Physical Activity & Movement Assessment

01

Physical History & Background

Sport, exercise, and movement background — including how active you were growing up. Your history shapes your current capacity and injury patterns.

How would you describe your overall physical activity history from childhood to now?

Consistently active throughout — sport, exercise, or manual work have always been part of my life

Active in younger years, significantly less so as an adult

Never particularly active — sport and exercise have always been low priority

Variable — periods of high activity followed by long gaps

What is your approximate training age — how many years have you trained with reasonable consistency?

Less than 1 year — relatively new to structured training

1–3 years

3–10 years

10+ years — exercise has been a long-term consistent habit

Which of these have been part of your physical history? Select all that apply.

Team sport

Combat sport / martial arts

Running / endurance

Cycling

Swimming

Gym / weightlifting

Dance / gymnastics

Yoga / Pilates

Manual labour / physical work

Racket sports

Outdoor pursuits (climbing, hillwalking, skiing)

None of the above

What is your occupational physical demand — how active is your working day?

Sedentary — desk or screen-based work, sitting most of the day

Light activity — some standing and walking, mostly light duties

Moderate — on my feet much of the day, moderate physical demand

Heavy — manual, physical, or physically demanding professional role

02

Current Activity Profile

What you're actually doing right now — not what you used to do or intend to do. Be specific and honest.

Which types of physical activity are you currently doing — with at least some regularity?

Resistance training

Running

Cycling

Swimming

HIIT / circuit training

Sport

Yoga / Pilates

Walking

Mobility / stretching

Nothing regular right now

How many days per week do you exercise or do structured physical activity on average?

0–1 days — very sporadic

2–3 days

4–5 days

6–7 days — daily or near-daily

When you do exercise, how would you honestly rate your typical intensity?

Very light — walking, gentle movement, never out of breath

Moderate — elevated heart rate, breathing harder but can still hold a conversation

High — working hard, breathing heavily, limited ability to hold a conversation during effort

Maximal — pushing near limits regularly, competitive or very high-performance training

How long is a typical training session?

Under 30 minutes

30–60 minutes

60–90 minutes

Over 90 minutes regularly

How well do you recover between training sessions?

Well — I feel ready to go again within 24–48 hours, rarely persistently sore

Moderate — takes 2–3 days to feel fully recovered after hard sessions

Poor — I often feel fatigued from previous sessions, persistent soreness or heaviness

Very poor — exercise often makes me feel worse for days afterwards

How do you feel mentally and emotionally after a typical workout?

Better — clearer, calmer, energised. Exercise reliably improves my mood

Variable — good sometimes, depleted other times depending on how I slept and ate

Worse or indifferent — exercise doesn't reliably improve how I feel

03

Injury, Pain & Physical Limitations

Current and past injuries directly shape movement capacity, exercise design, and the physical stress load your body is carrying.

Do you currently have any pain, injury, or physical limitation that affects your movement or exercise?

No — currently pain-free and movement is unrestricted

Minor — occasional discomfort that doesn't significantly limit activity

Moderate — pain or limitation that affects how and what I can train

Significant — chronic pain or injury that substantially limits physical activity

Where is your current or most significant pain / injury? Select all that apply.

None currently

Lower back

Neck / upper back

Shoulder

Hip

Knee

Ankle / foot

Elbow / wrist

Generalised / widespread

Have you had any significant surgeries, fractures, or trauma that affect your musculoskeletal function?

Do you have low back pain — even mild and intermittent?

No — my back is not a concern

Occasional — mild stiffness or aching, typically with prolonged sitting or poor sleep

Frequent — a recurring pattern that affects daily comfort and exercise choices

Chronic — ongoing back pain that significantly affects my life and movement

Do you sit for extended periods — more than 6 hours in a typical day?

No — I'm on my feet or moving for most of my day

Sometimes — mixed sitting and movement through the day

Yes — most of my day is spent seated

Yes, and I notice it — hip tightness, back stiffness, or neck issues from sitting

04

Movement Quality Screen

Five fundamental movement patterns, scored 0–3 using FMS-inspired criteria. Perform each test carefully and score honestly. 0 = pain present. 1 = cannot complete. 2 = compensated pattern. 3 = full clean pattern.

0

Pain present — STOP

1

Cannot complete

2

Compensated

3

Full clean pattern

🦵

Deep Bodyweight Squat

Mobility, stability, and bilateral symmetry

Stand feet shoulder-width apart, toes forward or slightly out. Arms overhead. Squat as deep as you can, heels flat on floor. Observe in a mirror or on video if possible.

