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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
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Official course text for: ISSA’s Certified Personal Trainer
10 9 8 7 6 5 4 3 2 1
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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
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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
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