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Table of Contents
Population Description…………………………………………………………………………………… 2-5
Prescreening – Initial Meeting………………………………………………………………………… 6-11
Prescreening – Fitness Assessments……………………………………………………………….. 12-21
Sample Program…………………………………………………………………………………………….. 22-34
Follow-Up……………………………………………………………………………………………………… 35-37
Appendices
Appendix A – Informed Consent Form………………………………………………….38-39
Appendix B – PAR-Q…………………………………………………………………………….40
Appendix C – Client Profile……………………………………………………………...……41
Appendix C-1 – Client Pre-participation Questionnaire………………………….42
Appendix C-2 – Client Health History Questionnaire……………………………..43-44
Appendix C-3 – Client Lifestyle, Physical Activity, and Fitness
Background and Goals………………………………………………………………………...45-46
Appendix D – ACSM’s Risk Stratification Table……………………………………..47
Appendix E – Seven-site Skinfold Measurement Procedure,
Log and Percent Body Fat Equation……………………………………………………..48-49
Appendix E-1 – Heyward Body Fat Classification Chart………………………...50
Appendix F – Rockport 1-Mile Walk Test Protocol and
Predicted VO2max Equation……………………………………………………………….51
Appendix F-1 – Rockport 1-Mile Walk Test Recording Form………………...52
Appendix G – ACSM’s Indications for Terminating Exercise Testing………53
Appendix H – ACSM’s Push-up and Curl-up (Crunch) Test
Procedures for Measurement of Muscular Endurance Protocols..................54
Appendix H-1 – ACSM’s Push-up and Curl-up Muscular
Endurance Classification Charts……………………………..……………………………55
Appendix I – Muscular Strength Lifting Procedures and
1-RM Prediction Equation…………………………………………………………………...56
Appendix J – YMCA Sit-and-Reach Procedure……………………………………….57
Appendix J-1 – YMCA Sit-and-Reach Modification
for Low Back Pain……………………………………………………………………………….58
Appendix J-2 – YMCA Sit-and-Reach Classifications………………………………59
Appendix K – Cardio Workout Recording Log……………………………………….60
Appendix K-1 – Rate of Perceived Exertion Scale…………………………………..61
Appendix K-2 – Incidental Activity Recording Log…………………………………62
Appendix L – List of Example Resistive Exercises………………………………….63-71
Appendix L-1 – Resistive Training Recording Log…………………………………72-73
Appendix M – Example Stretches and Cues for Them…………………………....74-78
Graham, C.
POPULATION DESCRIPTION
The population that this program is for are unhealthy, physically inactive women,
ages thirty through forty-five. Things that need to be considered when programming for
this specific clientele include: age, height, weight, occupation, health history, lifestyle,
current physical activity status, injury history, medications/supplements, nutrition and
eating habits, sleep habits, socioeconomic status, environmental support, family
responsibilities, and the client’s personal goals and objectives. Providing exercise guidance
to this population in particular is especially important because women are far more likely to
exhibit unhealthy behaviors and be overweight or obese. Before even beginning the
program, these above factors must be considered and dealt with so that that best possible
program is produced. The following paragraphs deal with, and elaborate on the description
of this population.
As previously stated, the following program is designed for women ages thirty to
forty-five. Women in this age range were selected because once women leave adolescence,
their physical activity levels and health decline. According to research conducted by the
Weight-Control Information Network, in 2010 a staggering 35.5% of women over the age of
twenty were obese 1. This population needs to be assisted in developing appropriate
physical activity programs and general healthy lifestyles.
Height and weight also need to be taken into account when designing this
population’s exercise program. It is likely that the height of the population this program is
designed for will range anywhere from 5’3” to 5’6”; there may be exceptionally short and
tall people, but most women tend to fall within the previously mentioned height range.
Given and sex and height criteria, this means that the population will most likely range from
140 lbs. (for women 5’3” and below) to 210 lbs (women 5’6” and above). These values are
generalized so as to create BMI values that will accurately represent the clientele’s
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kilograms per meter squared. Most likely, the women within this population will have BMIs
ranging from 25.0 - 34.9; these numbers translate to overweight to obesity: classes I and II 2.
When developing this program, it will also be important to consider the client’s
health history, injury history, and any medications or supplements they may be taking.
Having this information is imperative because some client’s may have health issues or
injuries that prohibit them from certain forms of activity or preliminary exercise testing, or
may require a physician’s presence while they were carrying out the program. Knowing this
information will also help provide any necessary modifications to their program. Health
issues that are likely to be present include: high cholesterol (specifically LDL), hypertension,
and pre-diabetes or already diagnosed diabetes. Having knowledge of their medications (or
supplements) will help to accurately measure exercise responses. Some client’s maybe on
blood pressure medication, and therefore when exercising they may not achieve an
‘expected’ blood pressure reading even though they are working out at the recommended
level.
The client’s lifestyle must also be analyzed so that the exercise programming can be
effectively implemented. This means examining their current physical activity status, their
nutrition/eating habits, and sleep habits. It is likely, given the sedentary lifestyle of most
Americans, that these women do not get the minimum recommended amount of physical
activity a day. It is not unreasonable to say that most of these women spend most of their
day in the seated position; whether it is sitting behind a desk at work, or in the driver’s seat
of a minivan as they shuttle children to and from various activities. Some of the women may
also be smokers, which would prove to be another difficulty to work through when trying to
encourage a healthier lifestyle. Looking at these women’s weight and sedentary lifestyles
would also suggest that their diets are not stellar, either. Like most Americans, they
consume more calories than what their body require, and too many of those calories come
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from sources of saturated fat, simple sugars, and processed/fast foods. Sleep patterns also
need to be taken into account when designing their exercise program. Sleep is a vital part of
a person’s health, so if sleep suffers so do almost all other aspects of a person’s life. Their
program, ideally, should be carried out at a time of day when they are not too tired, and
should not conflict with regular sleeping.
The client’s occupation and socioeconomic status will affect their program as well.
People who are financially secure (middle/upper-middle/upper class families) are more
likely to spend money on things like exercise. Because of this, most of this population will
probably have jobs that pay decently. People of lower socioeconomic statuses do not have
terribly financially secure jobs and, therefore, don’t have the monetary assets to spend on
activities like gym memberships or personal training.
The client’s familial responsibilities and environmental support will also play a key
role in the success or demise of their program. Most of these women will probably have
spouses and children to tend to, on top of going to work. It will be important, as the exercise
programmer, to accommodate these special needs. There may be some cases where the
program needs to be done in ten-minute bursts - because of the time crunches between
work, picking up kids, and running errands. In these cases, it will be necessary to develop
quick, convenient, and effective exercises that the client can perform at the drop of a hat.
