The Marketing Mix: the Four “P’s” of Marketing
● PRoduct: communicate benefits of using product
● Price: identify competitive price of service
● Promotion: determine how the service will be promoted
● Place: select place/method of distribution
Basics of Behavior Change
● Health Belief Model: people are motivated to make change due to risk or perceived risk
of health issues (ie high blood pressure, diabetes, ect)
● Self Determination Theory: people are motivated to make change due to competence,
connection, and autonomy
● Competence: motivated because individual has the necessary skills to achieve
their goals
○ Enhanced when receive positive reinforcement/feedback
● Connection/relatedness: motivated due to connection to others
● Autonomous: motivated due to free will (intrinsic) and being in control of their
goals/actions
Exercise environments: task vs. Ego involving:
● Task involving: focuses on individual effort and improvement
○ Improves self-confidence and autonomy
● Ego involving: competition
○ Can increase anxiety and reduce chances to achieve goals
Transtheoretical model of behavior change: examines clients individual readiness to achieve
change
● Precontemplation: no intention of changing
○ Best strategy is education
● Contemplation: don't exercise but thinking about increasing activity
○ Best strategy is listening and education
● Preparation: do exercise but planning to do so more regularly
○ Best strategy is to help create goals and time management
● Action: started to exercise but have not maintained routine for more than 6 months
○ Best strategy is to help clients create action steps to maintain progress/activity
● Maintenance: maintained regular exercise for more than 6 months
Process of change: purpose to help client move from stages of change
Self-efficacy: one’s belief to engage in activity, self-management, and goal-achievement
● Developed through 6 sources of information:
a. Past performance experience:
b. Vicarious experiences:
c. Verbal persuasion:
d. Physiological state appraisals:
e. Emotional state and mood appraisals:
f. Imaginative experiences:
Principles of behavioral change:
1. Operant conditioning: behaviors are influenced by their consequences
a. Antecedents: stimuli that precede behavior and often signal likely consequences
of the behavior
b. Stimulus control: when antecedents are manipulated in the environment to
maximize desirable behaviors
i.
Ex: setting an alarm extra early for someone who is always late
c. Consequences of operant conditioning:
i.
Positive reinforcement: presents positive antecedents to increase
likelihood of recurring behavior
ii.
Negative reinforcement: removing or avoiding aversive stimuli following
undesirable behavior
iii.
Extinction: positive stimuli is removed; unlikely that the behavior will
reoccur
iv.
Punishment: decreases the likelihood of the behavior recurring
Behavior-Change Strategies:
1. Stimulus control:
a. Make adjustments to the environment to increase likelihood of healthy behaviors
b. Willpower
2. Written agreements and behavioral contracting
a. Can be used together or individually; client MUST have an active role in the
development
3. Cognitive Behavior Strategies
a. Goal setting (SMART goals)
b. Feedback (intrinsic or extrinsic)
i.
As efficacy and ability improve, trainer reduces external feedback to allow
client to provide feedback for themselves
4. Decision making: gives client control over their own program participating
a. Trainer shouldn't make every decision/micromanage
b. Give clients knowledge to be successful on their own
5. Self-monitoring: helps clients keep track of program progress and identify barriers
a. Requires honesty and self-reflection from clients; can include journaling
Trainer-Client Relationship Stages:
1. Rapport: building mutual trust
a. Builds overtime
b. Verbal and nonverbal communication is important:
i.
Voice: not too loud or too soft; confident
ii.
Maintain friendly eye contact when speaking
iii.
Facial expressions: be genuine
iv.
Hand gestures: minimize while listening to guest:
v.
Body language: attentive and positive
2. Investigation: review client’s health and fitness information, gather information regarding
medical clearances, health risks, goals and exercise history
a. Use the following strategies to demonstrate listening and reaffirm client’s
engagement:
i.
Encourage
ii.
Paraphrase
iii.
Ask open-ended questions
iv.
Reflect
v.
Summarize
3. Planning: trainer plans exercise plan with client, who is ready to begin training
a. Set goals
i.
SMART goals: Specific, Measurable, Attainable, Relevant, Time-bound
ii.
Process goals: goals the client does (ie workout 3x/week)
iii.