0

1

2

3

Score 3: Full depth, heels flat, torso upright, knees track toes, no forward lean.
Score 2: Depth achieved but heels rise, knees cave, or notable trunk lean.
Score 1: Cannot reach parallel depth even with heels elevated.
Score 0: Pain at any point during movement.

Score: —

🦩

Single-Leg Balance

Proprioception, hip stability, ankle control

Stand on one foot, eyes closed, other foot just off the floor. Time how long you can hold before touching down — both sides. Use the worse side for scoring.

Left side (seconds)

Right side (seconds)

0

1

2

3

Score 3: 30+ seconds both sides, minimal sway.
Score 2: 10–30 seconds, or clear asymmetry between sides (>5 sec difference).
Score 1: Less than 10 seconds on either side.
Score 0: Pain, dizziness, or unable to attempt.

Score: —

💪

Max Push-Up Test

Upper body strength endurance and core stability

Perform maximum full push-ups with strict form — chest to floor, full lockout, body in a straight line. Knees-down modification if needed (note below). Count total reps.

Reps completed

Knees-down modification used Pain present during push-ups

0

1

2

3

Score 3: Men ≥20, Women ≥15 full push-ups.
Score 2: Men 10–19, Women 8–14. OR any reps with good form on knees.
Score 1: Men <10, Women <8. OR only knees-down with poor form.
Score 0: Pain present.

Score: —

🙇

Hip Hinge — Toe Touch

Posterior chain length, hip mobility, lumbar pattern

Stand with feet together, knees straight. Reach both hands toward the floor. Note how far you reach and any compensations (knees bending, back rounding excessively, pain).

0

1

2

3

Score 3: Palms flat on floor or fingertips easily touch floor, knees straight.
Score 2: Fingertips reach mid-shin to floor with slight knee bend or spinal compensation.
Score 1: Cannot reach below mid-shin, significant restriction.
Score 0: Pain in lower back, hamstrings or elsewhere during movement.

Score: —

🙌

Overhead Wall Reach

Thoracic mobility, shoulder flexion, lat length

Stand with your back flat against a wall, heels 5cm from the wall. Raise both arms overhead and try to touch the wall behind you with both thumbs — without arching your lower back away from the wall.

0

1

2

3

Score 3: Both thumbs touch wall comfortably, low back remains flat.
Score 2: Near touch but lower back arches significantly, or one arm is notably limited.
Score 1: Cannot get within 15cm of wall with either arm.
Score 0: Pain in shoulder, neck, or back during movement.

Score: —

05

Core Function & Flexibility

Self-assessed core stability and overall flexibility — through questions rather than equipment-dependent tests.

Can you sit in a full cross-legged position on the floor comfortably for several minutes?

Yes, comfortably — no issue at all

With some discomfort — hip tightness or knee restriction but I can manage it

No — hip or knee restriction prevents this position

Can you lie flat on your back without needing a pillow under your knees?

Yes — completely flat is fine

I'm more comfortable with a small pillow under my knees — lower back tightens flat

I need a pillow under my knees — lying flat causes noticeable low back tension or pain

How is your overall flexibility and mobility in daily life?

Good — I move freely without restriction in any direction

Average — some areas of tightness but nothing that significantly limits me

Poor — noticeably stiff, multiple areas of restriction that affect daily movement

How do you find getting up from the floor — without using your hands?

Easy — I can get up smoothly from the floor without hands

Possible but difficult — I need effort or a slight assist

I need to use my hands — I can't get up from the floor without assistance

How would you describe your core strength and stability?

Strong — I have good core stability and it feels functional in exercise and daily life

Average — some core strength but it's not a focus and I notice weaknesses

Weak — my core is a clear weakness and may be contributing to back or posture issues

Do you notice postural issues — forward head posture, rounded shoulders, excessive forward lean, or significant anterior pelvic tilt?

No — I'm not aware of significant postural issues

Possibly — I suspect I have some postural issues but haven't had them assessed

Yes — I have been told I have postural issues or I clearly notice them myself

06

Conditioning Capacity

Cardiovascular fitness and work capacity — assessed via a practical stair test and self-report. No equipment required.

Stair Breathlessness Test: Climb two full flights of stairs at a normal walking pace. How do you feel at the top?

This is a simple but revealing clinical marker of cardiovascular conditioning.