Besides taking care of their families, the response that these women’s families have
concerning the program is equally important. These women will need constructive and
unwavering support from their family and friends in order for the program to be successful.
Part of having a solid support system is to make sure that the exercise program does not
detriment the women’s relationships with their friends and family. If the program disrupts
their relationships too much, not only will the client be unhappy, so will the family and
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friends. This will give them double the reasons to discontinue the program; therefore it is
vital to make sure that it works for them on a familial and social level as well.
The final thing to consider with this population (or any population) is what they
want to get out of the program? What are their goals and objectives? When developing
these, it is important to respect what the client wants, but also to inform them what is
realistic and healthy. Whatever the clients’ goals are, that will be the biggest determinant in
what goes into the program and how it will be carried out. For most of this population, the
goal will be to lose weight; specifically, lose fat. To do this successfully (IE long-term),
smaller goals will need to be set. Goals such as increasing their incidental activity,
decreasing fat-mass while maintaining (or increasing) lean mass, steadily increasing the
amount of exercise done each week, etc.
February 2010. Overweight and Obesity Statistics.
http://win.niddk.nih.gov/statistics/index.htm. Retrieved on 9/6/12.
1
Thompson, W.R., Gordon, N.F., & Pescatello L.S. (2009). ACSM's
Guidelines for Exercise Testing and Prescription (8th ed.).
Lippincott Williams & Wilkins.
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Initial Meeting and Prescreening
During the initial meeting with the clientele, it will be important to open lines of
communication, build trust with individual clients and empower them, establish
creditability as, and determine what will happen after this first meeting. A series of
prescreening forms will also need to be explained and completed before starting any fitness
assessments. However, before he subject of prescreening forms and procedures are
broached, a relationship must be established between client and programmer. To do that,
lines of communication must be opened.
It is important to open lines of communication with the client so as to set a firm
foundation with them. By doing this, it helps put the client at ease and become more relaxed
and confident in the programming process. In order to set up lines of communication,
introductions will be made and the client will be given information as to my educational
background and experience in the field of health and fitness. Specific focus will fall on
classes and coursework that are especially pertinent to exercise programming abilities. This
will help to ease the client and encourage them to have confidence in this programming
process. Clients will also be asked questions about themselves: Why they want to start an
exercise program, what their interests are, what their dislikes are, etc.
Establishing credibility and inquiring the clients about themselves will create a twoway communication system. Two-way communication gives the client a feeling of
empowerment and responsibility. They should realize that they are to be just as involved
and invested in the programming of their program as the exercises programmer is. The
client should feel comfortable and secure with the rest of the prescreening and
programming process. It should be emphasized to the client that this is their program, and
in order for it to work effectively, we must both communicate efficiently and successfully
with one another.
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However, merely establishing a good relationship with the client is only part of
making this program successful. The client will also need to have trust and respect for the
programmer’s professionalism and knowledge. In order to further gain the clients’ trust and
respect, they will be informed of past and present involvement in CPR/AED/First Aid
training, ACSM and NSCA and the certifications gained through those organizations. Proof of
these certifications will also be presented if the client asks for them, and any questions
regarding the certification exams and requirements will be answered. Clients will also be
made aware of ACSM’s guidelines concerning physical activity and the benefits associated
with even the minimum requirements. To establish credibility further, it will be important
to discuss the health benefits of regular activity, such as lowering blood pressure and
possibly increasing their HDL count. Taking these steps to establish credibility and will
hopefully lead the clients to realize that they are in capable hands.
Despite seeking out assistance for developing a functional exercise program, some
clients may still be timid and unsure of their own ability to successfully carry out the
designated program. For clients who are hesitant about starting an exercise program for
whatever reason – be it they’ve never been active, or it’s been years since they exercised
with any regularity – it will be very important to empower them. Without empowerment,
there is no motivation, and without motivation the client will not continue with their
program for very long. To empower the clients, it is imperative to ask them what kinds of
physical activities they enjoy doing, or have enjoyed doing in the past. They do not need to
be strictly ‘gym-based’; physical activities may include gardening, mall walking, walking
around the neighborhood, etc. By having them do activities they have some familiarity with,
the clients will feel more comfortable and secure with carrying out their program.
The clients need to be given, and should be given the right to dictate what activities
they would like incorporate into their program. It is also important as the programmer to
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find out if there are physical activities that the clients do not want to do. By having the client
directly involved in the choices of physical activities and exercises in their program, they
will feel more control over the structure of their program and therefore have more
satisfaction in carrying it out. Clients should also be encouraged to suggest modifications in
their program as time goes on, whether it is adding a new type of physical activity/exercise
or if its dropping an activity that’s no longer enjoyable for a new one. By getting them
involved in the creation of their program, the clients will feel more responsible and will
hopefully be more motivated to follow it. Also, by doing activities that they like, they will be
more likely to adhere to the eventual increase in activity volume and will be closer to being
intrinsically motivated. Another way to empower the clients is to help them realize healthy,
attainable goals. Getting them to focus on small, health-oriented goals as oppose to just
going down a couple jean sizes will also motivate them to keep following the program.
After opening lines of communication, gaining the clients’ trust, establishing
credibility, and empowering the client, the next step in the initial meeting is to have them
sign an informed consent form (Appendix A). This form is to ensure that the client is fully
aware of the physical endeavor they are about to embark on. It covers the types of
physiological/exercise tests that may be given prior to actually starting the program, and
the program itself. It gives reasons as to why certain tests will be administered, and why
their program is set up the way it is. All tests and procedures are clearly presented in the
form, but the client should be given an oral rendition of the document just to be sure that
there is no confusion as to what they are signing. The informed consent should also present
information concerning the possible risks associated with exercise and exercise testing.
Prior to having the client sign this form, it is important to have an attorney or legal review
board to look over it. This measure is taken to make sure that necessary information has not
been left out of the informed consent, and anything arbitrary has been taken out of it. The
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purpose of the informed consent document is to protect both the client and exercise
programmer.
The second prescreening document clients will need to complete is a Physical
Activity Readiness Questionnaire (Appendix B). A PAR-Q is the minimum amount of
prescreening that an exercise professional should implement. It is a brief questionnaire
compromised of “yes/no” questions that assess a clients’ health. It is a very broad means of
determining risk, but even if a client answers “yes” to just one of the questions, it is advised
that they receive medical clearance before carrying out an exercise program. Having clients
complete a PAR-Q is useful because it may point out some potentially serious health issues
that both the programmer and client need to be aware of.
