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U. S. PUBLIC HEALTH SERVICE

COMMISSIONED CORPS

ANNUAL PHYSICAL FITNESS TEST

TRAINING GUIDE

Version 1.

APFT Training Guide

• Welcome Statement………………………………………………………………………... Table of Contents
  • Adult Physical Activity Recommendations………………………………………..
    • Determining Heart Rate Intensities……………..…………….…………………….
• The Borg Scale & Talk Test………………………………………………………..………
  • Best Practices & Training Guidance………..………………………………….. 6 – - Program Design & Training Schedules….……………………………….….. 7 –
    • Progression and Overload Principles…………………………..,……………. 8 –
  • Preparing for the Run & Training Progression……………….………..10 –
    • Dynamic Warm-Up Exercises……………………….………………………… 11 –
    • Physical Training Sessions…..……………………….………………………... 17 –
    • Recovery, Cool Down and Stretching….…………………………………. 23 –
    • APFT Monthly Tracking Log..………………………………………………………….
  • References..…………………….….…………………………………………………. 28 –
    • Appendix…….…………………………………………………………………………. 31 –

Adult Physical Activity Recommendations According to the Department of Health and Human Services’ 2018 Physical Activity Guidelines, it is recommended that adults achieve 150 to 300 minutes of moderate-intensity physical activity per week.7,^9 This is equivalent to about 30-60 minutes of exercise, five days a week. For adults that engage in vigorous-intensity physical activities, which is roughly twice the energy expenditure of moderate- intensity activities, it is recommended to engage in 75 to 150 minutes of physical activity per week to obtain optimal health benefits.7,^9 At least 2 days per week should be devoted to strengthening exercises of the upper body, lower body and core muscles. The American College of Sports Medicine (ACSM) defines moderate intensity as 50-69% of an individual’s max heart rate and vigorous intensity as 70-89% of max heart rate.^9 The easiest way to determine an approximate max heart rate is to take 220 minus your age. According to the American Heart Association, most individuals can gradually work up to exercising comfortably at 85% of the maximum heart rate after a few months of regular exercise.^13 The chart below provides ranges of moderate and vigorous heart rate intensities. Heart rate measures are provided in beats per minute.^8

Determining Training Heart Rate Zones Based on Age and Exercise Intensity Age in Years Maximum Heart Rate Target Heart Rate for Moderate Intensity Moderate Intensity 10 second count Target Heart Rate for Vigourous Intensity Vigourous Intensity 10 second count

The Borg Scale (Rate of Perceived Exertion) & Talk Test 1: Very Light Activity Includes activities such as watching TV or riding in a car. 2 - 3: Light Activity Feels like you can maintain for hours. Physically it is easy to breath and have a conversation. 4 - 6: Moderate Activity Feels like you can exercise for hours. You are breathing more heavily and can only hold a short conversation. 7 - 8 : Vigorous Activity On The verge of becoming uncomfortable. You are short of breath and can only speak short sentences at a time. 9: Very Hard Activity Very hard to maintain exercise intensity. You can only breathe or speak a single word at a time. 10: Max Effort Activity Feels almost impossible to keep going. You are completely out of breath and unable to speak. The Borg Rate of Perceived Exertion (RPE) scale ranges from 1-10, with a score of “1” representing very light exertion and a score of “10” representing maximum effort. Individuals should be exercising between a RPE of 4-6 during low to moderate intensity training and 7-9 during vigorous and high intensity training sessions.^8

earlier with the Borg Intensity and Heart Rate scales, refers to how hard you exercise. Time refers to the amount of time spent exercising and Type is the different ways in which you can exercise (cardio vs. strengthening as one example). Each of these variables can be manipulated to further help progress the officer in his or her training. All are important to consider when addressing injury prevention. Different activities will stress different muscles and it is important not to do too much of the same activity and to vary your workouts in intensity, time, frequency, and type of exercise. Activity Guidelines and Program Design All physical training sessions consist of the following components in this order.

