University of California
Type of paper: Thesis/Dissertation Chapter
Personal Training Case Scenario
Please type your response in paper format, double spaced. Paper should include questions and detailed answers and should be 6-8 pages in length. Citing is not necessary as it will be assumed that all of the information obtained will be from the NSCA Essentials of Personal Training text. Papers will be due April 19th and will be 20% of your grade. You have just been contacted via telephone by Jane Doe, a 40 year old female who would like to meet with you to discuss the possibilities of obtaining your personal training services. Please describe the consultation process that you will use. (Client-trainer compatibility should be a main component here). Jane Doe called me on the phone one day while I was at the Community Center working at the help desk. We set up the initial interview for the following day. The importance of the initial interview is for the personal trainer and the client to assess compatibility, develop goals, and establish a client-trainer agreement. When Jane first arrives for the interview I will provide a description of the services available and that I can provide her.
I will explain to her that I am certified through the National Strength and Conditioning Association as of May 2012 and I have completed an Essentials of Personal Training class for credit at Northern Michigan University. I will explain to her the mission statement of the Community Center (mission statement of NSCA is to unify members and facilitate a professional exchange of ideas in strength development as it relates to the improvements of athletic performance and fitness) unique features to the program, and where and when services are available. I will then need to evaluate her readiness for fitness by assessing her level of motivation and commitment. I will ask her to discuss her past experience with exercise, time management skills, and possible obstacles that would prevent her from meeting with me. I would have her complete an attitudinal assessment which helps me understand her relationship with fitness. It is also important for me to explain for her and to understand roles, resources, expectations and boundaries of the program. I will try to get an understanding in what kind of training that Jane is interested in and if I think that my abilities would allow us to make a good match. After establishing compatibility I would discuss with Jane her goals and objectives as it relates to motivation. I would help explain that developing specific goals are important that they are able to be measurable, realistic, and time sensitive. If her idea in losing weight is 15 pounds a week, I will have to explain to her that it is simply not a realistic goal, because a more fitting objective would be 1-2 pounds per week. After establishing goals, a very important part of the initial interview is the client-trainer agreement. I will then present Jane with a written document describing the services, people involved, expectations of those people, cost structure and payment process. It will also include termination policy and other issues that may be pressing. I would give Jane the document and ask her to read it so she understands everything and we would discuss it thoroughly so there is no miscommunication; once it is signed by both of us it becomes valid. After meeting with Jane, she has decided she would like you to be her personal trainer. You have scheduled a fitness assessment with Jane for the following day. Please describe what information you will need to tell her to so that she is prepared for the assessment. I will let Jane know that the purpose of the assessment is to gather baseline data and provide a basis for developing goals and effective exercise programs. I want to choose tests that will match with her goals. I will tell Jane to dress in comfortable athletic clothing and to wear appropriate tennis shoes. I will make sure that before she comes to the fitness assessment that she needs to make sure she gets adequate rest, that she stays hydrated throughout the day and brings water with her, and that if she eats it should be at least a couple hours before our meeting. Her goals are:
* Lose 30 pounds
* Decrease body fat
* Increase overall health
* Increase muscular strength and endurance
* Increase mobility
* Increased cardiovascular capacity
* Better eating habits
Jane has arrived for her assessment. Which paperwork will you complete with her and why? Based on her goals, which fitness tests will you perform?
Will nutrition advice be included in your assessment process? Why or why not?