After completing the PAR-Q, it will be important for the clients to provide specific
information about themselves. This information will be given in the forms of a Client Profile,
a Pre-Participation Questionnaire, a Healthy History Questionnaire, and a Lifestyle/Physical
Activity/Fitness Background and Goals form (Appendices C – C-3). These forms will cover
necessary information like medications and family health history that will enable the
client’s risks to be stratified. It is suggested to use the ACSM’s risk stratification along with
the history information to conclude a clients’ risks level. ACSM’s table concerning risk
stratifications can be found in Appendix D. Having knowledge of a clients’ medical history,
including past injuries, surgeries, and current medication, will be useful in designing their
program as well. For example, if a client has had multiple shoulder injuries in the past, it
may not be the best idea to incorporate swimming as a regular aerobic activity.
Having the client fill out the lifestyle evaluation form (Appendix C-3) will help the
programmer appraise further risks (IE smoking, sedentary lifestyle) as well as determine if
an increase in incidental activity needs to be incorporated into their program. A
Lifestyle/Activity assessment also provides information as to the clients’ eating habits. If
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necessary, the programmer may want to refer them to a dietician or nutritionist if their diet
poses a threat to the success of their program. Sleeping habits and their general daily
routines will also be covered in this Appendix C-3. Having this information will help to
determine when would be the best time for the client to work out and whether or not if the
workouts need to be set up in intervals of ten to fifteen minutes, instead of being done all at
once. Also, incorporating activities mentioned in the Physical Activity/Fitness Background
assessment (again, Appendix C-3) to their exercise program may prove to strengthen the
client’s motivation, because they are doing something that is familiar and that they enjoy.
If it is discovered that a client is at high risk for a heart attack or some other
cardiovascular event (via Appendix D), the next step is to gain physician clearance before
continuing any further. Obtaining medical clearance determines whether or not it is even
safe for them to engage in an exercise program. While this step may be disheartening for the
client, it is important to keep them safe and alive. It is also important as the programmer to
send the client to the doctor if need be so as to keep my credibility in check.
Following all this paper work, the next step in the initial meeting is to determine
what the client wants out of the program. What are their goals? Are their goals
reasonable/attainable? It can be argued that the program goals all the most important facet
in maintaining the clients adherence to regular exercise. As the programmer, it will be my
job to help the client determine and realize appropriate short term and long-term goals for
them. It will also be my responsibility to verify and explain why some goals may or may not
be realistic or attainable. These goals will be determined by the findings of the prescreening
forms and questionnaires.
Once the goals are set, the next step in this process is to start brainstorming certain
exercises and activities the client would like to involve in their program. These can be
activities that the client is familiar with or exercises that they are interested in trying out.
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During this time, activities that they may have never thought of before will be presented,
and the client will decide if they would like to add those to their program. We will also
explore various settings in which the workouts will take place; whether it is at a gym, in
their home, or at a park. It may help the clients adhere to the program better if they are in
surroundings that they find comfortable. It is imperative that the client be comfortable
throughout the duration of the program, otherwise they won’t be likely to continue with it.
It is also be a good idea to see if the client would like to listen to music as they work out, so
as to make the program even more enjoyable. We will also decide how involved the client
would like me to be in their program – outside of creating it. For the first six weeks, my
presence will be important. This is because having someone to hold the client accountable
will help to instill a sense of responsibility and –hopefully – motivation. Being there will also
help the client to learn proper procedures for performing the exercises of their program.
Meaning, they will learn correct form and learn to decipher the ‘feelings’ of appropriate
exercise intensities.
Before continuing on to the fitness assessments, the client and I will agree upon a
time and location for out first session. We will confer with each other and make sure that it
is understood where the location is and what we plan on accomplishing that day. Providing
that the client has medical clearance and is prepared (IE proper clothing, footwear and has
followed pretesting procedures), we will then move on to the fitness assessment portion of
the prescreening procedures.
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PRESCREENING – FITNESS ASSESSMENTS
In order to properly set realistic goals for each client, a series of initial
measurements must be taken. These measurements will be derived from various fitness
assessments. Depending on the findings from these tests, the client will be able to more
accurately gauge what kind of objectives they wish to set for themselves. These assessments
will also serve as determinants of the clients’ physical strengths and weaknesses. Figuring
out what the client struggles with will also dictate what modifications – if any – need to be
made to certain exercises found within the program. Prior to the fitness testing, the client
would’ve been informed to refrain from eating, smoking, consuming alcohol and caffeine, or
participating in moderate intensity exercise for at least four hours preceding the tests. The
clients will also be instructed to keep themselves regularly/normally hydrated and to wear
loose-fitting exercise clothes and gym shoes
The first fitness assessment that will be performed is body composition, followed by
cardiovascular testing, muscular strength and endurance, and finally flexibility. The reason
the tests will be ordered in this way is to ensure the most accurate baseline information.
Body composition will be performed before cardiovascular fitness because performing
aerobic activities have the possibility of altering the client’s water and electrolyte levels,
thereby skewing their true body make-up. Muscular strength and endurance will follow the
cardiovascular testing because if they were performed before the aerobic fitness
assessment, there would be a chance of fatiguing the muscles involved in aerobic activity,
providing an inaccurate measurement. Flexibility follows muscular strength and endurance
because the client’s muscles and ligaments will be ‘warmed up’ and prepared to stretch.
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Body Composition
As stated before, body composition will be the first assessment performed on the
client. Body composition refers to the break down of a person’s physical make-up. Usually,
body composition is broken down into a two-part model: Fat mass and Fat-Free mass.
There are a couple of reasons for assessing the client’s body composition. One is to simply
have a numerical value from which objectives and goals can be set. Chances are, several of
the women in this population are overly fat, so they will most likely want one of their goals
to be to decrease the amount of subcutaneous fat on their bodies. Another is to determine
whether or not the client has an additional risk factor.
Before body composition is actually measured, the client’s height and weight will be
measured and recorded. This reason for collecting this basic information is to keep track of
weight loss (or gain). Also, by knowing a person’s body mass and their percent body fat, the
percent lean mass of a client can be estimated as well. Having an idea of the client’s lean
mass is important because it will be ideal throughout the program to at least maintain the
participants lean mass value, since lean mass plays a vital role in everyday, independent
functioning. Body composition will be measured by using skinfold measurements. This is
because skinfolds, when done properly, can provide reasonably accurate numbers reflecting
the client’s subcutaneous fat. An additional reason for using this method is its feasibility and
appropriateness. While not as accurate as ADP or underwater weighing, measuring
skinfolds is much cheaper and (when compared to UWW) it is much more comfortable,
especially since these women will not be familiar with the procedures for ADP or UWW.
Measuring skin folds is easy and less stressful on the client, so it is the method that will be
used for this program. A seven-site procedure and formula (Appendix E) will be used when
measuring the clients.
