HKIN #446: Essentials of Personal Training Pre-Prescription Issues Day #2

1. HKIN #446: Essentials of Personal TrainingPre-Prescription IssuesDay #2

2. Required Reading . . . • Pp- 139-140 (8.1-8.2) • Text Chapter #11 (pp. 187-195)

3. The Art & Science ofPersonal Training Human Kinetics #446: Essentials of Personal Training

4. In general, the job of any fitness/exercise trainer can be categorized into three identifiable (yet overlapping) phases: • 1) The Pre-Prescription Phase • 2) The Exercise Prescription Phase • 3) The Technique Instruction Phase

5. The Job of the Personal Trainer The Mantra of the Course. . . Pre-Prescription Phase 1 Technique Instruction Phase 2 Exercise Prescription Phase 3

6. 1)The Pre-Prescription Phase

7. The Job of the Personal Trainer  Pre-Prescription Phase 1 Technique Instruction Phase 2 Exercise Prescription Phase 3

8. Pre-Prescription Objectives • A) To address issues of legal liability • B) To gather information about the client • C) To establish client-trainer rapport

9. A) Addressing Issues of Legal Liability • Negligence is defined as “the breach of a duty to exercise care” • A trainer can be held liable for negligence where injury has been caused by his/her failure to take reasonable precautions in preventing foreseeable harm • A trainer cannot be held liable for an injury that could not be reasonably foreseen or prevented 

10. Tools to protect a trainer against legal action from a client include: • a) Waivers • b) Informed Consent/Release Forms • c) Medical History/Health Status Questionnaires

11. a) Waivers (i.e pp193) • Def’n: A contractual agreement which disclaims the trainer of personal responsibility and indicates that any and all exercise associated risks are assumed by the client • Waivers are intended as attempts to absolve a trainer of liability even in the case of negligence 

12. A well designed waiver should contain: • A clear statement of the protection being sought by the trainer • A clear description of the client within the terms of the agreement • A clear statement of the level of physical and emotional exertion to be anticipated by the client • The client’s affirmation that he/she possesses a sufficient level of physical/motor conditioning/skill • The client’s affirmation that he/she aware of the nature of the activity and any inherent risks therein 

13. The client must be told that the form includes a waiver of liability • Any questions the client might have should be answered before he/she signs • By signing, the client is acknowledging that he/she is: • a) Informed • b) Participating voluntarily • c) Willing to give up his/her right to pursue legal action against the trainer • Anchorsabovezipline 

14. From an ethical standpoint, the use of waiver forms may be problematic to some trainers • Thus, a frequently utilized alternative includes a well designed “Informed Consent/Release Form”

15. b) Informed Consent/Release Forms i.e pp 192 • An informed consent form represents a written document intended to inform a client of the nature of the exercise programs and procedures in advance of his/her participation therein as well as any reasonably foreseeable potential risks associated with these programs and procedures 

16. A well designed informed consent/release form should contain: • A clear description of the client within the terms of the agreement • A clear description of the intentions, potential limitations and/or capacities of the trainer • A clear statement of the level of physical and emotional exertion to be anticipated by the client • The client’s affirmation that he/she aware of the nature of the activity and any inherent risks therein • A clear statement that the client may withdraw his/her consent at any time 

17. Before signing: • Each phrase within the contract should be clarified to the client by the trainer • The client should be granted the opportunity to ask questions and have these answered by the trainer • By signing, the client is acknowledging that he/she is: • a) Informed • b) Participating voluntarily (but retains the right to deny consent or stop at any time) • Informed Consent • CSEP evaluation consent

18. c) Medical History/Health Status Questionnaires • A medical history/health status questionnaire represents a form intended to secure assurance that a client is physically sound and able to safely participate in exercise programs and procedures • In addition, such questionnaires may reveal contraindications to exercise that the trainer can take into account during the exercise prescription phase 

19. c) Medical History/Health Status Questionnaires pp. 158 • Information requested within these questionnaires should be limited to health status information relevant to exercise program prescription and the client’s participation therein • e.g. PAR-Q & You • e.g. PARmed-X • e.g. PARmed-X for PREGNANCY • http://www.csep.ca/english/view.asp?x=698

20. Physical Activity Readiness Questionnaire (PAR-Q) • Represents a tool for identifying clients (aged 15 to 69) who may need medical clearance before participating in an exercise training program • Notes: • Potential clients under 15 require written permission to exercise from a parent • Potential clients over 69 require written permission to exercise from a physician

21. Physical Activity Readiness Medical Examination (PARmed-X) • Represents a checklist to be used by physicians with patients who have had positive responses to the PAR-Q • After visiting a physician, a client may return to the trainer with a “Physical Activity Readiness Conveyance/Referral Form” which should be kept on file and used to inform exercise prescription

22. Physical Activity Readiness Medical Examination for Pregnancy (PARmed-X for Pregnancy) • Represents a checklist to be used by physicians to evaluate pregnant women wanting to participate in an exercise program • After visiting a physician, a client may return to the trainer with a “Health Evaluation Form” which should be kept on file and used to inform exercise prescription

23. B) Gathering Client Information For Exercise Prescription • Tools include: • a) Questionnaires • b) Client Interviews • c) Fitness Testing

24. a) Questionnaires • Information requested within these questionnaires should be limited to factors considered essential in informing exercise program prescription and the client’s participation therein • Medical history/health status type questions may appear • Also, exercise objectives, physical activity likes, dislikes, exercise experience, age, gender, time availability, etc. • EXAMPLE QUESTIONNAIRE #1 • EXAMPLE QUESTIONNAIRE #2

25. b) Client Interviews • This represents an ongoing dialogue between the trainer and his/her client and is intended to compliment questionnaires • Initially it is important in that it reveals the client’s objectives, interests, needs and level of exercise understanding which further inform the initial exercise prescription • Follow-ups are important in that they reveal changes which inform exercise prescription adjustments

26. c) Fitness Testing • This is optional • Reveals additional information about the client’s personal exercise needs and objectives • Can be a motivational tool (two approaches): • Compare results to age-adjusted norms • Compare results from test to test • Not a diagnostic tool that assesses: • The diseased versus nondiseased status of a client • A client’s readiness to engage in exercise 

27. Flexibility Aerobic Power Anaerobic Power Muscular Strength Muscular Endurance Resting Heart Rate Blood Pressure Pulmonary Function Body Composition • Fitness test measures include, but are not limited to:

28. C) Establishing Client-Trainer Rapport • Rapport establishment begins with initial contact and continues throughout all interaction and communication between the trainer and client • Since client-trainer rapport is relevant to a client’s exercise compliance, it is important that it be maintained within a motivational environment where communication is strongly encouraged 

29. The most important quality a personal trainer can possess when it comes to developing client-trainer rapport is a personality that is genuinely warm and caring • In addition, the trainer should always attempt to display a unconditionally positive and non-judgmental attitude simultaneously with his/her ability to empathize