Product goals: goals the client achieves (ie weight loss)
b. Form/discuss alternatives
c. Create plan
d. Evaluate plan in action
e. Motivational interviewing: ask probing questions, listen to and engage in friendly
conversation effectively, provide education, build self-confidence, and encourage
4. Action: Client begins training using exercise program
a. Teach new motor skills
b. Help client set up self-monitoring system
c. Use individualized teaching techniques:
i.
Tell - show - do
ii.
Remind client it takes time to develop skills and provide them opportunity
for focused practice
Learning Stages:
1. Cognitive learning stage: show - tell - do
2. Associative learning stage: provide appropriate feedback that is balanced (ie not too
much or too little)
3. Autonomous learning stage: client demonstrates effective performance of motor skills
a. Less teaching and more monitoring for trainer
Health Risk assessment: identify risk and negative risk factors to determine if client needs
medical clearance and/or medically supervised program
● PAR-Q assessment: Physical Activity Readiness Questionnaire
○ Minimal health risk appraisal prereq
○ Quick and easy to administer (non-invasive)
○ Limited by lack of detail
Positive Risk
Factors
Criteria
Points
Age
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Men: 45+
Women: 55+
1
Family History
●
●
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Myocardial Infarction
Coronary revascularization
Sudden death before 55 in father or 65 in mother
1
Cigarette Smoking
●
Current smoker OR quit smoking within 6 months
1
Sedentary Lifestyle
●
< 30 minutes of moderate intensity 3x/week for
minimum of 3 months
1
Obesity
●
●
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BMI of 30+ and/or
Men: Waist measurement of 40 inches
Women: waist measurement of 35 inches
1
Hypertension
●
●
Systolic BP of 140+ or diastolic BP of 90+
Must be confirmed on at least two measurements
or by taking antihypertensive medication
1
Dyslipidemia
●
●
●
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LDL cholesterol 130+
HDL cholesterol < 40
Total serum cholesterol 200+
Taking lipid-lowering medication
1
Prediabetes
●
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Fasting plasma glucose >100 but <120
Or impaired glucose intolerance (140+) confirmed
on 2 separate measurements
1
Negative Risk
Factors
HDL Cholesterol
Criteria
60+ mg/dl
Points
-1
Following PAR-Q health-risk appraisal, determine risk classification:
1. Low risk: less than 2 risk factors
a. Medical exam, exercise test, and doctor supervision not needed
2. Moderate risk: 2+ risk factors
a. Medical exam for MODERATE exercise not needed
b. Medical exam for VIGOROUS exercise IS NEEDED
c. Exercise test and doctor supervision not needed
3. High risk: symptomatic or know CV, pulmonary, renal or metabolic (diabetes) disease
a. Medical exam and exercise test for moderate AND vigorous exercise IS
NEEDED
b. Doctor supervision for exercise test recommended
Health conditions affected exercise:
● Cardiovascular
○ Atherosclerosis: fatty deposits from cholesterol and calcium buildup in artery
walls
■ Causes thickening of arteries, loss of elasticity of arteries, angina,
possible myocardial infarction, and heart attack
● Respiratory:
○ Bronchitis (COPD): leading cause is smoking, then gastroesophageal reflux
disease; causes regular cough with mucus
○ Emphysema (COPD): linked to smoking and preventable but not curable; causes
shortness of breath, wheezing, ect
○ Asthma
○ Chronic Obstructive Pulmonary Disease (COPD): chronic inflammatory lungs that
causes obstruction of airflow
● Musculoskeletal: consists of muscles, bones, tendons, and ligaments
○ Sprains: ligaments connect bone to bone
○ Strains: tendons connecting muscle to bone
○ Overuse injury (most common)
○ Herniated discs: fragment of disc is pushed into the spinal cord
○ Bursitis: sacs that cushion bones/muscles/tendons near joints become inflamed
○ Tendinitis: inflammation/irritation of tendons (tendons attach muscle to bone)
○ Arthritis: inflammation of 1+ joints
○ Atrophy: muscle loss
● Metabolic: diseases that interfere with metabolism/utilization of energy
○ Diabetes: inability to produce/process insulin
○ Thyroid disorders:
○ Hernia:
