programming-pt-with-clients

Programming Personal Training with Clients

Level 3 Certificate in

Personal Training© Central YMCA Qualifications (CYQ), 2010

All rights reserved. Without limiting the rights under copyright reserved above, reproduction of this resource for assisting course delivery is permissible for approved CYQ training providers for INTERNAL USE only.

Unit AimsThe learner will:• Understand how to prepare PT programmes• Understand the importance of long term behaviour

change for PT• Understand the principles of collecting information

to plan a PT programme• Understand how to screen clients prior to a PT

programme• Understand how to identify PT goals with clients• Understand how to plan a PT programme with

clients

Unit AimsThe learner will:• Understand how to adapt a PT programme

with clients• Be able to collect information about clients• Be able to agree goals with clients• Be able to plan a PT programme with clients• Be able to manage a PT programme• Be able to review progress with clients• Be able to adapt a PT programme with clients

How the Unit is AssessedCase Study and Viva:Using a real, apparently healthy individual (e.g.

a peer, family member, friend or partner) who does not require medical intervention, learners are required to produce and implement a case study that contains:

• Client profile• Detailed 4 week PT programme• 12 week PT overview

How the Unit is AssessedClient Profile:

• Client’s personal details

• Description of lifestyle

• Medical screening (PARQ)

• Postural screening

• Past and present physical activity

• Exercise preferences

How the Unit is AssessedClient Profile:

• Description of client’s attitude to physical activity

• Stage of readiness to participate

• SMART goals (short, medium and long term)

• Barriers to achieving goals

• Proposed strategies to overcome barriers

How the Unit is AssessedDetailed 4 Week Programme:The 4 week plan should contain a minimum of 4

session plans (1 per week) and the sessions should be between 30 and 60 minutes duration. For each session there should be:

• Detailed session plan/programme card• Session evaluations (with records of adjustments

made)• Evidence of adjustments made to 4 week plan• Client evaluations

How the Unit is AssessedSession Plans:The session plans with the 4 week plan must

also contain:• Appropriate warm up activities• A minimum of 2 of the following

cardiovascular approaches to training (on CV machines or other CV modes):– Interval – Fartlek– Continuous

How the Unit is AssessedSession Plans:• A minimum of 4 resistance approaches using

RT machines, FW or alternative methods (e.g. body weight):– Pyramid sets– Super-setting– Giant sets– Tri sets– Forced reps– Pre/post exhaust– Negative/eccentric training

How the Unit is Assessed

Session Plans:

• 1 core stability exercise

• 1 PNF stretch

• Appropriate cool down activities


Session Plans:• Content may be spread across all 4 sessions and

do not have to be in each session• 1 session plan must contain information regarding

environments not designed specifically for exercise (e.g. outdoor, office, home)

• The programme should specify the acute variables to be applied (sets, reps, intensity, time, rest)

• The programme should meet the client’s goals and should adhere to sound principles of programming


12 Week PT Overview:

The 12 week programme should relate to and build on the 4 week programme and should show projected logical progression from the 4 week programme at weeks 6 and 12.

How the Unit is AssessedViva:

The viva will ensure that you have sufficient knowledge and understanding of the PT programme they have devised.

Your ability to progress or regress activities according to the client’s goals, wants and needs will also be assessed during the viva.

How to Prepare PT Programmes

By the end of the session you will be able to:

• Describe the range of resources required to deliver a PT programme

• Explain how to work in environments that are not specifically designed for exercise/physical activity

Resources

Environment for the session:

• Inside areas (e.g. gym, studio, sports hall, home/office)

• Outside areas (e.g. parks)

ResourcesPortable equipment:

• Benches• Free weights• Bands• Steps • Swiss balls• Medicine balls• Dumbbells

ResourcesFixed equipment:

• Fixed resistance machines

• Cable machines

• CV machines (e.g. Upright/recumbent cycle, treadmill, stepper, rowing machine, elliptical trainer and cross trainer)

• Vibration plates

EnvironmentConsider the following:

•Health and safety considerations relating to different environments, to include:

– Environment– Equipment– Clothing– Support from others– Others users of the environment


• Personal safety issues• Weather conditions• First aid equipment• Knowledge of location and of facilities (e.g.

