Harvard Step Test

Assess the cardiovascular fitness of your patient or client by having them take the Harvard Step Test! It’s a good way to check on their fitness and give them a nice exercise!

By Matt Olivares on Apr 08, 2024.

Fact Checked by RJ Gumban.

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What is the Harvard Step Test?

The is one of the most common tests physicians use to check on a person’s cardiovascular fitness. It was developed by Harvard University doctors in the 1940s. They designed it so the test measures a person’s heart and lungs, specifically their ability to supply their body with oxygen as they partake in this exercise.

Not only is this test one of the most common ways to check a person’s cardiovascular fitness, but it’s also one of the easiest to conduct! People taking this test only need to step up and down a step (usually a twenty-inch-high step) at a rate of thirty steps per minute. This will go on for approximately five minutes (which is the usual length of time that this test is conducted).

Once the test taker is done with the test, they take a rest. While they are resting, the test conductor will monitor and record their heart rate. They will calculate the test taker’s cardiovascular fitness score by taking into account the length of the Harvard Step Test as well as the heart rate of the test taker while they are at rest.

Printable Harvard Step Test

Download this Harvard Step Test to assess the cardiovascular fitness of your patients.

How to conduct the Harvard Step Test

The Harvard Step Test is one of the most simple fitness tests to conduct because not only are the instructions straightforward and easy to follow, but it also doesn’t require much from the person conducting it. The only things you need are a twenty-inch step, a chair, and a stopwatch. There are steps that are designed for this particular test, so if you can procure one or if you already have it, that’s great! If you don’t, then a staircase or a bench of equal length should suffice! Just make sure that they are not slippery and are stable enough.

Do make sure that your patient is wearing fitness-related clothing so they are comfortable while doing the exercise! It’s a fitness test, after all.

Once everything has been prepared and your patient is dressed for the exercise, do the following:

  • Explain the purpose of this test to your patient and how it’s done. All the patient needs to do is step up and down at a pace of thirty steps per minute. The test will go on for five minutes, and you should encourage them to finish it even when they tire. Tell them to start as soon as you say “GO” and stop when you say “STOP.” Ready your stopwatch!
  • Once you have explained how this test is conducted, you may begin the test! Don’t forget to activate the stopwatch and stop it when the five minutes are up.
  • Tell the patient to sit down and rest on a chair, which is supposed to be next to or near the twenty-inch step.
  • While resting, you, the conductor, will have to record their heart rate by checking the pulse on their wrist. Make sure to write down their heart rate!

How to score the Harvard Step Test

The last thing you have to do is measure the heart rate of the patient by checking the pulse on their wrist. You will specifically measure the heart rates between one, two, and three minutes of recovery.

The specifics are:

  • The heart rate between 1 and 1 ½ minutes of recovery after finishing the test
  • The heart rate between 2 and 2 ½ minutes of recovery after finishing the test
  • The heart rate between 3 and 3 ½ minutes of recovery after finishing the test

Once you have recorded the heart rates, it’s time to calculate their fitness index. To do so, you need to follow this equation:

  • (100 x test duration in seconds) divided by (2 x the sum of the heart rates) = fitness index

Here’s an example (this stipulates that the test duration was five minutes, which is the usual length of this test):

  • (100 x 300) / 2 x (90 + 80 + 70)
  • 30,000 / 480 = 62.5

The Fitness Index is 62.5!

Please refer to this table to know the score ranges and their specific designations:

Harvard Step Test Score Designations

Harvard Step Test Example

The Harvard Step Test normally doesn’t have a test sheet that comes along with it, so we created a template for you to record your findings and calculate a patient’s fitness index! It has instructions and editable fields to indicate the heart rates between minutes and their total score. It also comes with the table above and an additional comments box so you can expound on your findings (if you want or need to) and indicate any key decisions and the reasonings behind them.

Here’s what a filled-out Harvard Step Test sheet looks like:

Download this Harvard Step Test Example (Sample) here:

Harvard Step Test Example

If you like what you see, then feel free to download it from our platform for free! You can choose to print it if you prefer filling out physical copies, or you can go paperless and just fill out the editable fields on the PDF!

When is it best to conduct the Harvard Step Test?

Since the Harvard Step Test is a physical fitness test that focuses on cardiovascular fitness, it can be conducted at any point of the day. However, the best time to conduct it would be in the mornings. More specifically, the best time is in the morning when the person has just (supposedly) gotten a good night’s sleep and has not consumed any food or caffeine (coffee or tea).

