ACE 6th Edition Chapter 11: Integrated Exercise Programming: From Evidence to Practice
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ACE 6th Edition Chapter 11: Integrated Exercise Programming: From Evidence to Practice 1

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    Chapter Goals:

    • Be able to define and then list the steps of an evidence based practice.
    • Use the concept of evidence based practice to program exercise. 
    • Discuss the personalized implementation and progression strategies for programming of exercise for your clients.
    • Know the key considerations we have when doing maintenance for the programs.
    • Find the main considerations for recovering from your training sessions. 
    • Be able to design programs of muscular and cardiovascular training that are personalized and based on evidence for your clients that range anywhere from physically inactive to highly active individuals and make use of the research and programming tools from every phase of the ACE IFT Model.

    Introduction

    All aspects of programming for exercise should be based on a combination of client attributes, goals, and preferences, the personal trainers level of experience and expertise, and the latest findings in research in the health and fitness industry.

    This approach to exercise is programming is what we call the evidence based approach. 

    Evidence-based practices align with the specific goals of the clients and make it a client-centered approach to the optimal decision making with respect to the design of exercise programs. 

    Evidence-based Practice

    The first sets of interactions between the trainer and client are focused on the trainer primarily learning more about their client. The trainer works to gather personal attribute related data about their clients like their age, history of their health, status with chronic diseases, and their goals that deal with exercise training. 

    The baseline assessments also give important information regarding the client and answers many of those aforementioned stats. 

    Trainers also work to identify the personal preferences that the clients have and make sure that they will be fulfilling those throughout their program. 

    The evidence based practice will be made up of five steps to ensure we use the best information possible. The steps will be:

    • Formulate a question
    • Search for health and fitness research evidence that will best answer this question
    • Scrutinize the quality of the research found
    • Incorporate the research evidence within the program you are designing
    • Evaluate the exercise program outcomes and periodically reevaluate the evidence you found

    The basic concepts for interpreting the scientific research that we may find will include searching for biases, reading through the research articles, evaluating said articles for the truth, and then looking for consensus to be made in the community. 

    ACE IFT Model Cardiorespiratory Training Programming

    Chapter 8 covered the foundations for this style of training, and this chapter will expand on these in this section. 

    Base Training Guidelines

    Focus on moderate-intensity cardiorespiratory exercise with an RPE of 3 or 4, and their needs to be a focus on the client enjoying the exercise. 

    Keep intensities lower than the talk test threshold, below VT1.

    Increase the duration and the frequency of the bouts of exercise.

    Progress to Fitness Training when the client can complete 20 minutes minimum of cardio exercise lower than the talk test.

    Fitness Training Guidelines

    Progress the cardio duration and the frequency based upon the goals and the time of available for the client.

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    Integrate vigorous intensity exercise intervals of an RPE of 5 or 6 with segments performed at intensities lower than, at, or above VT1 and just lower than VT2.

    Performance Training Guidelines

    Progress the moderate and vigorous Cardio Exercise

    Program a good amount of volume for the achievement of the goals

    Integrate max or near max intensity intervals of an RPE of 7 to 10 and these are done at or above the VT2 to increase the speed, performance, and aerobic capacity. 

    Periodized training plans may be used for incorporating the right amount of time below VT1 and VT2.

    The easiest methods for monitoring the intensity of exercise for your clients while in the base training phase is through the talk test. The client is going to be below that of the ventilatory threshold one when they are able to talk and perform exercise comfortably at the same time. This also means that the client would point out they are working at an RPE of 3 – 4 when using the 10 scale. 

    Training should feature zone 1 mostly, and then depending on how physically active they were prior to the start of the program, it should be continued for 2 – 6 weeks. Once comfortable here, and able to perform stead state exercise for 20 minutes or more in zone 1, then the client moves to fitness training. 

    This fitness training phase will vary the goals greatly due to the dependence being on the goals of the client and not building up that essential base from before. So, this stage is seen as a lot more creative and fun when it comes to the design. 

    Intervals, if done, should be very brief and a 1:3 work to rest ratio is utilized. 

    The client can when they are working well at the below ventilatory threshold two mark. 

    Performance training is essentially the culmination of training for individuals working on cardio. This is the last phase of the training, and it is where the people who want to compete and have goals in sports and events will mostly train. 

    This will have the work being very high intensity in this stage. In this stage and the previous fitness phase, we may see the use of high-intensity interval training. 

    ACE IFT Model Muscular Training Programming

    We discussed muscular training thoroughly throughout chapters 9 and 10 and set the foundation for that training modality. This chapter will focus on the guidelines and a little more detail for how we apply the ACE IFT Model in this section.

    Functional Training Guidelines

    Focus on establishing and reestablishing stability in posture and the mobility of the kinetic chain.

    Exercise Programs should improve the muscular endurance, flexibility, core function, and static and dynamic balance. 