1

No change — completely unaffected

2

Slightly aware of my breathing

3

Noticeably breathless, need a moment

4

Quite breathless — takes 1–2 min to recover

5

Very breathless — takes several minutes

How long can you sustain moderate aerobic effort — brisk walking, cycling at a steady pace, swimming — before fatigue forces you to stop or significantly slow down?

Under 10 minutes

10–30 minutes

30–60 minutes

Over 60 minutes comfortably

How many bodyweight squats can you perform in 30 seconds? (Full depth, stand fully between each rep — do it now if possible.)

Squat test in 30 seconds — measures lower body conditioning and movement efficiency.

Squats in 30 seconds

How would you honestly rate your overall cardiovascular fitness right now?

Poor — I get breathless easily and tire quickly with moderate effort

Fair — reasonable base fitness but room for significant improvement

Good — I can sustain moderate effort for extended periods without difficulty

Excellent — I train regularly at high intensity and have a strong aerobic base

07

Breathing Pattern & BOLT Score

CO₂ tolerance — a window into autonomic nervous system state, stress load, acid-base balance, and oxidation rate. The single most informative physiological measure you can take without equipment.

Instructions — read before starting:

Sit quietly for 2–3 minutes first. Normal relaxed breathing.
Take a normal breath in — not a deep breath.
Breathe out normally and pinch your nose closed.
Start the timer the moment you pinch your nose.
Stop at the first definite urge to breathe — not the maximum hold. Do not push through.
Your breathing must return immediately to normal — if it doesn't, you went too long.

0.0

<10s Significant20s Fair30s Good40s+ Excellent

Enter or confirm your BOLT score:

Use your most consistent result if you tested more than once.

How would you describe your typical breathing pattern at rest?

Slow, nasal, diaphragmatic — I breathe through my nose and my belly moves

Chest breather — I notice my chest rising and falling more than my belly

Mouth breather — I frequently breathe through my mouth, especially at night

Anxious breather — I notice frequent sighing, yawning, or feeling like I can't get a full breath

Do you breathe through your nose during exercise?

Yes — nasal breathing throughout moderate intensity exercise, mouth only at maximum effort

Partially — I try but switch to mouth breathing quickly as intensity increases

No — I mouth breathe from the start of most exercise

08

Body Awareness & Self-Knowledge

How well you know and tune into your own body shapes how we interpret your data, monitor protocol effects, and coach your progress.

When something changes in how your body feels — digestion, energy, sleep, pain — how quickly do you notice and how accurately can you describe it?

1

I rarely notice or struggle to describe it

2

I notice major changes but miss subtler ones

3

Reasonably in tune — I notice most changes

4

Highly aware — I notice and can describe changes accurately

5

Very highly attuned — sometimes perhaps over-aware

How do you respond when you're unwell, overloaded, or fatigued — physically and emotionally?

I back off — I rest, adjust my training and diet, and listen to what my body needs

I try to push through — I don't like stopping and often train or work through it

I become anxious or worried — symptoms cause me significant distress or health anxiety

Variable — depends on life circumstances, what's happening with work and family

How is your current relationship with exercise — emotionally and psychologically?

Healthy — I enjoy it most of the time and it feels balanced in my life

Compulsive — I exercise excessively or feel guilty and anxious when I miss sessions

Avoidant — I don't exercise and actively avoid it, or have significant resistance to starting

Neutral — exercise is something I do as a duty, neither enjoyed nor dreaded

09

Goals, Priorities & Context

What you want from your physical capacity — and any context that shapes how we approach it.

What is your primary physical goal right now?

Improve energy and reduce fatigue — physical capacity for life, not sport

Fat loss and body composition change

Strength and muscle building

Athletic performance — training for a sport or event

Rehabilitation — recovering from injury, illness, or significant deconditioning

Longevity and healthy ageing — moving well and independently as I get older

How motivated are you to improve your physical fitness and movement right now?

1

Very low

2

3

4

5

Moderate

6

7

8

9

10

Extremely motivated

What barriers or challenges most limit your physical activity right now?

Time

Fatigue / low energy

Pain or injury

Motivation

No gym or facility access

Unsure what to do

Work demands

Family / caring responsibilities

Cost

No significant barriers currently

Is there anything about your physical history, movement, or exercise that this questionnaire hasn't asked about that you think is important for your practitioner to know?

Physical Activity &Movement Assessment

Send your Physical Activity Assessment to Stephen

Physical Activity &
Movement Assessment