It is important that the test taker is well-rested, has not eaten any food, and has not drank coffee or tea because these factors affect a person’s heart rate and recovery time.

Besides having a good night’s sleep and not having consumed any meals and caffeinated drinks, the test taker must also avoid partaking in any physical and strenuous activity at least twenty-four hours before the test. They must also avoid consuming alcohol at least twenty-four hours before the test. These factors also affect a person’s heart rate and recovery time.

If your patient tends to drink caffeinated or alcoholic beverages or partake in strenuous activities, it’s best to inform the test taker several days before the scheduled Harvard Step Test so that everyone is prepared and the best results can be obtained.

What are the benefits of the Harvard Step Test?

It is simple to do and it is inexpensive!

The Harvard Step Test is one of the most common and simple exercises that healthcare and non-healthcare professionals can use. It only requires a step that’s twenty inches high, a chair for test takers to sit on during the resting phase, and a stopwatch!

The instructions are easy to follow since the only thing that the test takers need to do is to step up and down the twenty-inch step!

Given all this, both the test conductors and test takers will have an easy time with it, and it will take only approximately ten minutes to complete (including the heart rate measuring!).

It can instill motivation in patients and athletes.

More often than not, the Harvard Step Test is part of a routine check-up or training program. This test isn’t simply for gauging a person’s cardiovascular fitness. It’s also used to improve it. By partaking in this exercise consistently (alongside other fitness tests), the results will definitely improve over time.

Once the test takers see their results, especially if they are results from the second or third test, and the results show improvement, this might inspire them to continue taking this test on a routine basis.

On the part of athletes, once they reach a certain level of cardiovascular fitness and they can maintain those results for a certain period (this is up to their trainers/coaches), they will be able to take on more demanding fitness exercises.

It can help with risk stratification.

Risk stratification is a type of practice that has healthcare professionals categorize their patients based on their patients’ respective health levels, conditions, and a whole lot more. Through risk stratification, professionals can determine what is best for their patients, like what medicines to take (if medicines are needed), what kinds of interventions need to be implemented, etc.

In the context of the Harvard Step Test, it can help with risk stratification in the sense that it can determine what recommendations for the patient in terms of their lifestyle (what foods to eat, what they should avoid doing, etc.) as well as to create personalized fitness programs to improve their overall fitness levels.

Why use Carepatron for fitness-related work?

Carepatron houses a massive resource repository encompassing a wide variety of healthcare-related fields, especially physical therapy (and, by extension, fitness)! If you are interested in adding the Harvard Step Test as part of your fitness regimen for patients or athletes, then feel free to do so! You don’t even have to cough up money for it because you can download our Harvard Step Test sheet template for free!

If you want to conduct more comprehensive examinations of your patients that involve other tests, we have a wide variety of other physical therapy and fitness assessments that might interest you, like the Illinois Agility Test, 30-second Chair Stand Test, and a whole lot more.

Accessing our platform doesn’t just grant you access to our resource repository. You can also access our super cool and super secure storage system, which allows you to store your clinical documents in a HIPAA-compliant manner! If you have filled out Harvard Step Test sheets and you want to create backups of your files, you can do so by storing them with us! You can even select who gets to access these files besides you!

We at Carepatron are all about helping healthcare professionals with their work, so take advantage of our platform so we can help streamline your workflows and help you preserve your work!

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How long does it take to accomplish the Harvard Step Test?
How long does it take to accomplish the Harvard Step Test?

Commonly asked questions

How long does it take to accomplish the Harvard Step Test?

It only takes approximately ten minutes to accomplish the Harvard Step Test, including the test itself and the recovery phase when the conductor will measure the heart rate of the test taker.

How often should Harvard Step Test be conducted?

That will depend on the person conducting it and the context of why it is being conducted in the first place. If it’s part of a sports training program, this exercise might be conducted on a daily basis or three times a week (it really depends on the program). If it’s part of a rehabilitation or clinical program, it might be once a week, fortnightly, or monthly.

Is the Harvard Step Test even safe, considering they will be stepping up and down repeatedly?

The Harvard Step Test is, more often than not, safe, so long as the test taker is relatively healthy. If a test taker has pre-existing conditions or has not engaged in physical activities for quite some time, it’s best to get medical clearance before taking the test.

The step that will be used for this test should only be twenty inches high. That’s short enough for anyone to step up and down. The worst that can happen is a person tripping because their foot hit the step or they stepped awkwardly. It’s also common for step takers to feel a little fatigued during and after the test.

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