The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 124
Purpose/Background: A reliable and valid method of measuring and monitoring a gymnast’s total physi-
cal fitness level is needed to assist female gymnasts in achieving healthy, injury-free participation in the
sport. The Gymnastics Functional Measurement Tool (GFMT) was previously designed as a field-test to
assess physical fitness in female competitive gymnasts. The purpose of this study was to further develop
the GFMT by establishing a scoring system for individual test items and to initiate the process of establish-
ing the test-retest reliability and construct validity of the GFMT.
Methods: A total of 105 competitive female gymnasts ages 6-18 underwent testing using the GFMT. Fifty
of these subjects underwent re-testing one week later in order to assess test-retest reliability. Construct
validity was assessed using a simple regression analysis between total GFMT scores and the gymnasts’
competition level to calculate the coefficient of determination (r2). Test-retest reliability was analyzed
using Model 1 Intraclass correlation coefficients (ICC). Statistical significance was set at the p<0.05 level.
Results: The relationship between total GFMT scores and subjects’ current USAG competitive level was found
to be good (r2 = 0.60). Reliability testing of the GFMT total score showed good test-retest reliability over a one
week period (ICC=0.97). Test-retest reliability of the individual component items was good (ICC = 0.80-0.92).
Conclusions: The results of this study provide initial support for the construct validity and test-retest reli-
ability of the GFMT.
1 Northwestern University, Chicago, Illinois USA
2 Grand Valley State University, Grand Rapids, Michigan USA
3 Rehabilitation Institute of Chicago, Chicago, Illinois USA
4 Northwestern University Feinberg School of Medicine,
Chicago, Illinois USA
This study protocol was approved by the Northwestern
University Institutional Review Board, Offi ce for the
Protection of Research Subjects
Acknowledgements: The authors would like to thank Sarah
Baker PT, Michelle Beers PT, Amy Brannon PT, Lilliana de
Armas PT, Matthew Erwin PT, Kathleen McGaghie PT, Jamie
Meyer PT, Jackie Ostrowski PT, Jaime Passaglia PT, Rachel
Plummer PT, Megan Robertson PT, Elizabeth Schornak PT,
Mackenzie Strobel PT, and Mark Wildeboer PT for their
MEASURING FITNESS IN FEMALE GYMNASTS: THE
GYMNASTICS FUNCTIONAL MEASUREMENT TOOL
Mark D. Sleeper, MS, PT, OCS1
Lisa K. Kenyon, PT, PhD, PCS2
Ellen Casey, MD3,4
assistance in collecting data and Karen Hayes PT, PhD for her
guidance and advice.
Mark D. Sleeper, MS, PT, OCS
Department of Physical Therapy and
Human Movement Sciences
645 North Michigan Ave.
Chicago, IL 60611
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 125
Women’s competitive gymnastics is a multifaceted
sport that requires a high level of physical fitness and
skill to succeed. Speed,1-4 strength,2,3,5,6 endurance,5
agility,7 flexibility,3,8-12 balance,2,13 and power8,14-16 are
all physical abilities that play a role in the success of
a competitive gymnast. A gymnast’s physical abili-
ties may also be related to the ability to sustain injury
free participation in the sport.7,17-19 As such, it is
imperative that the coaches, trainers, and therapists
involved in the sport be able to monitor an individual
gymnast’s physical abilities and overall fitness level
as a means of promoting healthy, injury-free partici-
pation in the sport.
Traditionally, field-testing has been done in a variety
of sports in an effort to measure sport-specific physi-
cal abilities.20-28 For example, speed, power and agil-
ity are physical abilities needed for success in the
sport of soccer. Field-tests have been developed in
an attempt to quantify each of those physical abili-
ties.26,29,30 Some field-tests, such as the hop test31 or
the agility T-test,32 focus on a specific aspect of sport
function. Other tests, such as the Functional Move-
ment Screen™ (FMS™),33,34 include a battery of indi-
vidual items designed to assess an athlete’s abilities
across multiple aspects of function.