Toilets, drinking water, route planning)• Possible hazards


• Public liability insurance

• Risk assessment

• Available space

• Any additional planning requirements

• Body weight exercises

Portable Equipment

• Hand weights/dumbbells

• Resistance bands

• Focus pads

• Medicine balls

• Stability balls

• Skipping ropes

Portable Equipment

• Step

• Benches

• Trees

• TRX

• Bosu

Long Term Behaviour Change for PT


• Explain why it is important for clients to understand the advantages of PT

• Explain why it is important for a PT to work together with clients to agree goals, objectives, programmes and adaptations

• Explain the importance of long term behaviour change in developing client fitness

• Explain how to ensure clients commit themselves to long term change

Advantages of Personal Training• Regular 1:1 contact with instructor to aid

motivation• Increased motivation and adherence• More frequent programme reviews• Formal reviews as scheduled and agreed

with client• Informal reviews, ongoing observation and

assessment at every session• Programmes updated and progressed more

regularly

Advantages of Personal Training

• Individualised programmes for the participant – more personal

• Programmes designed to address functional capability including core stability, postural deviations as well as client goals

• Reduced risk of injury whilst training

• Continuous feedback on technique

• Goals achieved by the client more quickly

Goals and Objectives• To ensure programmes truly address

client’s specific needs

• Client is paying for the service, therefore expects goals to be achieved

• Discuss the benefits of progressive exercise programmes

• Change programmes immediately if a client’s circumstances change

Strategies for Managing Change

• Behaviour

– Substituting alternatives– Rewards– Social support– Commitment


• Cognitive

– Increasing knowledge of benefits– Risks– Consequences– Understanding beliefs– Identifying healthier choices


• Humanistic

– Relationship between client and instructor

How to Use Strategies• Decision balance sheet to identify barriers

• Problem solving strategies for overcoming barriers

• Increase confidence

• Goal setting

• Action planning

• Promoting autonomy and interdependence (relational skills)

Approaches to Long Term Behaviour Change

Consider the following:

• How to plan an intervention to increase likelihood of participation

• How to integrate various methods of behaviour change in the development of an exercise programme

Social Support

• Friends

• Family

• Other service users

• Buddy systems and training partners

• Group exercise

Teaching Approach


•Learning styles (visual, aural, kinaesthetic)

•Verbal and non-verbal communication

•Equal opportunities (e.g. age, gender, race, disability)

Goal SettingAgree SMART goals (short, medium and long term)

SpecificMeasurableAchievableRealisticTime-framed

Principles of ProgressionApply the principles of progression, to include:

• Specificity

• Progressive overload

• Reversibility

• Adaptability

• Individuality

• Recovery time

Client CommitmentTo ensure client commitment, also consider the benefits of:

•A reward system•Self belief and visualisation techniques•Relapse strategies•Having a network of support

And consider the risks of overtraining and its impact on long term behaviour change

Collecting Information


• Explain the principles of informed consent

• Explain why informed consent should be obtained

• Summarise the client information that should be collected

Informed ConsentConsider the following:

• Adhere to the Code of Ethical Practice

• Identify health and safety considerations

• Refer to a GP or other medical professional where required

• Take into account data protection requirements

Client Information

Collect the following information:

• Personal goals– Future goals and aspirations– Expectations

Client Information


• Lifestyle information:– Work patterns– Eating patterns– Relevant personal circumstances– Stress levels– Hobbies/regular activities– Time available to exercise– Family/friends support

Client InformationCollect the following information:

• Medical history– Health history (health questionnaire)– Current health status (PARQ or alternative)– Risk factors– Identification of medical conditions requiring

medical clearance– Past and present injuries and disabilities– Postural analysis– Any musculoskeletal discomfort

Client Information


• Physical activity history– Past and current

• Physical activity likes and dislikes– Past and current

Client Information


• Motivation and barriers to participation– Attitude– Perceived barriers– Actual barriers– Intrinsic barriers (e.g. fear, embarrassment)– Extrinsic barriers (e.g. time, cost, family

commitments)