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A seven-site procedure was chosen because it allows for a more thorough
examination of the client’s body. Also the seven-site procedure has been found to be slightly
more accurate than the three-site formulas: with an error of 3.8%, as oppose to the 3.9%
error rate of the three-site formulas 1. Using the seven-site procedure will be helpful in
determining if the client has an excess amount of fat in their torso/abdomen. This is
important to know since abdominal fat has been linked to increased risk for diabetes and
heart diseasei. Measurements of the clients’ triceps, chest, subscapular, midaxillary,
abdominal, suprailiac and thigh regions will be taken three times and the average measure
of each site will be used in the seven-site formula. Measuring each site three times, makes
sure that there are similar readings throughout; thereby making the readings as accurate as
possible.
The procedure for this assessment will start out with the client removing any
unnecessary clothing (sweaters, shoes, etc.), so as to not skew any height or weight
measurements. When taking the client’s height, it will be important to instruct her to stand
up straight. Telling her to pretend that a string is attached to the top of her head and is
being pulled up will give the correct mental visual to help her stand in the correct manner.
Following height, weight will then be measured. Again, any unnecessary garments will be
removed, so as to not add ‘false’ weight. Before the prescreening assessments, it will be
made sure that the scale is leveled and torn. The client will be informed that an adult’s
weight can fluctuate a few pounds throughout the day, especially when a woman is going
through her menstrual cycle. The client will also be informed that we will do our best to
make sure that she is weighed on the same scale, at about the same time each time we meet.
Once the client’s weight is recorded, we will finally move on to measuring the skinfolds.
Again, the protocols for this procedure can be found in Appendix E. Once the skinfold
measurements are complete, and the numbers are plugged into the seven-site formula and
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the body density equation, the client’s body fat percentage will then be classified using
Heyward’s body fat percentage chart (Appendix E-1). Classifying the client will give an idea
just how overweight/obese they may be. Knowing this information may affect their
program and/or will affect their goals and objectives.
Cardiovascular Endurance
After body composition, the cardiovascular assessment will take place. Measuring
this aspect is necessary because cardiovascular health is the most component of fitness.
Cardiovascular endurance testing is used to assess the body’s ability to utilize oxygen
efficiently. Therefore, it is a measure of not only cardiovascular fitness, but of respiratory
capabilities as well. The variable being assessed in cardiovascular is the client’s VO2max.
Because this population is unfit and will not necessarily be looking for great gains in their
VO2max, it does not make sense to have them perform a maximal cardio assessment.
Therefore, we will be conducting a submaximal test from which the client’s VO2max will be
predicted. General guidelines for conducting submaximal cardiovascular tests can be found
in Appendix F.
Based on the client’s current fitness status and familiarity with exercise, the test that
will be used to measure cardiovascular fitness is the Rockport 1-mile walk test (Appendix F1). This method will be used because it does not make any sense, given the clients’ current
health and physical activity statuses, to have them do running or cycling tests. Having them
do more strenuous cardiovascular assessments when they are not usually vigorously active
will not garner an accurate VO2 measurement.
This fitness assessment will take place at a track. This setting has been chosen
because of its non-graded nature and because distance can be easily measured. Before the
testing, the clients’ resting heart rate and blood pressure will be measured and recorded, so
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as to provide resting measurements that will be used in determining exercise intensities for
the program. A heart rate monitor and complimenting watch will be given the client and
they will perform a five-minute walking warm up before starting the test. After the warm
up, they will walk as fast as they can on a track until they have completed one mile.
Immediately following the Rockport, their heart rate and blood pressure will be measured
again, so as to make sure there are no abnormal physiological readings. Once their values
have been recorded for a second time, the client will perform a five-minute cool down walk.
The procedures for this assessment can be found in Appendix F, and the formula for
predicting the clients’ VO2max can be found there as well. The equation that predicts
VO2max incorporates the clients’ body weight, age, gender, the amount of time taken to
complete the test, and heart rate following the test. Once the values are plugged into the
equation, the clients’ predicted VO2max will be given, and from that their cardiovascular
fitness level will be determined. The recording sheet for the Rockport can be found in
Appendix F-1.
As the exercise programmer, it will be important to make sure that the client is
reasonably comfortable while performing the test, and if any indications for terminating
testing (Appendix G) occur, the client will be instructed to stop the assessment and begin a
cool down walk, or a passive cool down where they sit or lay down. This is for the client’s
safety.
Muscular Fitness
The next fitness assessments to take place will be those concerning musculoskeletal
fitness. Muscular fitness is imperative to living healthily. Being muscularly fit helps increase
metabolic function, decrease joint pain, decrease lower back discomfort, and prevent
osteoporosis. Muscular fitness will be assessed in two components: endurance and strength.
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Strength will be performed last in this section so that the muscles will not be fatigued and
hinder the endurance measurement. Muscular endurance is the ability of a muscle group to
execute repeated contractions over a period of time. Muscular strength refers to the
external force that can be generated by a muscle/muscle group.
Muscular Endurance
To assess muscular endurance, ACSM’s push-up and curl-up protocol (Appendix H)
will be used. These tests have been selected because they are quick, efficient, feasible, and
reasonably accurate. Despite these women’s lack of physical activity, chances are they are at
least familiar with both exercises. Most of them have probably done a few at some point in
their life, as well. Also, the equipment for conducting these tests is cheap – just a mat and a
stopwatch. These tests can also be done quickly, which is ideal for a population who do not
regularly devote time to physical activity.
The push-up test will be first. The clients will be shown correct push-up position,
which is outlined in Appendix H, and then will get into position themselves. During the test,
the clients will perform as many push-ups as they can while maintaining correct form.
Based upon the number of push-ups completed, I will then use ACSM guidelines to classify
the client’s fitness category based on age and gender (female). This information can be
found in Appendix H-1.
The next muscular endurance test will be the partial curl-up test. For this test, the
clients will lye supine on an exercise mat in a position in accordance with ACSM guidelines
outlined in Appendix H. A piece of tape will be affixed to points on the mat at either eight
centimeters (for clients of 45 years of age) or twelve centimeters (for those younger than
45) away from the client’s fingertips. A metronome that is set at fifty beats per minute will
play to cue the client as to how quickly they should rise and fall during the exercise. The
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exercise is timed (one minute) and the client’s feet will be held to ensure proper form.
During the one minute, the client will perform as many partial curl-ups as they can without
pausing. Once the test is complete, ACSM guidelines will be used to assess their muscular
endurance for this test (Appendix H-1).
It should be noted that special attention must be made to the form in which these
exercises are performed, specifically the lower back and neck. The lower back should be
nice and straight throughout the push-up test, and the neck should not be tense (nor too
slack) during either assessment.
Muscular Strength
The muscular strength assessment will follow the muscular endurance portion of
the fitness assessments. While most of these women will not be seeking to necessarily
increase their muscular strength, it is still an important part of their over all health.
