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Professional Consultants

DONNA F. SMITH, C.C.N., C.N.
Licensed, Board Certified
Clinical Nutritionist

WILLIAM H. BRELAND, P.T., S.C.S.
Physical Therapist
Board Certified Sports Specialist

ROBERT J. WOLFF, D.C.
Chiropractor

T. ROGER HUMPHREY, M.D.
Physician

Advanced Clinical Nutrition
Wichita Falls, Tx
76309-3119
Office (940) 761-4045
Fax (940) 761-2881
E-Mail: wsnqas@aol.com

The information and services provided are for nutritional support, and not for the treatment of any medical condition or disease. By using this web site, you understand and abide by this disclaimer.

Copyright 1999
Donna F. Smith

Women Sports Nutrition Logo
Anthropometric Questionnaire
Date:
Name:
E-Mail:

WSN Acct. No.:

1. Blood Pressure /

2. Resting Heart Rate (RHR.)
   Your RHR.

a. The instant you awaken tomorrow morning, and before you move a muscle, lie there and take your pulse for one full minute.
b. Scoring:
50-60 Athletic
60-80 Healthy
80-100 Poor Health

3. Target Heart Rate (THR)

  Your THR

(Karvone Formula)
a. Take 220
b. Minus your age
c. Minus your resting heart rate (RHR)
d. Multiply by 46 percent
e. Then add back your resting heart rate (RHR)

4. Respiratory Lung Capacity (RLC)   Your RLC

a. Reminder: Each time you take a measurement, pull the tape as tight as possible so that you will be able to take accurate comparison measurements at a later date.

b. To begin: Take your tape measure and wrap it around your chest, just under your armpits, and above your breasts.

c. Inhaling Lung Measurement: Now take a huge, deep breath by inhaling through your nose until your lungs are full and you feel like you could burst. Note the placement of the measuring tape, that it is still under your armpits and across the chest. When you are inhaling your full breath, you are ready to take that measurement. This number is your Inhaling Lung Measurement. Record it in the space below.

d. Exhaling Lung Measurement: After taking your Inhaling Lung measurement, exhale fully out of your mouth. When all the air is out, puff out the last breaths with quick, sharp puffing sounds to be sure all of the air is cleared from the lungs. When your lungs are clear of air, you are ready to take that measurement. This number is your Exhaling Lung Measurement. Record it in the space below.

Inhaling Lung Measurement:
Exhaling Lung Measurement:
Your Respiratory Lung Capacity (RLC):



Score for Respiratory Lung Capacity
15% or greater = Athlete
10.0% - 15% = Healthy
5.0 %- 10.0 % = Normal/Average
3.0 5% - 5.0 % = Unfit
2.5% = Possible heart and respiratory weakness


Record this information in the appropriate space on the Exercise and Athletic Training Questionnaire.
Click here to record this information now.

Copyright, 1999 Donna F. Smith