Congratulations on taking the first step toward turning your passion into your career. We're here to help you succeed! For any questions, reach out to 805-876-9924, and a real ISSA trainer will be in touch. Foundations and Applications for a CERTIFIED PERSONAL TRAINER Tenth Edition CONTRIBUTORS Vanessa Scott, BS Senior Production Manager, ISSA Scottsdale, AZ Kelly Fortis, MA Gilbert, AZ Jenny Scott, MS, Senior Content Developer, ISSA Scottsdale, AZ Michelle Kirk, Ph.D Arlington, VA Jeremy Richter, MBA, MA San Diego, CA Rex Owens, BS, MSc. Sacramento, CA Daniel Ramos-Alvarado, MS El Dorado, CA John Bauer, BA Content Developer, ISSA Mountain View, CA Madison Grey, BA Content Coordinator, ISSA Tempe, AZ ACKNOWLEDGEMENTS Elite Editing Editing and Proofreading Services Baltimore, MD Eliteediting.com Pineapple Media Marketing and Design Solutions Toronto, ON www.pineapplemedia.ca Official course text for: ISSA’s Certified Personal Trainer 10 9 8 7 6 5 4 3 2 1 Copyright © 2021 ISSA LLC Produced by ISSA LLC, Phoenix, AZ, 85020 All rights reserved. No part of this work may be reproduced or transmitted in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including xerography, photocopying, and recording, or in any information storage and retrieval system without the written permission of the publisher. Direct inquiries about copyright, permissions, reproduction, and publishing inquiries to: ISSA LLC, 11201 N. Tatum Blvd Ste 300 Phoenix AZ 85028-6039 DISCLAIMER OF WARRANTY This text is informational only. The data and information contained herein are based upon information from various published and unpublished sources that represent training, health, nutrition, and genetics literature and practice summarized by ISSA LLC and Genetic Direction. The publisher of this text makes no warranties, expressed or implied, regarding the currency, completeness, or scientific accuracy of this information, nor does it warrant the fitness of the information for any particular purpose. The information is not intended for use, in connection with the sale of any product. Any claims or presentations regarding any specific products or brand names are strictly the responsibility of the product owners or manufacturers. This summary of information from unpublished sources, books, research journals, and articles is not intended to replace the advice or attention of health care professionals. It is not intended to direct their behavior or replace their independent professional judgment, If you have a problem or concern with your health, or before you embark on any health, fitness, or sports training programs, seek clearance and guidance from a qualified health care professional. SUBJECTS COVERED Foundations and Applications for a CERTIFIED PERSONAL TRAINER Psychology of behavior change Human anatomy and physiology Energy systems Human metabolism Biomechanics and human movement Principles of program design Flexibility training Cardiovascular training Resistance training Exercise selection and technique Cueing clients Nutrition and supplementation Common chronic health conditions Lifespan considerations Growing and marketing a personal training business Emergency management in fitness TABLE OF CONTENTS 1| HEALTH, FITNESS, AND PERSONAL TRAINING 7| CLIENT ASSESSMENTS 203 9 • Subjective Assessments 204 • The History of Personal Training 10 • Objective Assessments 209 • The Future of Personal Training and Fitness 17 • Body Composition Assessments 210 • ISSA Certified Personal Trainer Code of Ethics 18 • Cardiorespiratory Fitness Assessments 222 • VO2 Max Norms 227 2| PSYCHOLOGY OF BEHAVIOR CHANGE 21 • Muscular Strength and Muscular Endurance Assessments 228 • Behavior Change 22 • Movement and Posture Assessments 233 • Stages of Change 24 • Posture and Movement Assessments 236 • Processes of Change 26 • Interpreting Findings 247 • Motivational Theories and Applications 30 • Motivational Interviewing 38 8| ELEMENTS OF FITNESS 261 • Blending SDT and MI 44 • The Warm-up • Setting Goals That Motivate Behavior 45 • Flexibility Training 265 54 • Core Training 266 • Balance Training 268 • Reactive Training 272 • Scope of Practice 3| MOVEMENT SYSTEMS 57 265 • The Nervous System 59 • Resistance Training 278 • The Muscular System 70 • Cardiorespiratory Training 278 • The Skeletal System 80 • The Cooldown 281 • Joints in the Human Body 87 4| SUPPORTING SYSTEMS 95 9| PRINCIPLES OF PROGRAM DESIGN 283 • Acute Variables of Fitness 284 • The Circulatory System 96 • The Principles of Fitness 293 • The Lymphatic System 106 • Periodization 299 • The Respiratory System 108 • Overreaching and Overtraining 302 • The Endocrine System 111 • Training Categories and the Elements of a Fitness Program 304 • The Digestive System 120 • The Integumentary System 127 5| CONCEPTS OF BIOMECHANICS 129 10| CONCEPTS OF FLEXIBILITY TRAINING 311 • Methods of Flexibility Training 314 • Flexibility and the Principle of Specificity 315 • Anatomical Reference Terms 130 • Acute Variables for Flexibility 316 • Balance, Equilibrium, and Stability 138 • Dynamic Stretching 318 • The Laws of Motion 142 • Pre-Contraction Stretching 338 • Friction 148 • Static Stretching 343 • Levers 152 • Flexibility and Special Populations 359 • Torque 155 • Self-Myofascial Release 360 • Muscles as Movers 156 6| ENERGY AND METABOLISM 181 11| CONCEPTS OF CARDIOVASCULAR EXERCISE 367 • Cells 182 • Benefits of Cardiovascular Exercise 368 • Food as Energy 185 • Cardiovascular Training Principles 372 • Adenosine Triphosphate (ATP) 186 • Modifying Acute Training Variables 374 • Anaerobic Energy Production 188 • Measures of Cardiorespiratory Fitness 381 • Aerobic Energy Production 190 • Warm-Up and Cooldown 392 • Metabolism and Energy Balance 194 • Physiological Adaptations to Aerobic Exercise 393 • Modes of Cardiovascular Exercise 395 • Environmental Influences on Activity 409 12| CONCEPTS OF RESISTANCE TRAINING 413 18| BUSINESS AND MARKETING 661 • Benefits of Strength Training 415 • Styles of Personal Training 662 • Classifying Strength 417 • Starting a Personal Training Business 668 • Strength Curve 419 • Marketing a Business 671 • Strength Training and Training Principles 420 • The Client Life Cycle 680 • Physiological Adaptations to Anaerobic Exercise 426 • The Importance of Client Retention 686 • Modifying the Acute Training Variables 427 • Managing a Personal Training Business 687 • Resistance Equipment 437 • Personal Training Best Practices: • Comparing Free Weights and Weight Machines 440 • Body Weight Exercise 442 • Rep and Set Schemes 443 • Sample Strength Training Workouts 444 13| EXERCISE SELECTION AND TECHNIQUE 449 Advice from Seasoned Fitness Professionals • Code of Ethics 19| SAFETY AND EMERGENCY SITUATIONS 690 694 697 • Own the Fitness Floor 698 • Common Exercise Injuries and Injury Prevention 450 • CPR Certification 702 • Key Communication Principles 452 • Injury Prevention 704 • Cueing 455 • Emergency Equipment and Protocols 704 • Movement Categories 457 • When to Call Emergency Services 711 • Exercise Categories 490 14| NUTRITION FOUNDATIONS 507 • Macronutrients 508 • Water 528 • Micronutrients 530 • Dietary Guidelines and MyPlate 538 • Understanding Food Labels 543 • Common Diet Trends 546 • Portion Sizes 561 15| SUPPLEMENTATION 567 • What Is a Dietary Supplement? 568 • Nutritional Supplements 570 • Performance Supplements 583 • Ergogenic Aids 592 • Botanical Supplements 597 16| CHRONIC CONDITIONS 601 • Exercise and Hypertension 602 • Exercise and Diabetes 608 • Exercise and Arthritis 614 • Exercise and Coronary Heart Disease 621 • Exercise and Asthma 625 17| LIFESPAN POPULATIONS 631 • Exercise and Youth 632 • Exercise and Older Adults 641 • Exercise and Pregnancy 651 • Exercise and Adaptive Fitness 655 GLOSSARY 716 REFERENCES 765 ISSA | Certified Personal Trainer | 8 CHAPTER 01 HEALTH, FITNESS, AND PERSONAL TRAINING LEARNING OBJECTIVES 1 | Describe what a personal trainer does and who they can help. 2 | List the subject matter a successful personal trainer must be educated in. 3 | Describe the general benefits of personal training as it relates to exercise and physical activity. ISSA | Certified Personal Trainer | 9 CHAPTER 01 | HEALTH, FITNESS, AND PERSONAL TRAINING The fitness industry is a multibillion-dollar business bringing in more than $94 billion in 2019 according to the International Health, Racquet & Sportsclub Association (IHRSA). The industry includes fitness technology and wearables, wellness programs, large and small membership-based gyms, fitness studios, nutrition services, and physical recovery services. Within these aspects of fitness, personal training is one of the most prevalent. THE HISTORY OF PERSONAL TRAINING The roots of personal training are difficult to pinpoint. Some say personal training started in the 1950s, when personal trainers were first becoming actively certified, while others contend that personal training dates back to the beginning of recorded history. Dedicated health and fitness destination resorts dating back to the 1800s have been identified. While the profession and terminology associated with personal training did not yet exist, the concept of optimal health (which is the motivation behind the profession) was already being touted by ancient philosophers. Around 400 BCE (Before Common Era), Hippocrates wrote: Eating alone will not keep a man well; he must also take exercise. For food and exercise, while possessing opposite qualities, yet work together to produce health…and it is necessary, as it DSSHDUVWRGLVFHUQWKHSRZHURIYDULRXVH[HUFLVHVERWKQDWXUDOH[HUFLVHVDQGDUWLÀFLDOWRNQRZ ZKLFK RI WKHP WHQGV WR LQFUHDVH ÁHVK DQG ZKLFK WR OHVVHQ LW DQG QRW RQO\ WKLV EXW DOVR WR proportion exercise to bulk of food, to the constitution of the patient, to the age of the individual. PERSONAL TRAINING DEFINED The profession of personal training is a relatively new field that