Strength does not need to refer to how much weight one can squat or bench press (a fact
that should be made clear to them), rather having adequate muscular strength can allow
people to function more independently as they get older. Also, having strong muscles –
especially trunk muscles – can help to alleviate low back pain.
As with their cardiovascular assessment, instead of testing these women maximally,
they will be performing a submaximal muscular strength test. The reason for this is because
it is not safe to have them perform 1-RM testing because none of them will be familiar with
proper lifting procedures or technique; therefore, it is dangerous to do it. Instead, the
clients’ muscular strength will be measured via a submaximal leg press and bench press
exercises (Appendix I). Specifically, 5-RM tests will be performed to predict their 1-RM. The
prediction equation for 1-RM can be found in Appendix I as well.
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The two strength tests to be used are a leg press exercise and a bench press
exercise. Two different tests will be used so that both upper and lower body strength can be
analyzed. Bench pressing is a classic method of assessing a person’s muscular strength, and
it is simple to do providing the lifter is given the proper safety and form cues, and if they
have a knowledgeable spotter. Traditionally, back squatting is used to measure lower body
muscular strength. However, since proper form for squatting can be difficult to learn (even
more so once additional weight is added), it is in the client’s best interest to perform a leg
press exercise instead. It is easier to keep form when doing leg pressing and it is still an
accurate way to measure lower body strength.
The leg press assessment will be performed first, so as to give the client’s upper
body more time to recover from the push-up test earlier. The test will begin by explaining
the leg press equipment to the client, showing them how they should be positioned in the
machine and how the weight adjustments work. Before the actual testing begins, the client
will perform several repetitions of the exercise at a very light intensity as a warm up. When
it is time for the actual test, the machine’s weight will be adjusted so that it is roughly fifty
percent of the client’s body weight. If the client is able to do more than ten repetitions at
that weight, then the weight will be increased in small increments until the client is able to
only lift the weight five times. Using that weight and the 5-rep-max-to-1-rep-max equation
outlined in Appendix I, the client’s predicted 1-rep max will then be calculated.
Since using the predicted 1-rep max method is not as accurate as performing the
actual test – because muscular fatigue between sets may affect the clients’ lifting ability –
rest periods of about two minutes between each set will be implemented. This is to be sure
that fatigue does not alter the clients’ 1-rep max. If the client does become overly fatigued
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during the testing, then they will be allowed to rest for a minimum of twenty-four hours
before retesting.
Following the leg press max test, the client will move on to the bench press
assessment. As before, the client will be shown proper lifting procedures (Appendix I), and
will have them perform a series of light intensity warm up repetitions before the actual test.
The same protocol followed in the leg press assessment will be followed in this portion of
the testing (IE warm-up, lift, 5-rep conversion). Just as with the leg press, if the client gets
overly fatigued to the point of being unable to properly lift, they will repeat the test after a
minimum of a twenty-four hour rest period.
Flexibility
The final part of the fitness assessments, flexibility, will follow muscular strength.
Having the client perform flexibility testing last is ideal because their muscles will be
sufficiently loosened and warmed up following their cardiovascular and muscular
endurance/strength testing. Testing flexibility is important because it provides information
as to the client’s range of motion within certain joints and areas of the body. Often
inflexibility (along with insufficient muscular strength, as previously mentioned) is the
cause of low back pain, specifically inflexibility in the Gluteals and Hamstrings. By assessing
their current flexibility levels, and incorporating that component into their exercise
program, it will not only aide in all-around physical comfort, but increasing the range of
motion in their joints and muscles will allow the clients to make greater gains in their goals.
For assessing their flexibility, the client will be doing a standard sit-and-reach test
(Appendix J). The sit-and-reach protocol has bee selected because it is easy and quick. Most
of these women will have some memory of doing the sit-and-reach for school P.E. classes,
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and for those not familiar with the process can pick it up easily. The sit-and-reach is also a
fast test to finish.
For the interest of comfort and safety, clients will have the choice of performing
either the ‘standard’ sit-and-reach test, or the modified ‘back-saving’ sit-and-reach test
(Appendix J-1). The modification will be an option for clients suffering from chronic low
back pain. The client will perform a few warm-up stretches before performing three
measured sit-and-reach assessments. The average of the three measurements will be their
‘score’. Using ACSM guidelines for sit-and-reach (Appendix J-2), the client’s flexibility will be
classified.
Thompson, W.R., Gordon, N.F., & Pescatello L.S. (2009). ACSM's
Guidelines for Exercise Testing and Prescription (8th ed.).
Lippincott Williams & Wilkins. Page 68.
1
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SAMPLE PLAN
After all the client’s information is gathered from the prescreening meeting and the
in preliminary exercise testing is completed, the exercise program will be developed. The
program itself will be designed around the client’s fitness goals and objectives, as well as
the findings from the initial meeting and exercise tests.
The exercise program for this clientele will involve training of the cardiovascular
system, resistive training and flexibility. The program will last 18-weeks, split into three 6week intervals so that progress can be evaluated and measured. Because of the varying
schedules, there will be no set time for the program to be performed. Rather, the client
participating will determine what time of day is best for her to participate; whether they
knock out their workouts in one fell swoop or if they accumulate their workouts in the
appropriate increments. The length of each session will be dependent on where the client’s
are in the program: those just starting out will have shorter sessions than those who are
farther into the program, in accordance to the dose-response principle – that is, the more
you have to do in order to get results. This is because it is in the client’s safety to make that
they are properly acclimated to working out since they have been predominantly sedentary
up until this point. Whether the client is working out at home, at a facility, all at once, or in
increments, it is important that they be dressed appropriately and have their program at
hand so that they know what is expected of them for that session.
CARDIOVASCULAR FITNESS
Since this population is focused on basic health benefits, as oppose to optimal health
benefits, the intensity of the cardiovascular portion of their program will range between
40% - 49% of their calculated VO2reserve or their HRR (which was determined during the
initial cardiovascular exercise tests), or 55%-64% of their HRmax. Each client will be fitted
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with watches and corresponding heart rate monitors so that they will be able to accurately
gauge how hard they are working out. The client’s should be able to carry out a ‘breathy’
conversation through out the cardio segment. Performing cardiovascular exercise will
improve the client’s blood pressure, resting heart rate, increase the efficiency of oxygen
delivery through their body, and is also a means of decreasing body fat. Also, providing that
the cardiovascular exercise is weight bearing (IE walking or jogging), it will also help to
strengthen their bones.
