ACE 6th Edition Chapter 1: Role and Scope of Practice for Personal Trainers

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Chapter Goals:

• Know the benefits that come with physical activity. 
• Describe the role and scope of practice for the Ace Certified Trainers.
• Describe the differences and similarities that are found for trainers and other professionals on the healthcare continuum. 
• Find when and where to refer clients to allied healthcare professionals. 
• List the main factors for professionals to be recognized and careers to develop related to personal trainers. 

Health Benefits that Associate With Exercising Regularly

Children and Adolescents

• Improvements in bone health.
• Improvements in weight statuses. 
• Improvements in the cardiorespiratory and muscular fitness levels from ages 6 – 17. 
• Improvements in cardiometabolic health between ages 6 and 17. 
• Improvements in levels of cognition.
• Reductions in the risk of depression.

Adults and Older Adults

• Lowering the risk of all causes of mortality, cardiovascular disease mortality, the risk of cardiovascular diseases in general, hypertension risk levels, type 2 diabetes, adverse blood lipid profiles, and cancers of the organ in the body. 
• Improved cognition primarily for older adults. 
• Reductions in dementia.
• Improved quality of life levels. 
• Reductions in levels of anxiety. 
• Lowered risk for depression. 
• Improvements in the sleep quantity and quality. 
• Slow or reduced weight gain.
• Improved health of bones.
• Improved function physically. 
• Lower risk for falls in older adults and lowered risks for fall-related injuries. 

When someone gets insufficient levels of physical activity, uses tobacco, has poor nutrition, and excessively intakes alcohol, these things are considered to increase the risk for noncommunicable diseases. Another thing thought to joint this list is prolonged amounts of sitting throughout the day. 

These noncommunicable diseases have passed the number of communicable diseases when looking at the number of deaths globally. 

Most noncommunicable disease deaths will come from cardiovascular disease, cancer, diabetes, and chronic respiratory diseases. 

The percentage of deaths relating to cardiorespiratory fitness levels being low has been seen to be substantially higher than the percentage that relates to obesity, smoking, high cholesterol levels, and diabetes. 

The 2018 Physical Activity Guidelines for Americans has set a complete list of guidelines and activity examples for people to follow for them to improve their fitness, cardiovascular and muscularly, bone strength, balance, and flexibility; these guidelines exist for all age and sex groups and for those with chronic diseases. 

The job of personal trainers use to rely on interacting and training with the fitness enthusiasts that were present in gyms, but due to the rising number of adults and children that are physically inactive, we see the shifting of personal training for the general public and overall health, while also still seeing the use for fitness enthusiasts. 

A lot of personal trainer work with individuals that have chronic diseases, and they work in some settings different from the typical gym. 

The job is changing quite a bit to adjust to these new needs and working with other healthcare professionals like physicians, physical therapists, and rehabilitation professionals. 

The Ace Personal Trainer Certification

The Program as a whole is designed to assess the candidate’s level of competency in developing and delivering safe and effective exercise programs for people or groups that are apparently healthy or have medical clearance to participate in the exercise. 

Candidates who earn this certification will show that they have met or exceeded the level of competency needed to work without much supervision in their field of personal training. 

These candidates that meet the requirements will be able to work as trainers with minimal supervision and work to develop and implement personalized programs of exercise that will improve fitness and well-being for the people or groups of people who are healthy or at least have medical clearance for activity. 

Defining Scope of Practice 

The scope of practice defines the legal range of services that the professionals can provide in their field, the settings in which these may be provided, and the guidelines and parameters that need to be followed. 

Many factors enter into the definition of the scope of practice like education, training, and the certifications attained or needed for work in a field. 

We also must pay attention to the laws and regulations that exist in the fields. 

Scope of Practice for the Ace Certified Personal Trainers

A trainer should never provide services that exist outside of the scope of practice as it is defined. 

Typically, this is tested when clients ask questions regarding the desire to change their weight or body fat levels and wanting advice on nutrition to do so. 

It is not within the scope of practice for personal trainers to provide services that registered dieticians would normally do. 

General Scope of Practice for Personal Trainers

Actions Outside of the Scope of practice:

• Diagnosing any illnesses or diseases that may be present in clients. 
• Prescribing diets or nutritional supplements for clients.
• The treatment of injuries or diseases or even the rehab of an injury. 
• Monitoring the clinical progress of medically referred clients. 
• Counseling clients.

Actions Within the Scope of Practice

• Assessing exercise limitations that exist.
• Finding the possible risk factors through assessments of the person. 
• Referring clients to the appropriate medical professionals through allied healthcare.
• Referral to someone who may help with diet and nutrition plans. 
• Following the guidelines for programming clients programs that are set throughout this book.
• Using exercise programs to help clients for the betterment of their overall health. 
• Designing programs for clients once they are released from rehab programs. 
• Using coaching techniques to support your clients through changing behaviors. 
• Providing advice on general health and wellness for people. 
• Document the progress and report it to the right professionals with the client’s permission. 
• Helping clients to adhere to the programs set by their physical therapists or physicians. 

