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Introduction
About ACE
1) ACE is dedicated to promoting physical activity and protecting consumers against unsafe and ineffective fitness products and instruction ACE sponsors university-based exercise science research that targets fitness products and trends One of three certifying organizations to be accredited by the National Organization of Certifying Agencies (NOCA)
2) 3)
2)
3)
ACE develops the study materials without using the actual exam
Rather than teaching answers to the exam, ACE prepares you to be a safe and effective personal trainer
2)
Multiple-choice portion
a. b. c. 150 questions 3 hours to complete 72 seconds per question
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Questions are written using the Personal Trainer Exam Content Outline
Exam content
1.
2. 3.
4.
5.
6)
Exercise Physiology
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Fitness
A. Being active improves health: 30 minutes of accumulated physical activity on most days of the week Being fit goes beyond health and requires a comprehensive exercise program that includes the following components
1) 2) 3) 4) Cardiorespiratory endurance Muscular strength and endurance Flexibility Body composition
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B.
d.
c.
Capillaries tiny vessels across which the exchange of gases, nutrients, and waste occurs between the blood and the cells of the body
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13
14
15
16
5)
18
Cardiac output = HR x SV
A typical cardiac output at rest: 60 bpm x 70 mL/beat = 4200 mL/min (approximately 1 gallon of blood per min)
4)
19
b. However, blood pressure greater than 250/115 mmHg is an indication to terminate exercise (hypertensive response)
20
21
22
b.
23
b.
24
b.
25
b.
2.
The ability to extract the O2 at the capillaries and use it in the mitochondria
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b.
c. d.
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28
Altitude
1) 2) Since there is less partial pressure of O2 at higher altitudes, HR and respiratory rate increase During exercise HR may increase up to 50% higher than normal
3)
4)
Decrease exercise pace so the client can complete the session without becoming exhausted
It can take up to 25 weeks to acclimate to a new altitude
29
Heat
1) 2) Due to increased dilation of blood vessels near the skin, venous return and SV decrease At any given exercise pace, HR will be higher as the heart tries to maintain cardiac output to meet the needs of the working muscles Producing sweat so that it may evaporate from the skin is the bodys cooling mechanism High humidity does not allow sweat to evaporate The main concerns of exercising in the heat are sweat evaporation and consumption of 48 ounces of water every 1015 minutes during exercise
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3) 4) 5)
Cold
1) 2) Exercising in the cold causes the kidneys to increase urine production, risking dehydration Heat production during exercise is usually enough to prevent hypothermia
3)
4)
When exercise stops, however, the client needs to be protected from the cold
Keys to exercising in the cold are drinking plenty of fluids and dressing in layers
31
Energy production
1) Adenosine triphosphate (ATP)
a.
b. c. d.
32
Energy production
Energy System Substrate Limitation to Produce ATP Primary Use
ANAEROBIC
Phosphagen Creatine phosphate (CP) Stored ATP Muscle stores very little CP and ATP High-intensity, shortduration activities; less than 10 seconds to fatigue High-intensity, shortduration activities; from 13 minutes to fatigue
Anaerobic glycolysis
AEROBIC
Fatty acids, glucose, and glycogen Depletion of muscle glycogen; insufficient O2 delivery Long-duration, subanaerobic threshold activities; longer than 3 minutes to fatigue
33
2) 3)
34
MET (cont.)
4) To determine the VO2 equivalent of any MET value, simply multiply the MET value by 3.5
a. For example, a typical step aerobics class is about 7 METs
b.
35
2)
b. c.
37
b. c.
d.
39
Neuromuscular anatomy
1) Motor nerve: conducts impulses from the central nervous system (CNS) to the periphery signaling muscles to contract or relax
2)
Motor unit: a motor nerve and all its associated muscle fibers
a. All fibers comprising a motor unit are homogeneous (they are either all fast-twitch or all slow-twitch) Motor units made up of 510 fibers are responsible for fine, delicate movements such as blinking the eye Motor units made up of thousands of fibers are responsible for forceful movements such as jumping
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b.
c.
Musculoskeletal anatomy
1) Muscle fiber: a muscle cell
2)
Myofibrils: a contractile protein in a muscle fiber; there are many myofibrils arranged in patterns within a muscle fiber Sarcomere: the functional contracting unit of the muscle cell
a. b. Myofibrils are made up of several repeating sarcomeres along the length of the muscle cell The area between the Z-lines
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3)
4)
Actin and myosin: contractile protein filaments within the myofibril; they generate muscle contraction by sliding past one another
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b.