Within the United States Association of Gymnastics
(USAG), a system of competitive levels ranging from
a low of 4 to a high of 10 is used to rank the skills and
abilities of individual gymnasts. To move from one
competitive level to the next, a gymnast must achieve
a specific all-around score and be able to perform
specific skills that increase in difficulty as the com-
petitive level increases. Individual tests for flexibil-
ity, strength, endurance, and power have been
suggested as useful tools to gauge gymnastic poten-
tial.35-38 These physical abilities are included in the
USAG Talent Opportunity Programs (TOPs) Test, a
multi-test battery designed to measure a gymnast’s
basic skill in addition to the physical abilities of
strength, endurance, power, and flexibility.39 Although
the TOPs protocol has changed a number of times
since its development by William Sands,37 it is used
primarily with young club gymnasts ages 7-10 years
of age to identify competitive potential and aid in the
development of the United States competitive gym-
nastics program. The TOPs was thus not designed to
address the needs of gymnasts of all ages or those
who compete through high school or collegiate pro-
grams. While specialized training is needed to admin-
ister the TOPs and the number of people deemed
qualified to administer the test is limited, the reli-
ability and validity of the TOPs test have not been
Currently there is not a reliable and valid measure-
ment tool to evaluate the specific physical fitness
abilities needed for successful competition in either
men’s or women’s gymnastics. Previous studies have
examined possible correlations between a gymnast’s
level of competition or intensity of training and vari-
ous singular physical fitness traits.3,12,40 Nelson and
co-workers3 investigated the relationship between
gymnasts’ flexibility and strength and varying train-
ing intensity levels. The gymnasts at the highest
level of training were reported to be the most flexi-
ble, had a slender body type, weighed less, and dem-
onstrated higher amounts of both functional and
absolute strength especially in the upper body. In
1989, Faria et al41 examined the relationship between
anthropometric and physical characteristics of male
gymnasts and overall competitive performance suc-
cess. These researchers concluded that the top gym-
nasts were stronger in both absolute upper body
strength and upper body strength relative to body-
weight, possessed greater overall flexibility through
the hip region, shoulder girdle, and back, and pos-
sessed the least percentage of body fat.41 Neither of
these studies used a standardized measurement tool
to determine an overall fitness score or explore the
relationship between age or body weight and physi-
Without a reliable and valid field-test for measuring
gymnasts’ physical abilities, fitness evaluation and
training are often left to the tradition-driven ways of
individual coaches. As stated by Sands,19 “…. Gym-
nasts often simply ‘trick’ themselves into shape
meaning they perform skills over and over until
they acquire the fitness and skill to perform the
movement”.(p.367) This may lead to an athlete who is
simply fit to do certain skills but who does not have
the overall fitness level necessary for prolonged par-
ticipation in the sport. With the consistent increases
in the complexity and difficulty of the gymnastics
elements being performed during competition,7
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 126
a reliable and valid method of measuring and moni-
toring gymnast’s total physical fitness levels is
needed to collectively measure the physical abilities
of gymnasts and monitor their physical state.
Establishing the reliability and validity of a measure-
ment tool is a multi-step and complex process that
must be investigated within the context of the tool’s
intended use. Various types of validity must be consid-
ered when evaluating a new measurement tool. Con-
struct validity, or the ability of a tool to measure the
abstract concept it is intended to evaluate, is one type
of validity that must be assessed. Methods of construct
validation include convergence and discrimination,
factor analysis, the known groups method, criterion
validation, and hypothesis testing.42 Methods related
to hypothesis testing are based on the ability of a mea-
surement tool to reflect specific assumptions that form
the framework underlying the theoretical basis of the
construct. Given that a single study cannot definitively
verify a theory, construct validation is considered to
be an on-going process.
Various forms of reliability such as intra-rater reli-
ability, inter-reliability and test-test reliability must
also be considered when evaluating a measurement
tool. Test-retest reliability is used to establish that a
tool will obtain the same results across repeated
administrations of the same test. Intervals between
test administrations must be long enough to avoid
the impact of factors such as subject fatigue and
learning effects but close enough to avoid true
changes in the measured variable.
Overview of the GFMT
The Gymnastics Functional Measurement Tool
(GFMT) was developed to assess a gymnast’s overall
fitness level while minimizing the impact of gym-
nastic skill on testing scores.43,44 Identifying fitness
deficits to be targeted for improvement as part of a
gymnast’s individual training regime may prove use-
ful in injury prevention. As a field-test for female
competitive gymnasts of all ages, the GFMT was
designed to be carried out by coaches, trainers and
therapists using equipment commonly found in any
gymnastics gym (club, high school, collegiate, etc.).
Given that successful participation in women’s com-
petitive gymnastics requires a combination of abilities
related to flexibility, speed, power, strength, muscular
endurance, and balance,1-16 the individual items of the
GFMT were developed based on knowledge of these
requirements, a review of the literature, and consulta-
tion with experts in the field of women’s gymnas-
tics.43,44 The 10 items comprised in the GFMT are
summarized in Table 1 and detailed in Appendix I.