○ Pregnancy:
○ Illness/infection
● Medications
○ Antihypertensive: used to treat hypertension (high-blood pressure)
■ Beta blockers: limit sympathetic nervous system
● USE RPE instead of HR if client is on beta-blockers
● Can also increase, decrease, or not effect resting and exercise HR
■ Calcium channel blockers
● No significant change in max exercising HR
Conducting Cardiovascular Assessments:
● Take pulse manually through radial artery (inside of wrist on thumb side)
● Resting heart rates (RHR)
○ Normal: 60-100 BPM
○ Slow (bradycardia): less than 60 BPM
○ Fast (tachycardia): over 100 BPM
○ Overall average: Women 72-80 BPM and men 60-70 BPM
■
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Women have faster average BPM because of smaller heart chamber,
lower blood volume, and lower hemoglobin (protein in red blood cells that
carry oxygen to the body)
○ Body
Measure exercise heart rate (HR)
○ Measure pulse for 10 seconds then multiply by 4 OR measure of 15 seconds and
multiply by 4
Rating of Perceived Exertion: used to identify intensity levels of exercise
○ 6-11: HR of 60
○ 12-16: HR or 120
○ 17-20: HR of 200
Assessment Types:
● Push-Pull Assessments:
○ Perform up to 20 reps so that trainer can accurately assess movement efficiency
and potential muscle imbalances
● Static postural assessments: assesses client’s posture and potential movement
compensations while standing statically
○ Other assessment exercises: overhead squat assessment
○ Postural deviations:
■ Scoliosis: lateral (side-to-side) curvature
■ Lordosis: inward curvature
■ Kyphosis: outward curvature
● Cardiorespiratory assessments:
○ Talk Test: perceive client’s ventilatory threshold (breathing levels) during
cardiovascular exercise by ability to speak directly following exercise
■ Used as a primary assessment for clients exercising in ventilatory
threshold one
● ventilatory threshold one: 50-75% VO2; cannot speak comfortably
but can put together some words/sentences
○ Ratings of Perceived Exertion (RPE): subjective measure of client’s perceived
exertion during cardiovascular exercise
■ Trainers ask clients questions about how they are feeling to determine
RPE on a scale of 1-10 or 6-20 (Borg)
○
Muscle Contraction types:
● Concentric: muscle shortens under load; overcoming load
○ Ex: quads during upward phase of squat
○ Ex: push part of push-up
● Eccentric: muscles lengthen under load/tension
○ Ex: quads during downward phase of squat; resisting load
○ Ex: lowering of body during push-up
● Isometric: muscles do not shorten OR lengthen under load; there is little movement
○ Ex: hips contract isometrically during squat to stabilize hip joint during movement
Roles of Skeletal Muscles during movement
● Agonist: “prime movers” that provides main force to complete movement
○ Not always the muscle that is contracting concentrically (shortening); can be a
concentric or eccentric contraction
■ Ex: bicep muscles use both concentric and eccentric contraction in bicep
curl, and are the agonists in both contractions because they are the prime
movers
○ Ex: biceps in bicep curl; triceps in arm extension
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Antagonist: muscles that oppose the agonist; typically relax so as to not impose the
agonist OR slow down/stop movement
○ Ex:triceps in bicep curl; biceps in arm extension
○ Altered reciprocal inhibition: overactive agonist muscle causes decreased
function in the antagonist
Synergist: muscles that stabilize joint during the movement to help the agonist function
effectively; also help to create the movement
○ Ex: brachioradialis and brachialis during bicep curl movement to stabilize the
elbow joint
○ Synergetic dominance: synergist muscle takes over agonist muscle
■ Ex: hamstrings (synergist) replaces glutes as prime mover (agonist)
during hip extension
Fixator: muscles that stabilize the origin of the agonist and the joint that the origin moves
over to help the agonist function effectively
○ Ex: rotator cuff (guardians of the shoulder joint) during bicep curl
○ Most fixator muscles are in the hip and shoulder joints
Co-contraction: simultaneous contraction of two or more muscles in the joint
○ Determinate factor of evaluation of motor control
