Active Endorsement
National Occupational Standard
CPD Mapping Toolkit
D522
CPD Mapping Toolkit
© SkillsActive 2013
Design, agree and adapt
a physical activity
programme for adults
with long term
neurological conditions
(LTNCs)
Page 1
Mapping CPD Courses to National Occupational Standards (NOS)

NOS or ‘standards’ establish the benchmark of competence required in different
fitness industry roles/skills. Each NOS consists of a detailed breakdown of the
minimum skills and knowledge needed to be competent.

Developed in conjunction with technical experts and employers, NOS act to ensure
employability skills are reflected in qualifications and CPD.

Training providers are required to part-map CPD courses to demonstrate
occupational relevance (e.g. to the learner and employer). N.B. There is no
requirement to fully-map CPD to the NOS.
How to Complete this Mapping Toolkit
1.
Review the content of your course (including learning outcomes and assessment
criteria) in relation to the NOS contained within this mapping toolkit.
2.
Demonstrate how and where your CPD course covers the NOS by completing
the relevant sections within the ‘Mapping Evidence’ column throughout this
mapping toolkit.
3.
Mapping need only be completed for elements of the NOS where there is a clear
link to content and/or assessment covered by the CPD course. All areas that are
not covered by the CPD should be left blank or denoted as not applicable (N/A).
You will not be penalised for leaving mapping blank where it is irrelevant to your
course.
4.
The information you add to the ‘Mapping Evidence’ column can include any
aspect of course delivery/resources/assessment etc such as, PowerPoint
presentations, course manuals, handouts, assessments, lesson plans. It is,
however, important that you are able to submit anything you have mapped as
evidence for the endorsement process.
CPD Mapping Toolkit
© SkillsActive 2013
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D522
Design, agree and adapt a physical activity
programme for adults with long term
neurological conditions (LTNCs)
Summary
Patients with long-term neurological conditions (LTNCs) are at present poorly served with regard
to exercise referral, despite a growing evidence base confirming the value of exercise for this patient
group.
Hospital and GP referral of individuals with LTNCs to tailored exercise programs is at present
limited, though the benefits to be accrued are being increasingly realised by both individual health
practitioners and societies such as the MS Society and the Parkinson’s Disease Association. Delivery
of such services should follow guidelines which provide guidance on participant inclusion /exclusion
criteria and competency of instructors, to ensure safe effective practice and protect the interests of
participants and instructors.
Practitioners and other healthcare professionals may specifically direct a patient to suitably trained
instructors and facilities where a structured and individualised physical activity programme can be
designed and delivered for them, including home exercise.
Fitness instructors who are responsible for designing and delivering structured and individualised
physical activity programmes for participants with a LTNC or assigning them to an appropriate
physical activity must have a range of appropriate knowledge and skills specific to current guidelines
and monitoring the effects of the programme on their conditions. These instructors should have
established close liaison with neurology health professionals in their local area.
Tailoring an exercise programme will use many of the core aspects of programme design and
delivery such as communication skills, principles of training and guidelines for teaching. In addition,
there are specific knowledge and skills related to working practice and the technical exercise aspects
to consider in programme design including: understanding of the particular disease process and how
it is managed; how physical activity influences the disease process; the positive and negative aspects
of physical activity on neurological disease; an understanding of relevant medications and their
influence on the individual's ability to exercise, and also psycho-social issues. The latter are
particularly important to LTNC patients in terms of perceived barriers to exercise participation,
such as transport and the lack of appropriately skilled instructors, which deter many of them from
embarking on exercise programs
This unit is designed to cover LTNCs, except for stroke which is covered in a separate unit,
and includes the skills and knowledge required to prescribe safe and effective exercise programmes
for this patient group.
Elements covered:
D522.1 Design and agree a physical activity programme for participants with
LTNCs
D522.2 Deliver, review and adapt a physical activity programme for participants
with LTNCs
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© SkillsActive 2013
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D522.1
Design and agree a physical activity programme for participants with LTNCs
Competencies/Skills
1
establish an effective working relationship with participants, their
carers and appropriate health care professionals
2
collect, record and interpret information about your participant
with neurological disease using safe, appropriate and recognised
methods, ensuring to liaise with health care professionals
regarding the interpretation of information, as required
Mapping Evidence
Information to cover:
a) personal goals
b) referral form
c) informed consent to participate to transfer medical
information
d) medical history and medication
e) current and previous physical activity history and
preferences
f) functional capacity and risk assessment
g) social and psychological considerations
h) outcome measurement
Methods to cover:
a) reports
b) interview
c) questionnaire
d) observation
e) functional assessments
f) risk assessment
3 stratify and manage risk according to appropriate guidelines and
protocols
4
follow the correct procedures and protocols for liaising with
health care professionals, including those for confidentiality
5
establish and agree the participant’s readiness to participate
6
plan and agree goals that are appropriate to your client and their
current level of ability
7
plan and prepare objectives, activities and delivery methods (see
1 above) that are appropriate to your participant’s goals and
condition
8
design and agree a programme adapted to your participant’s needs
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D522.2
Deliver, review and adapt a physical activity programme for participants with
LTNCs
Competencies/Skills
1
assess, monitor and manage risk to your participant throughout