Table 1. Individual Items Comprising the GFMT.
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 127
The purpose of this study was to continue developing
the GFMT by establishing a scoring system for indi-
vidual test items and initiating the process of estab-
lishing test-retest reliability and construct validity.
Given the authors’ belief that a gymnast’s total GFMT
score would vary based on her current USAG compet-
itive level, construct validity was assessed using the
known-groups method of construct validation.
Approval for the study was obtained from the Office for
the Protection of Research Subjects at Northwestern
University. Healthy competitive female gymnasts were
recruited from gymnastics clubs throughout the Mid-
western and Mid-Atlantic United States. Inclusion crite-
ria required the subjects to be female, between 6 and 18
years of age, and competitive in gymnastics at USAG
levels 4 to 10. Exclusion criteria included musculoskele-
tal pathology currently limiting the gymnast’s ability to
train or compete; a history of, or current systemic ill-
nesses including cardiovascular or pulmonary disease;
musculoskeletal disease or rheumatoid arthritis; and a
lack of informed assent given by the participant or con-
sent given by the parent/legal guardian. A total of 105
subjects participated in the study. Refer to Figure 1 for a
flowchart reflecting subjects’ participation in the study.
All testing was performed in the subjects’ home
gyms or in a gym familiar to the subject. Subjects did
not have prior knowledge or exposure to the specific
items composing the GFMT. Each subject provided
her own USAG competition level which was recorded
by the testers. Prior to testing, subjects completed
their regular, coach-directed warm-up routines with-
out regard to the requirements of the GFMT. Given
that field-tests composed of multiple items are often
administered in stations each consisting of an indi-
vidual item,43,44 subjects were placed into groups of
10 to 12 and moved through each of the 10 stations to
complete the GFMT. Data was collected by second
year Doctor of Physical Therapy students from
Northwestern University and by gymnastics coaches
with a minimum of 5 years of coaching experience.
In an effort to simulate actual practice patterns,45-47
all data collectors were provided with a detailed set
of instructions for administering each item on the
GFMT but did not undergo any specialized or exten-
sive training. Raw data for each item of the GFMT
was recorded in units of measurement that were
appropriate for the item tested. Units of measure-
ment for the raw data of each item are listed in Table
1. Subjects were not intentionally masked as to their
item scores. Individual GFMT items were completed
in the following order to help reduce the effects of
regional fatigue: Rope Climb Test, Jump Test, Hang-
ing Pikes Test, Shoulder Flexibility Test, Agility Test,
Over-grip Pull-up Test, Splits Test, Push-up Test, 20-
yard Sprint Test and Handstand Hold Test. Subjects
were given a minimum of 5 to 10 minutes rest
between administrations of each item of the GFMT.
From the 105 total subjects, a convenience sample of
50 subjects was chosen to participate in test-retest reli-
ability testing. These 50 subjects were retested with
the GFMT one week after initial testing. Test condi-
tions and administration were consistent between the
2 administrations of the GFMT including warm-up and
item order. To help ensure that test-retest reliability
Figure 1. Flowchart refl ecting subject’s participation in study.
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 128
rather than intra-rater reliability was assessed, testers
administered different items from the GFMT on each
of the 2 administration dates.
Development of the Scoring System
To develop the scoring system for the GFMT, raw scores
in the appropriate units of measurement were recorded
for each of the individual items on the GFMT. The raw
scores for each item were used to calculate the range,
mean, and standard deviation for each individual item
of the GFMT (n=105). Data was then transformed to an
ordinal scale using the following procedure. In an
attempt to reduce the possibility of ceiling and floor
effects, 5 percent of the total range of the raw scores was
added to the high score of each item and 5 percent was
subtracted from the low score of each item. The result-
ing range of scores for each individual item was then
divided by 11 to create a 0 to 10 ordinal scale for each
individual item on the GFMT.48-50 The ordinal scale for
each item was used to create a total GFMT score out of
a possible 100 points (10 points for each item). Based on
these findings, the scoring for each individual item and
for the total GFMT score were finalized and are provided
in the GFMT Score Sheet found in Appendix II.