Speed, Agility, and Quickness Training
● Speed: body’s ability to move as fast as possible and determined by stride rate and
stride length
● SAQ (Speed, Agility, Quickness) exercises
○ Appropriate # of exercises for different levels:
■ Beginner: 4-6
■ Intermediate: 6-8
■ Advanced: 6-10
○ Example exercises for seniors: stand up figure eight
○ Example exercises for youths: follow-the-snake, redlight-greenlight
■ 1-3 sessions/week; 4-8 drills/session; 1-4 sets/drill; 3-5 reps/set
○ Example exercises for weight loss: circuits
Plyometric Training: speed and force training
● Low intensity drills
○ Beginners: 80-100
○ Intermediate: 100-150
○ Advanced: 140-200
Kinetic Chain: interrelated groups of joints, body parts, and muscles that work together to
provide movement in the body; consists of muscular, articular, and neutral systems
● Upper kinetic chain: fingers, wrists, forearms, elbows, upper arms, shoulders, shoulder
blades, and spinal column
● Lower kinetic chain: toes, feet, ankles, lower legs, knees, upper legs, hips, pelvis, and
spine
●
○ Each link of the chain is capable of independent movements
Closed vs. open chain: dependent on whether distal part of chain is either free (open) or
restricted (close) to move
○ Closed: rest of chain will move towards fixed end of the extremity
■ Tend to be “functional” aka targets and utilizes multiple muscles to provide
joint stabilization
■ Ex: during a squat, ankles, upper/lower legs, knees, hips and pelvis will
move toward the feet (fixed extremity chain)
● Closed chain exercises: squat, lunges, wall sits, push up, pull up
○ Open: distal end of extremity is free to move
■ Tend to target only one muscle
■ Ex: during a bicep curl, the fingers (distal end of upper kinetic chain) is
free to move
● Open chain exercises: lat pulldown, hamstring curl, bicep curl,
seated leg extension
Muscular Training Principles:
● Progression: in order to progress strength, must progress training
○ Ex: increase reps, weight, sets, ect.
○ Can also be used in cardiovascular training
● Specificity: train a specific way to achieve specific goals
○ Ex: target arm/shoulder muscles during training to improve rope-climbing ability;
target cardiovascular training of slow-twitch fibers for running a half marathon
● Overload: increase intensity, duration, type and/or time progressively to achieve results
○ Ex: increase load by 5%
● Reversibility: when you stop training, you lose gains/progress in ½ the amount of time
○ Ex: build 4 pounds of muscle in 10 weeks = lose 4 pounds of muscle in 5 weeks
● Diminishing Returns: as strength increases, it takes longer to make progress (ie
“plateau”)
○ Changes training program/exercises when plateauing
Energy Systems
1. ATP-CP System: Adenosine tri-phosphate responsible for short, quick movements (6-10
seconds/1-2 rep max)
2. Glycolytic System: kicks in after 10 seconds of ATP-CP and responsible for short, quick
movements that are slightly longer (ie 200m sprint)
3. Oxidative System: relies on energy converted from fat/carbs to do aerobic exercise
The Five (5) Biomechanical Processes that Occur During a Warm-Up:
1. Cardiorespitory: increased utilization of oxygen by muscles
2. Blood flow: increased blood flow to active muscles:
3. Body Temp: increased body temp
4. Motor skills and brain transmissions: move faster
5. Discomfort from muscles to cardiorespitory system
Three (3) Groups of Proprietors:
1. Ligament, joint, and skin
2. Neck and ear
3. Muscle
Resistance Training Concepts:
● Progression: when clients demonstrate mastery of movement, progress clients to more
challenging movements
○ Ex: alternating arms to single arm for upper body
Guidelines for Clients with Chronic Disease:
1. Metabolic
2. Coronary Artery Disease (CAD)
3. Hypertension
a. Clients with hypertension should be taught RPE to self-regulate
4. Stroke:
a. Activity lasting 3-5 minutes with long resting periods in between activities
5. Diabetes
6. Asthma
7. Hypoglycemia: lower blood glucose levels than normal
a. Clients should exercise after eating a meal as it is the time glucose levels will be
closest to normal
8. Degenerative Disk Disease: spine gets worn down and eventual degenerates
a. Occurs in people ages 30-50 and most common in the thoracic spine
b.