• Current fitness level– Evaluation of current levels of all components of

fitness, to include:• Muscular strength• Muscular endurance• Cardio respiratory fitness• Flexibility• Motor skills• Core stability • Functional ability

Client Information

Assess components of fitness by taking physical measurements as appropriate for the clients:•Blood pressure (manual and digital)•Anthropometrics (height and weight, waist circumference or waist to hips ratio)•Body Mass Index•CV fitness (e.g. Astrand bike test, Rockport walking test, step test, Cooper 12 minute walk/run)

Client InformationAssess components of fitness by taking physical measurements as appropriate for the clients:

•Range of motion (e.g. Sit and reach test, visual assessments during stretch positions)

•Muscular fitness (e.g. Abdominal curl/sit up test, press up test)

•Postural assessments (e.g. Squat technique, walking gait)


• Stage of readiness– Stated future goals and aspirations– Exercise readiness questionnaire

• Posture and alignment– Upper and lower body– Repetitive movement patterns that may cause issues

• Functional ability– Ability to carry out everyday tasks easily and pain free– Using an ADL questionnaire

How to Screen Clients


• Explain how to interpret information collected from the client in order to identify client needs and goals

• Explain how to analyse client responses to the PARQ

• Describe types of medical conditions that will prevent PTs from working with a client (unless they have specialist training/qualifications)

• Explain how and when PTs should refer clients to another professional

Information Gathering

• Select and record client information correctly

• Obtain consent to exercise

• Identify contraindications to exercise

• Recognise and defer clients where applicable

Information Gathering

• Consider methods for collecting objective information

• Consider methods for collecting subjective information

• Use additional questioning where required

• Check client’s understanding of the information collected

Analyse Client Response to PARQ


• Any ‘yes’ responses

• Client concerns regarding readiness

• Instructor concerns regarding readiness

• How to interpret client’s body language

• High blood pressure reading

Analyse Client Response to PARQ


• High heart rate reading (tachycardia ›100 bpm)• Low heart rate reading (bradycardia ‹60bpm)• Whether any additional questioning is required

Medical ConditionsThe following types of medical conditions will prevent PTs from working with clients (unless they have specialist training/qualifications):•CHD•Pre and post natal•Diabetes•Disability•Cancer •Stroke

Medical Conditions

The following types of medical conditions will prevent PTs from working with clients (unless they have specialist training/qualifications):•Severe musculoskeletal issues/injuries•Ageing (when resulting in age-related issues)•Exercise referral (specific controlled medical conditions)•Obesity•Rehabilitation patients

ReferralConsider the limits of your own expertise and competence in prescribing a progressive exercise programme. Refer where required to:

•GP

•Physiotherapist

•Other health professionals/consultants

•Senior colleague (if appropriately qualified)

How to Identify PT Goals with Clients


• Explain how to identify client’s short, medium and long term goals

• Identify when PTs should involve others, apart from their clients, in goal setting

• Explain how to use SMART objectives in a PT programme

Goal Setting

Identify short, medium and long term goals for the following:•General health and fitness•Physiological•Psychological•Lifestyle•Social•Functional ability

Goal Setting

• Short term goal: weekly (mini process goals)

• Medium term goal: 1 – 3 months (process goals)

• Long term goal: 3 – 6, 6 – 12 months (outcome goals)

Goal Setting

Consider involving others where appropriate:

• Positive ParQ – referral/deferral

• Family and friends for external support and encouragement

• GP or other health professional for medical reasons

Goal Setting

Use SMART goals to:

• Break down a long term goal into more achievable sub-goals and to enhance sense of progression/success

• Demonstrate progress against baseline measures

• Structure a PT programme

How to Plan a PT Programme with Clients


• Identify credible sources of guidelines on programme design and safe exercise

• Summarise the key principles of designing programmes to achieve short, medium and long term goals, including the order and structure of sessions

• Describe a range of safe and effective exercises/physical activities to develop all components of fitness

• Explain how to include physical activities as part of the client’s lifestyle to compliment exercise sessions

• Explain how to design programmes that can be run in environments not designed specifically for exercise

• Identify when it might be appropriate to share the programme with other professionals