The ACE Personal Trainer Certification is made for exercise professionals that want to provide one on one and small group exercise instruction for people that are healthy or have been cleared to work out with the trainer. 

No specific course is needed for people to enter the profession of personal training.

To become an ACE personal trainer, they must pass the certification exam, which would show that they can safely and effectively provide service for individuals. 

Many routes can be taken for studying for the certification exam, and some include things such as college and outside sources like this. 

The trainer’s main responsibility is to protect the public from any harm when training them. 

Personal trainers have a responsibility to themselves and to others to ensure that they understand their qualifications and boundaries for their job, and with this, they should be ready to refer clients to other healthcare professionals when they need to. 

This referral process might require further investigation through forms we will discuss later in the book, like the medical history questionnaires. It is just important to understand that there may be this need for further digging for information to protect yourself and your client. 

Supplements are not regulated by the FDA and therefore, their strength and effects will not be guaranteed. For this reason, trainers should avoid the referral of the use of supplements to their clients. 

The main thing a personal trainer certified through ACE will be looking to provide and expected to provide for the clients will be a regular exercise program and maybe even some small advice and insight into nutrition, lifestyle, and post rehab information. Anything that goes into too much depth and is very detailed in these other realms will border on the personal trainer exiting their scope of practice and providing a service far beyond what they should. 

Example Scenario for Appropriate and Inappropriate Actions          

If a client is found to stand with some exaggerated lordotic posture, it would be inappropriate for the trainer to diagnose the condition for the client as having lordosis, but it would be appropriate for the trainer to implement a program focusing on core conditioning to improve the strength and flexibility imbalances that are present in the muscles that act on the hip and the spine. 

If a client wishes to lose weight by trying some new commercial diet, it would be inappropriate for the trainer to help the client understand and then implement that diet, but it would be appropriate for the trainer to help the client to make choices nutritionally with the USDA website referral.

If a client is cleared for exercise following their physical therapy for impingement of the rotator cuff, it is inappropriate for the trainer to continue with the physical therapy exercises for treating the injury, and it is appropriate for the trainer to implement new exercises to improve the stability of the shoulder and build on the work that was done in the physical therapy. 

If a client is found to have tight IT bands, it is inappropriate for the trainer to provide them with a form of deep tissue massage for the relief of tightness, and it is then appropriate for the trainer to instead teach the client some techniques for self-myofascial release and foam roller usage. 

If a client is found to have soreness after a weekend of a tennis tournament, it is inappropriate for the trainer to recommend that the client use some medication for help, and it is appropriate for that trainer to instead discuss the right techniques for light, dynamic, and active stretching for the areas that are affected. 

If a client may be telling you that they are depressed due to some spousal problems, it is inappropriate for you to listen to the client and provide her with recommendations to improve that situation, and it is appropriate for you to simply listen to the client with empathy and maintain the client confidentially you have with them. 

The Healthcare Continuum 

The Healthcare Continuum comprises health professionals accredited with certifications, registrations, and licenses to practice for the identification, prevention, and treatment of diseases and disorders. 

These are the workers that we refer your clients to when there is a need that is outside of the scope of practice or if it is a case where medical clearance is needed for the client to participate in the exercise program in question. 

One of the primary ones will be what is considered the gatekeepers for health, and these are the physicians and nurse practitioners. 

We then have all healthcare workers outside of that stem from the gatekeepers. This will include all of those within nutritional support, mental health, alternative healthcare, trainers and coaches, and rehabilitation professionals. 

All of these fields have specific people working within them, all the way from dieticians to chiropractors and everything in between. 

All of the professionals we include in these categories will be people that are licensed or accredited in some way by an organization or school. 

Exercise Professionals in Allied Healthcare

Many healthcare professions all recognize the importance of physical activity in improving and maintaining good health. So as such, we have a lot of cases where there is a partnership between the personal trainers and many other fields in health. 

A lot of these places, when they are linked with personal trainers, will require some further and specific certification in addition to the personal trainer cert. These often give more training in working with the groups of people that the allied health facility treats. 

Career Development

Personal trainers should think about the general area they wish to progress their career if that is something they desire. These can be anywhere from the director of a facility, a GM, owning their own studio, or specializing in a certain group of people. 

Once these things have been thought about, there will be many ways to further your education.

Furthering education can be through many means, such as going for a college degree in business, exercise science, or getting more certifications in more specific fields. There are many ways that personal trainers can differentiate themselves from others and provide specific services they desire. 

It is important to look into those aforementioned allied healthcare fields, as there will be opportunities with many of those places, such as being a physical therapy assistant or things like that. 

The field of personal training is always evolving, and career development is changing frequently.