Some paperwork I will have Jane complete is a health appraisal screening. This is to help identify known diseases and possible risk factors associated with coronary artery disease and question if Jane may need medical referral before starting the exercise program. I would have Jane fill out a Par-Q (physical activity readiness questionnaire) form which identifies if individuals are healthy enough to start training or if they need additional medical attention. Another form I would have her fill out is the health/medical questionnaire. This form identifies any diseases, personal medical history, health concerns, medication and lifestyle management. I would then proceed to ask Jane questions to gather a lifestyle inventory so I can understand some of her daily habits and figure if she has any behaviors that are positively or negatively impacting her health. I would ask questions about her diet, stress management, physical activity, and sleep pattern. I would then give Jane a document on informed consent which gives her information about the content and process of the program delivery. I will evaluate all this information and collect all the paperwork and keep it in a personal file for Jane Doe so I can keep a record of my client. After filling out paperwork we will began some of the fitness testing. I will start with some of the rest tests (blood pressure and resting heart rate) first, because if Jane wants to improve her cardiovascular capacity and overall health, it is important to take note of how her exercise affects her blood pressure (exercise is proven to lower BP) and if her resting heart rate decreases after the program (that would mean the program was effective). To asses her body fat and weight I would perform two body composition tests on Jane to make the assessment more valid. I would use the waist to hip ratio, and then I would perform the skinfold test because it directly measures thickness of fat tissue. This test is valid and can be reliably measured properly and this test you can easily see results. I would use waist to hip ratio instead of body mass index because that is not always accurate and it doesn’t account for muscle weight (muscle weighs more than fat). After the resting tests I would have Jane move on to some flexibility tests for reasons that she wants to increase her mobility.
I would have Jane perform a sit and reach test because it measures hip and low back flexibility. Since Jane wants to increase her muscular strength and endurance, I will have her complete the muscular strength test last so it won’t tire her out before the muscular endurance tests. I will have her perform the one-minute sit-up test because it measures abdominal strength and hip flexor muscle groups. I will also have her perform the push-up test because it uses her own body weight. For muscular strength I will have her complete a 1-repetitions maximum bench press and leg press to see where her maximum strength is in her arms and legs. To asses for cardiovascular endurance, I will have Jane complete the YMCA step test because it measures the heart rate recovery response immediately after the test. I will also have Jane complete the Rockport walking test which estimates the VO2 max for older men and women and it requires only walking at a fast pace. I will give general nutrition advice to Jane to address misinformation and advice as it relates to physical performance, disease prevention, weight loss and weight gain. I can refer Jane to a dietician if I believe she has a disease state affected by her eating, but I should only give information on nutrition after assessing Jane’s diet, and I can give her recommendations that can match to Jane’s dietary goals. I can help asses Jane’s diet through dietary recall, diet history, and ask her to keep a diet record. I am not certified to prescribe anything to Jane, but if I recognize more complicated nutrition issues, I am only here to guide her diet, be a source of credible information, and refer her to someone when necessary. During the assessment, Jane explains to you that she suffers from anxiety, stress and mild depression. How will you educate her regarding exercise and its effects on these conditions? I will explain to Jane that the benefits of exercise are endless and that there is evidence that participation in physical activity has significant mental health benefits, which include a reduction in anxiety and depression, decreased reactivity to psychological stress, and enhanced cognition. Many workout routines for continuous periods of time can be relaxing, and many routines are rhythmic which can be calming to the central nervous system and this can cause a quieting of the cognitive activity associated with anxiety or stress. Along with anxiety, research evidence consistently reveals that physical exercise yields significant effects for men and women who suffer from depression and less severe forms. Exercise
offers an appropriate and effective means of coping and feeling better, while also increasing ones overall health. When exercising, your brain releases serotonin (neurotransmitter with antidepressant effects) and the levels are elevated during and following the activity. Being socially interactive that occurs in an exercise setting or forming a sense of accomplishment after a workout makes people feel a sense of independence and decreased feelings of helplessness. Therefore, being physically active not only helps you to look better, but it helps to make you feel better on the inside as well.