Activity Time (Minutes)

Dynamic Warm-up 5 – 10

Physical Training Session 20 – 40

Cool-down 5

Stretching 5 – 10

The components (dynamic warm-up, physical training, cool-down, and stretching) of the program design will be further defined with examples of specific exercises that the officer can perform. These exercises should complement a mixture of endurance activities such as running, biking, stair stepping, and elliptical training. 3 - Day Training Schedule A 3-day training schedule is the ideal place to start for someone that is new to exercise. Monday Tuesday Wednesday Thursday Friday, Saturday, or Sunday Dynamic Warm Up 5 – 10 min Recovery* 10 min Recovery* 10 min Pre- Planned Activity Cardio 20 min Strengthening 15 min Walking 15 – 30 min (Very light to light intensity) Cardio 30 min Walking 15 – 30 min (Very light to light intensity) Strengthening 20 min

(Moderate to Vigorous Intensity) (Moderate to Vigorous Intensity) (Light to Moderate Intensity) Cool Down 5 min 5 min 5 min Stretch 5 min 5 – 10 min 5 min 5 – 10 min 5 – 10 min Totals 50 – 55 min 20 – 40 min 40 min 20 – 40 min 40 – 45 min

• Recommend on recovery days to participate in walking program and light stretching as needed to improve flexibility. Schedule above based off of ACSM FITT Principle guidelines.^9 With a three day training program it is recommended to practice your APFT at least once every other week as your pre-planned activity. Limit vigorous intensity workouts to no more than 2 to 3 times per week. 5 - Day Training Schedule A 5-day training schedule is appropriate for someone that has been exercising consistently. Frequency, Intensity, Time, and Type of exercises will vary for the individual level of fitness. Monday Tuesday Wednesday Thursday Friday Saturday & Sunday Dynamic Warm Up 5 min Recovery* 5 – 10 min 10 min Recovery* 5 min Pre- Planned Activity Cardio 15 - 20 min Strengthening 15 min (Moderate to Vigorous Intensity) or Mock APFT Walking 15 – 30 min (Very light to light intensity) Cardio 30 min (Moderate to Vigorous Intensity) Strengthening 20 min (Light to Moderate Intensity) Walking 15 – 30 min (Very light to light intensity) Cardio 15 – 20 min Strengthening 15 min (Moderate Intensity) Cool Down 5 min 5 min 5 min 5 min Stretch 5 min 5 – 10 min 5 – 10 min 5 – 10 min 5 – 10 min 5 min Totals 45 – 50 min 20 – 40 min 40 – 50 min 40 – 45 min 20 – 40 min 45 – 50 min
• Recommend on recovery days to participate in walking program and light stretching as needed to improve flexibility. Schedule above based off of ACSM FITT Principle guidelines.^9 With a five day training program it is recommended to practice your APFT at least once every other week as your pre-planned activity. Limit vigorous intensity workouts to no more than 2 to 3 times per week.

Preparing for the Run If you’ve never run before, the following is a conservative training schedule for achieving a goal of running for 20 to 30 minutes without stopping. This guide is based off the most up-to-date evidence available.^1 - (^33) It is a weekly progression of walk/run sets. If you perform four ( 4 ) sets that equates to a total 20 minute run, if you perform 6 sets of the run/walk ratio, you will run 30 minutes. Whether you run two times or three times a week, it is recommended to take a day off in between. Soreness lasting more than 2 to 3 days may be the onset of musculoskeletal injury and should not be ignored. Please allow your body adequate time to heal in between training runs. Phase 1: Initial Stage The goal of the initial stage is to adapt the body to exercise and focus on proper form. The Initial stage typically consists of lower intensity activity for shorter duration (e.g., run/walk). Programs initiated too aggressively may result in injury. Phase 2: Improvement Stage The goal of the improvement stage is to increase overall exercise stimulus, following the FITT (Frequency, Intensity, Time, and Type) principles, to allow for significant improvements. Individuals may progress quickly during this phase with solid preparation in Phase 1. Phase 3: Re-evaluation Once goals are achieved, re- evaluate fitness goals at this time. Diversification in training is important for long term success to prevent overuse injuries and maintain individuals’ interest in activity.

Week Days per week Walk/Run Ratio

1 3 – 5 20 – 30 minute (min) walk only 2 2 – 3 4 – 6 Sets of (4.5 min walk + 30 sec run) 3 2 – 3 4 – 6 sets of (4 min walk + 1 min run) 4 2 – 3 4 – 6 sets of (3.5 min walk + 1.5 min run) 5 2 – 3 4 – 6 sets of (3 min walk + 2 min run) 6 2 – 3 4 – 6 sets of (2.5 min walk + 2.5 min run) 7 2 – 3 4 – 6 sets of (2 min walk + 3 min run)

Training Progression for Sedentary Individuals The chart below provides guidelines for progression for frequency, intensity and duration of physical training sessions for sedentary members. Program Stage Week Exercise Frequency (days per week) Exercise Intensity (% heart rate max) Exercise Duration (minutes) Initial Stage 1 3 40 - 50 15 - 20 2 3 - 4 40 - 50 20 - 25 3 3 - 4 50 - 60 20 - 25 4 3 - 4 50 - 60 25 - 30 Improvement 5 - 7 3 - 4 60 - 70 25 - 30 8 - 10 3 - 4 60 - 70 30 - 35 8 2 – 3 4 – 6 sets of (1.5 min walk + 3.5 min run) 9 2 – 3 4 – 6 sets of (1 min walk + 4 min run) 10 2 – 3 4 – 6 sets of (30 sec walk + 4.5 min run) 11 2 20 – 30 min run only