It will also be important to monitor the conditions in which the client performs their
cardiovascular exercises: Is it excessively humid/hot? What sort of surface are they
exercising on? Questions and observations like these need to be taken into account, because
they will determine whether or not the intensity of the activity needs to be altered. If at all
possible, it may be beneficial for the client to perform their cardiovascular exercise indoors
on a stationary bike, treadmill, or indoor track so as to minimize environmental variables
that could negatively affect their work out.
Prior to each cardio segment, the client will perform a warm-up. The length of the
warm-up will be dependent on how long their cardio exercise is expected to last - at least
five minutes for every thirty minutes of cardiovascular activity. The length of the client’s
cardiovascular segment will get progressively longer as they move forward in the program.
The warm-up will be a less intense replication of what their cardiovascular segment is;
meaning, if the cardiovascular exercise is power walking, then they will walk for five
minutes at a lower intensity beforehand. The warm-up is performed so that the client’s
internal temperature is properly elevated and to increase blood flow to the necessary
skeletal and cardiac muscles. Warming up also prevents injury and abnormal cardiac
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rhythms. Prior to the warm-up, during the warm-up and the cardio segment, the client must
also be sure to maintain proper hydration.
WEEKS 1 – 6
For the first six weeks of their program, the client’s cardio activity will consist of
walking. Where they perform this will be dependent on their schedule and resources. If they
have access to a treadmill, they may use that; otherwise, walking around their
neighborhood or on a track will suffice. Some clients may find it easier to use a treadmill
since it is easier to control their pace and intensity. For those unable or unwilling to use a
treadmill, they can use their heart rate monitors to keep track of their intensity and the
appropriate pace at which it is reached. If they are walking with a friend, they can also use
the talk-test to monitor their intensity.
Walking has been selected because it is something all the clients are familiar with
and will be able to do. Walking is also a weight bearing activity, so it will help improve and
maintain the women’s bone health. Walking also utilizes the body’s major muscle groups to
some degree: Quadriceps, Hamstrings, Gluteals, core, chest and back muscles. This will
allow blood flow and oxygen distribution to be maximized.
For the first three weeks of the this six-week segment, clients will be walking three
times a week, accumulating at least twenty minutes of cardio exercise in each of those
sessions. Because they are not performing thirty minutes of activity, it will not be necessary
for their warm-up to be five minutes. Rather, clients will warm-up for two to three minutes
before advancing onto their cardio segment. The reason that these clients will only be
performing twenty minutes of cardio at a time is to make sure that they are safely
introduced to the activity before making progressions in activity length. Since these clients
are coming from relatively sedentary backgrounds, it will be more important to take their
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safety into account and start out slow, rather than run risk of producing exercise
contraindications because they did too much too soon.
Each client will be given a recording sheet (Appendix K) that they will use to
monitor their heart rate, rate of perceived exertion, distance, and workout duration and
pace of the workout. Prior to the sessions, the Rating of Perceived Exertion Scale (Appendix
K-1) will be explained to the client. They will be told that for their cardio segment, they
should maintain a RPE range of 13 to 16.
It will be emphasized that, at the start of this program, speed/intensity is not the
primary goal; instead the client should focus on getting the full twenty minutes of walking
time in. As long as they are diligent about completing each cardio session, their speed and
tolerance of intensity will improve. That is not to say that this walk should be easy. If the
client does not perform above a leisurely pace, then they will not see as much or any
improvement – again, the dose-response principle.
As far as form is concerned, the client will need to keep her arms bent at a 90-degree
angle and will need to swing them at her sides in a manner more vigorous than if she were
just casually strolling. However, this workout is not the Ministry of Silly Walks, so the arm
swinging should not be exaggerated to the point of being goofy. The point of involving the
arms is to increase blood flow to the upper body, thereby increasing he body’s oxygen
utilization. To ensure proper walking technique – and to differentiate this activity from
jogging – one foot must be kept on the ground at all times.
As the client’s progress past the first three weeks, the duration of their
cardiovascular program will increase to thirty minutes, performing a five-minute warm-up
beforehand. The frequency of the walks will be kept at three times a week and intensity
should be maintained or elevated if possible – but not past the recommended 55%-64% of
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HRmax/40%-49% of VO2reserve. If the client wishes to alter their cardio program at this
point by adding more variety to their cardio segment, they may; providing that the chosen
cardio is safe for them to perform.
Throughout the program, the client should also be encouraged to increase their
activity outside of their exercise program. This is referred to as incidental activity – activity
that is done without the intention of exercise or direct health benefits. Even though
incidental activity alone will not achieve the same results as an exercise program, coupling
the two can increase the speed at which health benefits are achieved and the magnitude of
the benefits. An incidental activity recording form can be found in Appendix K-2. Also, more
information concerning incidental activity can be found on page 33 of the Sample Plan.
WEEKS 6 – 12
Before continuing on in their program, the client’s resting blood pressure, resting
heart rate, weight and body composition will be reassessed and explained again. By
retesting these health variables, the client will be able to see the progress they have made.
They will also discover what goals and objectives they may have already reached, those that
still need to be achieved, and those that they may need to reevaluate. New objectives and
goals may be added to their program at this time as well.
By now the clients should be able to complete three thirty-minute walks a week at a
moderate intensity. In the first three weeks of this second phase, the frequency of the walks
will be increased to four days a week. If the client feels like they are able to bump it up to
five times a week at this point, they may. As before, their cardio segment will be preceded
by a five-minute warm-up. The clients will continue to record their own data (Appendix K)
and make note of any extra cardiovascular exercise they have done in additional to their
program (Appendix K-2).
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In the next three weeks of this phase (weeks 9 -12), clients will be asked to focus
more on the intensity of the cardio segment. The clients will be encouraged to try and
exercise nearer to the 64% of their HRmax/49% of their VO2reserve as much as possible. It
will be explained that when filling out their recording sheets (again, Appendix K), their
effort should correlate with a 14 to 16 rating on the RPE scale. If that is not clear enough for
them, they will be told that they should be breaking a sweat during their walks and that
they should be mildly fatigued (but not exhausted) after their thirty minutes is complete.
WEEKS 12 – 18
As with the transition from phase one to phase two, each clients’ resting blood
pressure, resting heart rate, and body composition will once again be measured to assess
progress. From this information, the client will be able to compare their progress since the
start of the program. Again, based on the retesting findings, the client can determine what
goals have been achieved, which ones are close to being completed, which ones need
reassessing, and what ones – if any – they wish to add.
In these final weeks of the program, things will progress in much the same manner
as they did in the second six weeks. The main changes in this final phase will come in the
form of duration. Since the goal/one of the goals of these women will be to lose body fat, in
order to maintain that loss it is recommended that they engage in cardiovascular activity for
at 60-90 minutes most days of the week. Hopefully, some women will be able to get to the
sixty minute point by the time this program is complete, and can move towards ninety
minutes after the program evaluation and follow-up.