Explain to Jane some of the resistance and aerobic training adaptations she can expect to see as a result of her training program. Why would it be important to someone starting an exercise program to understand these training adaptations? Acute responses to exercises are changes that occur in the body during and shortly after an exercise bout. And chronic responses to exercise are changes in the body that occur after repeated training bouts and persist long after the training session is over. During the initial phases of resistance training there is a dramatic increase in the activation of motor units and improvements in strength are due to neural adaptations. Resistance training leads to muscle hypertrophy but it is usually not measured until 8-12 weeks after the beginning of the program. A lot of neurological responses, muscular and endocrine changes will be seen in resistance adaptation. An example of a neurological change would be the number of motor units recruited. An endocrine change includes an increase in epinephrine which increases fat and carb breakdown by the cell for more ATP (energy) production. Some chronic adaptations include after about 1-2 months most strength increases due to hypertrophy and skill of movement. Women tend to build stronger and thicker bones and high volume resistance training may induce glycolitic enzymatic adaptations that increase muscle endurance. Resistance training programs increase fat-free mass, improving body composition. Resistance training programs increase metabolic rate, due to the high metabolic activity of muscle. The effects of aerobic exercise are regulated by the intensity, frequency, and duration of the activity. If one exercises at a greater heart rate, then the training adaptation will be greater. Heart rate and stroke volume increases because the cardiac output is increased, yet the heart also becomes stronger in size because it has to pump more blood (decreased resting heart rate). The energy systems in the body also become better at producing energy and stored energy in the form of fat is utilized during aerobic training which leads to a change in body composition. Body increases the available fuel sources as well as the enzymes responsible for utilizing those fuel sources. The respiratory changes include increased lung capacity and blood flow. It is appropriate to know this so the client won’t over train or detraining. Changes are the exact opposite of what occurs during training programs. Some common markers for overtraining include decreased performance, decreased body fat, decreased maximum oxygen uptake, increased muscle soreness and increased sympathetic stress response among other things. It is important for Jane to recognize the changes her body will be making as a result of exercise so she can see improvement and stay motivated. During your assessment, you find the following:
* Height: 62 inches
* Weight: 180 lbs.
* Body Fat: 30%
* Blood pressure: 138/85 mmHg
* Resting HR: 70
* Upper body endurance: average
* Lower body endurance: poor
* Rockport walk test 18 minutes
* Sit and reach: 16 inches
Jane has committed to training with you two days per week and three times on her own. Based on your fitness testing and her stated goals, what will be some of the short-term and long-term goals you will set at the end of the assessment? Why is it important to set goals? What are some important characteristics of goal setting? Goals are important to set because they keep the client motivated to not only work out with the trainer but also make sure they are making the program effective by working out on their own too. It is important to have something to work towards because there is always room for improvement and once achieved, setting a goal gives you a sense of accomplishment.
Some easy goals I would first start out with are that Jane commits to show
up to train with me two days a week for at least one month, three on her own, and that she aim to work out 5 days a week total. Another short-term goal is that Jane aim to lose about a pound a week. A long-term goal for Jane would be to have a 10% reduction in body weight at the end of 6 months, so her goal would be to lose 18 pounds in 6 months. According to Jane’s BMI she falls in the class one obesity, and has a very high blood pressure which puts her at risk for heart disease and diabetes, so it would be an important goal to drop her blood pressure to about <130/<85 at the end of 6 months. Her Rockport walk test also fell in the range of poor so a long-term goal would be to get her time down to 14 minutes instead of 18 which would help improve her Vo2 max which ultimately helps increase her cardiovascular capacity and aerobic endurance. A short term goal would be to drop about 12 seconds off of her time each week. Some general goals would be to increase her upper and lower body muscular strength and endurance. A nutritional goal I will first start out for Jane is to eat a healthy breakfast every morning after she wakes up and to drink at least six cups of water every day. A long-term goal is to eventually have Jane eat 2-3 cups of fruit and veggies, 5 ounces of lean/low-fat meat and poultry, 3 ounces of whole grains, and about 3 cups of low/non-fat dairy every day (recommendations are referenced from choosemyplate.gov). Some characteristics of goal setting include that they should be specific, measureable, and observable. It’s important to clearly identify time constraints. By beginning with goals that are simple to achieve, the personal trainer can create a sense of achievement and self-confidence for the client so they can eventually make their goals more challenging. Goals should be recorded, monitored, and evaluated. Short-term goals should be set first to achieve long-term goals, and they should also be prioritized so the most important ones are first. Describe your resistance training program in detail and why you have chosen this plan for this specific client. Jane is a beginner when it comes to resistance training. Topics to include are: Since Jane is a beginner in resistance training I will have her meet with me for an over an hour on Mondays and Thursdays. Her main goal is muscular endurance so I will alternate the upper and lower body exercises.