continues to expand its boundaries and redefine itself. Prior to the early 1980s, no minimal requirements existed to qualify or identify a person as a personal trainer. People engaging in training was fairly uncommon. Many learned about training solely through personal experiences in the gym. Recognizing the need for standardization and credibility, Dr. Sal Arria and Dr. Frederick Hatfield pioneered a program of personal fitness training that merged gym experience with practical and applied sciences. Today, a personal fitness trainer can be defined as a person who educates and trains clients in the performance of safe and appropriate exercises to effectively lead them to optimal health. Personal trainers can be self-employed (in-home and private) or work in health clubs, physicians’ offices, physical therapy clinics, wellness centers, schools, hospitals, rehabilitation facilities, and private studios. ISSA | Certified Personal Trainer | 10 What a Personal Trainer Knows As the industry continues to expand its boundaries and the realm of scientific knowledge concerning the human response and adaptation to exercise continues to grow, it is essential for personal trainers to be competent in the following topics and subjects: • Exercise programming • Exercise physiology • Functional anatomy and biomechanics BIOMECHANICS: • Fitness assessments The study of the mechanical laws governing movement of living organisms. • Nutrition and supplementation • Common chronic diseases CHRONIC DISEASES: • Basic emergency and safety procedures • Psychological and physiological challenges throughout the stages of life • Human behavior and motivation Conditions lasting a year or more that limit daily activities and/or requires ongoing medical attention. Arguably, the science of motivation and changing behaviors are the most important aspects of a successful health and wellness program. However, many fitness professionals do not know enough about either to effectively help clients make lasting change. A fitness professional’s ability to educate and effectively draw clients into the fitness lifestyle and optimal health comes from a plan that is based in the aforementioned areas as well as the knowledge of muscular, cardiovascular, and metabolic adaptations. These adaptations ISSA | Certified Personal Trainer | 11 CHAPTER 01 | HEALTH, FITNESS, AND PERSONAL TRAINING TRAINING EFFECT: The body’s adaptation to the learned and expected stress imposed by physical activity. are known as the training effect. The training effect is the body’s adaptation to the learned and expected stress imposed by physical activity. When the body experiences the training effect, it begins to change at the cellular level, allowing more energy to be released with less oxygen. The heart and capillaries become stronger and more dispersed to allow a more efficient flow of oxygen and nutrients. The muscles, tendons, and bones involved with this RESTING HEART RATE (RHR): The measure of heart rate when completely at rest. BLOOD PRESSURE: The force of blood pushing against the walls of the arteries during the two phases of the cardiac cycle. activity also strengthen to become more proficient. In time, the body releases unnecessary fat from its frame, and movements become more efficient. Additionally, resting heart rate (RHR) and blood pressure drop. These adaptations can be achieved with the help of an educated trainer who can develop an appropriate fitness and health plan for most individuals. To be effective, this plan must account for the basic principles of fitness training: overload, specificity, individual differences, reversibility, periodization, rest, overtraining, and stimulus variability. The plan requires a thorough understanding of the major muscles of the body and how they work, as well as an understanding of metabolism—how the body converts food into other forms of energy. In addition, trainers must learn about the function and regulation of the lungs, heart, blood vessels, hormones, brain, and nerves at rest and during exercise. Once a fitness professional has the knowledge and support to develop comprehensive, individualized, and periodized plans that effectively produce the training effect, they can make a drastic impact on the lives and health of their clients. THE CURRENT STATE OF HUMAN HEALTH The US surgeon general’s Physical Activity and Health report supports the role of physical activity for good health and disease prevention. The National Institutes of Health released a consensus statement on the importance of physical activity for cardiovascular health. In addition, the Centers HYPERTENSION: for Disease Control and Prevention (CDC) launched the Healthy People initiative, which lists physical High blood pressure reading more than 140/90 mm Hg. activity, fitness, and nutrition at the top of 22 priority areas. Finally, the American Heart Association included physical inactivity and low fitness