Test-retest and Construct Validity:
Test-retest reliability was analyzed using Model 1
Intraclass correlation coefficients (ICC).34 Although a
process of systematic randomization was not employed
in the study, a Model 1 ICC was used to reflect the
concept that individual items on the GFMT were
administered by different testers on each of the 2 test
dates.42 The variance assessed was thus restricted to
differences in the subjects’ scores in the test-retest
design and necessitated the use of a Model 1 ICC.42
Given that previous studies had reported a positive rela-
tionship between various singular fitness traits and a
gymnast’s level of competition,2,51,52 it was theorized
that the total scores on the GFMT would vary with a
gymnast’s current competitive level. This was based
upon the concept that at each increasing competitive
level, a gymnast is required to perform increasingly dif-
ficult skills that require a related increase in the gym-
nast’s physical abilities. Construct validity was thus
evaluated based on the authors’ belief that there would
be a direct linear relationship between a gymnast’s
physical abilities as measured by the GFMT and the
gymnast’s current level of competition as reflected by
the gymnast’s USAG level. A simple regression analysis
was performed using USAG competitive level to predict
total GFMT score.42 The coefficient of determination
(r2) was used to explore this relationship.42 Statistical
significance was set at the p<0.05 level.
Of the 148 subjects assessed for eligibility in this
study, 105 subjects participated. Forty-three of the
recruited subjects were excluded from the study due
to recent injury (n=38) or the lack of a signed
informed consent or assent (n=5). The mean age of
participating subjects was 12.64 years with these
subjects reporting participation in competitive gym-
nastics for a mean of 5.4 years. Mean height and
weight of the subjects were 42.76 kg and 149 cm
respectively. Subject demographics, categorized by
USAG competition level, are summarized in Table 2.
Mean GFMT component test raw scores and stan-
dard deviations are presented in Table 3.
Raw scores for all items on the GFMT demonstrated a
normal distribution with the exception of the Hand-
stand Test, which presented with a right skew. This
skew possibly reflects the complexity of this particu-
lar activity. The relationships between the subjects’
current USAG competitive level and individual com-
ponent raw scores are presented in Table 4. As indi-
cated in Table 4, several of these relationships were
statistically significant, however, r2 values demon-
strated moderate to poor relationships between USAG
competitive level and individual component raw
scores (r2 = 0.05-0.47). The relationship between total
GFMT scores (out of a possible score of 100) and the
subjects’ current USAG competitive level was found
to be good (r2 = 0.62). Figure 2 demonstrates the rela-
tionship between USAG competitive level and total
GFMT Scores. To rule out alternative explanations for
the relationship between USAG competitive level and
total GFMT scores, the relationships between total
GFMT scores and age and total GFMT scores and
bodyweight were also explored. Statistically signifi-
cant relationships were identified between total
GFMT score and age and between total GFMT score
and bodyweight (r2 = 0.13). However, r2 values dem-
onstrated a poor relationship between total GFMT
score and age (r2 = 0.29) and between total GFMT
score and bodyweight (r2 = 0.13).
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 129
Table 2. Subject Demographics by Competitive Level.
Table 3. Mean and Standard Deviation of GFMT Individual Item Scores and GFMT Total Scores (n= 105).
Raw item scores were used to examine the test-retest reli-
ability for each item on the GFMT. Test-retest reliability
of total GFMT scores was also determined. Reliability
testing of the GFMT total score showed good test-retest
reliability over a one week period (ICC=0.97). Test-retest
reliability of the individual component tests was good to
excellent (ICC = 0.80-0.92).42 Reliability coefficients are
shown in Table 5. A statistically significant difference
(p<0.05) between the first and second test scores was
identified for the GFMT Total score and for the following
test items: the Hanging Pikes Test, the Vertical Jump
Test, and the Splits Test.
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 130
The GFMT provides the coaches, trainers, and thera-
pists who work with female gymnasts of any age or
competitive level with a functional tool designed to
assess the unique aspects of fitness that are necessary
for safe and effective participation in the sport. Given
that the GFMT was developed as a field-test that can be
administered without extensive training using equip-
ment readily available in a gymnastics gym, the authors
believe that the GFMT can be easily incorporated into
any gymnastics program. Identifying fitness deficits that
can be targeted as part of a gymnast’s individual training
regime may prove useful in injury prevention.
Table 4. Relationship between GFMT Individual Test Raw Score and Composite Score and the Subjects’ Current
Competitive Level, Body Weight and Age (n = 105).
Figure 2. Relationship between USAG score and GFMT score.