Bench Press (free weight) 2 sets x 15 reps at 50 pounds
Leg Press (pivot based machine) 2 sets x 15 reps at 140 pounds Seated row (cam based machine) 2 sets x 15 reps at 30 pounds Leg curl (cam based machine) 2 sets x 15 reps at 20 pounds
Shoulder press (cam based machine) 2 sets x 15 reps at 15 pounds Squat (FW) 2 sets x 15 reps (try without any weights and then slowly add bar or dumbbells) Bicep curl (FW) 2 sets x 15 reps at 30 pounds
Standing calf raise 2 sets x 15 reps
Triceps pushdown (pivot based machine) 2 sets x 15 reps at 15 pounds Stability ball abdominal crunch 2 sets x 15 reps
* Exercise choice: I used a mixture of free weights and machine based exercises because Jane is a beginner. The core exercises I chose are bench press, leg press, squats, seated row, and shoulder press because those work major muscle groups. The assistance exercises are leg curl, biceps curl, calf raises, triceps pushdown and abdominal crunches which work small muscle groups. * Frequency: Because Jane is a beginner, she is only meeting with me two times a week and I want to make sure she has proper form when weight training so I would prefer she did her resistance exercises with me in the gym so I can coach her. The days are spaced out evenly so Jane has enough recovery time in between. * Order: It is important to alternate upper body and lower body exercises so that Jane doesn’t get too fatigued. She will complete one set of each exercise and then repeat because muscular endurance goals call for between 2-3 sets. * Load: Because Jane is a beginner I used percent of body-weight testing protocol for a guideline. Her weight is 180 pounds but I used the maximum 140 pounds as an average to get a good idea on how much weight she should be lifting. I used table 15.5 to help with body weight factors and used the calculation to estimate how much weight Jane should be lifting. * Repetitions: Because Jane’s goal is muscular endurance it is important to do 2-3 sets within 12-15 repetitions to get good results. * Volume: (total number of repetitions times the weight lifted per repetition) If I calculated all the repetitions times the weight lifted in a given day, Jane is lifting around over 5000 pounds. * Variation: Jane is only working out with me for two days out of the week and the only variation I will use is alternating upper body and lower body. *
Progression: 2-for-2 rule: if a client can complete two more repetitions than the repetition goal in the final set for two consecutive training sessions then I will add on more weight depending on the exercise and the amount of weight Jane can lift in the first place. Jane is inexperienced in weight training so for every exercise I show her how do it first and then see if she can do it with no weight. Then I will add on a third of the set weight and have her do 12 reps and then if she can complete that with proper form then I will have her complete the actual exercise. After about two weeks I will start progressing Jane and adding more weight so she can slowly increase and improve her performance. After a few months I will slowly increase the frequency and exercise choice to add variation so Jane’s muscles don’t get used to the same workouts and to also see improvement. Describe your cardiovascular plan in detail and why you have chosen this plan for this specific client. Topics to include are: When Jane meets with me on Mondays and Thursdays I will also have her do some aerobics but a light workout because those are also the days she will be lifting. * Exercise mode: On Mondays Jane will be on the machine (treadmill) and then on Thursdays the bike.
On the treadmill Jane will be walking, and on the bike Jane will be biking. On Wednesdays and Saturdays Jane will not be using a machine she will just be walking, and then she will use stairs at her home to do stair stepping. On Sundays Jane will be doing stretching and flexibility exercises. * Exercise intensity: Jane’s maximum heart rate is 190 bpm. Her HRR is 120. Because one of Jane’s main goals is to lose weight and burn fat, she should aim to be in the fitness zone which targets fat burning and her heart rate target should be 114-133 bpm. Since Jane is still a beginner, her exercises should be low to moderate intensity, she should still be able to hold a conversation and talk while exercising. * Exercise duration: 20-30 min for five days a week is a good goal to have for Jane. Although on the days she meets with me on Mondays and Thursdays her aerobic exercise will only be duration of 10 minutes so she doesn’t become too fatigued. On Wednesdays and Saturdays Jane will walk for 20 min and do stair stepping for 10 min for a total workout of 30 min. * Exercise progression: After a few months and losing weight and after Jane becomes more experienced, I will evaluate her and one of her goals will be to slowly move to the aerobic zone and her target heart rate will become 133-152 bpm.