Starting Pose Level 1 Level 2 Level 3

2. Lunge Progression : 10 repetitions Level 1: Perform lunges at a slow pace. The knee of the forward leg should not go past the toes. Level 2: Lunge deeper until back knee is about one inch from ground. Do not hit the ground with your knee. Level 3: Include a trunk side-bend. Starting Pose Level 1 Level 2 Level 3
3. Dynamic Calf Progression : Level 1: Standing Ankle pumps, perform 30 – 40 beats. Level 2 : Walk on heels for 10 – 15 steps, then walk on toes for 10 – 15 steps. Level 3: Perform in downward dog pose, pump ankles for 30 – 40 beats, reaching heels towards floor. Starting Pose Level 1 Level 2 Level 3

4. Bottom Kickers : 20 repetitions Level 1: Bend knee so that the heel reaches toward the buttocks, a stretch should be felt in the front of the thigh. Level 2: Jog in place, kicking heels up towards the buttocks. Level 3: Same as level 2, performed at a faster pace. Starting Pose Level 1 Level 2 Level 3
5. Straight Leg Progression : Alternate legs to complete 10 repetitions per leg Level 1: Kick leg out a comfortable distance, a stretch may be felt in the back of the thigh. Level 2: Perform same action as level 1, kick higher to increase the stretch. Level 3: Kick higher, reach opposite hand to opposite toes. Starting Pose Level 1 Level 2 Level 3

Starting Pose Level 1 Level 2 Level 3 Level 1: Sidelying with bent knees Level 2: Standing

8. Hip Abductor and Shoulder Progression : 20 repetitions Level 1 : With feet facing forward, step sideways, reverse direction after 5 repetitions. Level 2: Perform jumping jacks. Level 3: Add a mini squat to the jumping jack. Starting Pose Level 1 Level 2 Level 3
9. Shoulder Girdle Dynamic Progression : 20 repetitions Level 1: Start by shrugging shoulders up and down for 20 counts. Level 2: Perform small circles with your arms out at your side, do 10 clockwise and 10 counter clockwise. Level 3: Make your circles a little larger than in level 2. Starting Pose Level 1 Level 2 Level 3

10. Thoracic Rotation Progression : Level 1 : Start in a standing position with knees slightly bent. Do not extend knees past toes. Reach from side to side for 20 counts. Level 2 : Start in a hands and knees position and rotate your arm under your body. Perform 5 – 10 repetitions per arm. Level 3: Complete same movement as level 2, add a reach toward ceiling. Perform 5 – 10 repetitions per arm. Starting Pose Level 1 Level 2 Level 3 Level 1: Standing Level 2 and 3: Hands and knees position Activity Time (Minutes) Dynamic Warm-up 5 – 10

Level 3: Add a jump after squatting. Land with your knees bent to absorb the impact. Starting Pose Level 1 Level 2 Level 3

2. Push-Up Progression : 10 – 20 repetitions Level 1 : Begin on hands and knees with arms slightly wider than shoulder width. Keeping your back straight, lower your body towards the floor. Level 2: Perform a push-up on hands and feet, keeping both legs straight. Level 3: Place feet on a chair. Level 1 Level 2 Level 3
3. Glute Bridge Progression : For all levels, begin by engaging your abdominals. Level 1: Slowly lift your bottom off the ground and hold for 5 – 10 seconds. Perform 10 repetitions.

Level 2: Extend one leg, lift your hips up and hold for 5 – 10 seconds. Perform 5 repetitions per leg. Level 3 : Lift your bottom and slowly march in place for 10 counts, keeping your hips raised throughout the exercise. Starting Pose Level 1 Level 2 Level 3

4. Quadruped Progression : 20 repetitions total. For all levels, begin in a quadruped (hands and knees) position. Level 1 : Raise one arm up and then alternate to the other side. Level 2: Kick one leg backwards and then alternate to the other side. Level 3: Kick one leg backwards and raise opposite arm at the same time. Level 1 Level 2 Level 3
5. Superman : For all levels, start by laying on your stomach and tightening your core. Level 1 : Slowly lift one arm and the opposite leg off the ground. Slowly return back down and repeat with the other arm and opposite leg. Perform 20 repetitions.