levels, along with smoking, hypertension, and high RISK FACTORS: Variables associated with increased risk of disease or infection. OBESITY: An abnormal or excessive accumulation of bodyfat that may cause additional health risks. cholesterol, as primary risk factors for disease. Unfortunately, although the resounding benefits of physical activity and fitness are touted and reported, the United States is currently undergoing an obesity epidemic. In the United States, 25 to 35 percent of people remain sedentary (inactive). To make matters worse, federal resources and funding for physical activity programs have lagged far behind other aspects of health. Health and physical education in schools are low priorities, and when school districts are looking to trim their budgets, health and physical education programs are among the first expenditures to be reduced or cut altogether. ISSA | Certified Personal Trainer | 12 Each year in the United States, people spend more than $2.5 trillion on health care. This enormous figure translates into an expenditure of almost $7,000 for each member of the US population. Regrettably, this financial commitment has neither shown signs of abating nor produced satisfactory results with regard to treating a wide variety of chronic health problems. Attempts to identify the factors that have been major contributors to this virtual epidemic of medical problems have produced a litany of probable reasons why such a large number of individuals are so apparently unhealthy, including poor eating habits, sedentary lifestyle, stress, and poor health habits (e.g., smoking). At the same time, a number of studies have been undertaken to identify what, if anything, can be done to diminish either the number or the severity of medical problems affecting the public. These studies have provided considerable evidence that exercise and increasing physical activity has substantial medicinal benefits for people of all ages. PERSONAL TRAINING CLIENTELE According to IHRSA, as of 2019, health club memberships are projected to reach 230 million worldwide by the year 2030, and health club memberships among children under 18 years of age have increased by 187 percent since 1987. The number of people considering personal training services continues to grow. According to IHRSA’s annual Health Club Consumer Report (2019), 52.9 million Americans aged 6 years and older are members of health clubs. Over 12 percent of these members pay for the services of a personal trainer, and over 6 million health club members alone paid for a personal trainer this past year. In-home sessions, park boot camp sessions, and other nontraditional training sessions were not included in the gym data. Figure 1.1 Health Club Members by Generation (IHRSA, 2019) ISSA | Certified Personal Trainer | 13 CHAPTER 01 | HEALTH, FITNESS, AND PERSONAL TRAINING Here are some statistics from the report: • Three out of five personal training clients are women. • Clients report an average of 18 sessions with a trainer. • The average personal trainer charges between $15 and $100 per hour—with the average being $50 per hour. • The average number of training sessions used in 12 months breaks down as follows: SESSIONS PERCENTAGE 1-6 sessions 47 percent 7-11 sessions 12 percent 12-24 sessions 11 percent 25-49 sessions 8 percent 50+ sessions 11 percent Not reported 11 percent • The number of training sessions clients of different ages used break downs as follows: AGE RANGE SESSIONS 6-11 years old 22 sessions 12-17 years old 26 sessions 18-34 years old 15 sessions 35-54 years old 14 sessions 55+ years old 24 sessions These statistics support the growing trend and need for personal training services. While those 6 million people who purchased personal training services are sold on the need for personal training, there are many millions more who do not know or understand the benefits of hiring a personal trainer regardless of their health and fitness goals. This population represents the greatest opportunity for growth and income for fitness professionals. ISSA | Certified Personal Trainer | 14 BENEFITS OF PERSONAL TRAINING Two of the most widely publicized efforts to investigate the possible relationship between exercise and disease were longitudinal studies, each of which involved more than 10,000 subjects. In a renowned study of 17,000 Harvard graduates, Dr. Ralph Paffenbarger found that men who expended approximately 300 calories a day (the equivalent of walking briskly for 45 minutes) reduced their death rates from all causes by an extraordinary 28 percent and lived an average of more than two years longer than their sedentary classmates. Another study conducted by Dr. Steven Blair of the Cooper Institute for Aerobics Research in Dallas documented the fact that a relatively modest amount of exercise has a significant effect on the mortality rates of both men and women. The higher the fitness level, the lower