General Adaptation Syndrome (GAS): introduction of stress on the body
● Stages of GAS:
a. Alarm: increased soreness, questions program/exercise, decreased performance
b. Resistance: “good” stress, getting used to stress/soreness, minimized soreness,
increased performance
c. Exhaustion/Overtraining: overtraining, increased stress/irritability, decreased
performance, less recovery time
● Specific Adaptions of Imposed Demands (SAID): body and mind will adapt to the specific
demands, stress, and exercises for training specific muscles in order to achieve a
specific goals
Functions of the trachea
Connective Tissue (Largest to Smallest):
1. Epimysium: encases the muscle
2. Perimysium: acts as connective tissue between muscle fibers
3. Endomysium: encases single muscle fiber (or cell)
Sliding Filament Theory: myosin binds to actin, altering the configuration of the actin to cause it
to slide across the myosin filament
● Shortens the arcomere, but does not change the actual length of the myosin/actin
● ATP is the fuel source
● Sarcomere: basic contractile unit of a muscle
Biomechanical definition of “work”: force x distance
Questions of the day:
● Glycolytic enzymes are lower in children than adults, meaning that they cannot
comparatively participate in high-intensity exercise for an extended amount of time
○ Glycolytic enzymes: related to performance ability of high-intensity exercises
● Training for sedentary clients is optimal at 2x/week
● SAQ (Speed, Agility, Quickness) exercises
○ Appropriate # of exercises for different levels:
■ Beginner: 4-6
■ Intermediate: 6-8
■ Advanced: 6-10
○ Example exercises for seniors: stand up figure eight
○ Example exercises for youths: follow-the-snake, redlight-greenlight
■ 1-3 sessions/week; 4-8 drills/session; 1-4 sets/drill; 3-5 reps/set
○ Example exercises for weight loss: circuits
● Frontal vs Sagittal vs. Transverse plane:
○ Frontal plane: cuts body into front and back
■ Includes any lateral (side) movement parallel to front/back plane:
● adduction, abduction, lateral flexion of the spine,
eversion/inversion of the foot/ankle
● Ex: dumbbell lateral side raises, banded lateral walks
○ Sagittal plane: cuts body into left and right
■ Includes any forward/backward movement parallel to this plane
● extension, plantarflexion, dorsiflexion, and flexion
● Ex: bicep curls, forward and reverse lunges, squats, deadlifts, pull
ups
○ Transverse plane: cuts body into top and bottom
■ Includes any movements parallel to the waistline:
● rotation, pronation, supination, arm adduction, arm abduction
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● Ex: clamshells, side plank w/rotation, twisting lunges
Knock knees during overhead squat assessment: includes all of the following altered
joint mechanics
○ Decreased hip abduction, increased hip adduction, and restricted ankle
dorsiflexion
Muscle contraction and the sarcomere:
○ Sarcomere: combination of actin and myosin in the myofibrils
○ During muscle contraction, myosin (thick) filaments bind with actin (thin) filaments
by forming cross bridges. The thick (myosin) filaments pull thin (actin) filaments
past them, making the sarcomere shorter
Over-ingestion of iron:can cause gastrointestinal irritation and interfere with the
absorption of other minerals/vitamins, including zinc
Rotator cuff muscles: includes infraspinatus, supraspinatus, teres minor, and the
subscapularis
Purpose of corrective flexibility: improves muscle imbalance, range of motion, and
altered joint motion
○ Includes self-myofascial release and static stretching
○ Should be used in Phase 1 training
○ Enacts autogenic inhibition and reciprocal inhibition
■ Autogenic inhibition: ability of muscle to relax while stretching/under
tension
● Important because it prevents muscle/tendon from experiencing
extreme tension
■ Reciprocal inhibition: ability of muscle to relax on ONE SIDE of joint to
accommodate for contraction on other side of joint
● Occurs in the OPPOSITE muscle
● Important for protecting muscle from injuries
OPT model: used by trainers for strength-endurance training of clients
○ Phase 1: stabilization endurance
○ Phase 2: strength endurance
○ Phase 3: hypertrophy
○ Phase 4: maximal strength
○ Phase 5: power
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Five Stages of Cardiovascular Training:
○ Phase 1: light to moderate exercise (RPE 3-4/Borg 12-13)
○ Phase 2: challenging to hard (RPE 5-6/Borg 14-15)
■ Noticeable sweating, larger breaths, talking becomes more challenging