    Progress exercise volume and challenge as function improves.

    Movement Training Guidelines

    Focus on developing good patterns of movement without the compromise pf posture and stability of joints. 

    Programs need to include exercises for all five primary patterns of movement in various planes of motion.

    Integrate the exercises of functional training for helping clients keep and improve postural stability and kinetic chain mobility. 

    Load/Speed Training Guidelines

    Focus on application of external loads to movements to create increased force production for meeting the goals the client desires.

    Integrate the five main patterns of movement through exercise that load them in various planes of motion and combinations of those planes. 

    Integrate exercises for functional training that enhance the stability of posture and the mobility of the kinetic chain for the support of increased workloads.

    The programs need to focus on adequate loads of resistance  so clients can reach their goals in muscular strength, endurance, and hypertrophy.

    Clients that have goals relating to athletic performance will need to integrate exercises and drills for building speed, strength, quickness, and power.

    Functional training is akin to the Base training, but in this case it is for building the foundation for the future resistance or muscular training. The focus will be on the postural stability and the mobility of the kinetic chain through the use of exercise programs that improve the function of joints with improved muscular endurance, flexibility, core function, and the static and dynamic balance. 

    The focus will mainly be on the use of body weight style training or small weighted resistance with a focus on moves to support the spine. Deviations in posture and things will be addressed here also. 

    One focus for the purpose of muscular training in general is to perform the activities of daily living more efficiently. 

    There are many progressions and guidelines to note for the use of flexibility and balance training, which will be utilized and started in this functional training phase. 

    Movement training is the second phase of the muscular training modality, and here the focus will be on using the 5 main movement patterns and perfecting them. This stage is again, like the cardiorespiratory training phase 2 where it will be not so much about that foundation, but instead more focused and narrowed down to suit the goals of the client. 

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    One thing that may be a tad different with muscular training is that the foundation phase is something that will mostly follow throughout all three phases of muscular training just with newer progressions. 

    The one rep max tests will be important to know and implement for the clients in order to precisely determine the needed sets, reps, and weights to do for their goals. 

    Load/Speed training is the final phase of the muscular training, and here the clients that make it will have an increased need for fore and or production of speed. These are for the more advanced clients to progress on, and some fitness enthusiasts and people doing events and competitions in sports will likely end up here. 

    Some of the prerequisites for the advanced stage of muscular training are:

    • A foundation of strength and joint integrity
    • The adequate levels of static and dynamic balance
    • Effective functioning of the core
    • Anaerobic efficiency
    • Athleticism
    • No contraindications
    • No medical concerns that may affect the client’s ability to balance or perform motor skills

    Plyometric are among the modalities that will make it into this stage of training, and this is essentially the use of high power movements with the body like jumping. This training style is very taxing on the body, akin to the likes of sprinting. 

    Clients should take precaution when performing plyometrics and not do too much when they are starting off, as this is an easy training style to end up with an injury. 

    Periodization

    Periodization is the planned progression of exercise that is used to intentionally vary the training stimuli, especially in terms of volume and intensity. These plans will help to vary and change up the possible monotony that can come with muscular training. 

    These periodized plans will come in the segments of macrocycles, mesocycles, and microcycles. 

    A macrocycle is usually a time from 6 – 12 months of training.

    Mesocycles will make up the macrocycles and be a time of around 3 months.

    And then the microcycles will make up the mesocycles where the time will be 2 – 4 weeks. 

    We can also break the periodization up in different schemes like the linear or the undulating periodization. 

    Linear periodization is going to be a more consistent and predictable pattern that increases the volume or intensity in a line. 

    Undulating periodization is going to be more random and have many different styles of training within the microcycles. 

    Program Maintenance

    One underappreciated part of exercise training is that continuous progressions and improvements will be unrealistic outcomes of training. For many reasons like work travel, vacations, illnesses, and many other things, we see this tough to always do. 

    There is a lot of research into the effects of detraining and overtraining to help with this. 

    Detraining essentially says that in the time it took you to make whatever gains you made, you will lose those in a time period twice as long as that. 

    Recovery is an important part of exercise, as we cannot simply work out to no end. We must take the appropriate time to recover and make sure we can perform again. 

    The amount of recovery needed will vary, with more needed when beginning a program, and less being needed when you have been active for a long time. it is important to play with this time and make sure you feel recovered going into the next sessions. Passive recovery is another thing that can be utilized for us. 

    It is important to look out for overtraining, as this can cause people to not want to exercise, and instead stall their progress. 

    ACE 6th Edition Chapter 11: Integrated Exercise Programming: From Evidence to Practice 2
    ACE CPT Chapter 1: Role and scope of practice for the personal trainer 2
    ACE 6th Edition Chapter 11: Integrated Exercise Programming: From Evidence to Practice 3

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