the death rate (after the data was adjusted for age differences between the 13,344 subjects in this eight-year investigation). An analysis of the extensive data yielded by both studies suggests one inescapable conclusion: exercise is medicine! Accepting the premise that regular exercise can play a key role in reducing the risk of medical problems and decreasing health care costs is critical. Despite the vast number of individuals who lead a sedentary lifestyle, the need for and the value of exercising on a regular basis is an irrefutable fact of life (and death). For example, after a detailed review of the results of his long-term investigation, Dr. Paffenbarger concluded that not exercising had the equivalent impact on a person’s health as smoking one and a half packs of cigarettes a day. Fortunately, with few exceptions, most people are too sensible to ever consider ravaging their health by smoking excessively. Unfortunately, many of these same people fail to recognize the extraordinary benefits of exercise in the prevention of medical problems. ISSA | Certified Personal Trainer | 15 CHAPTER 01 | HEALTH, FITNESS, AND PERSONAL TRAINING Any list of the medical problems and health-related conditions that can be at least partially treated and controlled by exercise would be extensive. Exploring the most significant of these health concerns, here are details on how exercise is thought to help alleviate each condition: • Allergies: Exercise is one of the body’s most efficient ways to control nasal congestion (and the accompanying discomfort of restricted nasal blood flow). • Angina: Regular aerobic exercise dilates blood vessels, increasing blood flow and thereby improving the body’s ability to extract oxygen from the bloodstream. JOINT: An articulation between two bones in the body. • Anxiety: Exercise triggers the release of mood-altering chemicals in the brain. • Arthritis: By forcing a skeletal joint to move, exercise induces the manufacture of synovial fluid (fluid found in the cavities of synovial joints), helps to distribute it over the cartilage, and forces it to circulate throughout the joint space. CARTILAGE: Firm, flexible connective tissue that pads and protects joints and structural components of the body. • Back pain: Exercise helps to strengthen the abdominal muscles, the lower back extensor muscles, and the hamstring muscles (muscles in the upper back of the leg). • Bursitis and tendinitis: Exercise can strengthen the tendons, enabling them to TENDONS: Strong, fibrous cords made of collagen that attach muscle to bone. handle greater loads without being injured. • Cancer: Exercise helps maintain ideal body weight and helps keep body fat to a minimum. • Carpal tunnel syndrome: Exercise helps build up the muscles in the wrists and forearms, thereby reducing the stress on arms, elbows, and hands. • Cholesterol: Exercise helps to raise HDL (high-density lipoprotein, the “good” cholesterol) levels in the blood and lower LDL (low-density lipoprotein, the “bad” cholesterol) levels. • Depression: Exercise helps speed metabolism and deliver more oxygen to the METABOLISM: Chemical processes within the body that convert food into energy. brain; the improved level of circulation in the brain tends to enhance mood. • Diabetes: Exercise helps lower blood sugar levels, strengthen the skeletal muscles and heart, improve circulation, and reduce stress. DIABETES: A condition characterized by an elevated level of glucose in the blood. • Fatigue: Exercise can help alleviate the fatigue-causing effects of stress, poor circulation and blood oxygenation, bad posture, and poor breathing habits. • Glaucoma: Exercise helps relieve intraocular hypertension (the pressure buildup on the eyeball that heralds the onset of glaucoma). • Headaches: Exercise helps force the brain to secrete more of the body’s opiate-like, pain-dampening chemicals (e.g., endorphins and enkephalins). ISSA | Certified Personal Trainer | 16 • Heart disease: Exercise helps promote many changes—a decrease in body fat, a decrease in LDL cholesterol, an increase in the efficiency of the heart and lungs, a decrease in blood pressure, and a lowered heart rate—that collectively lower the risk of heart disease. • High blood pressure: Exercise reduces the level of stress-related chemicals in the bloodstream that constrict arteries and veins, increases the release of endorphins, HEART DISEASE: A term used to describe several different heart conditions. raises the level of HDL in the bloodstream, lowers resting heart rate (over time), improves the responsiveness of blood vessels (over time), and helps reduce blood pressure through maintenance of body weight. • Knee problems: Exercise helps strengthen the structures attendant to the knee (muscles, tendons, and ligaments), thereby facilitating the ability of the knee to withstand stress. • Lung disease: Exercise helps strengthen the muscles associated with