○ Phase 3: vigorous to very hard (RPE 7-8/Borg 16-17)
■ Profuse sweating and limited speaking ability
○ Phase 4: extremely hard (RPE 9-10/Borg 18-20)
■ Breathing as heard as possible, speaking is impossible/extremely limited
Upper-crossed Syndrome *UCS): characterized by forward-favoring head and rounded
shoulders
○ Possible causes: bad back posture, muscle imbalance, muscle tightness
○ Increased cervical extension, scapular protraction/elevation, decreased shoulder
extension and shoulder external rotation
○ Can hinder individual’s range of motion (ROM) and lead to discomfort/muscle
imbalance
○ Potential effects on health: headaches, biceps tendonitis, rotator cuff
impingement
○ Possible signs of UCS in overhead squat assessment: arms falling forward or to
the side, elbows flexed/challenged to stay straight, head leaning forward,
elevated shoulder blades
○ Exercises for UCS: floor cobra, chin tucks, myofascial release stretching, rotating
neck stretches
Lower-crossed syndrome (LCS):
○ Possible causes: muscle weakness/tightness of abs, glutes, and hamstrings;
overactivity and tightness of hip flexor muscles
○ Results in anterior tilt of pelvis, increased flexion of the hips, and hyperlordosis in
spine (excessive curvature of spine in lower back)
○ Possible effects on health: Hamstring complex strain anterior knee pain, and
lower back pain
Pronation distortion syndrome: flat feet causes tibia to rotate INTERNALLY
○ Possible effects on health: plantar fasciitis, posterior tibial tendonitis, patellar
tendonitis, and lower back pain
○ suppation : flat feet causes tibia to rotate externally
Types of fatty acids: fats are classified based on their level of saturation of hydrogen
(aka, why some fatty acids are classified as saturated- with hydrogen- or unsaturated)
○ Trans-fatty acids: unsaturated fatty acids that have been saturated to make them
harder at room temp and increase shelf life
○ Monounsaturated fatty acids: unsaturated fats
○ Polysaturated: contain multiple areas that are NOT saturated
○ Triglyceride: type of fat found in blood
■ Body converts calories not needed right away into triglycerides; hormones
release them between meals to provide body energy
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High triglycerides can be a sign of diabetes, metabolic syndrome (high
blood pressure, obesity and high blood sugar occur together), and lower
levels of thyroid hormones
Ischemia: body (esp brain) is not getting enough blood oxygen due to build up/blockage
in arteries
○ Can cause heart attack, stroke, leg pain, mesenteric ischemia (holes in
intestines)
○ Symptoms include chest pain, increased heart rate, pain in jaw/neck/shoulder,
nausea, fatigue, and shortness of breath, headaches, and dizziness
Atherosclerosis: cardiovascular disease characterized by hardening of arteries as well as
thickening of arterial walls and loss of elasticity.
Respecting personal space: give client 1.5-4 feet of space
Beta blockers: medication used for high blood pressure (hypertension)
○ decreases blood pressure AND heart rate while exercising
Reciprocal inhibition: neuromuscular reflex that inhibits opposing muscles during
movement
○ Can be improved by stretching
Diuretic: anti-hypertensive medication used to lower blood pressure
○ Different from beta blockers as they have NO significant effect on exercising or
resting heart rate
○ Effects the balance of water and electrolytes in the body
Causes of muscle imbalances:
○ Poor form
○ Structural issues
○ One-side dominance
ABC: Airways, Breathing, Circulation
○ Check these in order when a client is unconscious and unresponsive
Mechanoreceptors: allow an organism to recognize and respond to physical pressure by
relaying information back to the central nervous system
○ Include muscle spindles, Golgi tendon organs, and joint receptors
Replacing fluids:
○ For each pound of body weight lost during exercise, consume 600 ml of water
Joint and Muscle Anatomy
5 PArts of the Spinal Column (total 22 vertebrae)
● Cervical curve: 7 vertebrae
● Thoracic curve: 12 vertebrae
● Lumbar curve: 5 vertebrae
● Scum: 5 fused vertebrae
● Coccyx: 5 fused vertebrae
Directional terminology:
● Anterior: towards the front
● Posterior: backwards; toward the rear
○ Ex stretches: active kneeling hip flexor; posterior flies, trap extensions
● Lateral: side to side, away from the midline
○ Ex stretches: lateral bending (seated or standing)
● Inferior: downwards
● Superior: upwards