated). Hands should be shoulder width apart, arms extended straight out under the shoulders, back and legs in a straight line, and toes curled under. Females do a modified push-up with knees bent and touching the floor. Starting in the up position, hands should be slightly ahead of the shoulders so hands are in the proper position for the downward motion.

2. Lower until the chest is about 2 inches from the floor and rise up again.

3. Perform the test until you cannot complete any more push-ups while keeping your back straight and, if you are a male, keeping the legs straight as well. The key to completing the test properly is to maintain a rigid position and keep the back flat. If necessary, you can take a brief rest in the up position (not lying on the floor).

4. Record your results.

*Normative data for the push-up and modified push-up are based on a population that is 20 years of age and older. These data and the test protocol are used with permission of The Cooper Institute, 12330 Preston Road, Dallas, TX 75230.

The Sit-and-Reach Test*

Alert! If you have low-back pain, doing this test may aggravate your condition.

Equipment/Test Setting:

Tape measure or yardstick and tape and a partner to record your score.


1. Perform a series of static stretches. These stretches should focus on stretching the trunk and legs. Following the stretches, you may also want to do some brisk walking.

2. Place a yardstick on the floor and put a long piece of masking tape over the 15 inch mark at a right angle to the yardstick.

Remove your shoes and sit on the floor with the yardstick between the legs (0 mark close to your crotch), with your feet about 12 inches apart. Heels should be at the 14 inch mark at the start of the stretch to account for the fact that the legs tend to move forward when performing the stretch.

4. With the fingertips in contact with the yardstick, slowly stretch forward with both hands as far as possible noting where the fingertips are to the closest inch. Exhaling when you stretch forward and dropping the head may allow you to stretch a bit further. Do not use fast and sudden motions, which can injure your hamstring muscles.

5. Perform the stretch three times with a few seconds of rest between stretches.

6. Record the best of the three measurements.

*Used with permission from Fitness Testing and Assessment Manual, 4th ed. © 2000 by YMCA of the USA, Chicago. All rights reserved.

If desired, the results from these tests may be entered into an online form at the President’s Challenge Adult Fitness Test website. Once entered into the online form, each result will appear as a percentile which is the percentage of adults the same age who would score lower.

Personnel and Training Required

A technician who has been trained to administer physical fitness tests. The technician must be able to use a stopwatch, count, and read and record measurements from a yardstick.

Equipment Needs

For The Half Sit-Up Test:


  • Mat or rug,
  • Stopwatch or watch with a second hand,
  • Four strips of tape to place 3.5 inches apart on mat or rug to provide start and end position for the curl-up.

The Sit-and-Reach Test requires a tape measure or yardstick.

Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Physical Measurement


Adult, Senior


Ages 18+

Selection Rationale

These fitness tests were chosen because they have been recommended by the President’s Council on Physical Fitness and Sports and are publicly available.


Chinese, English

Logical Observation Identifiers Names and Codes (LOINC) Integrated fitness adult proto 62817-2 LOINC
Human Phenotype Ontology Postexertional malaise HP:0030973 HPO
Human Phenotype Ontology Exercise-induced muscle stiffness HP:0008967 HPO
Human Phenotype Ontology Exercise intolerance HP:0003546 HPO
caDSR Form PhenX PX150201 - Integrated Fitness Adult Protocol 6170205 caDSR Form
Derived Variables


Process and Review

The Expert Review Panel #1 reviewed the measures in the Anthropometrics, Diabetes, Physical Activity and Physical Fitness, and Nutrition and Dietary Supplements domains.

Guidance from the ERP includes:

• Revised descriptions of measure

Back-compatible: no changes to Data Dictionary

Previous version in Toolkit archive (link)

Protocol Name from Source

The Presidents Challenge Adult Fitness Test, 2008 & Fitness Testing and Assessment Manual 4th ed. YMCA, 2000


Presidents Council on Physical Fitness and Sports. The Presidents Challenge Adult Fitness Test. 2008. Available at the Presidents Challenge Adult Fitness Test website.

The Half Sit-Up Test and Sit and Reach were used with permission from Fitness Testing and Assessment Manual, 4th ed. © 2000 by YMCA of the USA, Chicago. All rights reserved.

The Standard and Modified Push-Up Test was used with permission from the Cooper Institute, Dallas, Texas 12330 Preston Road, Dallas, TX 75230. Additional information is available at the Cooper Institute website.

General References


Protocol ID


Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX150201040000 Location of fingertips during first stretch N/A
PX150201050000 Location of fingertips during second stretch N/A
PX150201060000 Location of fingertips during third stretch N/A
PX150201020000 Participant's gender Variable Mapping
PX150201010000 The number of half sit-ups performed in one minute N/A
PX150201030000 Number of push-ups completed N/A
Physical Activity and Physical Fitness
Measure Name

Integrated Fitness

Release Date

May 10, 2010


A measure to assess muscle strength, endurance, flexibility, and agility or balance.


An assessment or score used to indicate a person’s overall level of fitness. Different fitness tests are used to assess differing age groups. If results are low, interventions may improve a person’s fitness and health.


Physical Activity and Physical Fitness, muscle, exercise, endurance, flexibility, balance, strength, VO2 max, PACER, FITNESSGRAM

Measure Protocols
Protocol ID Protocol Name
150201 Integrated Fitness - Adult
150202 Integrated Fitness - Older Adult
150203 Integrated Fitness - Child

There are no publications listed for this protocol.