breathing and helps boost the oxygen level in the blood. LIGAMENTS: Short bands of tough but flexible fibrous connective tissue connecting two bones or cartilages or holding together a joint. • Memory problems: Exercise helps to improve cognitive ability by increasing the blood and oxygen flow to the brain. • Menstrual problems: Exercise helps to control the hormonal imbalances often associated with premenstrual syndrome (PMS) by increasing the release of betaendorphins. • Osteoporosis (fragile bones): Exercise promotes bone density, thereby lowering an individual’s risk of experiencing a bone fracture. THE FUTURE OF PERSONAL TRAINING AND FITNESS The need for personal training services continues to grow. It is imperative that fitness professionals keep up with the evolving recommendations for health and physical fitness that have a direct application for fitness programs and exercise recommendations. With the emergence of the latest technologies, information regarding health and fitness is easily accessible. However, because of the plethora of confusing and conflicting health and fitness recommendations available, it is important that fitness professionals work to help clients, friends, and family members simplify the science, identify credible resources, and navigate the numerous fitness and nutrition myths. ISSA | Certified Personal Trainer | 17 CHAPTER 01 | HEALTH, FITNESS, AND PERSONAL TRAINING As individuals who are committed to a long-term career in health and fitness, personal trainers will continue expanding their knowledge through additional courses in corrective exercise, corporate wellness, youth fitness, senior fitness, nutrition, and pre- and postnatal specializations to better serve their clients in achieving and living the fitness lifestyle. This lifelong commitment to learning is also reflected in the personal training recertification requirements that remain a standard in the industry. Individually and collectively, personal trainers have an inherent responsibility to positively influence and guide the health and fitness attitudes of those around them. ISSA CERTIFIED PERSONAL TRAINER CODE OF ETHICS Upon receipt of the ISSA certificate, members effectively become representatives of a leader in the fitness certification industry and thus are expected to conduct themselves according to the highest standards of honor, ethics, and professional behavior at all times. These principles are intended to aid ISSA members in their goal to provide the highest quality of service possible to their clients and the community. ISSA | Certified Personal Trainer | 18 Requirements for Certification 1. Certification will not be issued to any student/member/candidate who does not successfully complete or meet all pertinent qualifications or has not achieved passing scores on the relevant ISSA examinations. 2. Certification will not be issued to any student/member/candidate unless they have successfully completed a cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) certification as evidenced by a current and valid CPR/AED card. Code of Ethics 1. The ISSA certified fitness professional shall maintain a professional client-trainer relationship at all times. Fitness professionals have the obligation to properly assess clients, program for their needs, and provide health care referrals as needed for the best interest of the client. They must respect the client’s choices and decisions regarding their own health and provide accurate, factual information. They shall not misrepresent their education or credential(s) or work outside of their scope of practice. 2. CARDIOPULMONARY RESUSCITATION (CPR): An emergency procedure involving chest compressions and, often, artificial ventilation to circulate blood and preserve brain function in an individual in cardiac arrest. AUTOMATED EXTERNAL DEFIBRILLATOR (AED): A portable electronic device that can identify and electrically correct heart arrythmias, ventricular fibrillation, and tachycardia. The ISSA certified fitness professional shall not discriminate on the basis of sex, gender, race, religion, national origin, color, or any other basis deemed illegal. 3. The ISSA certified fitness professional shall maintain any and all primary and supplementary certifications (including CPR certification as required) that are necessary to execute their job. They will not misrepresent their status in regard to certification or qualification to ISSA, clients, or an employer. 4. The ISSA certified fitness professional shall uphold their social responsibility to promote inclusion and educate and inform within the scope of practice. 5. The ISSA certified fitness professional shall use their best judgment to maintain a safe training environment for clients. This includes the space being used and the movements being executed. At no time shall harm to others be intended. ISSA | Certified Personal Trainer | 19 ISSA | Certified Personal Trainer | 20