Every two weeks I will add five minutes to her walking time on Wednesdays and Saturdays so in two weeks instead of walking for 20 min she will be walking for 25 min and so on. I will also increase the intensity at which Jane walks on the treadmill and bikes on the bike by very small increments every two weeks. * Which types of aerobic training programs will you choose? Why? Jane’s goal here is weight loss and aerobic improvement, so progression is a very important component to this aerobic training program. Because Jane is still a beginner and needs to improve her Rockport Walking Test score, I chose walking as a main exercise. Using the treadmill at the gym will help give Jane an idea as to what pace and intensity she should be walking at so it makes it easier for her to walk on her own. I also chose biking because cycling is also a good way to get your heart rate up and improve your cardiovascular endurance. On her days not at the gym I also chose for Jane to do stair stepping because she can easily do it at her home and it is also a good activity to get your heart rate up and it works on coordination, leg muscles, and improves cardiovascular endurance. On Sundays Jane should have an easier day but it is still important for her to stretch and work on flexibility. Some exercises I will have her do include lunge walk, butterfly, arm circles, side lunges, behind neck and back stretch, semi straddle, wall stretch, and walking knee tuck. It is important for Jane to get her blood flowing before performing any stretches and for every workout it is also important that Jane have a five minute warm-up and cool down. I will show Jane how to do each stretch and then I will give her a sheet that explains and gives pictures and a specific order on how to do them so she can perform them on her own. Jane would like to set up an exercise area at her home.
What are some SPECIFIC guidelines and recommendations you could give her regarding which equipment to purchase and the logistics of setting up an exercise area? Some guidelines and recommendations I would give Jane regarding setting up an exercise area in her home would include that it is imperative that any exercise equipment purchased will fit into the home (think about ceiling height, door width, space of room). Cost is an important factor, and the equipment should not be kept out of sight because this might hinder the client being motivated to work out. The safety issues of a home exercise area includes keeping children and pets away from electrical outlets, running treadmills, free weights, bike pedals etc. A see-through gate around the area is always a good idea for a safer environment. When the equipment is not in use it should be turned off or locked or disabled or put into a different room. Other factors to think of are available electricity outlets and their safety, adequate lighting, air circulation, mirrors, and protective flooring and celling. All the equipment should be placed along the perimeter of the room close to the walls. Another thing to consider is to allow 25 to 49 square feet for activities such as aerobic dancing, free body weights etc. It is also good to think about allowing enough space for a TV, DVD player, or music system for exercise tapes or listening to music. A home exercise facility that has good lighting and air circulation, and good entertainment is more desirable to work out in. How would your overall approach to the program change if Jane was 30 years old and 3 months pregnant? If Jane were three months pregnant there are definitely some different guidelines that I would use to be cautionary and safe. First and foremost I would check with her healthcare provider to make sure that exercising would be safe and beneficial to Jane. After the first trimester I would not have Jane lie in any supine position for any exercises and I would have her use more weight machines because it changes the center of gravity, but non-weight bearing activities are favored because this would reduce the risk of injury and body weight is always an effective way of working out. I would adjust the program according to avoid training at high levels of fatigue and be careful with balance and agility exercises. I would avoid any activity that would increase the risk of falling or trauma to the abdomen. 30 minutes or more of moderate exercise is very beneficial for most days of the week and abdominal and pelvic floor strength is emphasized. Large increases in body temperature should be minimized as well. I would definitely still have Jane continue her walking and stair stepping and most of her stretches. I would decrease the amount of weight she would be lifting for her resistance training and I would get rid of any of the lifts where she has to lie down. I would make sure she didn’t become too fatigued and I would closely monitor for proper form.