When these two factors are present, tiny projections from the myosin filament attach to the actin filament forming a cross-bridge
44
45
c.
d.
46
Muscle spindles
Sensory receptors that lie parallel to the muscle fibers Respond to muscle fibers being over-stretched by causing a muscular contraction Component of the stretch reflex
9)
a.
b.
c.
Fascia
Tendons Ligaments Cartilage
48
All-or-none theory
1) When a single muscle fiber shortens, it generates its maximum force capability; there is no gradation of force When a motor unit is stimulated, all the muscle fibers it innervates contract with maximum force
2)
49
b. c.
d.
50
2) Peak force production is usually seen at resting length or slightly greater (1.2 times resting length)
3) At approximate resting length, more of the myosin cross-bridge heads can align with active actin receptor sites 4) Therefore, clients with poor posture that have chronically shortened or lengthened muscle groups are not able to produce optimal force at the misaligned joints
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3)
52
Contract forcefully
Fatigue quickly Primary energy system is anaerobic Used in short-term activities requiring strength and power Fast-twitch fibers are further classified into type IIa and type IIb Type IIa fibers are slightly more oxidative than type IIb It is possible to increase either the oxidative qualities or the glycolitic qualities of type IIa fibers through training However, muscle fibers cannot be changed from one type to another
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c.
Neural adaptations are responsible for gains in strength with little or no change in muscle crosssectional area after as much as 6 weeks of training
2)
6)
7)
56
Effects of stress
Tension headache, neck and shoulder discomfort, and back pain Premature coronary artery disease (CAD), hypertension, increased platelet adhesiveness, and heart attack
Immune system
CNS Gastrointestinal system
These negative changes primarily occur due to elevated levels of stress hormones (norepinephrine and cortisol) Exercise may help decrease stress hormone levels and alleviate these symptoms
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Muscular actions
1) Isometric (static)
a. b. No visible movement occurs The resistance matches the muscular tension
c.
Examples
1. 2. Wall sit Plank
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Human Anatomy
Please refer to the Anatomy Supplement and ACE Personal Trainer Manual for tables, descriptions and illustrations of the skeletal system and major muscle groups.
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Levers
1) A lever is a rigid bar (bone) with a fixed point around which it rotates when an external force is applied to it The fixed point is the fulcrum (joint)
2)
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Torque
1) Rotation at a joint
2)
3)
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Muscular roles
1) Agonist (prime mover)
a.
b.
2)
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66
2.
67
2.
e.
Both stabilizing and co-contracting play important roles in posture and efficient joint mechanics
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Nutrition
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2)
3)
b.
c.
4) 5)
Average person can expect to lose 12 pounds per week Obese person can expect to lose 13 pounds per week
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Healthy eating plans that reduce calories but do not rule out specific foods or food groups
Regular physical activity and/or exercise instruction Tips on healthy behavior changes that also consider your cultural needs
72
5)
6)
Scope of practice
As a fitness professional, it is within your scope to make dietary suggestions using the MyPyramid Food Guidance System (www.mypyramid.gov) and the 2005 Dietary Guidelines for Americans (www.nal.usda.gov/fnic); this information updates the Food Guide Pyramid released in 1992 and the 2000 Dietary Guidelines for Healthy Americans
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1)
2)
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To reduce the risk of chronic disease in adulthood: engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week For most people, greater health benefits can be obtained by engaging in physical activity of more vigorous intensity or longer duration
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2)
78
Updated Physical Activity Recommendations 2005 Dietary Guidelines for Americans (cont.)
4) To sustain weight loss in adulthood: participate in at least 60 to 90 minutes of daily moderate-intensity physical activity while not exceeding caloric intake requirements. Some people may need to consult with a healthcare provider before participating in this level of activity.
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Health Screening
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Typical forms
1) Legal issues
a. b. Informed Consent Liability Waiver Health Risk Appraisal/Health History Form PAR-Q Medical/Physicians Release Form Lifestyle Information Form Exercise History and Attitude Questionnaire Exercise Confidence Survey
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2)
3)
Psychological issues
a. b. c.
2) 3)
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b.
c. d.
4060% VO2max
4060% HRR 1213 RPE Greater than 6 METs Greater than 60% VO2max
2)
Vigorous-intensity exercise
a. b.
c.
d.
1)
c.
d.
2)
Blood Pressure
a.
b.
c.
d.