For those clients who increase their cardio segment time up to sixty minutes, they
will also need to increase their warm-up up to ten minutes. Clients will also be ready to
move outside the cardiovascular scope of just walking. If they so chose, they would be able
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to replace walking with slightly more difficult cardio activities like using the elliptical,
stationary bike, or jogging. If clients want to adjust their cardio routine, it is important for
them to understand that they need to keep their intensity level in the proper range. They
may find that they have to work harder or slower than expected when first trying a new
cardio work out. For example, if a client wants to try riding the stationary bike, they will
probably need to up the resistance more than they might originally think. This is because
stationary bikes primarily work only the lower body muscles, so they will not be moving
around as much as they would be if they were walking, thereby altering the amount of blood
being pumped through their body. Or, if a client wants to give jogging a try, they may find
that they only have to go slightly faster than their power-walking pace to achieve proper
intensity ranges. As with the other stages, clients will monitor and record their heart rate
during the exercise to make sure that they are working out at the proper intensity
(Appendix K).
COOL DOWN
Following each cardio workout throughout the program the clients will need to
perform a five-minute cool down. Doing a cool down ensures that body is gradually brought
back to a resting homeostatic state. Cool downs prevent the occurrences of abnormal
cardiac events, and keeps blood from collecting the clients’ extremities. Cool downs are
performed at intensities similar to that of the warm-up or lower.
RESISTANCE TRAINING
Resistance training will be an integral part of these women’s exercise programs.
While cardiovascular training is an excellent way to lose fat and maintain its loss, resistive
training will help to maintain lean mass, metabolic health, and bone health. Incorporating
weight training into their programs will also help with independent functioning, as they get
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older. It is likely that none of these women will have muscle strength as a goal for their
program; often women abstain from resistive training because they mistakenly believe that
the act will make them bulky and masculine looking. It is incredibly important to stress that
this will not happen. It needs to be explained to the client’s that it is impossible for them to
achieve the same muscle growth and definition as a man because of gender variances in
hormones and mechanical design of the muscles.
ACSM recommends that resistive training should be performed a minimum of two
days a week to obtain basic health benefits 1. It is recommended that resistive training
sessions be ‘split’, meaning working one major muscle group one day and another muscle
group on a different day. Ideally, the resistive sessions should have a forty-eight hour space
between them, so as to accommodate muscle soreness. Considering that these women are
not looking to make great gains in muscular strength and endurance, their program will
only have them performing weight-training sessions twice a week, with a two day rest
between each session. Since resistive training will only take place twice a week, the clients
will be working their full body and will focus on functional movements. Functional
movement resistive training will serve these women better than specialized lifting moves
because it is likely that this population will not be too concerned with power-lifting. Rather,
they will benefit more from performing moves that are incorporated into their everyday
life. A brief list of example functional resistive exercises can be found in Appendix L. This list
has been provided so that the client may pick and chose what exercises they would like to
perform during their resistive training sessions.
The two muscular related components of fitness are strength and endurance.
Therefore, to maximize a person’s muscular health, aspects of strength and endurance
training need to be included within the client’s program. As stated earlier, this population is
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not likely to be concerned with developing muscular power or muscular hypertrophy
training; so, the training methods for these to muscular components will not be included in
the program.
Since it is imperative to the client’s safety and the success of their program, the
resistive exercises will be performed in a gym/professional setting so that their form can be
spotted and critiqued if need be.
WEEKS 1 – 6
Prior to performing any exercises, the clients will warm-up if the resistant training
is not preceded by the cardio segment of their program. Being properly warmed-up will
ensure that their muscles are loose and ready to lift, and will help prevent any acute injuries
from occurring.
Since most of these women will have no frame of reference when it comes to weight
lifting/resistive training, the primary goal of the first six weeks of their program is to get
them familiar with various basic, functional resistive moments. Things like squatting,
rotating, reaching, etc. Because of their lack of experience in the realm of resistant training,
these first few weeks of training will be performed using just their body weight. This is so
the clients can get used to performing the exercises with proper form without having to
worry about any external resistance or weight. If need be, clients are welcome to use items
like body bars or chairs for support.
The clients will start by developing muscular endurance because it will be easier for
them to make gains there. Muscular strength training will be built-in once the clients are
comfortable with lifting and are strong enough to handle the intensity of strength training.
According to NCSA’s Strength Training text 2, muscular endurance training should be
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completed at less than or equal 60% of the clients 1-RM. The endurance recommendations
from NSCA will be modified a little bit to accommodate the client’s lack of resistive training
knowledge/ability. Instead of performing five to seven sets of twelve to fifteen repetitions,
the clients will start out doing at least one set of twelve to fifteen repetitions. During the
first few weeks, the clients will be allowed to rest as long as needed between sets to ensure
their safety and comfort.
For basic health benefits, resistive training will be done two times a week,
completing total body workouts at each session. Total body workouts have been selected
over split routines because the clientele will not make the appropriate health gains because
of the lower volume of work. Also, each resistive session throughout the program will be
less than an hour in length, since sessions that last an hour or more have a high drop out
rate.
Training logs for the client’s resistive workouts can be found in Appendix L-1. The
recording forms allow the client to keep track of her progress, as well as keep her workouts
nice, neat, and ordered.
WEEKS 6 – 12
In second six-week phase of their program, clients will begin to add light external
resistance to their workouts. Light dumbbells, medicine balls, body bars, and resistant
bands will be used. For the first three weeks of this resistive segment, the clients will
continue to perform one set of twelve to fifteen repetitions of each of the exercises, but they
will add the appropriate resistance to each lift (recall NSCA’s endurance intensity guideline
of <60%). It will be vital to continue to cue and watch form as resistance is incorporated
into the exercises.
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During the second three weeks of this phase, the volume of lifting will increase by
including muscular strength regimens to their program. To do this, the clients will begin to
slowly increase the amount of resistance from session to session to make sure that they are
effectively overloading their muscles. According to NSCA’s text 3, the guidelines for
developing muscular strength include an intensity of three to four sets of four to eight
repetitions at 75%-85% of the subject’s 1-RM, three to four days a week. However, keeping
in mind of the client’s goals, it probably will not be entirely necessary to follow these
guidelines exactly. The frequency of the client’s resistive training sessions will remain at
two times per week, but the intensity (referring to the sets and reps) of the workouts will
vary from session to session: switching periodically from strength to endurance, and vice
versa. During the workout, the client’s will be required to fill in Appendix L-1 so that their
progress can be efficiently monitored.