the programme
2
Manage medical complications and emergencies within the
boundaries of your role until the required medical help is available
3
deliver planned activities to your participant, adapting and
tailoring activities according to their individual needs
4
communicate and consult with your participant on issues to do
with their physical activity programme and progress
5
provide appropriate attention to your participant’s with common
co-morbidities
6
support participant’s in ways which will promote sustained change
in physical activity levels
7
enable your participant to move towards self-management, selfmotivation and participation through appropriate educational
opportunities
8
monitor your participant’s progress against agreed goals and
outcome measures, and adapt the programme accordingly
9
provide ongoing reports to communicate outcomes to the
appropriate health care/other professionals
D522
Mapping Evidence
Design, agree and adapt a physical activity
programme for adults with long term
neurological conditions (LTNCs)
Knowledge and Understanding
Mapping Evidence
K1 Government policy and published national guidelines for LTNC
rehabilitation.
K2 Awareness of national agencies, organisations and literature
relating to LTNCs.
K3 Relevant medico-legal requirements.
K4 How to interact appropriately with general practitioners, other
health care professionals and personnel involved in the process
of neurological rehabilitation.
K5 The importance of ensuring the participant’s information and
consent, meeting recommended guidelines, is received prior to
advising, prescribing or instructing exercise.
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K6 The protocol to follow when dealing with participants who have
been referred from primary care or hospital.
K7 The importance of an agreed link with a named specialist from
the hospital and/or community neurological team.
K8 Barriers to communication with the referred participant and the
communication skills needed to overcome these.
K9 How to identify when the participant needs to consult health
care professionals.
K10 How to identify changes in condition that indicate the patient
should be referred back to the referring health care
professional.
K11 Ethical considerations involved in on-going maintenance of
exercise behaviour including respecting inter-professional
boundaries and participant confidentiality.
K12 Methods of information collection and interpretation,
appropriate storage of confidential records and management
processes encountered in running exercise programs.
K13 Current relevant structures of the National Health Service, the
names and functions of different relevant medical organisations
and service providers.
K14 Background and evidence base to neurological exercise
prescription.
K15 Common risk factors and co-morbidities in neurological
medicine.
K16 How physical activity may influence other risk factors.
K17 Anatomy and physiology of the nervous system.
K18 Prevalence, causes, presentation, diagnosis, treatment, course
and prognosis of the following:
a. Multiple sclerosis
b. Parkinson’s Disease
c. Cerebral palsy
d. Neuromuscular conditions
e. Motor neurone disease
f. Acquired brain injury
g. Spinal Cord Injury
K19 Investigations for neurological disease including:
a. Neurological examination
b. Physiological investigations
c.
CT /MRI imaging
K20 Co-morbidity considerations such as:
a. Heart disease
b. Hyperlipidaemia
c. Hypertension
d. Diabetes
e. Depression and anxiety
f. Arthritis
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K21 The range of neurological medications and their exercise
considerations.
K22 Individual risk stratification using recognised guidelines and
protocols.
K23 Acute responses and chronic adaptations to endurance and
strength training and implications for the individual with
neurological disease.
K24 Beneficial effects of physical activity on neurological conditions.
K25 Contra-indications to exercise which need to be taken into
account for neurological diseases.
K26 Initial assessment including appropriate assessment of exercise
level using recognised sub-maximal tests.
K27 The on-going screening process prior to each exercise session.
K28 How to set up and manage a safe physical activity environment
relevant for neurological diseases.
K29 Both group and individual exercise programming principles for
the participant with neurological disease following guidelines.
K30 Monitoring intensity methods, e.g. heart rate and perceived
exertion.
K31 Exercise considerations for the participant with:
a. Multiple sclerosis e.g. temperature regulation
b. Parkinson’s Disease e.g. timing of exercise and medication
c. Cerebral palsy e.g. management of contractures
d. Neuromuscular conditions e.g. care in content of
strengthening program
e. Motor neurone disease e.g. consideration of disease
progression
f. Acquired brain injury e.g. behavioural issues
g. Spinal Cord Injury e.g. sensory and autonomic
considerations
K32 How to manage fluid, dietary and sanitary needs in and around
the exercise session.
K33 How to determine and adapt appropriate progressive physical
activity programmes appropriate to the condition using results
from the physical/exercise assessments, medical information,
national guidelines, consultation and participant aims.
K34 The motivational processes, models and techniques involved in
behavioural change for the referred patient/client to encourage
beneficial lifestyle changes and providing appropriate support to
sustain such changes.
K35 Mental health and mental health promotion in a neurological
population.
K36 How to communicate and consult effectively with the
participant about their programme and progress.
K37 How to manage medical complications e.g. seizures until
appropriate medical help is available.
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K38 How to respond safely and appropriately to emergencies e.g.
falls, TIAs (transient ischaemic attacks) until appropriate medical
help is available.
K39 The management, evaluation and reporting of information, in
verbal and written formats.
K40 How to use and adapt a system for monitoring and recording
the participant’s progress and updating their physical activity
programme.
K41 How to select and use appropriate outcome measures and
compile results to evaluate the participant’s individualised
programme and service effectiveness.
K42 How to evaluate the effectiveness of on-going maintenance of
exercise behaviour.
K43 When the support of a carer/assistant should be requested e.g.
where the client needs hands-on physical support due to their
condition or size.
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