Table 5. Score Means and Standard Deviations for Both Test Days and Intraclass Correlation Coeffi cients for Test Retest
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 131
Raw data collected in this study was used to develop the
scoring system for the GFMT. Transformation of the
raw data for each individual item to an ordinal scale
allowed for a total GFMT score out of a possible 100
points (10 points for each item) and permitted raw data
based on a variety of units of measurement to be con-
sidered within a total score. As reflected in Appendix I,
the raw score for the Rope Climb item reflects both the
amount of time needed to complete the climb and the
qualitative analysis of the climbing technique used by
the gymnast during the climb. Scoring for this item thus
reflects a 0 to 5 ordinal scale for time developed using
the procedures outlined above as well as a 0 to 5 score
for climbing technique as outlined in Appendix I.
The results of this study provide initial support for
the construct validity and test-retest reliability of the
GFMT. Although construct validity is only one of the
many forms of validity to be considered when evalu-
ating a measurement tool,42,46 the relationship
between a gymnast’s total GFMT score and current
USAG competitive level provides support for the con-
cept that GFMT scores will vary based on a gymnast’s
current competitive level. Examining data from the
individual items comprising the GFMT reveals that
certain items such as the Jump Test, the Agility Test,
and the 20-Yard Sprint Test relate more strongly to a
gymnast’s current competitive level than items such
as the Shoulder Flexibility Test and the Splits Test.
Despite the variations in the strength of the relation-
ship between individual items and competitive level,
the authors believe that all items on the GFMT must
be administered to fully assess a gymnast’s fitness
across multiple domain areas (strength, flexibility,
power, etc.). Maintaining a complete representation
of fitness within the GFMT is necessary in order to
adequately identify a gymnast’s fitness deficits and
aid in the development of a fitness program tailored
to address individual fitness needs.
The procedures and methods used in this study
allowed the researchers to evaluate the GFMT within
the context of its intended use as a field-test to assess
a gymnast’s overall fitness level while minimizing the
impact of gymnastic skill on testing scores.43,44 As such,
testing was conducted in a manner consistent with
the sport in an environment familiar to the individual
athletes. Each item on the GFMT was administered at
a separate station by different testers to reflect the
common practices of field-test administration. Testers
were intentionally provided with detailed instructions
for administering each item but did not undergo exten-
sive or additional training. Results are therefore felt to
reflect the application of the GFMT within the setting
for which it was intended to be used.
The intended purpose and use of a measurement tool
dictate the relative importance of various forms of reli-
ability. Given that the GFMT was designed as a physi-
cal fitness field-test, assessment of test-retest reliability
was felt to be essential. The one week interval between
test administrations attempted to control for factors
such as fatigue or learning effects that may have
impacted a gymnast’s performance while trying to
avoid enough passage of time to permit a true change
in a gymnast’s overall fitness.
This study was limited by several factors. The total num-
ber of participants at any given USAG level ranged from
9 to 21. Increasing these numbers to ≥30 participants at
each USAG level may have yielded different results.
Although methods such as using physical therapy stu-
dents and coaches to collect the data may have helped
to reflect the use of the GFMT within the context of its
intended use, greater methodological control and there-
fore different results may have been obtained through
the use of more stringent techniques such as employing
highly trained, researching physical therapists to collect
the data. While attempts were made in the test-retest
procedures to decrease the possibility of a practice or
learning effect, the authors’ recognize that such factors
may have impacted score differences between the first
and second administrations of the GFMT.
Further research is needed to continue the process of
establishing the various types of reliability and validity
of the GFMT. The possibility of correlations between
total GFMT score and such factors as body composition/
percentage of body fat and body mass index must be
explored. Future studies should also explore the ability
of the GFMT total score and individual item scores to
identify a gymnast’s risk for specific injuries and whether
the GFMT could be used to help determine if and when
an injured gymnast can safely resume high-level train-
ing and competition. Finally, since the GFMT was devel-
oped exclusively for female gymnasts, a different tool
that reflects the demands and specifications of men’s
competitive gymnastics should also be developed.
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 132
Although the process of establishing the reliability
and validity of any measurement tool is a complex
and lengthy procedure, the results of this study pro-
vide initial support for the construct validity and
test-retest reliability of the GFMT.
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The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 134
APPENDIX 1: INSTRUCTIONS FOR ADMINISTRATION OF THE GFMT.
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 135
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 136
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 137
The International Journal of Sports Physical Therapy | Volume 7, Number 2 | April 2012 | Page 138 Download full-text