WEEKS 12 – 18
In the final six weeks of their program, the clients will bump up their resistive
sessions to three times a week. They will continue performing the recommended sets and
repetitions per exercise, as recommended for strength or endurance training. As they
continue with the resistive portion of their program, they should be making and
maintaining appropriate gains in strength and in endurance, and in the amount of
resistance they use. In this case, ‘appropriate’ refers to enough resistance so that the
exercises are challenging, but does not completely fatigue the muscle/muscle groups by the
last repetition.
COOL DOWN
Following each resistive session, the client will need to stretch the muscles/muscle
groups involved in that day’s workout. Static stretches targeting these muscles will be held
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ten to thirty seconds. Static stretching has been selected because it is easy and effective.
Each stretch should be cued and observed to make sure that the clients are performing
them safely. Stretching should not be painful, and the client should only perform the
movement to the point of achieving a ‘stretching’ sensation in the allotted muscle/muscle
group. Modifications may need to be provided so as to best fit the clients needs.
FLEXIBILITY
Flexibility is also an important facet of health that must be addressed in any exercise
program. Both the cardiovascular and resistive portions of the client’s program have dealt
with the issue of cooling down and stretching. It is incredibly important that the clients
properly stretch after each work out the complete, be it cardio or resistive. A series of
example stretches have been supplied in Appendix M for the client’s convenience.
Some clients may disregard the importance of improving their flexibility, so they
need to be informed of its practicality within their program. Stretching decreases the
likelihood of injury/aches and pains that have the potential to result from habitual
cardiovascular and resistive activities. For example, walking without stretching can
eventually lead to IT Band syndrome; a painful tightness on the outside of the knee caused
by the tightening of the piriformis muscle which pulls on the IT Band tract, causing the
tendon to flip over the lateral femoral condyle. It is no fun.
INCIDENTAL ACTIVITY
As expressed in the cardio vascular section of the sample plan, clients should be
encouraged to increase their incidental activity as another means of increasing
cardiovascular fitness. Things like taking the stairs, parking at the far end of a store’s
parking lot, using a grocery cart instead of a Rascal scooter, etc. are all ways that clients can
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expend energy and increase their general fitness. An incidental activity log can be found in
Appendix K-2.
BODY COMPOSITION
One of the leading reasons females initiate some kind of exercise program is to alter
their body composition; this usually translates into decreasing fat mass. In order to
accomplish this, not only must these women following the above prescribed plan, but they
will also need to monitor (and possibly change) their eating habits. Please recall that the
client’s eating patterns were address in Appendix C-3. In order to start monitoring their
intake, the clients can use myplate.gov as a good jumping off point. If their diets are in need
of a major overhaul, the client will be referred to a dietician for further instruction and aide.
1 Thompson,
W.R., Gordon, N.F., & Pescatello L.S. (2009). ACSM's
Guidelines for Exercise Testing and Prescription (8th ed.).
Lippincott Williams & Wilkins. Page 220.
2
Brown, L.E., Editor (2007). Strength Training. Champaign, IL:
Human Kinetics. Page 118.
3 Brown,
L.E., Editor (2007). Strength Training. Champaign, IL:
Human Kinetics. Page 118.
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FOLLOW-UP
Over the clients’ eighteen-week program, my involvement as their programmer and
trainer will vary. At the start of their program and through the first phase (weeks 1 – 6), the
client will most likely need to have some kind of professional presence with them. This is
because given the fact that these clients have never initiated in a physical activity program
before, they will most likely lack the motivation to follow the program on their own and
they may possibly be self-conscious about working out. They will need someone there that
can hold them accountable and who can provide the necessary support and external
motivation.
Not only will it be important for me to be there as a rock of support, but early on it
will be imperative that I’m there at each session so as to make sure that the client is safe and
carries out their exercises with proper form. Having never done physical activity with any
regularity, chances are it’ll take a couple weeks for them to get a handle of properly
executing the exercises in their program.
Everyday that the client’s have a workout, we will open the session with a brief
overview of what is planned for that day and how they have been feeling since their last
session. Based on their last workouts and how they are feeling, the resistance for that day’s
session will be determined or altered. Their workouts will be recorded on the
corresponding log sheets (Appendices J, J-2, and K-1). Following each session, we will have a
post-work out discussion. The client will describe how they physically feel and what their
next workout will entail. The purpose of this first phase is to establish a regular schedule of
activity for the client. This will hopefully instill a habit of being physically active, and will
make the remainder of their program easier and more fun to complete.
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At the conclusion of phase one, the client will once again perform the program’s
initial physical assessments: 1-mile Rockport walk test, ACSM’s push up and sit up tests,
ACSM’s bench press and leg press tests, sit-and-reach test, and seven-site skinfold analysis.
The purpose of revisiting these tests after six weeks is to see how the client is progressing.
Based on the results of the examinations the client’s program will either be tweaked
appropriately or will continue as usual. Having the client run through the initial battery of
tests for a second time will also give them numerical proof of their achievements thus far in
the program. Seeing this will encourage them to continue with the program, and they will
hopefully be more excited about carrying on for the next two phases. This will also be the
time to take a look at their initial goals, see what has been reached, determine what has yet
to be accomplished, and add or alter other objectives.
Due to the advancements made in both physical capabilities and motivation, in
phase two (weeks 6-12) of the client’s program, they may no longer require my presence at
each of their sessions. However, due to the fact that the client should be increasing the
intensity of both their cardiovascular and resistive training portions of the program, they
will still be monitored as they work out. While they may not need as much external
motivation, for the client’s safety an exercise professional will remain close at hand to
provide spotting and cuing when necessary. Once again, before and after each session the
client will discuss how they are feeling, what they would like to change or keep in their
program, and how intense that day’s workout should be. The client’s will record their
workouts on the allotted sheets found in Appendices J, J-2, and K-1.
At the close of phase two, the client will once again perform the same series of tests
and analyses that they did before starting the program and at the end of phase one. Based
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on the findings of these tests, the client will reevaluate their goals, and determine how and if
they want to change them.
In phase three (weeks 12 – 18), the client should have gained a sense of confidence
and personal responsibility for their exercise. As exercise programmer, I will still be present
during their work out sessions, but the client should be affluent enough by now to take
themselves through their own workouts. They can, of course, refer to me for questions,
support, spotting, and cuing. As with the first two phases of their program, the client and
myself will pow-wow before and after each session to talk about how things are going and
where the client would like to be. In the final week of the program, the client will once again
perform the same battery of tests that they’ve come to love by now. After the final
assessments are completed, the client will look over their last eighteen weeks of work. They
will be able to see how much progress they have made and they will be able to determine
how and if they want to continue with another program. If the client decides that they
would like to expand on the program, they will come up with new goals. These goals will
decipher how the program will be modified. Some clients may want to simply maintain
what they’ve achieved, others may want to focus on their endurance, while some clients
may actually wish to improve their strength.
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