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Chapter 6 NASM study guide
Guidelines for health and fitness professionals
What shouldn’t be done
- Counseling clients
- Diagnosing of conditions or injuries
- Rehab or physical therapy
- Providing meal plans or detailed diets
What should be done
- You should coach clients
- You should identify your client’s limits and past injuries
- Recommend a physician for medical advice
- You can provide general knowledge on nutrition but should refer a nutritional list or dietitian for more specific needs.
Objective and subjective information
Before starting a routine with any new client you need to assess their current as well as past health and fitness levels. For subjective information, you need to ask them questions and for objective information, you need to perform fitness assessments.
- Blood pressure
- Cardio assessments
- Postural assessments
- Performance assessments
- Body analysis
- Clients occupation
- Hobbies, general diet, and lifestyle
- Personal information
- A brief medical history
PAR-Q (physical activity readiness questionnaire)
The PAR-Q was created to help get specific answers on the health history of a new client. This helps determine possible risks of training with a client. If a new client answers yes to any of the questions on the PAR-Q, they will need to get written permission from their doctor in order to start training with you. You can check out the PAR-Q here.
Your client’s occupation
Asking a new client about their occupation can help determine a lot of postural problems that they may be experiencing. Here are some of the most common ones.
- Excessive sitting can cause rounding of the upper back and tight hip flexor’s
- Wearing high heels excessively can cause tightness in the muscles of the calves.
- Repetitive overhead movements experienced by construction workers, volleyball players or electricians can cause impingement in the shoulders.
- An upper crossed syndrome can be caused by stress due to the shortening of the upper trapezius and scalenes.
Your clients’ lifestyle
This gives the trainer insight into the likes and dislikes of their client. Active recreational activities can be added to the clients cardio training program.
Your client’s medical history
- Any medications taken by a client may affect how intense exercises should be.
- Chronic diseases need to be accounted for all exercises and programs.
- Past surgeries may limit your client’s range of motion or may cause joint instability.
- Pain should be accounted for and taken into consideration for all exercises.
- The medical history of your client will allow you to gauge the risk for any health-related issues your client experiences.
Common medications and heart rate/blood pressure
- Calcium channel blockers
- Thyroid medications
Note that it is not your job to educate your client on how to use these medications. All we need to know is the basic functions and how that can affect our training regimen with our clients.
Blood pressure and heart rate assessments
The two most common ways of recording heart rate are using the radial pulse on the thumb side of the wrist (preferred method), or the carotid pulse on the side of the neck (use with caution).
Blood pressure can be measured using a sphygmomanometer that has a pressure dial, inflatable cuff, stethoscope and a bulb with a valve. It is highly recommended for personal trainers to take a professional course for taking blood pressure.
https://exrx.net/Testing/HeartRate has all the blood pressure and heart rate assessments.
Target heart rate zones and the formula for maximum heart rate
The predicted maximum heart rate equation is 220-age. Multiply this number by the training zone (between 65% and 95%) of predicted heart rate Max.
Training zone 1: This helps to build your client’s aerobic base and will aid in recovery.
Training zone 2: This helps to build your client’s aerobic endurance.
Training zone 3: This helps your client build high-end work capacity (primarily anaerobic).
Body composition assessments
- Underwater weighing: The most accurate way of measuring body composition. It measures the mass per unit volume of the human body.
- Bioelectrical impedance: The most convenient way to measure body composition. Also known as body fat analysis. It analyzes the strength and the speed of an electrical impulse sent through the body. With the addition of information such as gender, weight, and height it can relatively accurately predict body fat percentage.
- Skinfold tests: The most difficult way to measure body fat. A skinfold caliper can measure can measure the width of external body fat in millimeters. You take the measurement from different sites on the human body and the grand total are added up in order to come up with a body composition total. Here’s a great site of how to take skinfold measurements.
Circumference measurements help to measure the circumference of different body parts. Some of the benefits of circumference measurements are: it’s easy to do, it provides quick information on client progress, it’s affordable and it’s not hard to learn the technique. Here is a good resource for circumference measurements.
Suggested circumference measurement areas:
- Upper arms
BMI (Body mass index)
The body mass index test is extremely easy and is a good way to screen patients and it applies to both men and two women. Body mass index is difficult to apply to people who have excessive muscle mass such as bodybuilders. Here are the ranges for body mass index. Here’s a good site to calculate BMI.
Formula: Weight (kg) / Height (m2)
<18.5 = Underweight
18.5 to 24.9 = Healthy
25 to 29.9 = Overweight
30 to 34.9 = Obese
>35 = Severe obesity
≥ 40 = OMGG 😳
YMCA three-minute step test
This is a test to calculate your client’s cardiorespiratory fitness level and efficiency. It is done in a time of only three minutes which makes it extremely easy to do. You will need a 12-inch step to perform this test.
- Have your client step up and down the step at a pace of 96 steps per minute.
- Is handy to have a metronome to have your client follow along with as they step up and down.
- After three minutes of stepping, you must immediately find the recovery pulse.
- Depending on this pulse, you will start your client in the appropriate heart rate training zone according to the text.
The Rockport walking test
This is another cardiorespiratory assessment in order to assess your client’s cardiovascular fitness. This test is best for obese clients.
- Jot down your clients wait and have them walk 1 mile on the treadmill as fast as he or she can control.
- Record the time it took for your client to go 1 mile and recorded their heart rate the exact second that they finish the 1 mile.
- Weight in pounds = 1 for men and 0 for women. The time is expressed in minutes and 100th of minutes. Heart rate is in beats per minute and age is in years.
- The formula is located on page 131 in the textbook. You do not need to memorize this formula, just recognize it as being the formula for the Rockport walk test.
Pronation distortion syndrome
This is characterized as having flattened feet and abducted knees. This can lead to pain in the lower back/lower extremities as well as injuries. It is very common for ACL injuries.
Lower crossed syndrome
This is a postural distortion syndrome that is characterized by an anterior tilt of the pelvis or lower back.
Upper crossed syndrome
This is characterized by a forward head posture and rounded shoulders.
The overhead squat assessment
MEMORIZE THE FULL THING! Especially the chart on page 144!