Expressed in mmHg
Allow 30 to 60 seconds between trials to allow normal circulation to return
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SBP mmHg
DBP mmHg
and or or or
160
100
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Medication
1) Health history forms should include information regarding any medications the client may be taking (prescription or over-the-counter) The personal trainer must be aware of the effects of medications on heart rate
2)
86
Musculoskeletal conditions
1) 2) Both chronic and acute injuries must be addressed in the health screen Serious injuries and past surgeries also should be included
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Purpose of measurements
1) 2) 3) Establishes a baseline Helps to monitor progress Increases your level of professionalism
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Disadvantages of measurements
1) Can be intimidating
2)
3)
Can be discouraging
Not always accurate
90
3)
91
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Formula:
Relative O2 uptake = O2 uptake (L/min) x 1,000
BW (kg)
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2)
Can be determined by a maximal functional capacity test or by the age-predicted maximal heart rate formula (220 age)
Formula:
Target heart rate (THR) = 220 age x desired intensity %
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96
Karvonen formula
1) 2) The mathematical formula that uses HRR to determine target heart rate (THR) A common mistake is forgetting to add back in the RHR
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A simplified system for classifying physical activities where 1 MET = resting O2 consumption
Resting O2 consumption equals approximately 3.5 mL/kg/min
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2)
3)
Provides an estimation of the VO2max without the risks associated with maximal exercise testing
Examples
a. b. YMCA Submaximal Step Test McArdle Step Test
c.
d.
2)
Formula:
Skinfold measurements
1) 2) 3) 4) Used to determine the ratio of fat mass to fat-free mass in the body Fat mass: adipose tissue Fat-free mass: bone, muscle, and organs Measurements are performed with a skinfold caliper
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6) 7)
Should be repeated by the same technician during reassessment to decrease error Should be performed prior to physical activity because fluid transfer to the skin could result in overestimations
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3)
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2)
Formula:
Desired body weight = lean body weight
3)
4)
Hip flexion
Shoulder flexibility
As with any test or exercise, the clients health and injury history should be considered
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2)
1 RM strength testing is not commonplace among personal trainers as the risks typically outweigh the benefits
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Push-up test
Half sit-up test
As with any test or exercise, the clients health and injury history should be considered
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3)
4)
9)
Reassessment
1) 2) Measurable changes usually take about 46 weeks The first follow-up assessments should be administered 412 weeks after the onset of training The information gained during the follow-up assessment can be useful in client motivation as well as in future exercise programming
3)
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3)
2)
Components
a. b. c. Warm-up Target heart-rate zone training Cool-down
3)
Monitoring intensity
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3045 minutes
7085% HRR Should be enjoyable, convenient, and adaptable Goal is to maintain fitness developed during improvement phase
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c. d. e.
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123
c.
Fartlek training
1. 2. Similar to interval training except the work-rest intervals are determined by how the client feels Has great application for running
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3.
125
126
b.
c.
Group 3 (advanced): activities that are variable in both skill and intensity such as soccer or racquet sports
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Chapter 8
Muscular Strength & Endurance
Chapter 9
Strength Training Program Design
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2)
Assess tightness and weakness (kyphosis and lordosis)refer to student outline for illustrations and associated muscle imbalances Ask clients about their lifestyles and repetitive movements they perform throughout their day
Design a program to address those issues, but dont neglect the importance of training the entire body as a system
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3)
4)
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Specificity
Outcome Endurance % 1 RM <70 Rep Range Sets 1220 812 18 13 16 15+ Rest Periods 2030 sec. 30120 sec. 25 min.
131
8)
Range of motion
a. b. c. Full range of joint motion should be executed with each lift This strengthens the agonists and stretches the antagonists Strength training can improve range of motion if done properly
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Modify FITT
Change order of strength-training exercises Substitute new exercises that target the same muscle groups Exercise specificity Injury prevention Plyometrics
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2)
Competitive Athletes
a. b. c.
Flexibility
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135
c. d.
b.
Injuries
1. 2. Be aware of previous injuries Recently injured soft tissues should not be stretched
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b.
Dynamic
1. 2. 3. An active stretch that mimics the activity to be performed Done through a full range of motion in a slow and controlled manner Examples include running in slow motion and practicing slow swings of a tennis racquet
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2. 3.
139
140
Sources of information
1) The forms
2)
3) 4)
Only after gathering these pieces of information can the personal trainer design the appropriate, safe, and effective exercise program
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Rates of change
1) Weight Loss
a. b. Maximum rate of weight loss is 12 lb per week Body fat decrease of approximately 1% per month
2)
Muscle Gain
a. Maximum rate of muscle gain is 12 lb per month
b.
3)
Progression
a.
b.