Sources of Information

• ACSM guidelines

• Reputable internet sources

• British Heart Foundation (BHF) guidelines

• Reputable journals (e.g. BHF, REPs etc)

Principles of Programme Design

Apply the principles of FITT:

Frequency

Intensity

Time

Type


Consider ACSM guidelines:CV fitness• High intensity, low duration, or moderate to vigorous

exercise with longer duration• 64% and 70 – 94% of MHR• Those already physically active (in aerobic activity)

require intensities at high end of continuum• For most individuals intensities within a range of

77% to 90% of MHR are sufficient to achieve improvements in CV fitness


Consider ACSM guidelines:Muscular fitness

• F – 2-3 times a week• I – 8-10 exercises (1 per main muscle group),

1 set of 8-12 reps on each exercise, resistance 75% 1RM

• T – 20 minutes• T – resistance machines/free weights


Consider ACSM guidelines:Flexibility

• F – ideally 5-7 times per week• I – to the end of ROM at point of tightness• T – 15-30 seconds for each stretch• T – static stretches

Principles of Programme DesignConsider the following:

• Overload• Adaptation• Specificity• Reversibility• Progression• Regression• Rest and recovery

(during and between sessions)


Apply the principles of periodisation:

• Macrocycles: long term (outcome) goal

• Mesocycles: medium term (process) goals

• Microcycles: short term (process) goals, where the detail of each training session is applied

Principles of Programme DesignConsider the order and relevance of fitness components for each session:•Warm up•Flexibility (as part of warm up)•Balance, motor skills training, proprioception training•Core stability•Cardiovascular workout•Muscular conditioning•Cool down, including flexibility


CV Fitness

Consider the advantages and disadvantages of each training system:

• Interval

• Fartlek

• Continuous/constant pace training


Muscular FitnessApply the following (as appropriate):• Strength • Endurance • PowerUsing a range of:• Resistance machines• Free weights• Cables• Body weight exercises

Principles of Programme DesignRT machines:

Principles of Programme DesignExercise bands:

Principles of Programme DesignFree weights:

Principles of Programme DesignCables:


Flexibility:

•Static flexibility exercises

•Dynamic flexibility exercises

•PNF – assisted flexibility exercises

•Self myofascial release – foam rolling


Motor Skills

• Balance and coordination exercises

• Exercises that challenge proprioception/ spacial awareness


Core Stability

• Stabilisation core exercises for the spine

• Mobilisation core exercises for the spine

Principles of Programme DesignCore stability exercises:• Drawing-in manoeuvre (stabilisation)• Superman (stabilisation)• Floor bridge (stabilisation)• Plank (stabilisation)• Abdominal crunch (movement)• Reverse crunch (movement)• Cable rotation (movement)

Principles of Programme DesignAim to include physical activities as part of the client’s lifestyle to compliment exercise sessions, to include:

•Activities of daily living (e.g. gardening, housework, shopping, walking)•Benefits of using pedometers – walking•Leisure activities (e.g. sports, hobbies)•Family activities (e.g. family activity)•Variety to aid motivation and adherence•Cumulative effect of being more active on a daily basis

Include on programme card as agreed with client

How to Adapt a PT Programme with Clients


• Explain how the principles of training can be used to adapt the programme where required

• Describe the different training systems and their use in providing variety and in ensuring programmes remain effective

• Explain why it is important to keep accurate records of changes and the reasons for change

CV Training Systems

Consider the advantages and disadvantages of each of these training systems:

•Interval•Fartlek•Continuous/constant pace training•Circuit training•Random

CV Physiological Adaptations

RT SystemsConsider the advantages and disadvantages of each of these training systems:•Pyramid systems•Super setting (agonist/antagonist; agonist/agonist)•Giant sets•Tri sets•Forced repetitions•Pre/post exhaust•Negative/eccentric training•Stripping method•Cheating method

RT Anatomical and Physiological Adaptations

RT VariablesApply the variables to RT to programme design:

• Progressive overload• Exercise choice• Exercise sequence• Equipment• Environment• Split routines• Type of muscle contraction• Individuality (workout time; recovery time)