2)
3)
Formula:
Energy cost of an activity = calorie cost x BW (lb) x minutes of activity
144
Goal setting
1) 2) Effective goal-setting will translate a clients vague statements into precise goals SMART goal
a. b. c. d. e. S pecific M easurable A ttainable R elevant T ime-bound
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c.
Attainable: by increasing physical activity and decreasing caloric intake by 150 cal per day, losing 10 lb in 3 months can safely and effectively be achieved (equates to approximately .8 lb lost per week)
Relevant: look better for cruise and have more energy to enjoy it Time-bound: goal is set to be achieved within 3 months
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d. e.
b.
5)
Outcome-centered goals
a. b. Focus on results (losing 10 lb, as in the previous SMART goal example) May be good for clients who are motivated by physiological results rather than behavior-change results
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148
Time
2060 continuous minutes or 10minute bouts accumulated throughout the day 1 set of 3-20 reps (e.g., 3-5, 8-10, 1215); 1 set of 10-15 reps if >50 yrs 15-30 sec.; 2-4 reps
Type
Large muscle groups; dynamic activity
Resistance
23
Volitional fatigue (e.g., 19-20 RPE) or stop 2-3 reps before volitional fatigue (e.g., 16 RPE) Stretch to tightness at the end of the ROM but not to pain; mild discomfort
8-10 exercises that include all the major muscle groups Static stretch for all the major muscle groups
Flexibility
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Guidelines for most special populations (refer to hand-out for specific concerns)
1) Physicians clearance
a. b. Request exercise guidelines and limitations from clients physician Maintain close contact with clients physician Longer than 10 minutes Many special populations have compromised metabolic and/or cardiorespiratory systems and it takes longer for their bodies to adjust during acute bouts of exercise
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2)
4)
Strength
a. Lower resistance and higher repetitions
b.
5)
Modify as needed
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Education
Income Smoking Weight Past exercise experience Exercise perceptions Self-efficacy
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Convenience
Location Cleanliness Friendliness of staff Cost Variety in programming and equipment Intensity
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c.
External rewards
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2)
Investigation
a.
b.
Health screen
Physical tests
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4)
Action
a. Where the teaching and training takes place
b.
The personal trainer coaches the client toward his or her goals
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Stages of learning
1) Cognitive stage of learning
a. Learners make many mistakes and have highly variable performances
b.
2)
3)
Types of learners
1) Auditory learners
a. b. Listen intently to the content of your words Instruction example: teach auditory learners breathing by making a light sound while exhaling and inhaling
2)
Visual learners
a. b. Watch you and your actions carefully Instruction example: teach visual learners breathing by exaggerating facial expressions and moving hands in the direction of the airflow
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Types of learners
3) Kinesthetic learners
a. b. Gather information through physical changes or feelings Instruction example: teach kinesthetic learners breathing by having the participant focus on the feeling of the air moving through the airway and the feeling of the lungs expanding and contracting
4)
Most people prefer one style of learning but can adapt to others
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Exercise instruction
1) Tell-show-do approach to teaching
a. b. c. d. Tell: a concise verbal description of the skill to be attempted Show: demonstration of the accurate desired action Do: an opportunity for the client to perform and practice the desired skill This approach allows the personal trainer to provide the client with an auditory, visual, and kinesthetic learning experience
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b.
c. d.
164
b.
2.
It is the personal trainers responsibility to provide protection in high-risk barbell exercises such as the squat, bench press, and incline press
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c. Most difficult people to reach for behavioral change d. e. Education is critical at this stage Typically, they initiate change only when others pressure them
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c.
They are not quite ready for change and are planning to take some action within the next 6 months
The average contemplator stays in this stage for approximately 2 years, telling themselves they will change but continuously putting it off Education and peer support are critical
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d.
e.
d.
d.
170
c.
d.
Musculoskeletal Injuries
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Acute injury
1) 2) Seek medical approval and recommendations prior to continuing existing program Rest, decrease FITT, and cross-train
173
Chronic injury
1) If chronic injury with pain exists for two weeks or more, seek medical approval and recommendations prior to continuing existing program
2)
174
175
Environmental conditions
1) Exercising in heat
a. b. c. Begin exercising in the heat gradually Always wear lightweight, well-ventilated clothing Never wear impermeable or non-breathable garments
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Environmental conditions
1) Exercising in heat (cont.)
d. Replace body fluids as they are lost
1.
2. 3.
e. f. g.
Record daily body weight Reduce FITT when appropriate Avoid times of day when heat and/or humidity are the greatest
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c.
Select garment materials that allow the body to give off body heat during exercise and retain body heat during inactive periods
Replace body fluids in the cold, just as in the heat
d.
178
Shortness of breath
Headache Nausea Lightheadedness
e.
Allow a minimum of three weeks to adjust at moderate altitudes (4,000 feet and higher)
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Emergency Procedures
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Facility readiness
1) First aid box
a. b. c. Where is it? Whats in it? How often is it restocked?
d.
2)
Emergency
1) A situation that requires the activation of EMS (life threatening condition, heart attack, neck or back injury) A health professional will need to clear the client prior to exercise, and the program may need modification
2)
182
Acute injury
1) 2) A condition caused by a singular event that requires either an EMT or an immediate referral Medical attention is advised prior to the next exercise session
183
Overuse injury
1) 2) A condition that has increased in pain or discomfort over a short period of time If there is general discomfort for two weeks or more advise the client to seek medical attention prior to exercise
184
RICE
1) Rest, Ice, Compression, and Elevation
2)
3)
185
Responses to exercise
Normal responses Elevated heart rate Warning signs Squeezing pressure in chest
Increased respiration
Sweating Cramping Fatigue Redness in face
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Scope of practice
1) The range and limit of responsibilities normally associated with a specific job or function
2)
3)
Standard of care
1) 2) 3) Appropriateness of an exercise professional's actions in light of current professional standards Based on the age, condition, and knowledge of the participant Examples:
a. b. Proper risk factor and medical screening Exercise testing and physical assessments
c.
d.
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Negligence
1) Both the failure to act and appropriateness of action
2)
3)
Acting inappropriately as compared with what a reasonable and prudent professional would do
Examples
a. Failing to stop a client from exercising above a recommended heart rate (failure to act or act of omission)
Encouraging a client to work above his or her recommended heart rate (appropriateness of action or act of commission)
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b.
Comparative negligence
1) 2) Measures the relative fault of both the plaintiff and defendant The court may apportion guilt and any subsequent award and damages
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Contributory negligence
1) The client plays a role in getting injured
2)
The plaintiff (client) cannot recover damages from the defendant (trainer)
193
Forms
1) Health risk appraisal (health history screen)
a. Purpose
1. Aids the personal trainer in determining heart disease risk factors and/or medical conditions that may make it unsafe for the client to participate in physical activity Provides a framework for designing a safe and effective exercise program
2.
b.
Limitations
1. 2. Cannot be used by a personal trainer to diagnose any medical condition Must be updated when any new medical condition arises (having clients update their health history forms every 612 months is a good practice)
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Forms (cont.)
2) Physical Activity Readiness Questionnaire (PAR-Q)
a. Purpose
1. Serves as a minimal prerequisite for beginning a low- to moderate-intensity exercise program
2.
b.
Limitations
1. Lack of detail
2.
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Forms (cont.)
3) Physicians clearance (medical release)
a. Purpose
1. 2. Provides the personal trainer with clarification of a clients status Explains any limitations and/or modifications to physical activity
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Forms (cont.)
4) Informed consent (express assumption of risk)
a. Purpose
1. When a client signs an informed consent, he or she is acknowledging to have been specifically informed about the risks associated with the activity
The two most important issues are voluntary participation and known danger Uses assumption of risk defense if challenged in court
2. 3.
b.
Limitations
1. 2. Not a liability waiver Intended to communicate the dangers of the exercise program or test procedures
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Forms (cont.)
5) Liability waiver
a. Purpose
1. 2. Used to release a personal trainer from liability for injuries resulting from an exercise program Represents a clients voluntary abandonment of the right to file suit
b.
Limitations
1. 2. Does not protect the personal trainer from being sued Documents that are poorly worded hold little value in court, as each state has its own policies
198
Insurance coverage
1) General liability
a. Covers basic trip and fall injuries that occur in a non-business environment
b.
These policies will not provide coverage for accidents that occur at work or while working
Includes coverage based on allegations claiming injury to clients Covers acts of omission (things the personal trainer did not do)
2)
Professional liability
a. b.
c.
d.
2)
Don'ts
a. Do not disseminate client names, addresses, or any other information to anyone without written permission from the client
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2)
3)
4)
However, as part of the personal trainers initial interview and assessment with a potential client, PHI is gathered
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e.
Sending a fax with PHI requires the personal trainer to first notify the recipient that a fax is going to be transmitted and mark the cover sheet "private and confidential"
If hard copies of PHI are mailed, label the envelope as confidential It is not advisable to e-mail PHI
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f. g.