RT Mesocycles

• Hypertrophy

• Strength phase

• Power phase

• Peaking phase

• Active recovery phase

BiomechanicsApply the principles of biomechanics, toinclude:

• Centre of gravity• Momentum• Posture and alignment• Levers• Stability

Flexibility SystemsConsider the advantages and disadvantages of each of these training methods:

•CRAC (contract, relax, agonist, contract)•PNF (Proprioception Neuromuscular Facilitation)•Self myofascial release•Static•Ballistic•Dynamic•Partner stretching

Record Keeping

Maintain accurate records of changes, in relation to:

•Client’s short term and long term SMART goals•Correct intensity•Different exercise choices•Adaptations and modifications•Long term behaviour change

Using an appropriate programme card

Collecting Information about ClientsBy the end of the session you will be able to:

• Establish rapport with the client• Explain own role and responsibilities to clients• Collect the information needed to plan a

programme using appropriate methods• Show sensitivity and empathy to clients and the

information they provide• Record the information using appropriate formats

in a way that will aid analysis• Treat confidential information correctly

Establishing RapportConsider the following:• The importance of empathy, warmth, honesty

and genuineness• Identifying potential barriers to

instructor/client interaction• The use of effective questioning techniques• The importance of active listening skills• Understanding the significance of non-verbal

communication• The need to maintain client confidentiality

PT Role and ResponsibilitiesConsider the following:• The Code of Ethical Practice• REPs registration• Client/trainer contract outlining role and

responsibilities• Positive communication• Clear instructions and arrangements• Sources of help/contact• Professionalism

Recording of Information

Record information using appropriate formats, to include:

•Medical questionnaires, psychological questionnaires, lifestyle questionnaires

•Fitness assessment portfolio/records (CV fitness, muscular strength, muscular endurance, flexibility, body composition, neuromuscular efficiency, posture, BP)

Agreeing Goals with ClientsBy the end of the session you will be able to:

• Work with clients to agree short term, medium term and long term goals appropriate to their needs

• Ensure the goals are SMART

• Agree with clients their needs and readiness to participate

Agreeing Goals

Work with clients to agree short, medium and long term goals appropriate to their needs:•Client to agree and set a goal contract•Identify and agree appropriate goal evaluation procedures•Review process agreed with the client•Adopt a flexible approach according to the client’s needs and abilities•Ensure goals are SMART•Conduct a readiness to exercise questionnaire

Planning a PT ProgrammeBy the end of the session you will be able to:

• Plan specific outcome measures, stages of achievement and exercise/physical activities

• Ensure the components of fitness are built into the programme

• Apply the principles of training to help clients achieve goals

• Agree the demands of the programme with clients• Agree a timetable of sessions with clients• Agree appropriate evaluation methods and review

dates

Planning a PT Programme


• Identify the resources needed for the programme, including the use of environments not designed for exercise

• Record plans in a format that will help clients and others involved to implement the programme

• Agree how to maintain contact with the client between sessions

Planning a PT ProgrammeAgree a timetable of sessions with clients:• Short term plan (weekly session plan)• Medium term plan (e.g. 3 month plan)• Long term plan

(e.g. 6 month or 12 month plan)

Carry out regular reviews of:• Short term process goals• Medium term process goals• Long term outcome goals

Managing a PT Programme


• Ensure effective integration of all programme exercises/physical activities and sessions

• Provide alternatives to the programmed exercises/physical activities if clients cannot take part as planned

• Monitor clients’ progress using appropriate methods

Reviewing Progress with Clients

By the end of the session you will be able to:• Explain to clients the purpose of review• Review short, medium and long term goals with clients

at agreed points in the programme, taking into account any changes in circumstances

• Encourage clients to give their own views on progress• Use agreed evaluation guidelines• Give feedback to clients during their review that is

likely to strengthen their motivation and adherence• Agree review outcomes with clients• Keep an accurate record of reviews and their outcome

EvaluationReview the following:• Session aims• SMART goals• Activities• Client performance• Own performance (preparation and

delivery)• Health and safety

Adapting PT Programmes with Clients


• Identify goals and exercises/physical activities that need to be redefined or adapted

• Agree adaptations, progressions and regressions to meet clients’ needs to optimise achievement

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